Permit 14
CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
A DEVELOPMENT SERVICES PERMIT #: ELR2004 -00017
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/26/04
SITE ADDRESS: 12435 SW WINTERVIEW DR PARCEL: 2S1106C -03300
SUBDIVISION: THORNWOOD ZONING: R -7
BLOCK: LOT: 004 JURISDICTION: TIG
Project Description: JOB NO. 3351
Prewire audio
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: X AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: ALL ENCOMP : X HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS:
Owner: Contractor:
DON MORISSETTE HOMES QUADRANT SYSTEMS
4230 GALEWOOD ST PO BOX 14833
STE 100 PORTLAND, OR 97293
LAKE OSWEGO, OR 97035
Phone: 503- 387 -7538 Phone: 503- 387 -7538
Reg #: SQH4- 5558211JLE
LIC 96806
ELE 26- 565CLE
FEES Required Inspections
Description Date Amount Ceiling Cover
[ELPRMT] ELR Permit 1/26/04 $75.00 Wall Cover
Elect'I Final
[TAX] 8% State Surcharl 1/26/04 $6.00
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard, Municipal Code, State of OR. Specialty Codes and
all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not
started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires
you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 -0010 throuc
Issued by Permittee Signature
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N DATE:
LICENSE NO:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
01/ 12:32 5032362322 QUADRANT SYSTEMS PAGE 02
s •• FOR OFFICE USE ONLY
E�ectrica �e 1 ,; eatron Reedy Electrical
DateiB �� 1' ► . Permit No.: -61 am '1 - a e7 /7
Cl Of Tigard t Planning Approval Sign
�3r Date/By: Permit No.:
13125 SW Hall Blvd. JAN 3 2004 Plan Review Other
Tigard, Oregon 972t ITY O TIGARD Datcfay: PertnitNo.m5To - OOS /e f
Phone: 503-639-41g 0 Posl•tteview land Use --
t.:a:,`l . T ., f : �'; +: C onta c t Case No.: __
Internet: www.Ci. .us ■ .' Contact ]uric,; - '�
,� ® See Page 2 for
24 -hour Inspection Request: 503.639 -4175 - Name/Method: I Supplemental fnformatloti.
1 ::a 4 JAVI I MOARN0 11 4.4W 0 .1 1 .40R 1 03.KWrWe r ererMarigl i, ,t. 6 0 1 4'..W . MI ,Al. i". .
aj New construction ❑ Demolition ■ Service over 225 amps- • Health-care facility
■ commercial ❑ Hazardous location
Addition /alteration/re • lacement ❑ Other: _ El Service over 320 amps- rating of ❑ Building over 10,000 square feet,
•i ' !1 +0 r ,,, A . 5 ' t' Aic.*0,s,l ti f . a,r A • - . ri : I & 2 family dwellings four or more residential units in
lig 1 & 2- Family dwellin: • Commercial/Industrial ❑ System over 600 volts nominal one structure
AccesSO Building Multi-Family ❑ Building over three stories ❑ Feeders, 400 amps or more
>� g y - ❑ Occupant load over 99 persons ❑ Manufactured structures or RV perk
■ Master Builder III Other: ❑ Egress/lighting plan ❑ Other:
a , 1 o i 1 i3.. i:,z∎ U., Ti ; b'��Aall 0' " '•' . 3. Submit seta of plans with any of the above.
Job site address :W t.1J �f5 -�/ The above are not a . . licable to tem . ors r construction service.
1 eS Vr co • v .,. 3fi+ •:�.5 �.,'{�,� 1�1T ^3;rL SOP :�,•.�, ,�, -�-n:� .f
.':t_. u w..Y' �!': �^� :'!. C �:: i t i.::��?S� 'y4 "�' � ....:"1
Suite #: j Blt4g. /Apt. #: Number of inspections per permit sits wed
Project Name D lY1o6 Sv,441.e 4,00-0- Description Qty Fee (ca.) fau -
Cross street/Directions to job site: New residential - single or multi - family per
� � Gc4.4-1., B dwelling unit. Indudes attached garage.
- 5-u �`+'°� -L Service included:
1000 sq, ft. or less 145.15 - 4
Each additional 500 so. lt. or portion thereof 33.40 — 1
Subdivision: 1T Lnw. a 4 t Lot #: Limited energy, residential ( 7s.0o [s��C1 a
i Limited energy, non residential 75.110 2
Tax m: . /. arcel #: Each manufactured home or modular dwelling
i �IG J; EN52. + 9 ` `i7 :. - .i ;i •:: ! ,;, T. , service and/or feeder 90.90 2
1,.3� tr, i , c Lori.i� ?,�l.u' l,a's •. ::?;.k 4;_Y,
Services or feeders - Installation,
les vu rip l -Jr a - I AN Will alteration or relocation:
pf t liner? Q to 200 amps or foes 80.30 2
201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
i :+ "�': , I W - '' " 601 amps to 1000 amps 240.60 2
, � : ia:. 1 ,,,; r, i e� ,ill ,i'rt1 uC�ue M! I �'� A � , r
27 : ;,la. , `•1eQ .d ��.. Pt1 i� +c. s, r+ + �� - over 1000 amps or volts 454.65 2 -
Name: `.. A fl )oc sV. 44c •L.lau• Reconnect only 66.85 2
Address: Temporary services or feeders - Installation,
alteration, or r
City /State/Zip: 200 amps or l 89doCation: 66,85 _ 1
Phone: 5a?- St `1- V V_ Fax: 201 amps to 400 amps 100.30 ' z
133
L � t � i 401 to 600 amps .75 ......
�s��l �7 i 1 C' ' r 'd�"yTr' :. , �l u4" o? Y Y. � I i p ��I 'iil - i A 0 r �' ^;f,�..
�til �J 9���4 d.l�ta::y.r �� �.� l.�a,.!�r - �.��..�` 'i` s�. °s Branch circuits - new, alteration, �� j- t on, ar
Name: extension per panel:
A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 6 2
City /State /Zip: B. Fee for branch circuits without purchase of
service or feeder fee, first branch circuit 46.85 2
i Phone: I Fax: Each additional branch circuit 6.65 2
I E -mail Mise.(Servicc or feeder not included):
s "7i1i � r{ ' ! 5 ' �f +, 1, �rllA�i
c;, , 1 Q , < n , u Each p ump or irrigation circle 53.40 _ 2
.. {il
4 ;1. b il.) -,, , I ,; - "y.., r iii .. - „>7 II li ..: < _ •_.. . y '' • .c r'? 'r . � ., LL • • - Each sign or outl l 53.40 2.
Job No: 3361 Signal eircuit(s) or a limited energy panel,
Business Name: ad S4rns Description; extension _ Page 2 2
Descr
Address: 1 57z{ , 1 k33 -
Cit /State/Zi L3( �� Each additional inspection over the allowable in any of the above:
y Per inspection zee hour (min. 1 hour 62.50
Phone:5ot - ^C5 ` ' Fax: 5.-yt- algt -- d>>i Investigation fee:
CCB Lic. #: Cl‘ ear _ Lic. #: LtrSV. -Cl.� 0t1ir' . r:�
1 ": !_ 1...7r., - ;; i 1 1 11 •t'?:9.it' Ati1PC4.7 :'';k5LI :7:a7 'ir Ii hi. r : n e ' J,"3 :' .,,
Supervising electrician 1 /,-, / / Subtoml $ 7�v
Signa required: ✓ rc N Plan Review (25% of Permit Fee) $
Print Name: I Lic. #: % 2/ ( I! State Surcharge (8% of Permit Fee) S cA
TOTAL PERMIT FEE $ Fla'
Authorized I Notice: This permit application expires if a permit Is not obtained within
Signature: Date: I (7.‘..s (OA I80 days alter It has been accepted as complete.
*Fee methodology set.by Tel- County Building industry Service Board.
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(Please print name)
is \lists \Permit Forms.ElePermitApp.doc 01/03