Permit 4
CITYOFTIGARD ELECTRICAL -
RESTRICTED ENER ENERGY
_'4i/n DEVELOPMENT SERVICES PERMIT #: ELR2004 -00213
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/19/2004
SITE ADDRESS: 12420 SW WINTERVIEW DR PARCEL: 2S1106C -04300
SUBDIVISION: THORNWOOD ZONING: R -7
BLOCK: LOT: 014 JURISDICTION: TIG
Project Description: Limited energy - 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: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS:
Owner: Contractor:
DON MORISSETTE HOMES QUADRANT SECURITY INC
4230 GALEWOOD ST PO BOX 14833
STE 100 PORTLAND, OR 97293
LAKE OSWEGO, OR 97035
Phone: 503- 387 -7538 Phone: 503- 387 -7538
Reg #: SERI- 5558211JLE
LIC 96806
ELE 26- 565CLE
FEES Required Inspections
Description Date Amount
[ELPRMT] ELR Permit 7/19/2004 $75.00
[TAX] 8% State Surchart 7/19/2004 $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
through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699.
Issued by777,0i 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
1
07/14/2004 14:39 5032362322 QUADRANT SYSTEMS PAGE 01
Eli=trical Permit Application FOR OFkICE USE ONLY
Received tt Electrical .p
City of Tigard RECE Vr® Date/BY: 7 "/4 o/ ,P r it No.:t: l 2 Ot ?
Planning Approval Sign
13125 SW Hall Blvd. ��y' Permit No.:
Plan Review Other
Tigard, Oregon 97223 IJUL 1 4 2004 Date/By: Permit No.:
Phone: 503- 639 -4171 Fax: 503 -598 -1960 —
Post- Review land Use —
Internet: www.ci.tigard.or.us CITY OF TIGARD J- l`II Date/Et : Case No.:
g -s c Contact
24 -hour Inspection Request: � bTft ISI s " Name/Method: : s•: pee page 2 for
CT Supplemental [nformatlati.
•
ERL ; `. .r: iS' •5§. nlo+'. IN Yr i(.i t3� rl L' /.1rcji -Zb < Ir ?Yt i' '+f 11 - - ..1; '�,� �,.-: •�ti,,.1. ,::t.._• i.... .y «, r ,1.IG �r 2 Vt,'(; t5},l'4 1. - i:�ly l:1 _ r v�° ' i s:-.; '
IQ New construction ■ Demolition in Service over 225 a s- " u' � '''' ' `�"
mP ■ Health -cart facility
III Addition/alteration/r •lacelalent 1� Other: commercial ❑Hazardouslocation
J ,i tt ;i t ° Y'r:'+ r ti ' 1 " -• l c ;� ❑ Service over 320 amps -rating of ❑ Buildin over 10000 s
'..�.:,..,..jla:. 1 I. t....._s �.f�} 1 i�r_ ?I : . ,� ?:; i; I & 2f am il dwellin 8 qun itsin ,
•f2 � Y Bs four or more residential units in
1 & 2 -Famil dwellin 1A Commercial/Industrial ❑ System over 600 volts nominal one structure
❑ Building over three stories
■ Accesso ■ ❑ Feeders, 400 amps or more
so Buildin
�I Acces Builder pd. ❑ Occupant load over 99 persons ❑ Manufactured stru park
_ Other: ❑ Egress/li plan Other: ctur or RV r
,� ❑
f3- ,tf5'pn, ",�. I :i",`j . •' "1 �`':74lE11;t`I�ht Kii,i!IC +�r, «. i L I Submit sets of plans With any of the above
Job site address: / 2'/ ZQ S W W 1'4)44(44 � yr'�� The above are not a noble to ten ore construction service
Bld' /Art. #: f� . :_ . µl 11:11 ( Il r1 1(4lILjJd�, rli ; i t'__';;,
Suite #: _ Number of itts�ectlou per e
PTO act Name: -Description P rmit allowed
Q Pee (ea.) Total
Cross street/Directions to job site: New residential-single or motel- faintly per
dwcittng malt. Includes attached garage.
Service included:
1000 sq. R or less • 145.15 4
Each additional 500 eq. ft. or portion thereof 33.40 I
Subdivision: Lot #: _ Limited env y, residential 75.00 2
Limited entity. iron residential 75.00 2
Tax ma • / • arcel #: Each manufactured home or modular dwelling
' f,' }i l l+ , 1-1 ''' r , ' , i 1 i i i i II t' ,-,, I i I I ` +, . . ' l it �' ,1 service and/or feeder 90.90
r M • ../ el P.4 e v- - /4u • .r O Services or feeders - (natallntion.
alteration or reloeatlont
200 amps or leas, 80.30 2
201 amps to 400 amps 106,85 2
�-'tI'''rr c.10 11 ? `- : ri '• ;IC}, r ' - i� " itt'SI',S.; - '(II' .i 601 amps o to 600 amps 160.60 2
= . :: _ Is • : =_, : . _'_ 1000 amps 24060 2
Name: 170 M (vl O ,•SS ` Over 1 000 amps or volts 454.65 ., 2
Reconnect only 66.85 2
Address: _ /7 --A •e Temporary services or fcedere - ifstallatlon,
Ci /StatclZl • : alteration, or relocation:
200 am or leas
Phone 5 30- ?5 t) Fax 201 sum to 400 amt — 100.30 I
I 1 ;i1 401 to 6'00 am 2
!I' I!_i�lfltI�V!,r;fF,; ), r:+, - T P,L1. {r >iI + i[) r.i:" 133.75 2
,.' Breach circuits - new, alteration, or
Name: extension per panel:
Address: A. Fee for branch circuits with purchase of
service or feeder fee, each branch circuit 6.65 2
Ci /State/L. : B. Fee for branch circuits without purchase of
Phone: Fax: service or feeder fee, first branch circuit 46.85 2
Each additional branch circuit 6.65 2
E-mail: — -
Mist, included):
. ., . .r,: (Servile feeder m
i` :i 1'', .;i:;',' :;:_r'.:: - :r:A t . it :9,,f E sehpumpa iaigatl oncucle
53.40 2
..............
:., I
_tf. ..... ::,, Each sign or outline l 53.40 2
Job
Emffmmmhrmnminmi No: Signal circuit(s) or a limited energy panel,
alterati criptiaa:
on, or extension 41:OPP 2
Address: P - 1 r
3 Des
� r ►
Ci /$tatP/ZI • : ✓ ' M d I 9 3 Each additional inspection over the allowable in an of the above:
Per inspeetionm. hour (min. I lour) 62.50
Phone: So 3 -SrSB Fax: COT- 2-310-7..r2. 7 .-- Investigation fire:
CCB Lic. #: 96,804,
i,or 5 aa
Supervising electrici / .�' : _.._..... L p ..: 1l , ' . a , 1' ; 3 ... ' , rr ,; =�: 'a; = "r: +,i
L / / Subtot S
IIMUMMIMIEMIEGZEIMIDIMAIRMMM s ature re • uired: L - Plan Review (25% of Pcrmtt Fee) $
State S Surehariennit Fee $ (o .
/^ TOTAL 1PRRNITT FEE $ 7 I . DO
Authorized ' Notice: This permit application expires if a permit is not obtained within
Signature: - ( - ig- t, Date: 1- f Y -e y 180 days after It has been accepted as complete.
*Fee methodology set by Tel -County Building Industry Service Board.
B rtil•u C. NIt l4n 14S
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(Please print name)
is \Dsts\Permit Form \ElcPermitApp.doc 01/03