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Permit CITY OF TIGARD ELECTRICAL PERMIT - RESTRICTED ENERGY yA DEVELOPMENT SERVICES PERMIT #: ELR2003 -00263 13125 SW HAI Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/28/03 PARCEL: 25101 AA -08700 SITE ADDRESS: 125QtiiSW 68TH AVE SUBDIVISION: WEST PORTLAND HEIGHTS ZONING: MUE BLOCK: LOT: 029 JURISDICTION: TIG Project Description: Pre -wire "area of rescue" system (intercom /paging). A. RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: X 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: 1 Owner: Contractor: ROTH, J T JR + THERESA QUADRANT SYSTEMS 12600 SW 72ND AVE, STE 200 PO BOX 14833 TIGARD, OR 97223 PORTLAND, OR 97293 Phone: Phone: 234 - 5558 Reg #: SUP 1211JLE LIC 96806 ELE 26- 565CEP FEES Required Inspections Description Date Amount Low Voltage Inspection [ELPRMT] ELR Permit 8/28/03 $75.00 Elect'I Final [TAX] 8% State Tax 8/28/03 $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 starte i in 1; s of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you o follow rules ado. ed by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 -0010 throuc Iss1 ed by -PO `/ 4 Permittee Signature .O 00 -. / �-�-� 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 08/27/2003 12:21 5032362322 QUADRANT SYSTEMS PAGE 05 i _R: E lectrical Permit Application Received & � �o Electrical Date/By 4J i k Permit No.: rt 00,3 -do p 3 •� Tigard ED Planning Approval Sign City of'I'>< and Date/By: Permit No.: 13125 SW Hall Blvd Plan Review Other Tigard, Oregon 97223 �� Daffy: Permit No.. Phone: 503 - 639 -4171 `86 90A0 ,, „ Post-Review Land Use ` ' , ' Internet: www.eii.tigard.or.us 'A 111 1 Date/By: Case No.: Contact Juris.: 24 -hour Inspection R u D - � , ' See Page for specr$2�> Narrre/Mceh Sir SurplementnlInformatiad. BUILDING DIVISION ,� I; Ip�. �{ , t ,.- _...r,. �.Rla`ii. - .�:��sr. ;, -,:. . ts ....�z , s , 1 1 u , . _ �•vu I ,0 , 1 . d.: ,-1 ,, 5`.�. L.C'u . . el n 1 /:.,1.' .',N iroA f �luG t �i. : Et' t �Y� IAL1 I f' I II . iv;:ii[ 'I ,; _ �, t �:'..�.��.�e. ».k� J 3I. .fir - <d a New construction r Demolition • Service over 225 amps- ■ Health -care facility • Addition/alteration/r r 1acement • Other: commercial over ❑ Bu ilding o cr 10,000 ❑ Service over 320 amps - rating of ❑ Building over 10,000 square feet, ;;= r ' h (f- 1T;il )- fiihca6t ir •' ''P;'. ' 1 & 2 family dwellings four or more residential units in • 1 & 2- Family dwelling V CommerciaUindustrial 0 System over 600 volts nominal one structure 111 Accessory Building ■Multi -l~ axltil a Building over throe stories ❑ Feeders, 400 amps or more Occupant load over 99 persons ❑ Manufactured structures or RV park • Master Builder 1 Other: 0 Egress/lighting plan ❑ other: I i .' yT air;c1;+1;� 4 (:(?'',.:\i''' ii . Ii , K:7. Submit sets of plans with any oftheabove. di •,:i ,..� I: d' J :..b- i:.........s :,.A e.1 ; . .1.i. � .... �.�i .....�.. ... :.1 .� Job site address: ! - +„� i LP— /� he Above are not , ticabls • to rem -7 oonseructlon service r• Z Sc �c J 01 he 1 � / I •:I '•I I . 7f1 . ' �E �Z N . i —. ',_, 4 Suite #: 1 Bld . /A #: � ;�: - , ., - N , um � ,Q inspections per permit allowed � E � („�,. _. ii / � Project Name: --1'T °� - CrnS 1 C o(1 Description Qty Pee (ea.) Taal 1 New residential -single or mold -family per Cross street/Directions to job site: dwelling unit. Includes attached garage. d1/( 0. Cz,l £ 4 c',i'+. f—_, ' I Stroke tadadet /� ; / i ' 1000 so. R or lm , 145.15 4 /” Fach additional 500 sq. ft. or portion thereof 33.40 1 Subdivision: ,� Lot #: Limited energy, residential 75.00 2 I united energy, non rosidendai 75.00 2 Tax ma erect #: r U�� - Each manufactured home or modular dwelling { I L A ' , J 3::nl 1 1 ) l'; '..lrr_ ) ! I r . ; ) l ' ° .:`� I Apr 90.90 2 service feeder / 'r Services or feeders - Installation, fa4 10 ti:: ( .. f 6-Xi .. Fil ,,ti Rrt-t 0 of alteration or reloeadoa: re S S `� �� - � -1el J �'r �` 22000 amps or less 1 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 _ _ 2 r' 1 1, 1 } ' °r. I `I 1 ' i . ' I ` ;J' 1I 1 i -. :r, i, ; , -'i 'l 601 Ennis to 1000 amps 240.60 2 Over f000 amps or volts 454.65 2 Name: Reoomtect only 66.85 2 Address: Temporary services or feeders - installation, alteration, or relocation: City / State/Zip: 200 autos or less 66.85 1 Phone: Fax: 201 amps to 400 amps 100.30 2 _ ,-. � 77 —, i� l i �T ,. , t l; ,) I . I ' r F ,:‘,,ii,,, � i 401 to 600 amps 133,75 2 „ _,.,..- _ I_u..� i.d. � <I, ,:r� l .sa , ,- . —. .. .Q. . � .: ,... . _. _ . Branch circuits - new, alteration, or Name: zT - i - f , Con, s'4..tMGsi•■ on e; d JL,t1C extension per panel: Address: A Fee for branch circuits with pie of service or feeder fee, each branch circuit 6.65 _ 2 . City /State/Zip: B. Fee far branch circuits without purchase of aer'i'e or feeder find er fee, t branch circuit 46.85 2 Phone: 5=3- 2'0I. CI *3 Fax Each additional branch circuit 6.65 1 2 Email Misc.(swvice or feeder not included): u; (1 1 �..:(_1.::'5.(1.2: I . Each pump or irrigation circle 53.40 2 ... ... ...._ ,. . ;..' >.• . . ._w Eachsiiatoroutlinelighting 53.40 2 Job No: 3 i3 9 _ Signal circuit(s) or a limited energy panel, Business Name: a d cr.,, SAS alteration, or extension 1 2 2 Description: Address: too v. i y r33 Cl /State/Zl -i-�6� -. , Each additional inspection over the allowable in an�of the above: e 1 Per inspection per hour (min. 1 hour) 62.50 Phone: 5r:,3- a3 y- 5'' Fax: S:e - d 6 - a,3a,i Investigation fee: CCB Lic. #: ') _ Lic. # �.(,S tc S CEr °` -, , w�i' - . i •�l, - 1 l,b,'•� i�l �d 1, 11 1 : } Il j '. c , i„�l , t a , el' Supervising electrici 1 � .— Subtotal $ FC - ‹ signature required: /4 . L 4 _ Plan Review (25% of Permit Fee) $ Print Name: .4 ck YYI; 1 1 1 Lic. #: i- Z/ / 1 C„/" State Surcharge (8% of Permit Fee) $ fp loo Authorized j (_..., Notice: This it application T PERMIT FEE $ - �. Date: e expires c if permit is not obtained within Signature: 1g0 days ot ter It has been accepted as complete. *Pee methodology set by Trl- County Building Industry Service Board. >ebex an . (Please print name) i :1Dsts1Pcrmit rorma\ElePeraritApp -doe 01/03 CITY OF TIGAfiD 24-Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST4_ BUP Received Date Requested / 1 / AM _ PM BUP Location / a / j In 8-- Suite MEC Contact Person Ph ( ) PLM Contractor Ph ( ) l — 06 0 Z SWR BUILDING Tenant/Owner ELC Footing ELC Foundation Access: Ftg Drain ELR 3 00 3 Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG/Slab Low Voltage F' a Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. ASS PART FAIL - SIT ❑ Please call for reinspection RE: n Unable to inspect — no access Supply Line 1 ADA Approach/Sidewalk Date ((— ( - 03 Inspector I'' r 4 Ext Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL