Permit Pk
ills. CITY OF TIGARD ELECTRICAL ENERGY
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RESTRICTED ENERGY
y; � DEVELOPMENT SERVICES PERMIT #: ELR2003 -00074
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/7/03
SITE ADDRESS: 16550 SW 72ND AVE B -09 PARCEL: 2S113AA -01000
SUBDIVISION: OREGON BUSINESS PARK 1 ZONING: I -L
BLOCK: LOT: OOC JURISDICTION: TIG
Project Description: Installation of limited energy for security system. Job No. 2876
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: 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: X
INSTRUMENTATION: OTHER: .
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
PACIFIC REALTY ASSOCIATES QUADRANT SYSTEMS
15350 SW SEQUOIA PKWY #300 -WM I PO BOX 14833
PORTLAND, OR 97224 PORTLAND, OR 97293
Phone: Phone: 234 - 5558
Reg #: MET 00002466
SUP 1211JLE
LIC 96806
FEES ELE 6qWnspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 3/7/03 $75.00 Elect'I Final
[TAX] 8% State Tax 3/7/03 $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
started ' ith n 180aays of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires
you t follow rules adopt-d by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 -0010 throuc
Iss ed by ; p ,,) , 61 1 . 4 Permittee Signature �/ / w
�.. " 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
1111 116-200111111PM FROM QUADRANT SYSTEMS 503 236 2322 P. 2
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Electrical PermitA 1 1 6 sk .
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• em - • Datereceived: 3 440. 43 Permit no.:
. 44 ! , `• , i'IC • City of Tigard . . • Pro ject/aPpl. no • Expire date: , •[ 11
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City of Tigard . Address.: 13125 SW Hall Blvd, Tigat4MAR q4.2.4.° '
Date issued: • . By; Receipt no.: : !I
• Phone: (503) 639-4171
- TIGNBD .
. Fax: (503) 598-1960 • CITY O F ( - _, A 1 Case file no.: Payment type: 7 .
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Land use approval: .
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TYPE OF PERNIIT
BUILDING DIVIS I :
O 1 & 2 family dwelling or accessory ' 0 Multi-family. CI Tenant improvement
Q New construction CI Addition/alteration/replacement . '8 Other. 01,. —,/, 0 Partial
.1 OR SITE INFORMATION
Job addless: 1 (, b ..c.A..11) .7A 4 4,11AAAM: uL,t. Bldg. no.: • Suite no.: Tax map/tax lot/accountio.: •
Lot 'Block: 1Subdivision; • • ki.
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Project name: KizArif WU) Se4 1 Description and location of work on premises:1.--6( :
Estimated date of completion/inspection: - . - • - -. 4 .-: -, VIS44il 5 ■,_ ,.. ,,,,,
CONTRACTOR. APPLICATION FEE SC
Job no: DS1( . Fee aim ..
Business name: .1,,,--,- .., ci •
ddenda1-agleormuld-fandly per
. • • • Description
Newresl Qty. (ea.) Total no:Onsp
• r Address:Ibt, 1 kik•
. , divellingunit. Includesattichedgarage.
J
C kii■iA-k . . j State(' I ZIP: C e243 Senieelatindesb • I 1!
PhOutiq - aci I Faxa1/4,,,,13a.)— I E-mail: ' 1003 sq. ft. or less ...._______........_...
Each additional 500 sq. ft. or poruon thereof t'
CCB'no.: • ■, '`..• Ifilee. bus. lic. noZA075W-Ca.
LiTited mere. residential • . . II.
• City/tnetro lic. • . Oi_,)., • 1,, • Limited energy. non-residuals'
AY • v-
• - 4.. mi Each numufactured home or modular dwelling sl.
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Signature of supervising electrician (required) • Date Se:Nies and/or feeder • A 1
Luz= no: 1 I ... •
. - Saviors orkeders installation, .. t .
Sup. gloat. name (priM): fa (..., ; II;
*Iteration orrelocatIon: i li
PROPERTY OWNER ! 1
200 amps or leas •
Name (print): : • 201 amps to 400 amps • • 2
r- 401 amps to 600 maps • : ._________1
Mailing addrest: • • 601 naps to 1000 amps •
City; • 1 State: ll ZIP: _ • Over 1000 amps or volts
Phone: • • I Fax: I E-mail: • Iteooneectonly • • •
Owner installation: The installation is being made on property I own 'Temporary services or feeders; - • i .„=,
which is not intended for sale1 lease, rent, or exchange according to • imesibliPtipalbxstiout or relocation: • • .i I;
• . 200 amps or less ' . 2 ij
ORS 447, 455, 479, 670, 701. • ' --tr
201 Rune to 400 ista 2 :,
Owner's signatUre: . . . Date: N • 401 to 600 amps • . ; it• • 4 .
Ir
ENGINEER Branch circuits - new, alteration,
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•or Wawa! per paneh
Name:
k Fee for branch circuits will' purchase of • • • ! 11
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Address: • • • • • • • • • seMce or feeder fee, each branch circuit • • "2
City: I State: IMP: B. Fee for blanch circuits without purchase • . i • if
of service or feeder: fee, firstbrands circuit 11
Phone: • • Fax: E-mail: • Y-
Each additional branch circuit , .
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PLAN REVIEW (Please check all that apply) • ham (Service or feeder not !Waded):
O Serviocover 225amps-commercial - CI Realth-carefacillty • • Bach pump or irrigation circle •
O Service over 320 amps-rating of 18L2 • 0 Razaniouslocation • Each sign or outline lighting • . ".;,.;___4,
family dwellings ' CI Bulldingover 10,000 equate feet four or • •Sigazil ekcilit(s) or a limited energy panel: I. g
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2 L
0 System over 600Volts nominal • more residential units in one structure abandon, or extensions • 7S
0 Builang over three stOries • 0 Feeders. 40t) amps or mons *Description: : i
0 Occupant load olni99 persons • 0 Manufactured suuctures or RV pan Each adelltional Impaction over tbe allowable In any of the ahem
0 Egnaisflighting plan • CI Other. • Pit" inspection 1 1 L I • ;.
• Submit sets of plans with ally of the above. • Investigation fee i fl
The above are mat applicable to titaporaty construction service. Other • —,--r
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toot AI jatiolledona accept avid cads, please call jun/Action for mom informant:4i Notice: This pertidt application _ Permit fee • • $
0 Visa CI Mastneard expires if a permit is not obtained Plan =view (at — %) $ • 1 fl
Cretritard numb . . 0 / / within 180 days after it has been State surcharge (8%) .... $ lo iik) ji
. • • * Expires —sf\ . 0 0 -,
. . accepted aS complete. TOTAL $
New --- loeowe 0 $ ' 6ivircol
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Cardholder elpatuns Amount , • 440-4615 ( )
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