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Permit r� 'v CITY OF T I G A R D ELECTRICAL PERMIT - RESTRICTED ENERGY ;:,; l DEVELOPMENT SERVICES PERMIT #: ELR2003 -00283 '` ' 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/19/03 SITE ADDRESS: 13690 SW 124TH AVE PARCEL: 2S103CC -06900 SUBDIVISION: WHISTLER'S WALK ZONING: R -4.5 BLOCK: LOT: 016 JURISDICTION: TIG Project Description: Burglar alarm. A. RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: X 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 ACE SECURITY 4230 GALEWOOD STE #100 5200 SW GREENWOOD CIRCLE LAKE OSWEGO, OR 97035 TUALATIN, OR 97062 Phone: 503- 387 -7538 Phone: 503- 750 -9351 Reg #: LSO3- 69244 ELE 3- 226CLE SUP 569LEA FEES Required Inspections Description Date Amount Low Voltage Inspection [ELPRMT] ELR Permit 9/19/03 $75.00 Elect'I Final [TAX] 8% State Tax 9/19/03 $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 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 la - Issued by i - Permittee Si natur- • 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 t 1 Electrical Permit Application l I,CE I Date received: 9' I? 0,_/ Permit no.:E 0:, )w3 .00 3 t Ci of Ti ardpiper" s Pro'ect/a 1 no.: Expire date: ^1, g X1166 J PP• P City of Tigard Address: 13125 SW Hall lgaz , OR 97223 Date issued: By/y/}" ' Receipt no.: Phone: (503) 639 -4171 Fax: (503) 598 -1960 SEP 1 9 2" Case file no.: Payment type: Land use approval: CITY OF TIGARD TYPE OF PERMIT ❑ 1 & 2 family dwelling or accessory ❑ Commercial /industrial ❑ Multi- family ❑ Tenant improvement New construction ❑ Addition/alteration /replacement ❑ Other: ❑ Partial JOB SITE I\FORNI ‘TIO\ Job address: I (.,q 0 S LA) 12y Bldg. no.: Suite no.: Tax map /tax lot/account no.: Lot: Block: 'Subdivision: Project name: I Description and location of work on premises: Pt' 144 t.v. sy S - P6LEcu i2L Estimated date of completion/inspection: CONTRACTOR .1PPLICAIIO\ FEE SCHEDULE Job no: Fee Max / � t.0_, E S E. c K Q Description Qty. (ea) Total no. insp Business name: New residential - single or multi - family per Address: 5 . 00 5 W ( ,,, z ee,,„ „Joao �%l/1- dwelling unit .Includes attached garage. City: 1" \ ,4,4- t I State: � ZIP: ci 7 0 (' Z Serviceincluded: Phone: 5 p - Ci 3s Fax: (q2 -q�/7 I E -mail: 1000 sq. ft. or less 4 CCB no.: y r 3 50 Elec. bus. lic. no: 22.6 Each additional 500 sq. ft. or portion thereof Ci /metro lic. no.: � CL Limited energy, residential i / 2 �' 0 -00 g g / / y G / 1 //o 3 Limited energy, non - residential 2 41. `_ _ r /: _ t _ sir.► ( - I4 -O Each manufactured home or modular dwelling Signature of supervising electrician (' . uired) Date /D 1 ' Service and/or feeder 2 Sup. elect name ( print): VV1 t . R EeO /tE. Limnse no:3. LF� Services or feeders- installation, alteration or relocation: I'R(iI'1 R 11 0111 \ Fi t 200 amps or less 2 Name (print): D op. IMo aQ1 t fk , 0v - 1_.S. 201 amps to 400 amps 2 401 amps to 600 amps 2 Mailing address: r0�30 Con YAl00.6 City: ¢',�� : C, OSed EGO I State:O ZIP 970. L' Over 110000tampp� amps 2 Phone: 75a -9:35-7 I Fax: I E -mail: Reconnect only i 1 Owner installation: The installation is being made on property I own Temporary services or feeders - which is not intended for sale, lease, rent, or exchange according to installation, alteration, orrelocati on: ORS 447, 455, 479, 670, 701. 200 amps or less 2 201 amps to 400 amps 2 Owner's signature: Date: 401 to 600 amps 2 I . \ (.I \ EER Branch circuits - new, alteration, Name: or extension per panel: A. Fee for branch circuits with purchase of Address: service or feeder fee, each branch circuit 2 City: 1 State: 1 ZIP: B. Fee for branch circuits without purchase Phone: Fax: E of service or feeder fee, first branch circuit: 2 Each additional branch circuit: P1.1\ REVIEW (Please check all that apply) Mlsc . (Service or feeder not included): ❑ Service over 225 amps- commercial 0 Health -care facility Each pump or irrigation circle 2 0 Service over 320 amps- rating of 1&2 ❑ Hazardous location Each sign or outline lighting 2 family dwellings 0 Building over 10,000 square feet four or Signal circuits) or a limited energy panel, 0 System over 600 volts nominal more residential units in one structure alteration, or extension* 2 0 Building over three stories 0 Feeders, 400 amps or more *Description: ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above: 0 Egress/lighting plan ❑ Other: I. I I I Per inspection Submit sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service. Other Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $ —} r l jurisdiction N otice: This permit application ❑ Visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ %) $ Credit card number: </_ / within 180 days after it has been State surcharge (8 %) $ (p 1 00 • Expires accepted as complete. TOTAL $ 111100 Name of cardholder as shown on credit card $ Cardholder signature Amount 440-4615 (6 /00 /COM) CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST 3 - 00 -? v INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Requested / ( 02 AM PM BUP Location / 3 6 9 / a � � Suite MEC Contact Person c Ph ( ) v — PLM Contractor _ /'j h ,i G` 2 C7 '7 r Ph ( j SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Ftg Drain Access: ELR V,d03'PAR3' 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 �Fi�.. � Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. QM), PART FAIL SI Please call for reinspection RE: 111 Unable to inspect – no access Fire Supply Line �� ADA Date /1 /25 / 2J Inspector c/ &13 Ext Approach/Sidewalk Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Ljl'ae: (W3) 639 - 4175 MST 3 _ 0 ) —� INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Requested / ( AM PM BUP Location / 3 6, 10 Suite MEC Contact Person Ph ( ) ao v — PLM Contractor N � • r a - 2 ifiv, Ph ( SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Ftg Drain Access: FIR 00 Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Are Sprinkler Fire Alarm _ Susp'd Ceiling Roof Other: 113j Anal PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Anal PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Anal PASS PART FAIL ELECTRICAL Service Rough -In UG/Slab Low Voltage - m Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. QM" PART FAIL SI E [] Please call for reinspection RE: 111 Unable to inspect — no access Fire Supply Line ADA / Z c/ Ext C .. / '" Approach/Sidewalk Date // /?/ Inspector Other: Final DO NOT REMOVE this inspection record from the Job site.