Permit CITY OF T I G A R D ELECTRICAL PERMIT -
RESTRICTED ENERGY
1 DEVELOPMENT H BMENT r SERVICES (503) 639 -4171 DATE ISSUED: 3 -00279
ED: 9!12/03
SITE ADDRESS: 13690 SW 124TH AVE PARCEL: 2S103CC -06900
SUBDIVISION: WHISTLER'S WALK ZONING: R -4.5
BLOCK: LOT: 016 JURISDICTION: TIG
Project Description: Installation of audio /video system.
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 INTERIOR AUDIO INC.
4230 GALEWOOD STE #100 600 SE MARITIME AVE.
LAKE OSWEGO, OR 97035 SUITE 320
VANCOUVER, WA 98661
Phone: 503 387 - 7538 Phone: 360 - 735 - 1500
Reg #: LIC 117368
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 9/12/03 $75.00 Elect I Final
[TAX] 8% State Tax 9/12/03 $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
Issued by Permittee Signature „9- 7
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
Sep 10 03 12:34p INTERIOR AUDIO 3606932288 p.1
Q FOR OFFICE USE ONLY
Electrlical Per ion Received Electrical
r SEP 1 1003 Date/By: ��f
2:A 4244 Permit No. :L/Q.ZDD.3 77
City of Tigard r Planning ApproJal Sign
Date/By: Permit No.:
13125 SW Hall Blvd. CITY OF TIGARD Plan Review Other
Tigard, Oregon 97223 n II�� Date/By: Permit No.:
Phone: 503- 639 -4171 FOP 9c 891Y )ON Post - Review Land Use
A r'."�:F'11 \ Date/By: Case No.:
Internet: www.ci.tigard.or.us ._/.4.: - l Contact ® See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 Name .Method:
7/ 4 Supplemental Information.
,lifilMEZIREEMEM OP; ea,.. ,, k .y r.. _. a�. :0MMvoe !T &11 _MMN ,. <r.�x �.:
G. New construction ❑ Demolition • Service over 225 amps- U Health -care facility
❑ Addltlon/alteration/re . lacelnent ■Other commercial ❑ Hazardous location
5 . , � � ❑ q Service over 320 amps- rating of 0 Building over 10,000 square feet,
y - 'a h h . .i. d ' Q F lF f_� ; ,1, u r ; ' t I & 2 family dwellings four or more residential units in
1 & 2- Family dwelling ■ CommerciaUlndustrial ❑ System over 600 volts nominal one structure
Accessory Building (� Multi - Family ❑ Building over three stories ❑ Feeders, 400 amps or more
❑ Occupant load over 99 persons ❑ Manufactured structures or RV park
(1 Master Builder ❑ Other: ❑ Egress/lighting plan ❑ Other:
g {'" ' ' Y" with any of the above.
,•�At: + ,...� :.!- - � � &S • ° ' � �.4�C2t�:'. ��'�� ¢'��� )`Q �(Ont""7 � Submit sets of plans '
The above are not a. , licable to tern 'ore construction service.
Job site address !/ t ry C Ste. ZL{ • dry, ur u la ,. r. , Y ° , 4 ° :1" RMii i
.S 16440. : I a 04. I Ei3dAt7L66447# Number of inspections per permit allowed
Project Name: Wh i SiA.2. FS VG ``..- Description Qty Fee (ea.) Total I 1
Cross street/Directions to Job site: New residential - single or multi - family per
dwelling unit. Includes attached garage.
Service included:
1000 sq. ft. or less 145.15 4
Each additional 5001g. ft. or portion thereof 33.40 1
Subdivision: VI hi s f (2X5 t* I Lot #: t Lo Limited energy, residential / 75.00 15, p O 2
Limited energy, non residential 75.00 2
Tax ma. /. arcel #: ' Each manufactured home or modular dwelling
't. ",'': %F` 1.3'.;F `" = - D` ± r 6 0 T ` t service and/or feeder 90.90
�1
�}� �`� Services or feeders - installation,
1fl5 f I Ct(SfC i f Div SYSk r I alteration or relocation:
200 amps or less 80.30 2
_ 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
®n'6``i' ` , ig1: et,tf 33 " +r alt 601 amps to 1000 amps 240.60 2
Mir a✓ �CC111 Over 1000 amps or volts 454.65 2
Name: SS 1 _ Reconnect only 66.85 2
Address: Temporary services or feeders - installation,
alteration, or relocation:
City /State /Zip: 200 amps or less 66.85 1
Phone: t 0,)i- ;• LI _1 Fax: 201 amps to 400 amps 100.30 2
°,: i;„ .. 2%. 7 .; 1. * : Q °6t ( "1 . -' 0 ; A.;.; 401 to 600 amps 133.75 2 ■ Branch circuits - new, alteration, or
Name: - 1.n ., 1(.'3r A -(.,A i,j 0 ..1-•i' C• extension per panel:
Address: (i} S Ci'I�iYI fi;Z /�V� `pit ilt A. Fee for branch circuits with purchase of
32LJ service or feeder fee, each branch circuit 6.65 2
City /State /Zip: VV1L Cl U. V& wiet otskptpi B. Fee for branch circuits without purchase of
((^ '� II � 1 1 f ( service or feeder fee, first branch circuit 46.85 2
Phone:
` i l 1 - 1 J C'Ll Fax: `C) 13 Qua.' Each additional branch circuit 6.65 2
E -mail: s -' ' () la1 Yl I ,(,(,tj 0 n L , coin- Misc.(Service or feeder not included):
;. « n�i;,;. } r . ' „- ; ' G e, F.. , _ 0 . , t? 1:i s ' it Fa pump or ritation 53.40 2
' ' ' °' Each ch sign or outline lighti ng 53.40 2
Job No: Q�' )t.p 4 Signal circuit(s) or a limited energy panel,
Business Name: T i r i cy Ari 1 o . r . 1 L
Description: tiara or extension Page 2 2
Desc
Address: Uel0 se Maritime Ave ra .its. 3 21.:.. -
City/ State/Zip: \G v� Cep Each additional inspection over the allowable in any of the above:
Clt
y p: `lCO u' 1 Per inspection per hour (min. 1 hour) 62.50
Phone: & C; - 135- is C>0 Fax: ^--1 ) ( 3 - n Investigation fee:
CCB Lie. #: j 3(„ Lie. #: I,v14 - ►rife ✓ci vqyoi r Other. t
Supervising electrician r na}.. Al: �a'�w ° =tFaQ "'' ' l �If `'., Ih v
u a r :`,
v . ` Subtotal $ - 1� .t7
signature required: !/ Plan Review (25% of Permit Fee) $
Print Name: S/t L t + &I rr7 ff f'I Lic. #: /r-1 3 l.! e State Surcharge (8% of Permit Fee) $
TOTAL PERMIT FEE $
Authorized f / Notice: This permit application expires if a permit is not obtained within
"
Signature: • Date: 9J/6 /if 180 days after it has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service Board.
41 (4/Mt , 3Ac 1 r
(Please print name)
i:\Dsts\Permit Forms \ElcPermitApp.doc 01/03
Electrical Permit Application FOR OFFICE USE ONLY
I' Received Electrical
Date/B : j PermitNo.•
G 11 Planning Approval / Sign 1
City Of Tigard L ((++e,� G DateB : ; 4j ' r /permit No.
13125 SW Ha11 Blvd. �e, Plan Review , M/ , ether V
Tigard, Oregon 97223 '‘%,1 DateB : emvt No.,
Phone: 503- 639 -4171 Fax: 503 - 598,01$ Post- Review Land Use
//i r,- ��(, ;i DateB : i Case No. e :
t
Internet: www.ci.tigard.or.us 1 _' J ?�
_ R e; - � Contact I Juris.: See Page 2 for
24 -hour Inspection Request: 503-639-417 o — -. • Name/Metho, W Su • • lementat Information.
r- Z ` .,.. _.,,'`' ? s - ";`F 11,' ,(, ' v,.. 671 . Y: S 'I i ter 4,1; ;'Ai 0 : rC X.11 t 4 t6,;: a , •x t
[2 New construction ❑ Demolition • Service over 225 amps- ❑ Health -care facility
commercial ❑ Hazardous location
❑ Addition/alteration/re • lacement : ❑ Other: ❑ Service over 320 amps-rating of
�� ���� ®� ®� � � � � ❑Building over 10,000 square feet,
�
,_ „ „„O -� 1 & 2 family dwellings four or more residential units in
❑ 1 & 2 -Famil dwellin_ ❑ Commercial/Industrial ❑ System over 600 vo n ture
❑ ACCeSSO Buildin: ❑Building over three stolts ries ominal
❑ Fee struc 400 amps or more
❑ Occupant load over 99 persons ❑ Manufactured structures or RV park
❑ Master Builder ❑ Other: ❑ Egress/lighting plan ❑ Other:
Q. , . � � P . ` w 1 8 @ d , ' 0 6 4 Submit sets of plans with any of the above.
�' , The above are not a hcable to tern , ora construction service.
Job site address: '
�
' i I 1 a " • li orito X01 B ate V e 4fZ
Suite #: Bld:. /A. t. • : Number of inspections per permit allowed
Pro'ect Name: lI dAl /.4.0 4 S'Y Description Qty Fee (ea.) Total i
New residential - single or multi- family per
Cross street/Directions to job site: a? /2/ 5 dwelling unit. Includes attached garage.
Service included:
1000 sq. ft. or less 145.15 4
Each additional 500 sq. ft. or portion thereof 33.40 1
i Limited energy, residential 75.00 2
Subdivision: #672, ,r Lot #:
d MI Limited energy, non residential 75.00 2
Tax ma. /. arcel #: Each manufactured home or modular dwelling
�g .l p {l g 6 0 "' 0 : ; Vi service and/or feeder 2
Services or feeders - installation,
alteration or relocation:
200 amps or less 80.30 2
201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
" 4. a��t\1 r t , , r amps to 1000 amp
—`� O 601 ver 1000 amps or vols ts 240.60 2 454.65 2
®l , i► gill Reconnect only 66.85 2
Address: o i , 0 / a's • • Temporary services or feeders - installation,
alteration, or relocation:
Ci /State /Zi .: L k pi' 03 ; ♦ 200 amps or less 66.85 1
Phone: 3� - x , 201 amps to 400 amps 100.30 2
AWE , " . t T _= 6 401 to 600 amps 133.75 2
°° ' Branch 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 /Zi.: B. Fee for branch circuits without purchase of
service or feeder fee, first branch circuit 46.85 2
Phone: Fax: Each additional branch circuit 6.65 2
E -mail: Misc.(Service or feeder not included):
a. - ° -v ;. , rg W. Each pump or irrigation circle 53.40 2
Each sign or outline lighting 53.40 2
Job No: 2'7 8'4 Signal circuit(s) or a limited energy panel,
alteration, or extension Page 2 2
�r
Business Name: N / f, _ _ Description:
Address: '
Each additional inspection over the allowable in any of the above:
Ci /State /Zi.: .__, ,y/ • 0 Per inspection pe per hour (min. 1 hour) 62.50
Phone: , — 3 .. ; L ,' ' I fee:
CCB L1C. #: 32222 Other:
Supervising electrician �� Subtotal $
sit ature re • wired: _� . ,,,,, / „ Plan Review (25% of Permit Fee) $
Print Name: L., — , Az 1111111211ILVSIMI State Surcharge (8% of Permit Fee) $
TOTAL PERMIT FEE $
Authorized Notice: This permit application expires if a permit is not obtained within
Signature: I ate: 180 days after it has been accepted as complete.
*Fee methodology set. by Tri -County Building Industry Service Board.
(Please print name)
i:\Dsts\Permit Forms \ElcPermitApp.doc 01/03
(;?
Electrical PAr 1 i 0 ation Received FOR OFFICE USE ONLY Electrical
Date/By: Permit No.:
City of Tigard n0 Planning Tal Sign
SEP 1 8 2 11 Date/By: — 'ermit No.:
13125 SW Hall Blvd. Plan Review ' Other
Tigard, Oregon 97223 Date
g g T1GA t .-\ Permit No.:
Phone: 503- 639 -4171 Ed Y t @1 O H M N \ ;BY:
R e Lb Land Use
Internet: www.ci.tigardB 31 ll '1111 \ Case No._
24 -hour Inspection Request: 503 - 639 -4175 ` �W ct Juris.: Su See Page 2 for
P q ��od: �% r Supplemental Information.
' X v, 117 M4 'y 0 y . S:7 , . * e' *i 4- e s -.' Sall' a'T 1 ,a
New construction ❑ Demolition ❑ Service over 225 amps- ❑ Health -care facility
Addition/alteration/re.lacement ❑Other: ❑ commercial ❑ Hazardous location
� me Service over 320 amps- rating of ❑ Building over 10,000 square feet,
_ C tt ®1 , ®'. a O a . 7 01Y- ,, , 4 I & 2 family dwellings four or more residential units in
0 1 & 2- Family dwelling ❑ Commercial/Industrial ❑ System over 600 volts nominal one structure
❑ Accessory Building El Multi- Family El Building over three stories ❑ Feeders, 400 amps or more
❑ Occupant load over 99 persons ❑ Manufactured structures or RV park
❑ Master Builder ❑ Other: ❑ Egress/lighting plan ❑ Other:
w ' ‚ ‚ o Submit sets of plans with any of the above.
The above are not a, . licable to tem s ora construction service.
Job site address. 1
Suite #: Bldg. /Apt. #: Number of inspections per permit allowed
Pro Name: I , 4 �,,, ,,, ti Description Qty I Fee (ea.) Total
New residential - single or multi - family per v
Cross street/Directions to job site: a rr. /2 / .,57 dwelling unit. Includes attached garage.
Service included:
1000 sq. ft. or less 145.15 4
Each additional 500 sq. ft. or portion thereof 33.40 1
Subdivision: , (� e LOt #: Limited energy, residential 75.00 2
Limited energy, non residential 75.00 2
Tax ma . / . arcel #: Each manufactured home or modular dwelling
, o- p a Rl g rpv i ®� g s ,, nd/or er 90.90 2
Services service a or feeders feed installation,
alteration or relocation:
200 amps or less 80.30 2
201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
p te W ;j 601 amps to 1000 amps 240.60 _ 2
�I Over 1000 amps or volts 454.65 2
a J �I /L Reconnect only 66.85 2
Address: 6 Iva 0 5u / I CO Temporary services or feeders - installation,
teration, or relocation:
Ci /State /Zi.:
* t I f W O A 2 0 0 amps or less 66.85 1
Phone: , — fi r Fax: 387- 76 ` 201 amps to 400 amps 100.30 2
s. 7 tl .. ' p 401 to 600 amps 133.75 2
Branch circuits - new, alteration, or
Name: extension per panel:
A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 6.65 2
City /State /Zip: B. Fee for branch circuits without purchase of
service or feeder fee, first branch circuit 46.85 2
Phone: I Fax: Each additional branch circuit 6.65 2
E -mail: Misc.(Service or feeder not included):
': , Each pump or irrigation cu 53.40 2
_q_� u. -_. �
Each sign or outline lighting cle
53.40 2
Job No:
J./ Signal circuit(s) or a limited energy panel,
/ alteration, or extension Page 2 2
Business Name: �� ` Description:
Address .59& '
City /State /Zip: �(�i4 -q Ci e, 9 7Q 6-2 Per additional inspection over the allowable in any of the above:
Per inspection per hour (min. 1 hour) 62.50
Phone: S33 - 357 —?(. 25" Fax: / -57s ( — 5 ={ - y` 71 Investigation fee:
CCB Lie. #: , Lic. #: _ C Other: 4j, Supervising electrician 40 Subtotal $
si _ attire re. uired: , ,, / Plan Review (25% of Permit Fee) $
Print Name: _,L ,_; /' /� ge State Surchar (8% of Permit Fee) $
!
Authorized / TOTAL PERMIT FEE $
Notice: This permit application expires if a permit is not obtained within
Signature: Date: 180 days after it has been accepted as complete.
*Fee methodology set. by Tri -County Building Industry Service Board.
- (Please print name)
i:\Dsts\Permit Forms \ElcPemvtApp.doc 01/03