Permit CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT #: ELR2003 -00191
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/3/03
SITE ADDRESS: 14226 SW 132ND TERR PARCEL: 2S109AB-09300
SUBDIVISION: RAVEN RIDGE ZONING: R -7
BLOCK: LOT: 022 JURISDICTION: TIG
Project Description: Installation of speaker wiring to finish off basement.
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:
MARC MOORE QUADRANT SYSTEMS
14226 SW 132ND TERR PO BOX 14833
TIGARD, OR 97224 PORTLAND, OR 97293
Phone: Phone: 234 - 5558
Reg #: MET 00002466
SUP 1211JLE
LIC 96806
FEES ELE c i nspections
• Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 7/3/03 $75.00 Elect'I Final
[TAX] 8% State Tax 7/3/03 $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 foils -. - adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 throuc
# 1� ' I y Permittee Signature
Issu d by 1L !.,_,• _A.: ��w - Ili' � OAP
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
Electrical Permit Application FOR OFFICE USE ONLY
Received ...., , Elctrical 9 ,,,..„
Date/By: ( .,V 0.2 Perm No.: L-4 .- 4 r--XIC ) "-'-00/ 7 /
City Planning Approval
Sign
of Tigard Date/By:
Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date/By: Permit No.:
Phone: 503-639-4171 Fax: 503-598-1960 A . & Post-Review Land Use
' 411111 Date/By: Case No.:
Internet: www.ci.tigard.or.us r ai", 6! Contact
ii.; ... El See Page 2 for
24-hour Inspection Request: 503-639-4175 "--""'" ' Name/Method: (0. Supplemental Information.
.',41 , i1 , -042.; ; :t'OLWIN4tE:YI.E : WOlaill'O'ai'iiII - jiiitAi - bi51.::•1;: ,f g ,:,
0 New construction 0 Demolition 0 Service over 225 amps- 0 Health-care facility
commercial 0 Hazardous location
D A:dditionialterationirepiacement 0 Other: 0 Service over 320 amps-rating of 0 Building over 10,000 square feet,
iRV 810tiCTION:14 ''''.- 'a'? ' 1 & 2 family dwellings four or more residential units in
0 1 & 2-Family dwelling El Commercial/Industrial CI System over 600 volts nominal one structure
0 Building over three stories 0 Feeders, 400 amps or more
111 Accessory Building El Multi-Family 0 Occupant load over 99 persons 111 Manufactured structures or RV park
0 Master Builder 0 Other: 0 Egress/lighting plan 0 Other:
',;-;:*,::''SE INFOIIMATIWAitiiPLOCATION:14:7M.4 Submit sets of plans with any of the above.
The above are not applicable to temporary construction service.
Job site address: P-/g-9-ee j.to /S,-J —7-771_4 --.-n.::--r:,,I;,N.t,:,u.:,,;;;At'Fio,,,,;$01fotugeCilit.':ilftAl';',::.::;
Suite #: , Bldg./Apt. #: Number of inspections per permit allowed
Project Name: Description Qty Fee (ea.) Total i
New residential-single or multi-family per
Cross street/Directions to job site: 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
.Limited energy, residential / 75.00 73 00 2
Subdivision: Lot #: Limited energy, non residential 75.00 2
Tax map/parcel #: Each manufactured home or modular dwelling
nigf.ii .:;;, i,7-A: '.01: service and/or feeder 90.90 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
ci: NI {PACititkr& OWNER . :ii;VATt.04t1VANIE7i5 .,4,,:.::,:i 601 amps to 1000 amps 240.60 2
Over 1000 amps or volts 454.65 2
Name: V-400 It--`&
Reconnect only
66.85
2
Address: 4 -,q--k-.1., 14 Ri-aDOE Temporary services or feeders - installation,
alteration, or relocation:
City/State/Zip: 200 amps or less 66.85 1
Phone: Fax 201 amps to 400 amps 100.30 2
,.. .,.,,-, . ,, „, 401 to 600 amps 133.75 2
IC '-‘ :; • '''''''''' ':" 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: Fax: Each additional branch circuit 6.65 2
E-mail: Misc.(Service or feeder not included):
• ,- Each pump or irrigation circle 53.40 2
Z.!,i*:04: , 1-. :i n: ''''''. ': k,: Each sign or outline lighting 53.40 2
Job No: Signal circuit(s) or a limited energy panel,
Business Na c"14 --
-. .1.,t_ A 0 rn---6.13-( alteration, or extension
Description: Page 2 2
Address: c IgdeD( jute 5
City/State/Zip: p- O 2. y Each additional inspection over the allowable in any of the above:
Per inspection per hour (mm. 1 hour) 62.50
Phone: Fax: Investigation fee:
CCB Lic. #: 94, gsc6 Other:
Lic. #: Np-
,
Supervising electrician / $ 76•°
signature required: Plan Review (25% of Permit Fee) $
\0/q------
Print Name: Lic. #: State Surcharge (8% of Permit Fee) $ le - 0 ci
TOTAL PERMIT FEE $ gi • °°
•
Notice: This permit application expires if a permit is not obtained within
y Authorized Date: y ,416,
180 days after it has been accepted as complete.
*Fee methodology set.by Tri-County Building Industry Service Board.
(Please print name)
i:\DstsTermit Forms \E1cPermitApp.doc 01/03
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all systems $75.00
Check Type of Work Involved:
n Audio and Stereo Systems
n Burglar Alarm
n Garage Door Opener
Heating, Ventilation and Air Conditioning System
•
•
n Vacuum Systems
n Other
COMMERCIAL WORK ONLY:
Fee for each system $75.00
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
n Audio and Stereo Systems
F - 7 Boiler Controls
n Clock Systems
n Data Telecommunication Installation
n Fire Alarm Installation
n HVAC
n Instrumentation
El Intercom and Paging Systems
n Landscape Irrigation Control
n Medical
F - 7 Nurse Calls
n Outdoor Landscape Lighting
n Protective Signaling
n Other
Number of Systems
* No licenses are required. Licenses are required for all
other installations
i:\Dsts\Permit Forms\ElcPermitAppPg2.doc 01/03
CITY OF TIGARD 24 -Hour
BUILDING ' Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received // Date Requested a-I AM PM BUP
,,
Location / �-/ 27- Ca / 3 �N Suite ME 7 66 337
Contact Person Ph ( ) 3 07- 71(7 !t 3 - G d 9
Contractor Ph ( ) SWR
BUILDING Tenant/Owner CELC2) 0 0 3 70
Footing ELC
Foundation /
Access: 0 /
Ftg Drain ( Iv _
Crawl Drain ''Z �' ` 3 I
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 P RT FAIL
UMBIN
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
inal
t L PART FAIL
. m
Rough -In
Gas Line
Smoke Dampers
ma
(62.1K*� PART FAIL
i' ' RI jQ
Service
Rough -In
UG/Slab
Cow Voltae
ire Alarm
/4
PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hail, 13125 SW Hall Blvd.
S 111 Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line.
ADA g/z 7/
Approach /Sidewalk Date Inspector Est
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
Ilk - —