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Permit CITY TI GA RD ELECTRICAL RESTRICTED ENERGY PERMIT i DEVELOPMENT SERVICES PERMIT #: ELR2005 a;i� DATE ISSUED: ELR2 005 "" 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S 109DA -03300 SITE ADDRESS: 15371 SW GREENFIELD DR ZONING: R -7 SUBDIVISION: SUMMIT RIDGE LOT: 010 JURISDICTION: TIG Project Description: Security, audio. A. RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: X 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 COMMUNITIES LLC QUADRANT SECURITY INC 4230 GALEWOOD ST #100 PO BOX 14833 LAKE OSWEGO, OR 97035 PORTLAND, OR 97293 Phone: 503- 387 -7538 Phone: 503- 234 -5558 Reg #: SUP 1 211 JLE LIC 96806 FEES ELE 26- 565CLE Description Date Amount REQUIRED ITEMS AND REPORTS [ELPRMT] ELR Permit 9/16/2005 $75.00 [TAX] 8% State Surcha 9/16/2005 $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 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699. Issued By: Ap_A�Ai6 Permittee Signature: Nrc 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 503 - 639 -4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. • of Ti and' CCIfIj g s �� ��� x Ci b �' /r� �S FetlrttltNnuiL1 t Sd � :+ 1.3125 Ball Blvd., Tigard, OR ) 7 �`' Plus Review ® 41t. eta � �.`Stf I I Other Penult: Phone: 503.639.4171 Fax: 503.598.1960 tnspootionLinn; 503,639,4175 � � 200 ; , t # � a �J 1 B y: 0 Internet: www et tige or us Date R° �Y /By Julia: QJ See Y x for t• , et o { Nenfled/Method .) j Su leatant a,'fo- w°��`,t' , 4` s,+ c�' ���,'✓x'cic'�r15�� re��rs�'i�i� r'r,.T�G��r W"S� #. 1i' ub y s � r a r~,. AB M Informati a s1dr�y���`t'r�'1 +j,Y, dary1 i� + ry Y 't:1f 1 xy Fit sra vrr „ w )'7 1� , eemont Please check all that apply; S �J� +'.?� �+ .� Jr a,.fL�a:i.. ftut ,SIP . S dr�l3�� �� ,711 i ?:.' l t 17.4 '� ir• 1 PTV; ew construction Q ti`u�• .. ,:,,, , 31r t � .' x,�• t , ,w;, "� • � . a L Q Demolition 0 Other ['Service over 225 amps, oom[n 1 Dar" '" 2 p - ❑Hazardous location = + r Fit;,..:-/ ' `3x�3�, k, {te a r+r,ut , Q Service over 320 amps — rating QBuildng over 10,000 sq. I ,, 7 � stir r r ''' '" r r .. ,, 1 P of t- and 2 -famil dwellings and 2- family dwelling ❑ Commercial/industrial y 4 or more new residential ❑ Accessory building 0 S ystem over 600 volts nominal units in one structure 0 Multi family ❑ Maater builder ❑Other: � yrz ?a3Y�f" . , QBuilding over three atoriet: ❑Feeders 400 am �*+, a�i G ,'r5�a�. Nfv',. �� , + t ti cr s' r t r � z � � r � amps or trot `i ,, r't�a E y IT t u , t i }' , , ['Occupant t over 99 orsans ©lulanufacturad structures c 2 p 53 7 ak, ?i . s< Job no : QE c� 5 Job site address: / greas/ ghtin plan RV park f • � � � / 6.- !]Hcrklth -car¢ facility (Other: City /Stake/ZIP: �� Submit 2 seta of plans with any of the above. 111 The above are not applicable to temporary construction service. Suite/bldg. /apt, no.: Project ;name: / Qjr� � `/ /, r t { J ' r w " �;1` 1 l f wit' .,� ` [Vr -,.. CZ , - !' ( �� . ra pe a....raid, d ' l l, n i xw t ui ,Lc =l: , .'�' mp t �a'` *li'•, ;;. Cross street/directions to job site: I Dnc an Q a• Boa New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: ` 1,000 sq. ft, or loss 145.15 MN �� / Lot no.: . Ea. add 1 500 sq. ft. or r .pion r 33.40 Tax map/parcel no.: . .° ` 75 energy, rani , ° " "4'•ey�' s�rr7 , � e v w united gY, dOnkial 't , t�K "ri,, � 1 ���iti' �+ �"' ;'F a r . Iva �`j 4" • p i ';rr' ilo.�t 39 'X" n Limited ener , non- IN 75.00 p (�) f L f : „vz �} Each man ufactured or modular III 90.90 `-�`' v r ( s- , ' dwellin_ service and/or feeder Services or feeders installation, alteration, and/or relocation J � yy t " '', �G"°. tiM�lw, t- j, .�•[p�` +g�i�,R'niAa >st^ntl an F y 200 amps or less 80.30 �r �. +•', . i.,.i k ,;•1 . ati L.Q.4• ;„yd ? i r g 1. 201 amps; [0 400 um , s 106.85 r Name: 601 amps to 1,000 amps 401 am. to 600 amps Name: Address: — 160.60 EMI 240.60 Over 1,000 amps or volts NI 454.65 MN City /State /ZIP: Temporary Reconnect only _ 66.85 Phone: ( ) Fax: ( ) reloCtttio services or feeders installation alteration, and/or Owner installation: This installation is being made on property that I own which is not 200 amps or 10 201 amps to 400 0 amps 100.,30 30 66 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701, re Owner sl aa>e 4 Date: 01 amps to 600 am • .1.11=11 f� I sat „ y � j� t r �, y 7� �tt Branch cirenits— new, alteration or ext y# ` t} 3AC:u,'' . 11 Lib 4 , . ` 4j y trr� ��t r • ' '„ ; A Fee for branch circuits with onaian, , er panel Business name: service or feeder foe, each Contact name: branch circuit 6.65 H. Foe for branch circuits Address; without service or feeder fee, each brrnch circuit 46.85 City/State/ZIP: .. ��� Miscellaneoy (service or feeder not included) Phone: ( ) Fax: : ( Pump o irrigation _ E-mail: ) Sign or outline lighting 53.40 p 1,8UOII CjI�IC 53.40 'r sq r f #x t �la i t.r• "hail w'r Gy:A + o H3p , ;?r u , ; t; r ekr,�v �gzY�'� IMl�t� v Ott n Signal Paco', el or limited- ' .Y- .t .rl. +tirYl �1+ " �`C #ri5�is�i,�r enCrg]fpan01,a1tCrarinq.Or Business name: .m.,-- ). +, 1 , , 1 ` . extension Describe: > i Y' � . a Page 2 Address: 1 -- ) l �' �. ^� Each additional Ins • ection over allowable in any of the above City/State./ZIP: s Per inspection Phone; (> • ; _Aria 1, ! C c1 -y Investigation per hour (1 hr min) MI MI 62.50 `` ' , .13 • r< Fax: eiz ) , - :DI a ,- industrial plantper hour , Suprv. Electrician signature. required: , Subtotal Print name: " Plan review (25% of permit fee) Date: r � State surcharge (8% ofpennit fee) • r ` t)♦ Authorized signature: i / TOTAL PERMIT PEE �� T Print name: t � J 1 This permitvvottuttion expires if a permit L not ubtaiu d wt� n1kl0 • 1 1 . Date; dim ether It bald been accepted as complete �� Fee tt>atho �oSY 6ok bY'td-County Building Industry Service Board " Number of rsuections net Durst( allowed. 06/27/2005 07;55 FAX 5035981960 . CI'fl' OF TIGARD C j 001 /001 AI Building Division _ .� Applicant Request for )?elrwit Action p City of Tigard , c EC E W E f TO: CITY OF TIGARD, BUILDING OFFICIAL OCT 6 2005 13125 SW Hall B1vd., Tigard, OR 97223 CITY OF TIGARD Phone: 503.639.4171 Fax: 503.598.1960 BUILDING DIVISION FROM: Applicant Tame: 11110 _* ig !CIA , A -` "_ il3 Mailing Address: N C 7- , ` EA'�✓/✓&--- City /State /Zip all 0./ A/ ) i V 0 1 0 Phone No.: ` t3' 7553 Fax No.. a3t _ . PLEASE TAKE ACTION CHECKED (✓) FOR THE ]FOLLOWING PERMIT: . CANCEL PERMIT APPLICATION, REFUND PERMIT FEES. . Permit No,: F' a Type of Permit: 101,,u_ \.ThFicA9,e_etec-t-hccli Site Address: 1 F57) 7 1 C,r4P.nfi P (ct. Dv . subdivision: , .mg Z. : ` Lot No.: C EXPLANATION: 1 e . (ail"a ci d �1c Jd ) ^— • • Signature: ,.., J %� 1)5 - - 1 _ Date: Print Name: Q`,r_ _ 1 r? c FOR OFFICE USE ONLY 7 . . Route to Admin.: Date: .t p ,QJ,l , ETIWEIMMIM Permit Canceled: Date: / • .7 o $ — Refand Prooe Date: 3/o5 ,,: i Cashie Re ce t: - _Date: 7/, ,_ #: - �c0 - n?,. . Arent: $ ti o-v pa meet T e: Ce,. �.� Perr : , 6 is \BuildinelPorniaLenPermitAzrion 09- 27- 04.43c