Permit CITY TI GARD ELECTRICAL RESTRICTED ENERGY PERMIT
.' i� DEVELOPMENT SERVICES PERMIT #: ELR2005 -00407
�' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 11/14/2005
PARCEL: 2S 109DB -03400
SITE ADDRESS: 13086 SW HAZELCREST WAY ZONING: R -7
SUBDIVISION: SUMMIT RIDGE LOT: 072 JURISDICTION: TIG
Project Description: Security, data, audio. Job #3563.
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: DATA : X 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 #: LIC 96806
ELE 26- 565CLE
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[TAX] 8% State Surcha 11/14/200E. $6.00
[ELPRMT] ELR Permit 111141200E $75.00
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: / Permittee Signature: sue. CAVQ
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.
•
1 , --e-s r� \'t(44-
Electrical l'erm't,, t ^. 1•oic Oi,
. • • City of Tigard ; -i 4�, Received _ - , :
13;,25 SW Hall .Blvd., Tigard, OR 97223 Plan ; (� ) Permit No.: t.��a
1. ' Phone: 503.639.41 71 Tax: 503.5S�,t p o 1 q 2 G'.. , : „j } Patcn Review
IVI V �§ 1 t)aB : Other Permit:
Inspection Line: 503.639,4175 I _� time Rcady/t;
lntemet: www,ci_tigard -onus Notified/Met o' Soo Pap 2 for
--s J r : hod:
Sit .. lomen
� .t.:;yi:.r ,wti ,s ; ;,� tellnformatiou
';r; .,:. .iF; t�:;; ��v��i� : : :,.."�"lf.;�ri+�;:e;s :--r. }?�a;�,. .. }l, ,r�a..� .,n•' > : :;f :r - :, "'sr., f "" ,a•�y� ,,, -
, u, . : t t , i . .E :: ; i !� t `a a x 9. !, s' 'T . Ij�' n" i '�5 . b, e , ,N: Al �
. ,_, . _ � _ : . ° �'p� N�1sb. :: ., .s>C. �w .. , -:r, al.�- +na�i�n r�a`p•h� � i ' c i' T,1� 'r f�a,. Tx4 Ree�t; •r;''t, r
a <, ,A., ds' kr?� . i.d 3i�i 7 � :.y��'�a.•,��:`I �1�t'k,1� \Y�Y � < y '
New construction : 1 • I II' ; ; ypNslierAtioiiiiep abemcnt Please check MI that apply:
12 Service over 225 amps, comm I ❑ 13a2ardous location
CI Demolition Q Offer
,,, ,: rs : . ,;..�: f .� 1= ❑Service over 320 am pa
21j : .� :�.a ,�y�y � t' N :,.., :,,.. :,,. :�. p -call ❑.6ulldn over sq.
:!ti ' -1*r o ",'oogi " ••., ICfJk, �l70, 1_,`:: H F, r:; z,. : :. :,.,.. :; rig 6 r 1 resid 4 l
. • � � • �r, +i ,� of 1 -and 2- family dwellings 4 or more flew residential
►. 1- and 2- family dwelling ❑ Commercial/industrial Q Accessory building ❑Systern over 600 volts nominal units in one structure
❑ Multi -fain ❑ Master builder 11 Other: ❑Building over three stories ❑ Feeders, 400 amps or more
y� t�i,i. S•�• LSD' "?' 3 nri' � .t: c.•,.. ❑Occu lnit 99 persona ❑Manufacht
J"r, .. ''it v.?`✓i " � i" ,t' F . �.I " • a ' �1 ; a- ii r., p load over icd structures or
:� . ,. ,• :,r ,... ,. . �V; °���,� : „ : : : : :<. � >,��3;,;£`�n;li'i :' ❑Fgress/lighdng &n RV park
Job no.: 3 '2 Job site address: 13cgt0 SW j zetcreel-- Y ❑health -care facility ❑Other:
City /State /21P: q Submit / sets ofplans with any of the above.
J aa DR, c 7Z The above arc not applicable to temporary construction service.
Suite/bId Japt_ no.: Project name: O Se : ":a' Pl `,j; c s`s. iN� �y
g '. * y,? tom,, .rj ,'dL '�ni .,' lip '• :f s'.�: ..
D...rlptbn Qty, Fat. i Total I "•
Cross street/directions to job Site: New residential single- or multi - family dwelling unit.
— Includes attached garage.
1,000 sq. ft, or less 145,15 4
Subdivision;. 1 Lot no.: -7 Z
I La. add'! 800 sq. fl. or portion 33.40 I
Tax ,nap /parcel no:: Limited energy, residential 75.00 2
, ? :"c?;k» + :: n ar'c _ Limited energy, non-residential
.lr a- r:01":..,, c *s y . "''y, -, ' Q, ..`i ” a:a`�Ckicv(','i?:':c1�1's ;W n <t � • `a � modur 75,00 2
�'•• °._ � :•' y._ -si" "�.�_'� :�' ? Each manufactured or modular
10�'IP�G 1.' — - i , dwcllhn vicc and/or feeder 90,90 2
Services or feeders installation, alteration, and/or relocation
200 amps or less '80,30 2
„c o :::::', $, ti * . ` " �y'� 't rs'�' •::n:• <;, ..' eti'. :..� ,>as.•° �'•, 20I am
;r. ,,., ... ;,? >,. �?�?�•1✓�a,^�;' �t� 2v' :w�d •t pfi�� 1��, :.; �;: ��;. �s to 400 amps 106.85 2
Name: p ";; 1 "` 401 amps W 600 amps 160.60
2
601 amps to 1,000 amps 240,60 2
Address: Over 2,000 amps or volts 454.65 2
City/State /2IP: Reconnect only 66.85 2
Temporary services or feeders installation, alteration, and/or
Phone: ( ) Fax: ( ) relocation
or Owner installation: This installation is being made on roe 201 that I own which is not 201 amps to 400 amps to 400 00 1
intended for sate, lease, rent, or exchange, a to ORS according 47, 449, 670, and 701. amps 100,30 circuit 2
401 Owner signature; amps to 600 amps 133.75 _ ranc 2
sO
Owner sig ' atur kv rrg'• :,e Date: hll circuits alteration, or extension, per panel
. . ., wiiKoPl±'Lit py' it ,4 �`(�$ (, so Ai:: . H
. _ , ��i�, . �� { a'�:;a;�� +,,`� 3.?�., : � left : 403 . 070:00.0,30 74 , A.Pce for branch cireuitB wlrh
Business name: service or feeder fee, each
-- _ branch circuit 6.65 2
Contact name: B. Fee fa branch circuits
without service or feeder fee,
Address:
each branch circuit 46.85 2
Each add'l branch circuit 6.65 2
City/State/ZIP: Miscellaneous (service or reeder not Included)
Phone: ( ) 1 Fax :: ( ) Pump ar irrigation circle 53.40 2
E -mail; 1 Sign or outline lighting 53.40 2
:'+ Vi , p ,(1 3 +,c:- = r' >j- ;: ;, i y4 � p yi . Signal eireuit(s) or limited-
.. .. :F'.C.'4'• :+:'.1 \'8 i.M .1.��: j.� :1.1!r'+'•I,' ', Vi,:R.V" . 7 ,i4{?�� 'Y CC'n� 1J :0':11i)�G ,! i : 7R.r. :.ti.�: " N ':' `4 >A.. energy Pane
.: /�,:
,'.;.. ` ) :'. 4`�.. : :.1;,,.,, ; f.;,a,...3r..'Ki,�:f.i ^. i : •, .'S�'f °t',panel, alecratton. Di
extension. Describe:
Business name: / q � Ni 2
1� � rt L ... /....� I Page 2 Vii
Address: ) , L • c/' :7? ( 4 Each additional inspection over allowable in any of the above
City/5tatcJZIP: _ ' - '' , / Per inspection 62.50
Investigation per hour (I hr min) 62.50
Phone: ( a ' '3 ) ` tl ._ 555 e Fax: l industrial plant per hour 73.75 -
CCB Lic.. C (J 5U -1". ) v 'l �� c tzt;t „5 ”} f� iEsf :.r'.,0 11 61ett ,, ; _
. . 1 Electrical Lic. ;c1� CL Suprv. Lic. :r �j A ,.- tN 1' .* L. i _ , ..
Subtotal 5,01
Suprv. Electrician signature, required: �� -
Plan review (25% of permit fee)
Print name: 'i '.. •-7 j c , ,! Date: ii Stat su (8 /e ofpermit fee)
V � /
Authorized s naitirc TOTAL PERMIT FEE D I , mD
I� G 4.2, -r,',4 I This permit application expires if a permit is not obtained within 180
Print name: .KGt. 'k s Date: 1 / days after it has boon accepted as complete
IS , / • Fee methodology set by Td- County Building Industry Service Board
i AllundinglPermiutELC- Pmnttgpp,d • • 12/al " " s per permit si
[ea ct Number of ins ion, t
440 15T(I wortom Hb �' pen, , 11...
CITY OF TIGARD , oQ (�
BUILDING DIVISION PERMIT #: ,Oe 1
I 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 4 N “�Iln��i
Insp Requests (24 Hrs.): (503) 639 -4175 A
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
Li
SITE ADDR -. 1 Z C../'e S 1 CLASS OF WORK:
SUBDIVISION: LOT #: � TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: j - `3 —i( Pour Time:
Code # Inspection Description Confirm # Contact # Message
i” gee- . kg , 76 62-4 `(7
r N
Corrections/Comments/Instructions:
c(
PASS r, Ps RTIAL APPROVAL CANCEL ❑ NO ACCESS
J
FA 4 A CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
t� Z.��
Insp -ctor: Dat . ` hone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION co A PERMIT #: ELR2005.00407
13125 SW Hall Blvd., Tigard, OR 97223
DATE ISSUED: 11/14/2005
Phone: (503) 639-4171 1\
444401
Inspection Requests (24 Hrs.): (503) 639-4175
....,...._. - - .. .
INSPECTION WORKSHEET FOR DATE: 12/2012005 TIME: 7:30AM PAGE: 35
SITE ADDRESS: 13086 SW HAZELCREST WAY CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 072 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE
DESCRIPTION: Security, data, audio. Job #3563.
OWNER: DON MORISSE l I E COMMUNITIES, LLC, PHONE #: 503-387-7538
CONTRACTOR: QUADRANT SECURITY INC PHONE #: 503-234-5558
Inspection Request Scheduled For: Date: 12/20/2005 Pour Time:
I
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 023759-01 503.519-6452 N
Corrections/Comments/Instructions: .%
, PASS fl PARTIAL APPROVAL 0 CANCEL NO ACCESS
fl AIL r c A LL FOR NSPEC,' ON 0 ADDITIONAL FEES ASSESSED
2,6 (6 ------
Inspector / ..' Date: ) . Phone #: (503) 718-7*
. .