Permit y
CITY OF TI GARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
.141 DEVELOPMENT SERVICES PERMIT #: ELR2003 - 00291
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/26/03
SITE ADDRESS: 12170 SW KELLY LN PARCEL: 2S103CC 08700
SUBDIVISION: WHISTLER'S WALK ZONING: R -4.5
BLOCK: LOT: 034 JURISDICTION: TIG
Project Description: All encompassing low voltage.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: X AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: X BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: X CLOCK: MEDICAL:
HVAC: X DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: X FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: ALL ENCOMP : X HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS:
Owner: Contractor:
DON MORISSETTE HOMES INC QUADRANT SYSTEMS
4230 GALEWOOD STE #100 - PO BOX 14833
LAKE OSWEGO, OR 97035 PORTLAND, OR 97293
Phone: 503- 387 -7538 Phone: 234 -5558
Reg #: SUP 1211JLE
LIC 96806
ELE 26- 565CEP
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[TAX] 8% State Tax 9/26/03 $6.00 Elect'I Final
[ELPRMT] ELR Permit 9/26/03 $75.00
Total $81.00
This Pen 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 �.ti Permittee Signature Aim , —.
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
_ -- - _- SIGNAT_URE OF SUPR.ELEC'N DATE:
LICENSE NO: -
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
: J9//2@3 11:25 5032362322 QUADRANT SYSTEMS PAGE 02
Elec Perm , 11 s ' , n
Received c/ �j Electrical r, /
Datc/By: . <J / e ) ' / Permit No,:Et 47c)t,Q3 ---a - ?/
City of Tigard SEP 2 5 Planning Approval Si
��Q i3atc/By, Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 CITY O T Date/By; Permit No.:
Phone: 503- 639 -4171. FaB{J�( m 6ti 16g� Post - Review Land Use
1 ION /'h , 1: ` I � "` Dater . C ase No.:
Internet: www.ci.tigard.or,.us
J 1 1
24 -hour Inspection Request: 503- 639 -4175 - " Contact duns•: S ee Page 2 for
P 9 Name/Method: T 1 C\ Supplemental Information.
_ �i NP Mild t '•8 q : ; , r ,i i' iti Tiis - inn fi ~ rr a :^ ,,,,•
� '' � � i'u�it'ma a �l'•�: sl.�'���'��,'�u�,��1„�'�r ] ,� �; y ,, 1
1►1 New construction IU Demolition ■ Service over 225 amps- • Health -care facility
commercial ❑ Hazardous location
■ Addi.tion/alterationlr .lacement . Other: ID Service over 320 amps - rating of ❑ Building er 10,000 square fc
.; ;'' T'IIt " . ?. :1;- i °:� �a}� m {t,i la G, A1, f.1 6), Sj7, i'jj1 I kO i 9 l : ,r{ :,v , �.. � 1 13 4 Ct,
� e W �,.�.� �..�Mr...��,:,f� �d'r _�; 4, r ' & 2 family dwellings four or more reAidcntlal units in
Ira 1 & 2 -Fazx l dwellin, ❑ Commercial/Industrial ❑ System over 600 volts nominal one structure
A - . ' ' B I . IU Multi- Faini
[a three stories amps B o ver thies 0 F eeders, 400 a e or more
❑ Occupant load over 99 persons ❑ Manufactured structures or 1W park
1 1 Master Builder I Other: ❑ Egressflighting plan ❑ Other:
)iii f MY%Tl"gFAiTIMI".0 lj" M ig,n r f t[14 71 submit sets of plans with any of the above,
Job site address: 'a (�} • . - �(�l (-C1� A- ,.:1,7..7:7,,.T. The above are not a. .ticable to tern construction ruction service.
L.43lyi r.. r :,.. , : .. : ., ,, ? , 1 0 , , 111 ∎ , „ , ., 1i \; �, , c , f, �. , ,„ (I „: „t . , p ..,, , 10, , Aj ! ,, U, d �' l „' S . n, �, 1
Suite #: Bid • • . Number of Inspections per p r t ' its allowed
_
Pro ect Name: r, =.... •, ..0 .2 -J a,p /j 4-- Description Qty Fee (en.) Total i
Cross street/Directions to job site: New rerldentlal- stogie or multi-family per
dwelling unit. Includes attached garage.
Service included:
1000 sq, it or less 145.15 4
Each additional 500 sq. it or portion thereof 33,40 t
Subdivision: 1 -■• sf Fps I Lot #: S 4 Limited enera resid ential
Limited y, non residential _ 75.00 2
Tax ma. /. arcel #: Each manufactured home or
c��� _ modular dwelling
U3 .'y.l� ?I� IVIe' r�i'I iii iii l .:c3I CS W:14�; f1,'iw1lU71 jj'�M;ij K ;i;;, -'. 71 service and/or feeder 90.90 2
Services or feeders - Installation,
I ' Yin I . - i . t,1, "-1"4 L -. . ii,, alteration or relocation:
L „� ,� a -
• 200 amps or less 80.30 _ 2
201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
k r i: i . I r f� 6�"+I'r,'ti N . fi 1I 1 7. .{ 601 amps t o 1000 amps 240.60 2
Over 1000 amps or vol 454.65
. p„ ,,.;,�.. N :.. �.'�.�; !.,,, 1 �, ..i �,)'Ss. S,. r • C 1 tl , � � I:, ?1, i l i .s J7s - volts „Ir Name 1= .i rT \ or1 £ i I ..,� aocannect only 2
66,85 2
Address: Temporary services or feeders - installat
alteration, or relocation:
b 200 amps or -less 66.85 1
Phone: 1-' t , a ,4 &t- O 9 1 201 am PS to 400 amps 100.30 2
_I ..:,;�li "�G " -.-- �� 1 ''`jr i r� ns: y , T., I1' i r' 6;�'1,: �3�C ,�,11�' %', . ••v [ i1 .. y, ;.,�, 401 to 600 amps 133.75 2
V. ,. fl. w, l.; F. d. d,. i.i':W,.wr1�11�11��L1A�,f.iSl•� Il . jr.5.,,.5 ,. a�,.-i,�t'� • „F.∎ { ,.F.,. �.Zi. - it s "YI
Branch circuits - new alt or
extension per panel:
_ A. Fcc for branch circuits with purchase of
service or feeder fee, each branch circuit 6.65 2
E. Fee for branch circuits without purchase of
service or feeder fee, fast branch circuit _ 46.85 2
Phone: Each additional branch circuit 6.65 __ ___
E -mail: Misc.(Service or feeder not included):
; i ^ Dig : ": ;1 pump S ion circle 3 ,40 2
y�, ;l;.,l�i�y i 1� t 1,,, 1 , { r ,; •:,rTrs,� '�'' ?�,tfih''aii•'Iri Plt'r�ali�,j. `' -,,r, F,� ,T,- .�; Each ran or irri t
a: 5.
Ri. ,... .d�.tiiii I�1 ,, 6t.. �a7fn., .. . , ,'d, m ., .,,. , .1.,.. .�...,,.,. ,.I,,., .:.1..,,:::' � I
Each sign or outline liglstin8 53.40 2
Job No: Signal circuit(s) or a limited energy panel,
,Q �• I 9 al teration, or extension
Business Name: CJ..�a_ _ J V{/i Page 2 2
Address: `teo Step (li a 3 Description:
Cit /State/ZI.: ` c -i t Z Each additional Inspection over the allowable in any of the above:
°-e' o C C 9 - Per inspection per hour (min. 1 hour) 62.50
Phone: ag' { - .$ Fax: .D.-?C - a :1_1_ Investigation fee:
CCB Lie. #: 6cP0 Lic. #: I -z I I Other V-7777,- ,. — --
Supervisingelcetricl• . —. ,_�i ' : .. ........ .. ....e:.u,1 rf• tl! .iF � r ) :., 'ci._LjP92,c1 :,;
f/'� Subto _ S __
sx_ ature re • uired: t. Plan Review 25% of Permit Fee $
Print Name: INZIERZINKIII. State Surcharge (8% of Permit Fee) $ U ,o n
Authorized ' - - - - TOTAX.- 1PERMIT_F>GJG $I
C ! j Notice: This permit application expires If a permit Is not obtained within
Signature: Date: / 1 380 days after It has been accepted as complete.
. 6 6 i a > :2. a,,,
'Fee methodology set by Tri- County Building Industry Service Board.
(Please print name)
i; \Dsts\Pennit Forms \ElcPcrmitApp.doc 01/03