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Permit ' r ELECTRICAL PERMIT - CITY OF TIGARD RESTRICTED ENERGY ENERGY it DEVELOPMENT / Tigard, SERVICES � 639 -4171 DATE ISSUED: 003 -00043 ED: 2� R20 SITE ADDRESS: 13658 SW LEAH TERR PARCEL: 2S109BA -08000 SUBDIVISION: DAFFODIL HILL ZONING: R - BLOCK: LOT: 006 ` JURISDICTION: TIG Proiect Description: ALt-- t�CUrr��E'j S ( (J G (� iJ V (�i /�� r A. RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: 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: ALL ENCOMP : X HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL # OF SYSTEMS: Owner: Contractor: GEORGE MARSHALL QUADRANT SYSTEMS PO BOX 91249 PO BOX 14833 PORTLAND, OR 97291 PORTLAND, OR 97293 Phone: 503- 768 -4573 Phone: 234 -5558 Reg #: MET 00002466 SUP 1211JLE LIC 96806 FEES ELE I4604Rnspections Description Date Amount Low Voltage Inspection [ELPRMT] ELR Permit 2/11/03 $75.00 Elect'I Final [TAX] 8% State Tax 2/11/03 $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 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699. '1 H Issued by ,/ am / / , . // j Permittee Signature (D'1 CC-14) LL( 1 497 r' 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- SUP-R.-- ELEC'N DATE: LICENSE NO: Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day tlk 2 -10 -2003 12 :34PM FROM QUADRANT SYSTEMS 583 236 2322 P.2 - 4 . ,. . • .. 1 Electrical Permit Application Date received:o� -/) o3 , P n o. 3 - G I d ' .4 f " City of Tigard • ,�/ED Project/appl.no.: Expire date: Ciryof Address: 13125 SW Hall BIvi, . `g , �. Olt 97223 : Date 13y: j Receipt no,: Phone: (503) 639 -4171 Fax: (503) 5981960 FEB 10 2003 Case file no.: Payment type: ' i - 7 Land use approval: • niTy OF TIGARD . D ISION TYPE OF PERMIT • '41 I & 2 family dwelling or accessory 0 Commercial/industrial O Multi-family , D Tenant improvement i -- 0 New constrtiction • 0 Addition/alteration/replacement 0 Other: ❑ Partial I • JOB SITE INFORMATION . Job address: F 3 ( cf ' S4) UAh! F(cp C1 - 1 cc-tk Bldg. no.: Suite no,: Tax map/tax lot/account no.: 1 Lot: e.? . ] Block: Subdivision: A , dr.: L Li ,11 Project nain • • s C . . Description and location of work on premises: t ., - , �i, j, : " • , ' --4.2,, , ' _ ,,, Estimated date of completion /inspection: . ss _, _. _ , _. _ _ ta•..w - •. . �A' ` ! CONTRACTOR APPLICATION i FEE SCHEDULE Job ho: M ;ax D:scai•tion H Business name: %.„.14 „..."ii _ . New residential - single or multi-fluidly per Address: To ( d . Includes attached garage. 11 City: , -y-Q .. ) State: r Z P: ()'4,• Z i 3 Serviceincluded: Phone: U - - Fax :,n( -,,y;), 'c . E -mail: 100o s •. ft. or less • 4 .� Elec. bus. lie, no ' Each additional 500 sq. ft. or portion thereof _�� CCB n0.: �[ I y � 1. SG rl lie. h dkc c� Limited energy, residential 111111111 I' City /metro . � Limited energy, non- residential Z sr " Each manufactured home or modular dwelling Si : • tune of supervising electrician ( -• itited Date Service and/or feeder ■� 2. s Liornseno(Z ( ♦s Services or feeders— installation, • PROPERTY OWNER alteration 0mpsorless relocation: ��� 200 amps or less 2' Name (print): • . 201 to 400 amps ___ 2 Mailing address: 401 amps to 600 amps ' Mme_ 2 601 amps to 1000arn.s _IIIIII♦ - 2 City: I State: I ZIP: Over WOO amps or volts . Phone: E-mail: toconnectonlZ • ■EM 1 Fax:. mail: • ' Owner installation: The installation is being made on property I own Temporary services or feeders- ;„; :::: which is not intended for sale, lease, rent, or exchange according to �M � i °o,orrelocation: i 200'amps or less 1111111 ) 2 ' OILS 447, 455, 479, 670, 701. 201 amps to 400 amps ___ <�� Owner's signature: Date:' • 401 to 600 am. s • 1.111111.1 _ it v ENG INELIt Branch circuits - new, alteration, I or extension per panel:: Name: A. Fee for branch circuits with purchase of I : I II Address: : service or feeder fee, each branch circuit •'' I City: State: ZIP: B. Fee for branch circuits without purchase ', of service or feeder fee, first branch circuit: ��. Phone: Fax. E • Bach additional branch circuit: ___ PLAN REVIEW (Please check all that apply) 1Klac . (Service or feeder not included): 111111 II 0Service over 225amps-commercial ' 'CIHealth-care facility' • Each •u .orirri !anon circle • •• 91 O Service over 320 amps.tadng of 1&2 . U Hazardous location • Each sign or outline lighting ___ 1' family dwellings 0 Building over 10,000 square feet four or • Signal circuit(s) or a limited energy panel, . 0 System over 600 'volts nominal more residential units in one structure alteration, or extension* ��� . ■ � C3 Building over three stories O Feeders, 400 amps or more *Ocean • tion• F 0 Occupant toad over 99 persons . • . is Manufactured structures or RV park Each additional inspection over the allowable in any of the above: ❑ Egress/lightingplan O Other. Per inspection 1♦_ _ ?- Submit sets of plans with any of the above. . Investigation fee 'I The above are not applicable to temporary construction service. Other I ' all,imtisdictions accept credit cards, please can jurisd for more information. • Notice: This permit application Pe fee $ �v_ — © Visa O Maste Card expires if a permit is not obtained Plan _review_ (at %)_$ Credit' Card numb= / within 180 days after it has been ---6-0-4 State surcharge (8%) .... $ I Expires accepted as complete. TO)I'Al ... $ Pi .(1 .__f N of cardholder as shown oa credit card . I I $ II Cardholder signature Amount , 440 (6,u(I/COtt) ■ li •