Permit CITY TIGARD r ELECTRICAL RESTRICTED ENERGY PERMIT
1111 ` • '.. COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00143
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/16/2007
PARCEL: 2S103CB - 09200
SITE ADDRESS: 12404 SW QUAIL CREEK LN ZONING: R -4.5
SUBDIVISION: QUAIL HOLLOW - EAST LOT: 050 JURISDICTION: TIG
PROJECT: HOWELL
Project Description: Wiring for sound.
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: 1
Owner: Contractor:
BENJAMIN HOWELL OWNER
12404 SW QUAIL CREEK LN
TIGARD, OR 97223 •
Phone: 503 -221 -8600 Contact #:
FEES Reg #:
Description Date Amount
[ELPRMT] ELR Permit 5/16/2007 $75.00
[TAX] 8% State Surcha 5/16/2007 $6.00 REQUIRED ITEMS AND REPORTS
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 or 1.800.332.2344.
Issued By: 4ti.6.i 2/0 Permittee Signature: S,e /sp, re al ely
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.
MAY -15 -2007 15:43 MORGAN STANLEY PDX P.03
City of Tigard ,� vi,, / 1 1 Rived Pcrt n it Nv.: ° 13125 SW Hall Blvd., Ti ,. Datemy: 5 / 15 / t 1 5 - S Eu2 2L�'� - com 3 y g g ;,9 1, , rte t ' Plan Review
9 a Phone: 503.639.4171 F : 5 Ls ,o D other Permit: �+� � gob(o°I
Alt Inspection line: 503.639.41 5 Date /B : " "'` �lJ�"
® D RAY Y •�� � H See Page E for
Internet: www.tigard- or.gov Ci 2001 Notified/Method: 11
1 A Supplemental Information
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❑ New construction ❑ Additio ,h�uh:,� :., I .1a i:lit.�.l�hla lhin�lli i,l. :,l::t�: WiL•:tt.11P: ar;Ili.�L. .l4''. � 1. 11'�1i1:,'LL�:tT: = :.fL'N
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Please check all that apply (submit 2 sets of plans w/items checked below):
� 0,1.01% ❑ Servix or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition Other. Re, .'
�.,I, � , Ih' , � I!, . ;! � :� ; g:,, lr':!; y
arl. nly�. a r II r � ac r +, where the available fault current ❑Marinas and boatyards.
t � 1 �9 ( 411 ��11 }� F U11I I 1 I I l�lnl�hr r ,I �,� i t 1 `IIy' ll � + ) I n :
I ILIt li: Iii - Ida it :,. ;11. .,11,_r : , ,.I:.lalladt,.11,.n , b t.l,, er„rel;t a;+.11 A. i i.utrili_;I; 14 ,Li_� I
Ile lill".a`.1∎.1i;f:'il „ b4. 1 exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
® 1 - and 2 - family dwelling ❑ Commercial/industrial less to ground, other installations. exceeds 14,000 ❑ commercial -use agricultcral
❑ Accessory building amps for all other installations. buildings.
❑ Multi family ❑ Master builder ❑ Other: ❑ Fire Pump. ❑ Installation of 75 K VA or
ilk 1. I " i', ^ ;! ' ' ill 111 J ir`
u I !iq: I \,1. L 'ya!,' .I .:iii2 r : a 1s� e ngi R : i `: ' Eme system. lar er separately .
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t . . it L i I :I �,- i., is i :1lq im.: r r,li, w"x rf�.11. it: i the s:13. or v i f Li l e i tiyrk�?fk 1.41 i'I i I. :91ri ?I I �� ❑ Addition of new m load of ❑ "A y derived system
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Job no.: Job site address: 12404 SW Quail Creek Lane ,100HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State/ZIP: Tigard, OR 97223 ❑ Health -care facilities: ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: J Project name: Howell 0 Service or feeder 600 amps or more.
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ffi nes
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Cross street/directions to job site: 121 I I� LI wee I ''
cr{ptlorr QtV. Fee. Total
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Quail Hollow J Lot no.: 1,000 sq. ft. or less 145.15 4
Tax map /parcel no.: m Ea. add'l 500 sq. ft. or portion 33.40 1
I ' , r 1 ,I-m: 11i !n:`I Pti'f'f n 1 1d ' �r �tl_: n•n••w ; 1 n °H`" +1 r " ; ,I . I °^ Limited energy, residential
+: f:: J v , C: t 1 1, I �I Z I�l with above .ft.
IH i,' - f ' 1tu` l c, : � tl� � 1 of r ' + i l t r .i1u'", , it ':i ' 1 . I i (with )
�1ai;li�� il:• •; 111 l,�i;;l�:� i iGd,'�7?L�' :1,1::Idn:ut :w Il u�ueb!:� ks:Ir.u:.:u lafh.h`:�i -. il; lie. list .flil��li;JLiLNiI�lillni; 75.00 2 lll
Wiring for sound Limited energy, multi- family 7500 2
residential (with above sq. ft.)
Services or feeders installation alteration, and/or relocation
l i: inl!.�":; iIrL' •` : ya l• . i . aae _ _j I a!:' Fl:IL ' l. a1 I , Ip, : I ., , ii r :r, : ; � j i1 " . t c nL'. c : 13f d9 ' n r r :
200 amps or less 80.30 2
n P i : � , , � }` r:�. - ii r i''i l1i tl � 11�. 1�ji:�.N3i , ' A, ( ca 5 5 � , �� • II:;II:t r 11 , , : i. .;l h•11 .� ' i j3 , P l�1;� 11i'Ir4 �hh° 1 lip i 1
i- +> .. dli.. ;,, t -ll;>: t,: nil t11 t1. �I1i:ai, :, a I'" :.� ',i•I.4:t1L', ,, ,1.:�:f ' i' I I .,,i:Ilhau;:11ral,••h i I'l ll,.,H �4 ,,a: 201 amps to 400 amps 106.85 2
Name: Benjamin Howell 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: 12404 SW Quail Creek Lane Over 1,000 amps or volts 454.65 2
City /State/ZIP: Tigard, OR 97223 Temporary services or feeders installation, alteration, and/or
relocation
Phone: (971)227 -0850 I Fax: (503)221 -8600 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
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A. Fee for branch circuits with
'' I ;, ; 9i..4' •,;'� 4 . �ue, r)� : a l: r il i Pl l : ,I , iii 1 •�_ In i l I N I
ail' :. 1- P III .lI ::� N:.∎ ins �� L k� �� AG (, fir. , d,, ry I r'tl I i.Nl i :11 , L. ,1 i :q 6.65 2 �l above service or feeder fee
I n.: N•„w tU;m: cx,.lalt U +...r� i. I n ih I' d.,,. wJU•ilrdtl: p..�1. ,' .• � . U I, I �Ih. ; I �'
nl;.t 5,dvn,.n.,h.n Ile I.a -.n
each branch circuit
Business name: Owner B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
rust branch circuit
Address: Each add'! branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City /State/Z1P: Each manufactured or modular
90.90 2
dwelling, service and/or feeder
Phone: ( ) I Fax: : ( ) Reconnect only 66.85 2
E -mail:
Pump or irrigation circle 53.40 2
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= � .1 1 :, . ,;jlf ,�! it F�; aII:1 ilE T I,l 9 I r.�i ! q ,r :; lifr 1ti I iiiii' t 1 illii111:Il r, 7ft.h�1j L. ,t14I 1fI;: t Sign or outline lighting 53.40 2
Business name: Owner Signal circuit(s) or limited -
energy panel, alteration, or
Address: extension. Describe: 1 Page 2 75 2
City /State/ZIP: Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) I Fax: ( ) Investigation per hour (I hr min) 62.50
CCB Lic.: I Electrical Lic.: J Suprv. Lic.: Industrial plant per hour 73.75 i l
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Suprv. Electrician signature, required: Subtotal: . OD
Print name: (L�r,, J Date: Plan review (25% of permit fee):
C State surcharge (8% of permit fee): ID • 00
Authorized signature: TOTAL PERMIT FEE: $Z, 1 ,
This permit application expires if a permit is not obtained within 180
Print name: Dale: lxr� PP P
days after it has been accepted as complete.
• Number of inspections allowed per permit.
I:U3ulding\Permiu1ELC- PermitApp doc 05/23/06 440.4615r(l1/05/t:OM/WEB
CITY OF TIGARD
BUILDING DIVISION - PERMIT #: ELR2007 -00143
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/1612007
Phone: (503) 639 -4171 �I�I1
Inspection Requests (24 Hrs.): (503) 639 -4175 F__
INSPECTION WORKSHEET FOR DATE: 5/18/2007 TIME: 7:02AM PAGE: 56
SITE ADDRESS: 12404 SW QUAIL CREEK LN CLASS OF WORK:
SUBDIVISION: QUAIL HOLLOW - EAST LOT #: 050 TYPE OF USE:
PROJECT NAME: HOWELL
DESCRIPTION: Wiring for sound.
OWNER: HOWELL, BENJAMIN PHONE #: 503 -221 -8600
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 5/18/2007 Pour Time:
Code # Inspection Description f --- - .. , Confirm # Contact # Message
13 Low voltage 048573 -01 971- 227 -0850 N
Corrections/Comments/Instructions:
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ig?' 4fe
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PASS 111 PARTIAL APPROVAL 111 CANCEL ❑ NO ACCESS
rr El FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL'FEES ASSESSED
Inspector: t ‘A VS Date: S11 lq Phone #: (503) 718- 2-4.