Permit C I TY OF T I G A R D ELECTRICAL PERMIT -
RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT #: ELR2003 -00262
° 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/28/03
SITE ADDRESS: 12285 SW WHISTLER'S LN PARCEL: 2S103CC -11100
SUBDIVISION: WHISTLER'S WALK ZONING: R -4.5
BLOCK: LOT: 058 JURISDICTION: TIG
Project Description: Audio & Stereo
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:
Owner: Contractor:
DON MORISSETTE HOMES QUADRANT SYSTEMS
4230 GALEWOOD STE #100 PO BOX 14833
LAKE OSWEGO, OR 97035 PORTLAND, OR 97293
Phone: 503- 387 -7538 Phone: 234 -5558
Reg #: MET 00002466
SUP 1211JLE
LIC 96806
FEES ELE Iq &$nspections
Description Date Amount Ceiling Cover
[ELPRMT] ELR Permit 8/28/03 $75.00 Wall Cover
Elect'I Final
[ELPLCK] ELR Pln Rev 8/28/03 $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 throuc
Issued by Permittee Signature % • /
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 639 -4175 by 7:00 P.M. for an inspection needed the next business day
08/27/2003 12:21 5032362322 QUADRANT SYSTEMS PAGE 02
v
.• i r FOR OFFICE: [JSE ONLY
Electrical Permit A 1 2eeeiverl Electrical
Date/B : 1 I at; Permit N• j A // -,P,p4
city of T>i and Planning Approval • Sign
Permi
131 SW Hall Blvd. • AUG 27 Review Other
No.:
AL
Tigard, Oregon, 97223 Datc/B : Permit No -:
phone: 503 - 6394171 Fax: 503 -598 -d ..1.1 Post - Review Land Use
OF ,:;'j; ' �,:. DateB : Case No.:
Internet: www.ci.tigaid.or.us U L .DIN rely a ��� Contact Juris.: ' I See Page 2 for
24 -hour Inspection Request: 503 - 639 Name/Method: Su . !mental lnformatind-
.. �_ ��. �f�. .,f4D,:- £tl.elL:1�ffi:,:�,��i Q , ^15 t � 'L� a C � I� .�s P /� � '�,3, 9' ,� `. � i�t,�.11�1ti I _ ::wl;'i•'r
.. �.. ���,: C?vtt�,. �t, r�: �i�iv :l�`k�r:�.k4�b......�.5140� I. '-., a1';.s._et�' �A rQ..�.:�:?���:� it , , I���' � .
1 M New construction IU Demolition ■ Service over 225 amps- ■ Health -care facility
❑ Addition/alteration/r- •lacement ■ Other:
commercial ❑ Hazardous location
C ❑ Service over 320 amps-rating of ❑Building over 10,000 square fact,
WWE.,4) Tw "; ; y4 NIVEu,1.111tStf. ,.o c 18c 2 family dwellings four or more residential units in
�- 1 & 2 -Famil dwellin l ■ Commercial/Industrial ❑ System over 600 volts nominal one structure
❑ Building over three stories ❑ Feeders, 400 amps or more
_r + iji' B ild . • Multi - Famil ❑ Occupant Toad over 99 persons ❑ Manufactured strvctureq or RV park
❑ Master Builder • Other: ❑ Egress/lighting plan ['Other:
n�% U i� ,771{�i171.MiiI *1 .11, ;iQc}ni iiIrE ,;,'Ti ,��,la7-:M ".14:: -;DI Submit sets of plans with any of the above.
The above are not a licable totem ra conatruetion service.
Job site address: 1 1a _ nS-aE QLL.c- r o1s .... i, ''' • T ,_'P, '- „11 I ^F. llll 2�JS° 1L101 9 1 . : sit rkk! g'l. 4,11;A
Suite #: Bld, ./A • t. #: Number of inspections per permit allowed
-
Pro'ect Name: S`: - 44-e
i /Yl .t Description Qty Rea (ea.) - Tout 1
Cross street/Directions to job site:
New unit. Includes attached garage. per
>: tip•
Service included:
1000 sq. R or lees 145-15 4
Each additional 500 sq. it. or portion thereof 33.40 1
.,.r Limited merit,, residential , / 75.00 1rx3r) 2
Subdivision: �I tLE�S � Lot #: Limited energy, non residential 75.00 z
Tax ma • / . -reel #: Each manufactured home or modular dwelling
E- 1i�t ri .., 1' 're �I P`l, ,(( , 1 � I Il l U tC 14"'f.U4'; i') f , l,t t service and/or feeder 90.90 2
or . installation,
�. u u alteration Sere ces or tbeders relocation:
I . 4 61, o • , 200 amps or leas 80.30 2
1 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
PE 1: ?'., :I.L- II �; I I " ', >,c. !I oi ,.' 7i, : � , CI,? }r l,:1 601 snips to 1000 amps 240.60 2
Over 1000 amps or volts 454.65 • • 2
Name: m .,444..„.„ P , , 1t- Reconnect only 66.65 2
Address: Temporary services or feeders - installation,
Cl /State/Z1 • : alteration, or relocation:
200 amps or lea 66.85 I
Phone :S _S"c►,l - 8 Fax: 201 amps to 400 amps 100,30 2
EEI i , t t kn ' I' I ql� „r 4 :q(.,h f.1, lcflf' i i , tl 401to600atnpe 133.75 2
'� } �., 1f I: tlar h..1 : "t -- t t 1.. ' s Breach
circuits ,
ts - new, alteration, or
Name: extension per panel:
A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 6.65 2
Ci /State/Zi s : B. Fee for branch circuits without purchase of
service or feeder foe, first branch circuit 46.85 2
Phone: Fax: Each additional branch circuit 6.65 2
Email Misc.(Serviee or feeder not included):
.!. , 7A ' i, (i ?qt . 11. o ... '- , I : t, i F ' S'! i r r ; t .: ..:a F. r . Each tannin or irrigation circle 53.40 2
Each sign or outline Iig1tting 53.40 2 ,
Job No: Signal circuits) or a limited energy pane],
Business Name: , act i f • Description;
alteration, or extension Nit 2 2
Description:
Address: '_,,,,, (yd33
e Each additional Inspection over the allowable in any of the above:
Per inspection per hour (min. 1 hour) 62.50
Phone: A3 "l- .r? Fax: 5::e - 3 . .k.,1„)......--.., investigation fee: _ —
CCB Lie. #: 9 I, I to Lie. #: Zits ” . - CEP oth -
1 .4 'P i J� te 111 "1' :r '11,aa„ i 1 '
,I I , , . i p�i 71%2T I : i , f , , +a
Supervising electrici • . 1 //�� Su $ . . . ; ,L I
si s • ature re • uired: . t,41 Plan Review (25% of Permit Flee) $
Print Name: IriraMEINSM , State Surcharge (8% of Permit Fee $ 00
TOTAL PERMIT FEE _ aJ
Authorized U.". _ ��,JJ Notice: This permit application expires if ■ permit Is not obtained within
Signature: '�°� �-) y Date:ei 180 days after It has been accepted as complete.
\ *Fee methodology set by Tri -County Building industry Service Board.
(Please print name)
i:'DstslPcrmit Forms\EicPennitApp.doc 01/03