Permit 1 ". ELECTRICAL PERMIT -
CITY TIGARD RESTRICTED ENERGY
JIiA DEVE ICES 639 -4171 DATE PERMIT # -001 13
ISSUED: - 13125 4/29 04
SITE ADDRESS: 12057 SW WHISTLER'S LP PARCEL: 2S103CD -WW290
SUBDIVISION: WHISTLER'S WALK NO. 2 ZONING: R -4.5
BLOCK: LOT: 090 JURISDICTION: TIG
Project Description: Data /telecommunication
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:
DON MORISSETTE HOMES INC QUADRANT SECURITY INC
4230 GALEWOOD STE #100 PO BOX 14833
LAKE OSWEGO, OR 97035 PORTLAND, OR 97293
Phone: 503- 387 -7538 Phone: 234 -5558
Reg #: SUP 121 1JLE
LIC 96806
ELE 26- 565CLE
FEES Required Inspections
Description Date Amount Ceiling Cover
[ELPRMT] ELR Permit 4/29/04 $75.00 Wall Cover
Elect'I Final
[TAX] 8% State Surchar€ 4/29/04 $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
04/27/2T 15:06 5032362322 QUADRANT SYSTEMS PAGE 03
ONLY
n r:
ie'ctrical Per�xut p icatro Received OFFICE l.ftiE i E,, ; °
TL_ — • Date/By. Permit xo.:trA Dq - 113
Planning Approval Sign
City of Tigard �pR 'Olt , Date/By: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 QT O F 11W\ ` '� � Datr/By: PerntitNo/11S7o2dt74'���
Phone: 503 - 639 -4171 Fax: 503 -' 8-�96.Ua DI V ; ' 5101 Post- Review Land Use
B i,.,,.p .� Date/By: Case No.:
Internet: www.ci.tigard.or.us '''1, 1( Contact ]uric.: El see Page 2 for
24 -hour Jnspcction Request: 503- 639 -4175 Name/Method: Supplemental nnformatlod.
' =i:,1 A, 9 •'', id O' 'di.; i.+a:7M W . '. at ini etili ii J ,Itii'l l Zai, ` t e � ag ' ,.i. l . WWi ' \ "� i rr �::�
• Service over 225 amps- I Health -care facility
IF' New construction Demolition commercial ❑ Hazardous location
• Addition /alteration/re • lacement • Other: ❑ Service over 320 amps- rating of ❑ Building over 10,000 square feet,
lib i n: j ? l ) , t .{ ^$1.9 tJi nti [r FicS OA 1 & 2 family dwellings four or more residential units in
11 1 & 2- Parnil dwellin: • Commercial/Industrial ❑ System over 600 volts nominal one structure
1111 Access° Buildm: comm
❑ B uilding over three stories ❑ Feeders, 400 amps or more
' ❑ Occupant load over 99 persona ❑Manufactured structures or RV park
Master Builder ■ Other: ❑ E plan 17.] other
�� .,,_ . ,,,�,, -..- -` i •,,�r•--- •-, - submit set.9 of plans with any of the above:
151QF;,jr. , .J o :, lu at P!�r<� <f'` )�:it , LJt �) \4 '�� .1 ').' J t tem ra construction service.
�, W!9 i_ The above are no a t, of a to
/ -5 :,,' , r i t II 7i rl" I t 1'5g i T i i, 11•f } : .,
Job site address: /, � s Ski is tees � � � .,.. �,,�;L � � `a � .. _ _,.,. ,.. (,^.' f , ti
... ��..f J:,� ! t<<4 ,I:.._,d 4..
Bid: IA. t. #: Number of inspections per permit allowed
Description i Qty Fee (ea.) Total '
Pro'ect Name: G1> c (1v 5 New reeidentlat- single or meld- family per ♦
Cross street/Directions to job site: dwelling unit. includes attached garage.
Service Included:
1000 sq. f, or lass 145.15 4
Each additional S00 N. ft. or portion thereof 33.40 I
Limited enemy, residential 75.00 2
Subdivision: Lot #: - I Limited ever :, non residential 75.00 - 2
Tax ma ./ • arcel #: Each manufactured home or modular dwelling 2
7 t p �a .' ... 73 sery andlor feeder 90.90
f1v , lP�1fu�[S@7J�1'�41i..'rf jlllr %Jn.(�.F:C ti I i.. _. ,._.
Servlc cs or feeders - Installation,
alteration or relocation:
200 am>sor less 80.30 2
701 a •ato400am• 106.85 2
y 401 amps to 600 amps 160.60 2
`� s . : ' 21 .j F �' T {tie n+l' !l 1 � �. `-1 +f \l t l ` I , : -R i r . i 6(}I amps to 1000 amt's 240.60 2-
�[ uJ... ,,,t ► �.a !! . . _ � , 1. t 9 . Over 1000 amps or volts 454.65
Name: _ Reconnect only 66.115 2
Address: Temporary services or feeders - Installation.
alteration, or relocation:
Ci /State/Zi • : 200 ant= less 66.85
Phone:
Fax 201 amps to 400 amps 10033. 0 2
40l to 600 amEs
klEgi ` DIZA, J �I' r��'tiRT,t' r « j _Jet,; 1,,C�Q _,.. lL i n,.... r .' '.(T Branch circuits - new, alteration, or
Name: extension per panel:
A. Fee for branch circuits with purchase of 6.65 2
Address: service or feeder fcc, each branch circuit
Ci /State/Zi s : B. Fee for branch circuits without purchase of 2
service or feeder foe, Text branch circuit 46.85
Phone: Fax: Each additional branch ciM it l 6.65 2
hi or feeder not included): 5340 2
E -mail: - , ,_ _ _ - -- _. — path pump or irrigation circle
Fir±,n.1rLu. iC: `.i,'lli1:.,Lrtrrf'r'0 ;f1l1P1!;!,1!.i:„.:,;";'. .' !"." r. -, ,..d,. . 53.40 , 2
Each !gm or outline • lighting
Job No: si eircr:it(s) or a limited energy panel,
alteration, or =tension 1' 2
Business Name: A1. , d l ' ' A/ .7y4 r. Description:
Address: r.
. X `f
r / Each additional inspection over the allowable in any of the above:
Cit /State /Zi • : , if 4 _ . ii ♦ Per itcectian per hour (min 1 hour) 62.50
Phone:.5`C3 - - SS • FigirfafirrjErnaill invest: tion fee.
CCB Lis #: 96 BD b Lie. #: p / L' Othe 1 - �_
r11�� _ .. 'I, I _.Y.a f '�: n v. yV i „+u .. 71'' ` '� it ,u , . . Jac: � r r s ..id.
Supervising electricia . -- - S $ 1 7 , S.G0 _
si .1 ature r - • uired: 1/ c t Plan Review (25% of Permit Fcc) $
EgnEgnmourrjurgEngirimismou State Su rch Pe rmit Fee $ GP TOTAL PERMIT FEE $ t . OO
Authorized � (cl�+• Notice: This permit application expires if a perm is not obtained w
Signature: ` , � - Date; Z7 -C 180 days after It has been aeeepted as complete.
'Fee methodology set by Tr1 County Building industry Service Board.
(Please print name)
i:\Dsts\Pcrmit Porn i\ElePcrmitApp•doc 01/03