Permit e
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`� ` a .CITY OF TIGARD ELECTRICAL PERMIT-
•
RESTRICTED ENERGY
N ,,i � ^ � DEVELOPMENT SERVICES PERMIT #: ELR2003 -00308
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/9/03 •
SITE ADDRESS: 12325 SW WINTERVIEW DR PARCEL: 2S110BC -03800
SUBDIVISION: THORNWOOD ZONING: R -7
BLOCK: LOT: 009 JURISDICTION; TIG
• Project Description: All encompassing low voltage.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: X AUDIO & STEREO: - INTERCOM & PAGING:
BURGLAR ALARM: X BOILER: LAN DSCAPE /IRRIGAT:
GARAGE OPENER: X CLOCK: MEDICAL:
HVAC: X DATA/TELE COMM: NURSE CA LLS:
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 QUADRANT SYSTEMS
4230 GALEWOOD PO BOX 14833
LAKE OSWEGO, OR 97035 PORTLAND, OR 97293 •
Phone: 503- 387 -3875 Phone: 234 -5558
Reg #: SUP 1211 JLE
LTC 96806
ELE 26- 565CLE
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 10/9/03 $75.00 Elect'l Final
n
[TAX] 8% State Tax 10/9/03 $6.00
Total $81.00
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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 rulesor direct questions to OUNC at (503)
246 -6699.
Issued by , . J t Permittee Signature P1 _ (4L 1
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
•
10/08/2003 10:07 5032362322 QUADRANT SYSTEMS PAGE 02
FOR OFFICE USE ONLY
Electrical Permit Application - 00
Recei o Electrical
DatrBy: / P /0� 3 1 _ Permit No. tll? 3 -OD30
g �� p // r ® Planning Approval P ign
City of Tigard I �l na nnin : pe�nit N °.:
13125 SW Hall Blvd. Plan Review Other
Da Permit No.:
Tigard, Oregon 97223 qr 8 2003 Post - Review Land Use
Phone: 503 - 639 -4171 Fax: 503 -59S- 960 ,<::, . , � ,. , Date/B : Case No .
i
� ` Contact Jutis. �:+ See Page 2 for
Internet: www.ci.tigard.ot.us �_ n .111 �
OF Su. elemental Informatiod.
24 -hour Inspection Request 503- 639 DIVISION Name/Method:
y a n
i l.A! 1 . 7.;i.;h„ •eau p.' d r'- � ! I • a l' yri r:.4 I ] •. il2r J' ' ,d
i ' V �i � ",il , � I'�"',ti�irtA -'. ;�?�J�� ^s'L � ..' :�Q,: ��calth -Care facility
Service over 225 amps- acilit
�0 New construction '� Demolition commercial ❑ Hazardous location
• Addition/alteration/re • lacement • Other: ❑ Service over 320 amps- rating of ❑ I Building over 10,0000 square feet,
v8;tl a c ri `-�� cTl,!x ,iffe §lit is �i lr jw I & 2 family dwellings c - '�..b:'a,Jr
10 I & 2 -Famil dwellin: ❑ System over 600 volts nominal one 6tNCture
PI Building over three senses ❑ Feeders, 400 amps or more
• Access.) Buildin: I• Multi-Famil ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park
■_ Master Builder • Other: 0 Egress/lighting plan
tt [plan0 Other: -
,.,.;^.,, , Subm sets o with any of the above
1 �.El ° 'ti Cl �' ��q ,��i L� i!^ �L? Vic') T ca.�. �t 6i� a i i ;ti rt,: not a • . Ilcable to tem ors construction service.
1ji i a ; L . __ / The above are of t l ii ; , ,
Job site address: l'a3 as .5 L.- LAY.rt+ er ' L � y .. j ; f,t ` ; •H r' t. Y 1 , 1 � � i,ei � 11f
I '.,I M F [: }`{F�ll': :iii' 't7ii k' ;
Suite #: Bid: . /A. t. #: 1, e Number of inspections per permit allowed
4 Description Qty Fee (ea.) Total f
Pro ect Name: M "� SkJ� u S New resldeadal- single or malts- family per +
Cross street/Directions to job site: dwelling unit. Includes attached garage. .
Service Included:
�) Gt_L,l a� C(1fr'1 1000 fl. or less 145.15 4
Each additional 500 ft. or .. ion thereof r 33.40 — III
Limited energy, residential J 75.00 -- t" •')
Subdivision p : - 1 R- . w0� d, Lot #: 9 Limited energy,] on residential 75
Tax ma . /. _ . Each manufactured home or modular dwelling
arcel #: . .�_ service and/or feeder 90.90
e ,r " FI 'IRI aKiii.Vailliki it �'.i.(i :,1 .'Stein : k :] ,'fie: _(I
Il ? 7'!'?rl%tina `l''''':'t:!-,7 . —_ - f t : •.. ......' . - ..' ... ' Services or feeders - installation,
i 0,•p a I . I t en r`a't -il fl '-" . alteration or relocation:
i 4, 200 am•s or less 80.30
M ILIMERV II Se. tm6 a . p rKv1 a -ktE� 20 amps to 400 amps 106.85
401 amps to 600 amps 160.60 _
(f1 601 am • 10 1000 amps 240 60
D - IT •: _dl�'I .. §:i I:'
tTi ^ �'tr ir. I'' i`11K:. . : : .:. . . : '� :'s 454.65
c,�lt °� . :: .,..a5 ,_.,..,j r. :.� � • . Over 1000 or volts
Name: - 4- e,r ,(rr, ± Ph n Reconnect o r 66.85
Address: Temporary services or feeders - installation,
alteration, or rdocatlan: 66.85
Ci /State /Zi • : 200 am.. or less
201 amps to 400 amps 100.30 IIII
Phone -t° 3 7 37 xTh' i 133 75
_ 401 t0 600 amps
Ei?� ritLif� ald:IZ'�I�i r4. �I {I,�r�� I.if .:�•�` L— i.: : -• i�J. i
- _ Branch Nrcuit9 - ncw� operation, or
Name: extension per panel:
A. Fee for branch circuits with purchase of 6.65
Address: service or feeder fee, each branch circuit
Ci /State/Zi .: B. Fee for branch circuits without purchase of
service or feeder fee, first branch circuit 46.85
II
Phone: Fax: Each additional branch circuit 6.65
E -mail: .. Mlse.(S�e or feeder not included):
Each pump or irrigation circle 53.40
T' Vg- , 'a --- . — ;r1 iF'. R; ,'f � 'i9E1" . r'i i . C ',<;iI j 4:.- ..r. ,i ..,`:' :.I 53.40
5 , , 1 •I!��. , �IAI�,GC� - u� ±,��; �� .. a 1 " ,! 6.U. , � :-� ' ....._.. ;.i^ :. �' `, • .. Each si o r outline liRFrting -
Job No: signal circa t(s) or a limited energy panel.
alteration, or extension Page 2
Business Na1ne cr...k . „ -•nn S lksmpGor,: Il
Address: - Pp &--+ I y .F33 Each additional ins . mica over the allowable In an of the above:
Ci /State /Zi .: Y,1,44 • o e- ' 13 Per inspection per hour (min. 1 hour) _ 11 6230 I
Phone: 5 .4 - 53 S . IZEINIMMIEMEM investigation fce:
Other:
Q T L _ - tom ,r
CCB LiC.
# : %0�� Li, 11': - I. ^ • LC 1 !l� ";T .'r'!.: I; iret� .;.,li�j.�rl�ll,, , t1 1,�17�7T'�! i '�.
Supervising electrici: • ? ,• -- Subtotal $ T o
Si y ature re. uired: „IA Plan Review (25% of Permit Fee) $
Print Name: —e 1 rd., 1110 WA State Surch:• :e 8% of Permit Fee $ 4,.
TOTAL PERMIT FEE $ •00
Authorized Notice: This permit application expires If a permit Is not obtained within
i'Co• D k 180 days after it has been accepted as complete.
Signature: - *Fee methodology set by TO-County Building Industry Service Board.
----.1 btu a).. an
(Please print name)
is \stsiPerttlit ForrnalcPemtitApp.doe 01/03