Permit rf l! CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2006 -00310
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/21/2006
PARCEL: 1 S134DB -11200
SITE ADDRESS: 11326 SW 110TH PL ZONING: R -4.5
SUBDIVISION: DAKOTA GLEN LOT: 014 JURISDICTION: TIG
Project Description: All encompassing low voltage.
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. GENESIS HOME TECHNOLOGIES
4230 GALE WOOD ST #100 9450 SW GEMINI DR
LAKE OSWEGO, OR 97035 BEAVERTON, OR 97008
Phone: 503- 387 -7538 Contact #: PRI 503 - 643 -1704
FAX 503 - 643 -3300
FEES Reg #: ELE 26- 989CLE
LIC 128098
Description Date Amount
[ELPRMT] ELR Permit 12/21/200€ $75.00
[TAX] 8% State Surchari 12/21/200€ $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 are set fort iTI OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain co s of these rules or direct questions to OUNC at
503. 6.6699 or 1.800.332 T
Iss ed By: . /' < Permittee Signaure: �` I `� ��� et..)
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.
' "IJec 21 2006 2:28PM GENESIS HOME TECHNOLOGIES 5036433300 p.1
Electrical Per it A 1 1 ' i i t o " I I' 01 r.I. I : 1 'I.4 J NI 1 ceived
City of Tigard a ,i X/ 06 Permit No., e_iepek DD /v
13125 SW Hall Blvd., Tigard. OR 97223 EC 2 Zoos plan Review
' U
Phone: 503.639.4171 Fax: 503.598.196 , fr 'lit ;,„,, = 3 other Permit
Inspection Line: 303.639.4175 ,; P„ 1 Date Ready/By: Au a' Pate 2 for
!litigant: www,oi,tigard.or.us �11 X 1IU 4J - - Notifed/Method: /a, Supplemental Information
il
, , ,. �, ` � y , �• ,,yr 7s ' u' ?tt�s} r I r'Ka�Y`" kt' , � iP' s 1 " ° 1 ''w "c i "+�i" " Vii} 1 `l '? q7T iS �� "� � " ",t1 Y;P't` nrl+. {+l�p
� w , ' yM1peJ• ��.n d �� . ., 7µp
i �t,S`y'f5 i i1 r 1 �r 1 �yy {M�'•,�¢;,t� 41I� T�.1 3 . li ;{ S i�Q } +���'� j� P `. ° /� , t F J �k� e t J ; i ;.�) fd'+1� r � f f�yuyl�, � F + I fed � p� +7 i � y ' Rd' ' In�",t , i3 (' � { �,y� yt! f)' • j ,\ r , i
liNai alta4� )FieMiguit11� ar�liii li11 F lmtl Yl ^f,1tA A3tnozies oth,ek ii, N1d. 4 ' 41 ,1M Ii tilYil.� •e 0 iP;1d L ..3 +e. vt fAL1C4JY1ift. ; 4.:,,:i,SNiAi'.fYli'�.p...1,HMF poigi ' er
VI New construction 0 Addition /alteration/replacement Please cheok all that apply:
Service over 225 amps, 00=1 ['Hazardous location
El Demolition ❑Other O
, i } ,. > e ( avtsl. , a G,Ra� u Lull r rrsn ,+ r ° b ❑Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft
I
,t , �!fi ' ` 1 1 11a " y' ' .�, « t. C 'ive't w s p 9 '- �. 7 6 t e r' Iti f ` '�'ry' o l -and 2- fas dwelli s 4 or more new residential
lF'g' '+TAIA '..' .kilki. .' kilwi lil4Ee 44tiniitalt?ti endVitit^tlsl3aA..r,-ul.",m.�'d kli; ".'st' tit iii ;' '8'.��$ ,. itilll Co Y ng
1 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi - famil ❑ Master builder ❑ Other: r ['Building aver three stories ['Feeders, 400 amps or mon
�r g 7 + , l c, �w } n » fi n i e, fa l� n��l ay Master b D z� r ��,tE v a� mo ther f �J N ❑Occu load ove 99 persons ❑M sI structu c
t:, 3 ��1 E "'e ' ' 2 {reiwAetAkividvlutem olb .tett r4�ri it , ,riedty. ai l? ii! , 4�5} k?' J + l i. L DEI? nigg plan t1C
- el 1 44— ❑Healthcare facility ['Other:
Job no.: Job site address:
Submit - I. sets of plans with any of the above.
City /State/ZIP -77 The above arc not applicable to temporary construction service,
t, ;3'k c lid ;tL 1x`a' . i,1.' ' '3 i' ?l� �i'�i
Suitelhldg.lapt, no.: Project mm�e: Flo.. ��.,+lulklvi ;�����taa , �.>,,, a,�. „- ,��...a � f�.
Deiertption Qty. Fee. Tate '
Cross street/directions to job site: New residential single - or multi - family dwelling unit,
Includes attached garage.
1,000 sq, ft or less 145.15 i
Subdivision: - /x,4,6,, l_ X vi I Lot no.: /1., Ea. �'l 500 sq. ft. or portion 33.40
F Limited energy, residential / 75.00 T'5 ct.t-
Tax map /parcel no Limited energy, non - residential 75.00
r� d t gaiirit'` ? . ' Y .n�"� a: l� ',11,x,', 1� TI �� h1 i � ji ft ;` i a Bach manufactured or modular
dwelling, service and /or feeder 9090 ,
/,ll 1 Xi 5 - ■ .1J Services or feeders installation, alteration, and/or relocation
t A y ` � �y p} �5� 200 amps or less __
a ,Ko 80.30
g 1 4etiv to a m .lr , v��s rci7'� @t i, irm t Ti
1, , t I r 4 st , kG � i t�� 201 amps to 400 amps 106.85
1Jl #' t 14117 ,111 .vur ,,Na ;s ' ilt,3 Yi�iice i S!it Ili l ' ea d,.t .. .,,tilts v3 £salad r..P.1 , ' 110 401 amps to 600 amps 160.60 '
Nano: ,as eo .. SS 4 // /41spl ,•f 603 amps to 1,000 amps 240.60
1... Over 1,000 amps or volts 454.65 :
Address; _ `. i ! s # .• Reconnect only 66.85 ,
City/State /ZIP: G k- 2 ej 6 seer 47 9 Temporary services or feeders Installation, alteration, and /or
Phone: (01) ji3 7- 7538 I Fax: ( ) relocation
200 amps or less 66.85 I
Owner Installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 .
intended for sale, lease, rent, or exchange, according to ORS 44.7, 449, 670, and 701, 4 01 amps to 600 amps - ” 133.75
Owner signature: Date: Branch circuits— new, alteration, or extension, per panel
!FR Ci a `� w.rvfr ws 4r ui i ' r r i) n v ,�t •Fe 7 r �` 8lnaityr , Lrs+Gr n f : ti
,. i) n K N . �, t I t d � 1 ( hi ^ & 4 • ` ,ur " �idl,.0 br.05.11A611.4 ' f , iHl y A. service for trench r circuits with
poN'x ++ � I �' „�.�k�tw'lutx.5mvrx�a:aih,�i, � S � � i.a " �li � ,r� . � s @� 1 r ' ?� �K service or Feeder fez, each
Business name: • branch Wilma 6.65
a, liec for branch circuits
Contact name: without service or feeder tee,
each branch circuit
Address: 46.85
Each add'I branch circuit 6.65
City /State /ZIP: Miscellaneous (service or feeder not Included)
Phone: ( ) Fax: : ( ) Pump or irrigation circle 53.40
Sign or outline lighting 53.40 .
E -mail: Signal circuit(s) or limited-
git3 .''1 ` ' c { 'I r, C '.'at.+u'” EK at",., r ` SSW , i 1 ' '' " lg , nnff ' ati ngt " t energy Pastel, alteration, or
extension. Describe: Peke 2 .
Business name:
Each additional inspection over allowable In any or the above
Addressc _ _.... --- ._..._.....,..
Per inspection 62.50
Cit; GENESIS HOME TECHNOLOGIES Investigation per hour (1 hrmin) 62,50
9450 SW Gemini Drive Beaverton, OR 97008 Industrial plant per hour 73.75
Ph0 Phn- 50 -643 -1704 Fax - 503 - 643 -3300 E5P3,+M ;,��art1r ` °Ot,1r N<' + ;; sari ` `
CC `fit CCB 128098, CLE28 -989, Subtotal 7c D.
2885 -JLE
3uF Plan review (25% of permit fee)
State surcharge (8% of permit fee) , o?
Print name: /.I .' w _ Date: - r TOTAL PERMIT FEE 0 8
r 4.... A.4
Authorized signature: This permit application expires if a permit is not obtained within 160
Print name: Date: r Fee methodology eel by b ft Trfa.$ cunt accepted as retry Se
i pr y t:onaty Building raduetry Sert Hoard
r• Number of inspections per permit allowed.
1,iBulldI PcmitulELC.PmnuIApp,doe 12103 440- 461ST(10J07(COMAV
CITY OF TIGARD
. ,..,.
BUILDING DIVISION PERMIT #: ELP2006-00310
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/21/2006
Phone: (503) 639-4171 k i •1!'t
Inspection Requests (24 Hrs.): (503) 639-4175 A. -LL.
INSPECTION WORKSHEET FOR DATE: 1/12/2007 TIME: 7:04AM PAGE: 36
SITE ADDRESS: 11326 SW 110TH PL CLASS OF WORK:
SUBDIVISION: DAKOTA GLEN LOT #: 014 TYPE OF USE:
PROJECT NAME: DAKOTA GLEN
DESCRIPTION: All encompassing low voltage_
OWNER: DON tvlORISSETTE HOMES, INC., PHONE #: 503-387-7538
CONTRACTOR: GENESIS HOME TECHNOLOGIES PHONE #: 503-643-1704
Inspection Request Scheduled For: Date: 1/12/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 04205&01 503-643-1704 N
Corrections/Comments/Instructions:
(
(
\ki. 6 ,Ii.t.,I.v._....
Ifrin
J_ck. • , 7 .
A PASs n PARTIAL APPROVAL 0 CANCEL El NO ACCESS
FAIL fl CALL FOR INSPECTION ADDITIONAL FE S ASSESSED I u lp
0 . 1- I ' V
Inspector: Date: plphone #: (503) 71