Permit CITY TI GARD ELECTRICAL RESTRICTED ENERGY PERMIT
l
' DEVELOPMENT SERVICES PERMIT #: ELR2005 -00418
Il 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 11/18/2005
PARCEL: 2S 109DA -11800
SITE ADDRESS: 12933 SW BLACK WALNUT ST ZONING: R -7
SUBDIVISION: SUMMIT RIDGE NO. 2 LOT: 107 JURISDICTION: TIG
Project Description: 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: X FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 0
Owner: Contractor:
DON MORISSETTE COMMUNITIES, LLC ALL WEATHERIZATION
4230 GALEWOOD ST # 100 3030 SE 59TH
LAKE OSWEGO, OR 97035 HILLSBORO, OR 97123
Phone: 503- 387 -7538 Phone: 503- 649 -6542
Reg #: LIC 46969
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 11/18/200E $75.00
[TAX] 8% State Surchart 11/18/200E $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
through OAR 95 -1'100. 01 You may obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699.
Issued By: , s Zir,, (/_) Permittee Signature: 7`7
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.
11/16/2005 16:03 FAX al 001/003
:Lec *rie'i1 Permit *DpICati,af _ at>It 1tl1.11 r , ..4. p\i.l
:ity_ of Tigard so lid"°
1�te/Ay, i I is'Jo✓ �, Permitl o v �j
11ZS SW Hall Blvd, Tigard. U 6tZ� PianRaview
hone: 303.639.4171 Fax: 5) 11106 6 r , n i . I . Day
topeation Line; 303.639.4173 Other Petmit.
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tternet: wwW.ci.tigard.or.us ( \ (i) 7n 114 2,1.„ �Date eth : - I El tiee Page 2tf
°Y 4'" 7t+ ,tt3 7 t +'o +• ttir� `r Notified/Method: tiappklMiaW information
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trnt►noit/eeplacemtmt Please check al t Apply:
Demolition Other: ❑Service over 223 amps, aomn'l ❑Hazardous location
,1� {l,ii ) tf? iyte +� +( tY t r �� ate,, 1 1 'Y 1 r s ' c ❑Service over 320 amps - ratio
! „+i f rit, zit.; {�ltn+i,�c i�)r Cil.i 'if'; .: , } < , i t , 1 • 1 '. ' 1( ` l i �l tt i + } t }(, t , 1+slYlltl �! ° y+ p . of 1 • and 2•faintly dwellings $ ct over rsldderl1ial '.
1,1 I - and 2 family dwellin: r Contmetoiai/indust al ■ Accessory building 044m over 600 volts nominal units In one structure
Multi fatnuy 0 Master builder 0Building over titres stories Meader*, 400 amps or more
i4''
� It ir'a r) f � l q yi � i + i ° "':'''':.,`'l j •'; + + c Y 0 i t ;',,I;0; r, 1 r , � < - , °Occupant load over 99 persons 0Manalbctured armatures or
.fr�..Bl•�f.1 f51.tt�rr4�, g i ..it. 1 '..', ' t ' .., "rl,. , t' tt+'1�. d,.'�ua, ?l jI„i ❑Egrew/lightiagplan RV park
>b no.: 3eZ J ;site address: C ❑Heahh -oar+o facility [f ather:
t f 3 Lzie G t 14, : ) t�/ , Submit „ sots of plans with any of the above,
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ity /State/71P: a
.. � • 6 Q The above are not pp • doable to temporary oottsttnidion tarvioe.
aite/bIdg./ t. no.. .y;!, it,rt''I r.,.1, Flit , .r.r [ • i... + h •
P roject name: _ `: {,.. +,. 11 sH il rq,i : i� b ... ; t ' . .1 . 1 ; .. . . ,
, +� e +' {) �J 1 '� 1 ��}Sflk> " 1 1
• tr n.,r1.. ri,filli,
C086 BtlOel/diCCCii0n3 t0 jU� site: �[ ( ,Q Nair daft qtr. IN*. . Tom Tom ••
4 . l �. New residential single- or multi-fluidly dwelling wilt
Includes attached garage.
1,000 sq. ft. or less 145.15 4
abdivision: 5 vy n a R,I, i Lot no.: Es. add'l 500 sq. ft. or portion 33.40 1
ax mil/parcel no.: �, �� ! r - Limited energy, residential 73.00 / 2
"cr ?'t�l 1 ++1 �t�l i� p�X' Y��'; a;iW'31tafAn . VII t , E i ; t + 7t l,t r fi t . Y . ,, , , l i ,; , ; " 4 k vt } t I t Limited energy, non.eesidsntiai 75.00 2
!i, ; xlJr3 r.t..r, an' i i is a t. , i ppl ,! Y utuiltotured or modular
.. . ..... •: .... . I lr. .! ti y; }t 1� t�,d,}. ( . Y $•. , �.f.. •3�y Esah m
Q , fr ,t, C V 1✓ dwelling, service and/or feeder 90.90 2
{ Services or feeders installation alteration, and/or relocation
lo w va I
4�' r,••' xtr ,,,r air ;� t , , 200 amps or lees 80.30 2
�l /�b5 "l:'1.1 ittt i <6i' /ii„ i.> i � (t .r r � , 1 a. ' r
<th'i,ik,'ifllt.r -?,tr'i ti� Z t) y ,q 5 {ti�l}'IrSiy'r_( l '' r)r' { ;{1 + w',1i I 1 'w ht"�jjrlr'Ily Y' ` 201 to aria a
.trV :,J . . t,1 �k7 „fo4Ct,.+l,t:.,Y„�:,rlh�i;� �I, 1 ( ,x, 4t:.�.1��+1.1,��:1�( �e t 400 p 106.83 2
oe: 401 amps to 600 amps 160.60 2
R
iQ D t ^ t��SC Cr�yl r✓1 t �r► r ft t° G � 601 amps to 1,000 amps 240.60 2
de '"Y 7,3o l t�A ieA A/bn /), .51- Over 1,000 amps or votes 454.63 2
ty /Statt/GIP: I d,. ' j � ^ Reconnect only 66.85 , ,, 2
f ^- > L t/ /� 2 , 7 7/ Temporary service. or readers installation, alteration, and/or
lone: (f3) 3 1 • 7 R I Fax: (5E3) 2)/(...2 e t-s I s relocation
weer installation: This initiation is being made property 200 amps cc less 66.83 1 own tended for sole, lease, re exchange, or'ding on ORS 447, 44 670, and 70I not 401 amps to 6 0 0 amps 133. 100.30 73 2 2
401 amps to 000 amps P p
ivner signature: Date:
} -new, ) t �ri (
}i' yzl{ tl 1Lt, ' !jd°pv k E'•4l {��4 !� t , , ,, , circuits ” , alteration, or extenders, per panel
/ i,.d:l lyitz, 4:.ir,l . ),11," a T i.V.' Y i k t 'c�,{i!,i!C(. f; `r l'i4 rt f 1 , .. l wit , ' , \ ''a 1 ' l' r rt' �
r •, . ! �l t ;. l } i; t , , erne, �1.tY:au A. Faa h olroub wtfh
} s erviilia branc ar feeder fee e ach
iless attune: i✓lt 6,63 2
tBi
i I . P. ✓ i`z c, o0 C � �- b ra nch circuit _
uitaet name: rr el � }.,� " B. Fee for blanch circuits
- � • / DAG,' v w/1hoar service or feeder tee, 46.83 2
each branch circuit
ems O
Each add 1 branch circuit 6.65 2
ty/State/ZIP: ifill,Slcd IC C, o
q7/z4 1l4tst:ellaneous (service or leader not inelud edZ
one: (�) � ( 2
Fax ( Q3) �c jq y$� Pump or irri�ation aide 53.40 1 2
Sign
trail: r . Mo , - l outline circut( .) Iiihting mi 33.40 • 2
;tti,}rt,} �!p'tF1( �}lf� , *'+ �g i � j,� �•� t, li't + fi r [ / R i i -,,A Signal it( or lmited -
Gt.. t s k t / ifa+1LR 'S`'+v ! tt, 9 ' r i ' �l 1l•iM�r} riZ 1 x'• ∎ t rt P l : 4t + 5
+` 41 'Fi.i +(' °nu am
ppi en, altarafian, ar
+. 1 r .,.. - t s , d }, s.. ( -.ii I'h.c, ( :,1.'b., fl.i.2,i�G, QY p
lsiness name: ' C �.-at� fi°^ C.-• extatalon. Describe: Fage 2 2
ldre99: �b }Y �7e I Cl" Each additional inapeclion over allowable In an of the above
X1111_ _r 9 Per inspection 62.30
ty/StstclZIP: Oe •
7123 invediglgiion per hour (1 hr min} 62.30
of permit fo
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one: 69 ) 6 y !/ 6 Z Fax: (51-.S ) u gt 7 Industrial • ant • er hour 73.75
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prv. Electrician signature. tic.: ( 6 g electrical tic.: . Lie.: a+ ? ud s'G. dMt,1.� ' ,, } i r }(1 ",4a 1;€ „> U la + 4 ,I x lr'''it'dt'1:: °.:14 �if
Suprv.
Bublf e)
gnature, aired: Plan review (25% e)
i
inn name: State sat (8% of permit fee)
Date
Ithorired signature: �- --- 1 O1 AL p1tRMlt'r l?ti6 '
Teu permit appncausn exedra Ira parsatt u ass owned Imam toe
inn riallnti: n ' J doily* alter it I born ueerpld se see pYde
4,1& C t � I Date:�fr / (-G * Fee methodology sot byTri• County Building Laduttty Service Board
**Mamba/ of tnsueaUons Der oerua allowed
CIF TIGARD -�
BUILDING DIVISION PERMIT #: ELR200 , 004lB
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/1B/2005
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175 .' 41. ..
INSPECTION WORKSHEET FOR DATE: 11/30/2005 TIME: 7 :09AM PAGE: 60
SITE ADDRESS: 12933 SW BLACK WALNUT ST CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE NO. 2 LOT #: 107 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE NO. 2
DESCRIPTION: LOW voltage.
OWNER: DON IvMORISSLI IE COMMUNITIES, LLC, PHONE #: 503-387 -763
CONTRACTOR: ALL WEATHERIZATION PHONE #: 503.649-65412
Inspection Request Scheduled For: Date: 11/30/2005 Pour Time:
- Code # Inspection Description Confirm # Contact # Message ,•
135 \4 Low voltage 022593-01 503 - 5196452 N
Corrections /Comments/ Instructions:
9
j` PASS ❑ PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: / -- 7 Date: / e, Phone #: (503) 718 -oZ 7' ��