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Permit
CITY T I G A R D ELECTRICAL RESTRICTED ENERGY PERMIT .,: �� " DEVELOPMENT SERVICES PERMIT #: ELR2005 - 00336 �I DATE ISSUED: 10/11/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S109DB - 02200 SITE ADDRESS: 15026 SW BLACK WALNUT TERR ZONING: R - SUBDIVISION: SUMMIT RIDGE LOT: 060 JURISDICTION: UR Project Description: Vacuum System. Job #3447. 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: Owner: Contractor: DON MORISSETTE COMMUNITIES, LLC ALL WEATHERIZATION 4230 GALEWOOD ST #100 3030 SE 59TH LAKE OSWEGO, OR 97035 HILLSBORO, OR 97123 Phone: Phone: 503- 649 -6542 Reg #: LIC 46969 FEES Description Date Amount REQUIRED ITEMS AND REPORTS [UELPMT] ELR Permit 10/11/200` $75.00 [UTAX] 8% State Surc 10/11/200` $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 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699. Issued By: "�20 2er Permittee Signature: _ S . 2 . .� 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. 10/11/2005 15:53 FAX (J 001 /009 Mk Alf I It r I :,I't EC ri .,. Permit• . ',, i ce EI� ; ,. �, 1.1 City of Tigard ? Reoefived _ i7 N ./ . Permit o. D 13125 3W Hall Blvd., Tigard, 4))t 97223 DateJH ; � Q t/ Phone: 303.639.4171 Fax: 303:598.1960 iew �*r I •'' Date /B v DatoJB . Other Permit! Inspection Lint 503.639.4175, I OCT 11 r...ly • •': �. Date Ready/By: '. ir ", 86. Page 2 for Internet www.oi.tigard.or.ua t Notified/Method: �� 3uppb7m.nRdJ<ntormation pr7c�Sv�)i.}t�Z * .��5i ' } t;r•�°ry�� ■ i\t.,• t a ' r r : :;r:6` rn") , i :x ' r,t , (5 Ill .t . :T Y 1 1 Y t 1 1 t {). ? �IY11.�+ 1 Y7 '1 t1,i1 i 1 d ill .+ J Y' 1 1! 11 :/ �+ i.. 11•l£GS.vxl i t i.,. • ;'P17a 1 �1Y i', I.; o- N ?..,.i' e `, llg;,Uf' , .F . , :' 4 , 4 . It. " J, 11 B :,.. 1. t . ' .4 �ze • '_4 New construction r .ii: ¢ s 4 i z , 41 T Please check all that apply: ❑ ( De N mo ll liti0n x 0 Other: ❑Service over 225 amps, comm'I ❑Hazardous location 1 1 1 41 } rn� ���i� ) \Y' r 11 1 ! I ! - �t V 1 T fp wi p ff,v p wi t 6aiw.lv(l, t i Oi y�,',t11•'4, t t t: i ; „'''n' ! z , wl,yr lg,•tsty li ; l',`i,Pri ifff� pot ❑ ornoeovor320�d rating ❑ 4orma g rattawtroi n over 10,000 dolal of l• and 2- fit nga 0 I - and 2- family dwellin; ❑ Comm;ercial/indu.9trial ❑ Accessory building ['System over 600 volts nominal unite in one structure ❑ M ❑ Master builder (] Other ❑Building over three stories ❑Eeaderi, 400 amps or more 1 :� Ybr Multi -ram+ q v5P • ^qf Ga u >.3.-,,, , i 1 -4. i ...; } . { 040Aw s Y1a1T !'vl +'� kt ya f1 , .t r } ,t ,( ,,,.tit � 1 , f i t 1 r ti:, q J_ v{om �u i ❑Oocupartl load over 99 persona ❑Manufacturod stntolures or "w *" ' �,. 4 r,5 s. ! r rif }.l lr, si . ❑Egrosa{lighiing plan RV park Job no.: ti 41 • .1 site address: 451 4 1447 ❑Hoaltlt -oaro facility ❑Chher: City /5tate�Z..IP: - Submit,j sots of plans with any of the above. T ,,c,),,.., 6 2 1,J sj \rw) ' The above are not applicable to temporary n service, Suit � � oofulntc�to s (bldg. / t. n0.: !!kkS{'.4rtl J}ltivUtSrsia�ll¢,1�� +3n • YI �'�`( "Villa a t +teT r, + N'`,171,:- ph 06tname: Jt,n t TsS�'Vil�t,vYanYu � � , Y,_.�i��bi' { r L /h ^t' f Project � L ::G�•L•�, +1f1Y!':'fiiF��r� Cross street/directions to job site: nw rten0a air. r». T «7u •• � , � New residential single - or multi- tam:11y dwellln` unit. lneludes Altschul garage, 1,000 Al. ft. or lees 145.15 4 Subdivision: :. /y) 4' r •G)t) Lot nC� Ea, add'I 500 s q. ft. or p o,; onion 33.40 1 Tax map/parcel no.: Limited energy, residential 75.00 ® 2 1,1!� `�. � �5 ;b�' y Bl'�l 7r x'i '�'�, p Vr>7 �1 f s aax n' a tt .'YrJ1 r `s :7 ,••,, Limited OrllC y noneoaidentiat 15.00 2 �1.� a n'�Y.'/37��`ia st y tit• :.`,P: ..'a.} T lVS �,4 ?,.. JS � t� 4 irf hY 7 �P' ;e141' E.azh manulratured or modular C(. fr-k I V _ v c dwelling, service and/or feeder 90.90 2 Services or feeders Installation, alteration, and/or relocation /Oh/ !/o I 200 amps or less 80.30 2 f a ier 1 N ] \ Y (, i t ,A9 n t rl 3,t1 i1 nt^'ii t�ltt Y � ? ��9 tY r 'l t itJ r 7 P; i is al ` ! .. i /i, r i gl111" 106.85 2 ly .. �;1�U } r..,, .1�f�,i7g11.: �4 f }� \' � � � {t'`�!� 1 A }�( ice lrn 117 ( Y J IF \Y Yi 'I+' 1 S� tyy �.l.f 7� . ^ 201 amps to 400 amps tad t.Q't f /At�'wY 41,1E iAleZ .a' r k io. F : Y I•,a•.>- ' fgAr,a); �,@1fS a∎lif 1 { Ntun ll 401 amps to 600 amps 160.60 2 rtSe� r✓1 !1�'t 1 T1� L.4- 601 amps to 1,000 amps 240.60 2 Address: 1 4 {23C� s G� I�� 1�Ur7 /� f' Over 4000 amps or volts 454.65 2 � City /StatelZlP: Reconnect only 66.85 2 `� �S �f= 6 Temporary service. or feeders installation, alteration, and/or Phone: (C,3) 3 ; 1538 Fax: ( 3) . <7 7415- relocation 200 imps or leas 66.85 1 Owner installation; in tthllation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, c$r exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.73 2 Owner signature Dais Fee for branch circuits with t ilt! f. r � P { � , �, is a r a µ Branch circuits -new, alteration, or extension, r nand i` , ) j{ O {{ i� � ' i IS S}'Vr r l i i g i t t ' , ' �V }r j¢ + '`t a I t 1. F' . '1 b ' 7,it { d ( Y. i1� „ {f'p' {i� j, A. • :..: ,..6'ki./• 8,. a}... i rin.v /41 A �/' ?ift71 W,� l'Ylti 1 11 ,?!.7`l 11 . ' 1 •c•r F\ i 4 ! n 7 1 :. � r ,:.C, •�s,1 11511J,vt:ri service ar feeder fact, each Business name: All tvea. e dJ-h,o„ i� � Yii ,.� brancholrouit 6.65 x Contact name: ,� fry � B. Foe for branch circuits J without service or feeder fee, q(, 85 2 4ddress: i� 5 n f,>\ 64-- each branch circuit 7 Each add'l brenoh circuit 6.65 2 :lity /StateJ7,IP: itri LS476 g 0 be q 7 tZ g Miscellaneous (service or feeder not included) Phone: ( ) �cf 9 Fax:: ( �jG�� �6$t j Pump or irrigation circle 53.40 2 P.. E mail. r' 3) sign or outline lighting 2 /' . Mrs.. z r,[ t -N w LE tin t �,�iy 'pt� pi � Signal oirvult(a) or limited- : ' . , '15�14�tY.0 t CYO l 'I'Z' _ N " 4:7f f ift *4:n yi ;P�s t, �Y t3 7 ,$� l rrt�r , a. ! • W a t s , t .., t ., ...:. , .iaurr�u�s2�sat��i }x +i+kl1;ts� °AOfaY Danal, alteration, or 3usiness name: . l 4 Kit 1 7 e , --I Z 6 +TU (j C oXtollafoh. Describe: Page 2 2 Address: � T y C f! c , ` Each add1tlone1 inspection over allowable In any of the above :ItYlStatelLII': /) Z Per inspection 62.50 t)tC. 4 7/ 13 uivefitIptio. per hour (1 hr min) 62.50 ?hone: (59 ) (, L j ei 6 7 I Fax: (S6) f industrial lent per hour 73.73 Cl3 Lic.: .. J4 � el l lectrical Lie.: Lie.: ]; ;a><.. 'rf ^:;;. 1 ; . 'd y r, .t bir T:`,143 ff :• gTA''T i ,' t Y 4 ; .. ,'� . 'IJ. ��, Yt 1 r { >lh .c VY, S upry i. tl:r:- subtotal iuprv. Electrician signature, ' uired Plan review 4f. ofm foe) ?tint name: State servha w ge (27 (81% of perm it fee) Date: 4uthorized signature: J TOTAL P1tRMlT FEE 61 •ta This permit appllcauen expires If • per7Att Is not ns0 MtA ebtaltn 150 day anus St hwa been accorded as er,eeyaets 'rant name: , iy. , / © b e i c - e f t (3...)v\ Date: /O j ( - 1 7 5 r • Poo methodology sot by Tri *County Building indue y s e r v i c e Board •• Number of lnuwaUw , Del Desn t allowed. CITY OF TIGARD I BUILDING DIVISION PERMIT #: ELR2005 -00336 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/11/2005 Phone: (503) 639 -4171 i 0.$1111 T 1 Inspection Requests (24 Hrs.): (503) 639 -4175 _ L. INSPECTION WORKSHEET FOR DATE: 12/14/2005 TIME: 7:01AM PAGE: 12 SITE ADDRESS: 15026 SW BLACK WALNUT TERR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 060 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: Vacuum System. Job #3447. OWNER: DON MORISSETTE COMMUNITIES, LLC, PHONE #: . CONTRACTOR: ALL WEATHERIZATION PHONE #: 503'649'6542 1 Inspection Request Scheduled For: Date: 12//412005 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 023480 -01 603 -209 -4897 N Corrections/Comments/Instructions: • g . PASS in PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL F / i L FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED i z / L i . ° Inspector — e: Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: ELR200S -00336 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/11/2005 Phone: (503) 639- 4171 �Wjm��gflll Inspection Requests (24 Hrs.): (503) 639 -4175 _,� INSPECTION WORKSHEET FOR DATE: 12/13/2005 TIME: 7:02AM PAGE: 5 SITE ADDRESS: 15026 SW BLACK WALNUT TERR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 060 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: Vacuum System. Job 13447. OWNER: DON MORIS SETTE COMMUNITIES, LLC, PHONE #: CONTRACTOR: ALL WEATHERIZATION PHONE #: 503 - 649 - 6642 Inspection Request Scheduled For: Date: 12/13/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message • 199 Electrical final 023392-02 5503-209 -1837 N Corrections /Comments /Instructions: 1 ©'j( 1"( S/ 6- I J U 12C � y � �6-- (' 1 r . • - / - IAL APPROVAL ❑ CANCEL ❑ NO ACCESS ` p ■ FAIL //-, L . •R INSPECTION ❑ ADDITIONAL FEES ASSESSED /2' /�_ Inspector: Date: . O Ph on e #: (503) 718- `