Permit .. - CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00331
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/4/2007
PARCEL: 2S104BD -07100
SITE ADDRESS: 13784 SW FERN ST ZONING: R -7
SUBDIVISION: PP1995 -017 LOT: 003 JURISDICTION: TIG
PROJECT: DDR DEVELOPMENT
Project Description: Limited energy for security, audio and data / telecommunications.
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:
DDR DEVELOP GENESIS HOME TECHNOLOGIES
14295 SW WOODHUE ST. 9450 SW GEMINI DR
TIGARD, OR 97223 BEAVERTON, OR 97008
Phone: 503 -260 -3017 Contact #: PRI 503- 643 -1704
FAX 503- 643 -3300
Reg #: ELE 26- 989CLE
FEES LIC 128098
Description Date Amount
[ELPRMT] ELR Permit 9/4/2007 $75.00
[TAX] 8% State Surcha 9/4/2007 $6.00 l 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 rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct . _ - 'ons to OUNC at 50 • +.6699 or 1.800.332.2344.
Issued By: / �/ Permittee Signature: nn r
Y' i�����I / I g , X );(4,,, �
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.
w r 4 2007 8:33AM GENESIS HOME TECHNOLOGIES 5036433300 p.1
Electrical Permit Application
RECeiVE i'011.24)111(1. 1 \ I ';1.: 0 :
City of Tigard "B ° frl I Permit W °.; 1 ZOO - • 1 3
■ 13125 SW Hell Blvd., Tigard, OR 97223 $ E P 0 4 2 00 Pion Review Other Pbrmit,
Phone: 503.639.4171 Fax: 503.398.1960 Date/13
Inspection Line: 503.639.4175 i - ry j` .- r ate Ready/By: turf 0 See Page 2 for
r : n tr 1 In rt%4tt www.tigard-or.gov _ . , 1 Bed/Method: � Supplemental irdomwtIon
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6Re A•ItlYU..uoxzaiz a,, .g o,ioW;.d4!°n •. ., Rhr 4.1:.)WM1.. 44 iu s ,...,, bpi .NM1 ..1• nr. sine l3L u.. x , n Y. �1 r. leizra c - 411i;
® New construction ❑ Addition /alteration/replacement Please check all that apply (eutunit,a gets of plane w/iteme checked below):
0 Service or feeder 400 amps or more ❑ Building over three starlet.
❑ Demolition ❑ Other: where the available fault current 0 Marinas and boatyard'.
,yep S a. Y1 P , o yn a Ftxr4 111 51 p+ V l � . i a 1 x1. Y amps at 130 volts or Floating bulldl
�. 1 ,{{ r
i ° a . 4 v ° ia t..SiE ' p iegt t exceeds ground, o m ❑ S �•
� , v Ymt,,t uSir t�m&mtws�P�al,�ktavtw4wSvI.1� . 1,1Mi Y 0 tt. - � ■ �`'' lest to gro°nd. Or exceeds 14,000 ❑ Commercial agricultural
0 1- 0tad 2- fancily dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installation'', buildings.
❑ Mul ti famil ❑ Master builder ❑ Other: ❑ Foe pump. tJ Installation of 75 KVA or
g, > „" .n. a -� v r �1 s qty 5 aye s s r a ❑ Bmereenoy System- larger separately derived system,
�,e `7 f. l . ii10 ,t . t t w r re.' ' r t " 5 , • �, ❑ ❑ „ „ r atel , r. -3 vr
x x.d.siv crux ihs, car ,, x13,vvi m444..1 , ;!�r x „ Addition of new motor load Of
Job no,: Job site address: 13784 SW Fern St. Ie7piiP °` more. °oo,ryAwy
iD Six or more realdentaal units. ❑ Recreational vehicle packs.
City /State/ZlP: Tigard Or. 97223 OHealtb -care facilities. ❑ Supply voltage for muro than
Sttite/bldg.apt. no.: J Project name:
CI Hazardous
or v: ,Y y 600 volts n°minel wr¢ �-# r µ
Hazardous locations.
■ 5+ervice of feeder 600
Cross street/directions to job site: De'criptton • . Fee. , • +
' New reildential single. ur muttidamlly dwelling unit.
Includes attached garage.
Subdivision: 1 1_ot no.: 1,000 sq. ft or less _ 145.15 4
Ea. add'l500 sq. ft. or portion 33.40 1
Tax map/parcel no.: limited energy, residential
,V n , r °?'''''rr xarwrvrfr,V T rw nw MSp'S' 't p of �. Py 75.00 2
; 1 ', k,i: v i wx �d ''t
� ralrcrvu,,isnrnsc i i i
vk A�k ,, ,,,, z w%' @ ".0b :'iNd , (with shove se.. ft )
limited Energy / P - 1 4 - residential (with above lft.) 7500 2
Structured wire / Security / Audio Services or feeders instulladon..alteration, and/or relocation
200 amps or less 80.30 2
‘4,..,4H,:, . � _ ;lI t , ,,, , p .. t M.,
3 ,I.. 1t ,' , 7S ,,,..,,;,,...,i0 ', 7 N r y ` ' • : 1 . ) • " ,, t • f r V wt, ri 201 amps to 400 amps 106.85 2
�� , � � .. ,s: �� �r
g} 'x,�l:l � '� �� A' 6. 4i , kti.lt. ,L. , r,'"rfft�l �, � p
Name: I) D R 4 e -.etf 401 amps to 600 amps 160.60 2
CC i L 601 airs to 1,000 amps 240.60 2
Address: L 4.2..q S 1 d, e(� , L d D + <�..-}` , Over 1,000 amps or volts 454.61 2
City /State/ZIP: D rZ4_ 14 y, ea., .41 Z- Z4 �W ➢ services or feeders installadon, alteration, and/or
Phone; (5 t LlaC - 3C) 17 I Fax: ( ) 200 amps or less 66.$5 L
Owner installatloni This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 4147, 449, 670, and 701, 401 amps to 599 amps 133.75 2
Owner signature; Date: Branch circuits - new, alteration, or extension, per panel
1 A. Fee for branch circuita with
y'.. u 7, i r wr nor r, Y' , • � P �' 1 3 , . , t Y 4,97, yt x;x w�,wc Oat' it.
„• f ite,w •. e a . . r� s e .: nw t....... . `,� tit. ,� 4 Fes; ° M � . ,m ,;; , r 1R :I above service or feeder fad 665 2
s..S na,.,M.: �.yr.
each branch circuit
Business name: B. Fax for branch circuits
without service or feeder fee, 46.85 2
Contact name: first branch circuit
Address: Each add'l branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City /StatelZIP: Bach manufucturod or modular 90.90 2
dwelling, service and/or feeder
Phone: ( ) I I ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
i @�t� ?a14 + ;" 1+ x w t r v� p r uu w 5 8' Gk sir at t ._... 2
.. ff,.'g g w'a :r_ i Y x ,:.1: f� .'.4:sta .:23:,''J'Nb ` n,�r3� 7 l vt�� 7' ...5 ;C t. Sign or outline li 53.40
Business name: Signal circuit(') or limited -
energy panel, alteration, or
Address: extension. Describe: i Page 2 75.04 2
City /State/ZIP: Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) I Fax: ( ) Investigation per hour (1 far min) 62.50 IIII
CCB I GENESIS HOME TECHNOLOGIES Industrial .:,.t .er hour 73.75
9450 SW Gemini Drive Beaverton, OR 97008 ` i■11M WY „ ..t,.,,,, Y 1 r,.,p •: ;! t i' ', ': ;IN *WV: : :'
Suer • Phn- 503. 43.1704 Fax- 503 - 643 - 3300 Subtotal: 75.00
Print n .27711' . CCB 128098, CLE26 -989, Plan review (25% of permit fcc):
2885 -JLE State surcharge (8% of permit fee): 6.00
Author TOTAL PERMIT FEE: 81.00
Print name •-�' p a te: This permit a after It haa bean permits not obtained within 180
Zi Pr6 fa ►ti YY1 e, - ! - `i " D 1 y accepted comp
• Number of inspections allowed per permit.
t,{eaitdlnp o nliai/C- PandtApp. 0353ro6 40.461dTe11/05/COMIW D
CITY OF TIGARD
BUILDING DIVISION ,41 PERMIT #: ELR2007-00331
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/4/2007
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 6/23/2008 TIME: 7:01AM PAGE: 53
SITE ADDRESS: 13784 SW FERN ST CLASS OF WORK:
SUBDIVISION: PP1995-017 LOT #: 003 TYPE OF USE:
PROJECT NAME: ,DDR DEVELOPMENT
DESCRIPTION: Limited energy for security, audio and data / telecommunications.
OWNER: DDR DEVELOP, PHONE #: 503-260-3017
CONTRACTOR: GENESIS HOME TECHNOLOGIES PHONE #: 503-643-1704
Inspection Request Scheduled For: Date: 6/23/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 071694-01 503-643-1704
VA
Corrections /Comments/ Instructions:
•
i c\ I
PASS El PARTIAL APPROVAL fl CANCEL I I NO ACCESS
I I FAIL 0 CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: G-Th N tifst..e° Date: 14 . ' (7t Phone #: (503) 718- A_
CITY OF TIGARD •
BUILDING DIVISION ! PERMIT #: ELR2007 -00331
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 914/2007
Phone: (503) 639 -4171 // u auil hims r
Inspection Requests (24 Hrs.): (503) 639 -4175 'VI
INSPECTION WORKSHEET FOR DATE: 10/12/2007 TIME: 7:01Am PAGE: 71
SITE ADDRESS: 13784 SW FERN ST CLASS OF WORK:
SUBDIVISION: PP1995 - 017 LOT #: 003 TYPE OF USE:
PROJECT NAME: DDR DEVELOPMENT
DESCRIPTION: Limited energy for security, audio and data/ telecommunications.
OWNER: DDR DEVELOP, PHONE #: 503 - 260 -3017
CONTRACTOR: GENESIS HOME TECHNOLOGIES PHONE #: 503-643 -1704
Inspection Request Scheduled For: Date: 10117J2007 Pour Time:
Code # Inspection Description . a m # Contact # Message
•
135 Low voltage 057466-01 503- 643.1704 N
Corrections/Comments/Instructions:
A1-k) 1'O \ ( 5 1 6U._
R.
?2-c Ccr c,Y-k, (v.AC) his4\a,.
•
C PAS� n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ( Y , 9 O �'�g Date: 1 0111401 Phone #: (503) 718 -1 f k