Permit r , '
CITY TI GA R D ELECTRICAL RESTRICTED ENERGY PERMIT
DEVELOPMENT SERVICES PERMIT #: ELR2005 - 00105
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 5/9/2005
PARCEL: 2S 109DA -05100
SITE ADDRESS: 15284 SW GREENFIELD DR ZONING: R -7
SUBDIVISION: SUMMIT RIDGE LOT: 028 JURISDICTION: TIG
Project Description: All encompassing.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: X 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: LL ENCOMP : X HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS:
Owner: Contractor:
DON MORISSETTE COMMUNITIES LLC GENESIS HOME TECHNOLOGIES
4230 GALEWOOD STE 100 8104 SW NIMBUS AVE #4A
LAKE OSWEGO, OR 97035 BEAVERTON, OR 97008
Phone: 503- 387 -7538 Phone: 503- 643 -1704
Reg #: LIC 128098
ELE 26- 989CLE
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 5/9/2005 $75.00
[TAX] 8% State Surcha 5/9/2005 $6.00
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC at 503 - 246 -6699.
Issued By: .2_7_4_,5 Permittee Signature: S1 L Cl/
OWNER INSTALLATION ONLY \
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mai 09 2005 12:04PM GENESIS HOME TECHNOLOGIES 5036433300 P, 2
r -
Electrical Permit Appli - -- -- _ >I{ DI t �( 1; t tit. ir`i.i
City of Tigard E I V E T " R e d —_, _ _ �.� rennet No.: r'_
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
t: -
Phone: 503.639.4171 Fax: 503.59$.1960 MAY 0 9 nIP+J Datc(By: Other Permit,
Inspection Line: 503.639.4175 M :_ Date Ready/Ely: I See Page 2 for
Internet: www,ci.tlgard.or.us _ CITY OF TIGARD Notlned/Methad: _- ) IV Supplemental Information
nfint to 5 Y K 9. M51k0:�5A1dg1vnn rr�Awmw,rkam+ „miff + , �
��4�� � � mvv�n -q,� �pv t xrea� ��r m�'�y� yt alp �p �qA� v y li iii ih } oE(2 Y 'c,�l` 1ti0t1�w ',� ,,,,
�h � , v�,r � a
; , ,.I' ; $ 4" I i1, .-.., rca ,41', . v��&88 }EY��, o's "Ll� �l st:I . w "r "n io . A . V i g � i l 14.4i
l , is � .. ,
ri New construction ❑ Addition /alteration/replacement Please cheek all that apply:
❑ Demolition ❑ Other;
❑ mt
Service over 225 amps, oon'1 ❑Hazardous location
{ + ivlt!�t v My + + +ry�' n!t�l�.na +a�n�pamnaaopa Ana, g}raus +nrux +t or lP 9 F wt m,arsMi,i, ❑Service over 320 amps – rating ❑Bufldng over 10,000 sq. f„
5 � f }�+) fi1,d } ; 1 #1}�, 1, 3 @y,,ri,��11E1EE� y ` I ,31 .c . i :s e. N ty �a ,Ni§" � �' igg ''' ) ""' l�i ' . 0 ,' ' Y e
t1,1+4 it il?ti l.til ' atli ��', Nx.1NkK,1t11ANdt1Aw„ htiNrtnttf a kairaS NkS�sfiIGS+SWf�F kMrlf to N4 � h fa.i ^USie f n � r ' .:.', of 1- and 2- t.�hmil dwellings 4 CT more new residential
11 1- and 2- Family dwelling ❑ Commeroial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
Di Multi•farnily ❑Nestor builder ❑Other; ❑Building over three stories ❑Feeders, 400 amps or more
1 +4 4 lv^ n + v g µ , uhna +lvw u�nt�y k ;s rAx xy�blp + +iq1 + Iwh}v.'p n ll�j f + c �%Y,:A S 1, } ❑Occupant load over 99 persona ❑Manutisetured structures or
e o 4 , ° dt T grata ua00104at irfti5COtnt4C'b.440. i (w :rr. ,
t�ik , . .4.N4xnH4,1 , Eli? ❑Et3iess/Ilghtingolan RV park
❑Health -cars facility ❑ate: _
Job no.: Job site address: S ee �. _ Submit 1 sets of plans with any of the above.
City /State/ZIP: ,4 A, 1 Q,�yo, r The above are not applicable to temporary construction service_
Suite/bldg./apt. no Project name ; in . '" ' '.a 3;: Ct i iri o 3''+ . ;
Deuriptlon Qv, Fu, Total •'
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 4
Subdivision: 4 rt4 e... 1 Lot no,: 2,,53 Ea add'] 500 sq. ft. or portion 33.40 1
Limited energy, residential / 75.00 '150. 2
Tax map /parcel no.: -
+ k { r } �� ryy""(({{ x r� �7 K
r U y�.�cv � gvtm ! rva a n u S �+ {�{} Limited energy, non - residential 75.00 2
6 u . �i,q� W fNk%iMO1�(l2001100.4Y31A�V l w I A N'd'Andv�4 �t :' add Me S , 4 8 menu or mo dul ar
/� /� dwelling, service and /or Feeder 90.90 2
#` / �'r e0 ,# , . • ).1g Services or feeders Installation, alteration, and /or relocation
r,r. 4 e 200 amps or less 80.30 2
i r y m ul ing:obim oxi�s p + Y x9wl.w,g7 y $t 201 am s to 400 106.85 2
l l . 44;19,, 1iYi�(i8,i%� � q .1 - ? M.:4 Myi + "5�, vloeileakt #4411B
Ntuno; � _ 401 amps to 600 amps 160.60 2 1
4 d`1 pe, &�zr,i , D01,�� 601 amps to 1,000 amps 240.60 2
Address; z.21,0 /e'i.' Jd .. & /00 Over 1,000 amps or volts 454 :65 2
Reconnect only 66.85 2
City/State /ZIP: Zee ,,��iv,& D 4#r a& 997O3c Temporary services or feeders Installation, alteration, and/or
Phone: (S ) J'7- 74--/ I Fax: ( ) relocation
200 amps or less 66,85 1
Owner installation: This installation is being made on property that 1 own which is not 203 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 '2
Owner signature; Date: Branch circuits – new, alteration, or extension, per panel
v� r. � y. r a K ,eN9xlWfxrAw 1w w .riwe .
gtRAMEN ;f��1$� 1 s }ij`�:1'� t �}� �.p. , '$[ } (eft �f tNf A, Fee for branch circuits with
+• w�' 4N444Y1, 4# ri #YYCYYCIklkl /ft7tllYaYfGl'YA'fii. service or feeder fee, each
Business name: branch circuit
6.65 2
B. Fee for branch circuits
Contact name; without service or feeder ibe, 46.85 Z
Address: each branch circuit
Each add'I branch circuit 6.65 2
City /State /ZIP; Miscellaneous (service or feeder not included)
Pump or Irrigation circle - 53,40 2
Phone: ( ) I Fax: ( ) Sign or outline lighting 53.40 2
E-mail: Signal circuit(s) or alteration, or limited -
ggt rpg iy u' �" y i d '" "t" t E yy t{ �} +� qq«1 }�y� 'q+ . %,
td3�li ?� d�d�� }t��A��4T,Vl,n„m,,,•,aki+�r � a:1���7.4"tH.��'�AEVNr'k��tkGi' 44��1tt'�a{� energy CY P ane
Business name: extension. Describe: Page 2 2
Addre44' Each additional Inspection over allowable in any of the above
Cit; GENESIS HOME TECHNOLOGIES investigation a
Inv on 62.50
per hour (I hr min) 62,50
— 8104 SW Nimbus Ave. #4A Beaverton, OR 97008 Industrial plant •.erhour 73.75
Phc Phn- 503 - 6.43 -1704 Fax- 503-643-3300 } wit �v ! ?" ; 'N - 4
CC CCB 128098, CLE26- 989,
Subtotal 7S
°I " I ^ ; Z„bn i .w, .',',"" try,, .a t t
L ' ( 2885 -JL 75 -- o,p
Sup / Plan review (25% of permit flee)
.T �o yyJ o Date: State surcharge (S% of permit fee) Q Oa
Print name;
¢� '� p TOTAL PERMIT FEE '/,, a$
Authorized signature; This permit application a pu is obtained within 180
- days ppl after It has expires been If accepted mlt ae not co mplete
Print name: Date: • Fee methodology as by Tri- County Building Industry Service Board
0 ° Number of inspections per permit allowed,
i,\ Bonding \ParmitclEt- C•Pv,m 1243 4411- 461ST(10/03fCDINWEB
CITY OF TIGARD --\ BUILDING DIVISION Y PERMIT #: ELR2005 00105
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5912005
Phone: (503) 639 -4171 ��rtip��yi��w) ilhl
I nspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TIM/ PAGE:
5/11/2005 7 :12AM 66
SITE ADDRESS: 16284 SW GREENFIELD DR CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 0213 TYPE OF USE
PROJECT NAME: SUMMIT RIDGE
DESCRIPTION:
All encompassing.
OWNER: PHONE #:
DON MORISSETTE COMMUNITIES LLC, 503 -387 -7630
CONTRACTOR: GENESIS HOME TECHNOLOGIES PHONE #: 503 - 643 -1704
Inspection Request Scheduled For: Date: 6/11/2006 Pour Time:
• Code # Inspection Description Confirm # Contact # Message
135 Low voltage 006572 -01 503 - 6431704 N
Corrections /Comments /Instructions:
71
,i,, -ASS n P fkRTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL E / CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
CS/7
Inspector: Date: Phone #: (503) 718-