Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
I DEVELOPMENT SERVICES PERMIT #: ELR2005 -00377
' 111 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/28/2005
PARCEL: 2S109DD -BVO43
SITE ADDRESS: 15698 SW GREENFIELD DR ZONING: R -7
SUBDIVISION: BELLA VISTA LOT: 043 JURISDICTION: TIG
Project Description: ALL Encompassing low voltage.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: X AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: X BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: X CLOCK: MEDICAL:
HVAC: X DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: X FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: ALL ENCOMP : X HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS:
Owner: Contractor:
RIVERSIDE HOMES INC TECHNOCOM INC.
1925 NW AMBERGLEN PKWY #200 15865 SW 74TH AVE.
BEAVERTON, OR 97006 TIGARD, OR 97224
Phone: 503- 645 -0986 Phone: 503- 670 -9910
Reg #: ELE 34- 269CLE
LIC 73872
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 10/28/200` $75.00
[TAX] 8% State Surchart 10/28/200E $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 952- 1 -0100. You may obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699.
Issued By: i� , � Permittee Signature:
r \�
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 am required on the job site at the time of each inspection.
•
Electrical Permit ApR t�ion 1 11 p�
•li ca` FOR OFFICE USE ONLY
\. !J U ka�
City of Tigard Received
Date/By / / Permit No.
13125 SW Hall Blvd., Tigard, OR 97223 p C Plan Review 05 ' �� -, ,_A!� - 00 Phone: 503.639.4171 Fax: 503.598.196 2 O 1005 _ ^ Q : .7 y. Date/By Other Permit:
4
Inspection Line: 503.639.4175 .. "1.!— Date Ready/By: runs. ® See Page 2 for
Internet: www.ci.tigard.or.us CITY OF TIGARD Notified/Method: Supplemental Information
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W ..t.�. ... -5"'.. . y :+Fi ..1 .. ":.��pI I\I - , �.�A2`,,. � «; Y..-. . * ,.t r. "s.� -' >: 'nd 'S=: a^ A ,:, a;.,. -,.< ^ .
:',t : =.` - °a, ;�,, x,. - - elliiE, b WiNk 9a-�. r ..� # . < "t, : ` t'�s- „ ., . 3r r� . r- 3 ' 3
. ,. .... �::�,''- .s. ... �, _� - �... x..,..s.u�;^.�t = .:t�a�'�'.�; �:4F.�:: �e�;�r���� ,:; �' ',P•LAN: REVIEW��?,, ,'yy"- ?.se��. �. 4
("New construction ❑ Addition /alteration/replacement Please check all that apply:
❑ Demolition ❑Other: ['Service over 225 amps, comm'I ['Hazardous location
F ,, Demolition
F n- ,.: w ; :'u., ; ,;, . �., ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
. > „s ' Y . Ck:.: ax . ".: =` CATEGORY UCTION ,, _a ::s.1 -W" ;A ` .�
r ., �•,., .,°,, trti? 14,d 4. , of 1- and 2- family dwellings 4 or more new residential
1 and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi family ❑ Master builder ❑ Other: ['Building over three stories ❑Feeders, 400 amps or more
,u .r , * - s .,,. ; �,, g ❑Occupant load over 99 persons ❑Manufactured structures or
:, ;_ =\ 11Ki> =i� _'JOB : '.' S ITE;INFORMATI_N' "A LOCATI lY 'h=' _g ';`��`'.; ^.
z," , ,.:'�.., �.�� .:. ,� _ _ O . - •. .,- -0' _ w- ,r;�::."��:„� #,,:�-� ❑Egress /lighting plan RV park
Job no.: ay 7Lf Job site address: IS Gyre sw G.te4ncelt fV ❑Health -care facility ❑Other:
#•�� Submit 2 sets of plans with any of the above.
City /State /ZIP: olt ^ J dQ.. e l; Zv i I I The above are not applicable to temporary construction service.
Suite /bldg. /apt. n o. Project name: rj w.ty ' : `' 4�r� `'�-''t`''* ?•FEE* +.S CHEDULE” i _" ?'' "° i
t
I -yT Description I Qty. I Fee. Total ""
Cross street/directions to job site: I..- Qa New residential single- or multi - family dwelling unit.
�J X 'f�+ Includes attached garage.
G" 7fce". e.W 1,000 sq. ft. or less 145.15 4
Subdivision: e I h VIni.E., Lot no.: L Ea. add'I 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.: gY, l
„ Limited energy, non - residential 75.00 2
,at,,• '�` .:. '.,:.i AM K r .. :. DESCRIPTION' OF- °WORK. ; g 5 i .: ` v '3a,,,. - � f
' ' :�•.'" �``�,,,,.M,,. - Each manufactured or modular
e \ /DTI j {,� JI` /I � e_ : 4 D dwelling, service and/or feeder 90.90 2
f V Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
�' ''=;., .. ":PROPERTY:; M *% "."Rr �: :`;;s:" =:,: r , tnzti , k`9y{r;�.+,�a` r nt ',P 201 ampsto400am
_,�'� .�OVVIVER,�; °� a` a- �)''; �" •'`� �;��r;t >:.,z,:�:�R..;,o-., TEIY� t , amps 106.85 2
401 amps to 600 amps 160.60 2
Name: 601 amps to 1,000 amps 240.60 2 `
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
iy /State /ZIP: Temporary services or feeders installation, alteration, and /or
Phone: ( ) Fax: ( ) relocation
200 amps or less 66.85 1
Owner installation: 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 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
7y,•*�S: x #;'�di;�.�k��rv+`�-��;7 ": `.1"' - : Tli l ,A ^ s:.�' -- •, #'.'-' % .. V ,. .�.,, �.�o.
;, , �;,,; k ®;,.APPLICANTa, >, �;" .' A,R t ®, CONTACT PERSON " `=''/ A. Fee for branch circuits with
service or feeder fee, each
Business name: branch circuit 6.65 2
B. Fee for branch circuits
Contact name: without service or feeder fee,
Address:
each branch circuit 46.85 2
Each add'I branch circuit 6.65 2
City /State /ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) Fax :: ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E - mail:
Signal circuit(s) or limited -
.,. ; 1vte " igi ?.; :�' `' a, ; . ` „�, :h,.;. ar, ° {'. :r a : T .=� 3;:u. ,P '
-, CONTRACTOR;� � ; z, �'''` '"�` � e a
�f.� r... �'�,.,,,: = �_a;.,,,'���'r ��:::<:�•, - ;€�< � ,:��'�:�� ..�; �� .��;.�*' +'i''� energy panel, It
eration, or
. �Lr - .v x� p::t�4'v re m` s'.r� -r. fie'rx`5 ,
Business name:-�'�,1, , no LOI+% ._ Jew : . e.
extension. Describe: Page 2 2
Address: PO L.,`x, C.q 5-, Each additional inspection over allowable in any of the above
11 Per inspection 62.50
City /State /ZIP: 1� �: N O L� d6 Z Investigation per hour (1 hr min) 62.50
Phone: (Col )6 70 Fax: (/Z ) �O 10 i Z. Industrial plant per hour 73.75
~,i- -, - .•�'ETJECTRICAL�.PERMIT FEES. ,
CCB Lie.: F 3E-9 Z El ectrical Lic.: 3y0,0 L A Suprv. Lie.: Subtotal `45 C.'"
Suprv. Electrician signature, required: Plan review(25 %ofpermit fee)
-
t name: C� y State surcharge (8% of permit fee) vO
_ Y�v. /01.5 a Weic tiei►,. Date: 2 . E .,,,,„ 7 05 -
Q TOTAL PERMIT FEE 4� t d
Authorized signature:
This permit application expires if a permit is not obtained within 180
d ays a it h as b een a ccep t e d as co
Print name: Date: * Fee methodology set by Tri- County Building Industry Service Board
•• N um b er o inspec per permi all owe d .
is \Building \Permits \ELC- PermitApp doc 12/03 440 -46 I 5 T(10/02/COM/WEB
Electrical Permit Application - City of Tigard •
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
;'.RESIDENTIAL °:WORKONLY ' z _ >u.
Fee for all residential system's combined $75.00
Check Type of Work Involve d:
❑ Audio and Stereo Systems
❑ Burglar Alarm
•
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Co ditioning
System*
❑ Vacuum Systems*
❑ .Other:
`COMMERCIAL; W ORK ONLI': r w
Fee for each commercial system ',75.00 •
•
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Insta ation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Sys ems
❑ Landscape Irrigation C• trol*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape ighting*
❑ Protective Signaling.
❑ Other
`tPPotaJ number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
i.\ Building \Permits\ELC -PermitApp.doc 04/03
CITY OF TIGARD .
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BUILDING DIVISION PERMIT #: ELR2005 -00377
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/28/2005
Phone: (503) 639 -4171 .4 �v,� 1 .
Inspection Requests (24 Hrs.): (503) 639 -4175 • J #'I �,.
INSPECTION WORKSHEET FOR DATE: 7110/2006 TIME: 7:05AM PAGE: 40
SITE ADDRESS: 15698 SW OREENFIELD DR CLASS OF WORK:
SUBDIVISION: BELLA VISTA LOT #: 043 TYPE OF USE:
PROJECT NAME: BELLA VISTA
DESCRIPTION: ALL Encompassing low voltage.
OWNER: RIVERSIDE HOMES INC, PHONE #: 503- 645 -0986
CONTRACTOR: TECHNOCOM INC. PHONE #: 50: -610 -9910
Inspection Request Scheduled For: Date: 7/10/2006 Pour Time:
ode • Inspection Description Confirm # Contact # Message
199 Electrical final 032856 -03 . 503 - 572 -4708 N
Corrections /Comments /Instructions:
-it SDI
c -....s'N.
A.pAss n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
MEI
-' IL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: (7 0 68 1 Date: 1 p Q.t Phone #: (503) 718-1Alt
4 .
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2005•00377
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/28/2005
Phone: (503) 639 -4171 :Ndioivip i i l �
Inspection Requests (24 Hrs.): (503) 639 -4175 „Jig-
INSPECTION WORKSHEET FOR DATE: 7/10/2006 TIME: 7:05AM PAGE: 41
SITE ADDRESS: 15698 SW GREENFIELD DR CLASS OF WORK:
SUBDIVISION: BELLA VISTA LOT #: 043 TYPE OF USE:
PROJECT NAME: BELLA VISTA
DESCRIPTION: ALL Encompassing low voltage.
OWNER: RIVERSIDE HOMES INC, PHONE #: 503 - 645 -0:986
CONTRACTOR: TECHNOCOM INC PHONE #: 503. 670 -9910
Inspection Request Scheduled For: Date: 7 /10/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 032856 -02 503-572-4708 N
Corrections/ omments /Instructions:
At* \ iN AS. I : 9 1 I
MI kikitaal l iKa l L .VI I k k
•
,la PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
[ '1• all = L o - I • "E %,• N ❑ ADDITIONAL FEES ASSESSED . . - ) Inspector: • V q3 L Date: Hq0 Phone #: (503) 718 -1.