Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
i DEVELOPMENT SERVICES PERMIT #: ELR2005 -00317
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/4/2005
PARCEL: 2S 109DA -08200
SITE ADDRESS: 12982 SW HAZELCREST WAY ZONING: R -7
SUBDIVISION: SUMMIT RIDGE LOT: 076 JURISDICTION: TIG
Project Description: All encomping 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: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: ALL ENCOMP : X HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS:
Owner: Contractor:
DON MORISSETTE COMMUNITIES, LLC GENESIS HOME TECHNOLOGIES
4230 GALEWOOD ST # 100 9450 SW GEMINI DR
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 10/3/2005 $75.00
[TAX] 8% State Surcharf 10/3/2005 $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 95 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699.
Issued By: t &Iti/L) Permittee Signature: Y C' .47A) 0-- U
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.
Sep 2005 1:31PM GENESIS HOME TECHNOLOGIES 5036433300 p.1
., . - F lgEtrical Permit A { � I.4 )1: t ll' l I4 ' I 1 ! ti 1 4 iN l 4
k'u
City of Tigard a �� Received y. , -- - - .� / Pemlit No I -
t3' 8 Date/By./ � �... ���2. 2�vs 3/ 7
13125 SW Hal Blvd..,ligard, OR 97223 . Plan Review
Phone: 503,639,4171 Fee 503.598.19 8 ` 11 1 ''v°•th ' 1 �,, I ; Other Permit
Inspection Li lie? 503 :x39.4175 I �7L 1 .:1 ail. 'a t Date Readyaly: J E See Page 2 for
Internet wutiv,ci.tigerd.or.us Y 0w rMRRP N i i Supplemental Information
' 41 ^: i" ' " _ ,y..' � "J� tlUtll? (' � •i JW'L SIS 4 Tk MV p 1 7 ( , p
..� �: '5l. nYN''1 • .:� ° - .�,: i. �.. �.4 •t ,.. �.,�. . , ,, •, ., .:L 1t C3 6:'S �
3.L! >'•1 ,1} a� t� �I . , P , ,t .. x ,� � +'j u 4�, 1 ' �A S�� ,�, �l4 (� R 1Tf ytilt 3ydE 1G.i } { "u t i ,IJ I , 1 ��Fi""� � P,1�. � "r '1 1 y' �`, tt' " �i
� 1, l ,.�4{4tlp�rf. 7, z � . y y y,',�'r�' ,� yV � .. 9.�. itY w 1 S, a l P • � ! r� ,1 p f ro , 1y}.. 1 t� 1, f x,,,.1 . '1971 t' � (1h5' �,.,(�n.'.�.��, � }4. ii U ,GS.Y l?f r y Fryf' "P f, FIY Y
4: '!':R�iSlfl!li L�Ad,' �V�� 1 y1^t4. H 3 ,4,!,.1_a 34,,n..l a lipl t Ait �kalVttim MI. ∎,fpl.�, M.iltr l . 1 5' L.lw t ',fly �',ilL r�,,ik 413 wriX�e.tdNNwo,i 2miti s,.wr y1lu se;kik��riain.! .,, i
F ilklit!e..•h . Gee, G
I,1 New construction ❑ ^ ddition /ltlberatiort/replpcement Please check all that apply:
❑Service over 225 amps, comm'I ❑hazardous location
❑Demolition El Other:
, - ( r � ,aa>s„ r•r wu T { �1 cap ,u, r,,, ,� , re , . „ , • ❑Service over 320 amps - rating ['Bulking over 10.000 sq. It,
T £ flit c ! @ "` N , E q �'a a t, o ,, r t t;� tttarp P : P P l � � I of 1 -and -Wail d
; 1 iikti iYatt .,,1a4 4r ' � , ila. 1.DULP.11: , atliiir hlnDtali iA∎IIVae ,., IV a F .� 4 d1. 1:.:,.x{1,,. I ) y dwellings 4 Of more new residential
IN 1- and 2- family dwelling 0 Commercial /industrial ❑ Accessory building System over 600 volts nominal units In one structure
E] 141u1ti farm [] Master builder ❑ Other ❑ 3uilding over three stories ['Feeders, 400 amps or more
r i� w t eutx c, % r Senn pa aaY..J.i,9 1 t1VtkY {.uljf�,L� FH tY 1171(, r r t i [Occupant load over 99 persons ❑Mtmufactured structures or
� 14 1 i 11�, tl i 1, ; .' 1 Y 7 ;b.' n (� V i� 1 t 1 5 Y'df+gt NWIR� t 1 iX i .r,, R, fitbi
i 'i� akitiatgAbtl +ittsis• tkali tlkhZ i4,4i.is, lai.14s,Atzt.t tiles firs!.Ya mii'Ak lSaltkAM'tkI +ONA tits F„l ❑Egress /liShtin8 Plan RV park
/ f �� Ste , / ❑Health -care facility • ❑Other:
Job no ": Job site address; / } ,Zzr die e s/ id . Submit
1. sera of plans with any of the above.
City /State /ZIP; -7 j A ee l 4 The above are not applicable to temporary construction service.
Suite /bldg, /apt. no ": Project name:
tY,1S ��' >4� N ,yr,�ii¢ wetrt a i �
1 +rti %ta :eR k i; t a,. t > n«I . rk;',,�'i .
neueiptkn Qtr, ne, Total ■`
Cross stroet/directions to Job site: New residential single -or multi - family dwelling unit.
Includes attached 'garage.
1,000 sq. R. or less 145.15 4
Subdivision: , - I Lot no.: 7r,i, Ea. add'1500 sq. it. or portion 33.40 I
Limited energy, residential f 75.00 75 o,°, 2
Tax map /parcel no.:
7Y t Y YI "� Y ' >� tk1 p w u g wdnxc, i ,Fla (,v tit , j • f � ty � a � 1 r Limited energy. non - residential 75.00 2
��,sr��E 1 Iirr1S6 L,i,µ�m�" >�r" �d Yfl Each tnanutttrad or modular
�/ e 7 e sn .4 .'1 , dwelling, service and/or feeder 90.90 12
Services or feeders Installation, alteration, and/or relocation
Ai ' ' , 200 amps or less 80.30 2
P irk l'1y1` 5� A � +Is,vcr� ra+ I; a�Myf�xn , a , , i< � 1 r fla•�s Y f < vv N � } n r v r „� yr l 201 Atli S b)400 am B 106.85 2
c� S, Wi , b yp • t 6 ; 5�' 4 _, ``,M ', '1 !,) �i kt G'l: ”' '�, t r t ' _ Qp�'t s }.E ° 1 �� ry'�]g `r i 4 ' t l p F '
JI Y t 1. 1 ii , ( Mk�1�LYYy5Y1Jhf .9'!�'i„Yl.`I.Y.1ilA..AkN„f LSJA,G , ( t dtAl'1171 �7eRtka7 R^F:I .K't at 1 401 amps to 600 amps 160,60 2
Name: ,D01 j p PAw/ .0 a1 601 amps to 1,000 amps 240.60 2
Address: t/ el 404/ y2Di2 1,Z, .'Air / p D Over 1,000 amps or volts 454,65 2
Reconnect only 66,85 2
City /State /Z1P: 0 0 4', . r - . or Temporary services or Ieeders installation, alteration, and /or
relocation
Phone: (6.0 ) 16 7 - ?CS g Fax: ( ) too 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: }a e g y� Date Branch circuits - new, alteration, or extension, per panel
1 " dt{t1£kt �Y`tat'Ak 1�faASIAf ?F,{l;{ 1" �L)u} a �1r. fit, a:aN�JSn nr�v {(1(; t(�
i hill ShB .. t,71tFSarw¢�u�is 1:1 �D14i11F., bail ll,'fftbltt � ; � 'd `Ja1111, $1 E ' $,r �t n 54fi&ttAl R A. 'cc for bran circuits with 1
service or -0-er —0, each
Business name: branch circuit 6.65 2
B. Fee for branch circuits
Contact name: without service or feeder fee,
46.85 2
Address: each branch circuit
Each mid'l branch circuit 6.65 2
City /State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) I Fax: ; ( ) Pump or irrigation circle 53.40 2
Sign or outline liahtina _ 53.40 _ 2
E Signal cinvit(a) or limited-
Y .3�4t+. li i rt ' ar N 1 4`1 f 1. lilr i l ' ir i w Mena ta { i ) ,) 3 f. ralll energy panel, alteration, or
extension. Describe: Page 2 2
Busin Sti fie:
Each additional inspection over allowable In any of the above
Per inspection 62.50
city GEN 'SIS HOME TECHNOLOGIES Investigation per hour (I br min) , 62.50
Geminl Drive Beaverton OR 97006
9450 S I ndustrial plant per hour 73.75
Phu Phn- 503 343.1704 Fax- 503- 643.3300. ;, Z' ,'` a1' iar'Z 'tw, ;; 1,'.l e i'i1kw,liai,,E.ii! a ' ?l '"z'`•a `;'
CC ', ls' , .,,/ 0.9 ;; (_) 2885-JLE Plan maw (25% of permit fee)
Sup `,, v
Date; State surcharge (8% of permit fee) (p o
Print name: . ... 44 . . , � �f - z S - tn 5
TOTAL PERMIT FEE ag / a.L'
Authorized signature: This permit application expires Ir a permit is not obtained within 180
days after It has been accepted as complete
Print name: ', Date: ' Fes methodology set by Tri- County Building Industry Service Board •
Pe Number of Inspections per permit allowed.
i Bu ;Inlag4Venrite'9LC•PornItAppdoo 12191 440.46I5TO 0/021W04/WEH
1 - - .:•
CITY OF TIGARD if
BUILDING DIVISION PERMIT #: ELR2005-00317
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: '10/4/2005
Phone: (503) 639-4171 '4001 6,
Inspection Requests (24 Hrs.): (503) 639-4175 AJ. --z!_i!.
INSPECTION WORKSHEET FOR DATE: 1/6/2006 TIME: 7:00AM . PAGE: 77
SITE ADDRESS:, 12932 SW HAZELCREST WAY CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 076 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE
DESCRIPTION: All encomping low voltage.
OWNER: DON MORISSE1TE COMMUNITIES, 1.1.C, PHONE #: 503-387-7538
CONTRACTOR: GENESIS HOME TECHNOLOGIES PHONE #: 503
Inspection Request Scheduled For: • Date: 1/512006 Pour Time:
Code # Inspection Description . Confirm # Contact # Message
135 Low voltage 0243613-01 503643-1704 N
Corrections/Comments/Instructions:
a 1/1 0
R . . Sql Ai. P: A A A IA A i k
■__, ;
M t r YfAtf/ I ' ' I 55 L
.......
),..._\.)
•
n PASS 0 PARTIAL APPROVAL 0 CANCEL 0 NO ACCESS
FAIL . K CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: liG Date: t (S Phone #: (503) 718-
. _
_ ~- ~ ' _ _ ' ` _ _- - _- -
CITY OF ��un n n�"m wm���mon��
BUILDING DIVISION
~�~°"~~~=""~~° ~~"°"~°"~~"~ PERMIT #: ELR2005'00317
13125SVV Hall Blvd, Tigard, ORQ7223 ^ DATE ISSUED: 1014/2006
Phone: (503) 639-4171 44440
Inspection Requests (24Hroj:(5D3)63Q'4175 �14 ^-.L.
INSPECTION WORKSHEET FOR DATE: 10/6/2005 TIME: 7:02A1v1 PAGE: 1
SITE ADDRESS: '2882 EWHAZELCREETWAY CLASS OF WORK:
SUBDIVISION: 0Uk4hA|T LOT #: 076 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE
DESCRIPTION: All enonmnpinQ|cmvvoltage. - //
\.J/
OWNER: DON hA[�R|S8E| |ECOk4KHUN|TlES. LLC, PHONE #: 503
CONTRACTOR: GENESIS HOME TECHNOLOGIES PHONE #: 503
Inspection Request Scheduled For: Date: 1016/2005 Pour Time:
.
Code # Inspection Description Confirm # Contact # Message
'-»��`
l�5 �� ...ow voltage 017657-01 603-643-1704 N
Corrections/Comments/Instructions: '
\�\k
/ �\�°~
.
' .
,
I | PASS U PARTIAL APPROVAL EI CANCEL EI NO ACCESS
n FAIL ri CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
�� �
Inspector: '��� Datg��w —��-� -1 ^� Phone #: (503) 718- .
', '
^.` . ' /
-. '