Permit CITY TI GARD ELECTRICAL RESTRICTED ENERGY PERMIT
41.
DEVELOPMENT SERVICES PERMIT #: ELR2006 -00024
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 1/17/2006
PARCEL: 2S 109 D B -03300
SITE ADDRESS: 13104 SW HAZELCREST WAY ZONING: R -7
SUBDIVISION: SUMMIT RIDGE LOT: 071 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: 1
Owner: Contractor:
DON MORISSETTE COMMUNITIES LLC GENESIS HOME TECHNOLOGIES
4230 GALEWOOD ST STE #100 9450 SW GEMINI DR
LAKE OSWEGO, OR 97035PR BEAVERTON, OR 97008
Phone: 503- 387 -7538 Contact #: PRI 503- 643 -1704
FAX 503- 643 -3300
FEES Reg #: LIC 128098
ELE 26- 989CLE
Description Date Amount
[ELPRMT] ELR Permit 1/12/2006 $75.00
[TAX] 8% State Surchart 1/12/2006 $6.00 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 95 - 001 -0100. You ma obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699.
Issued By: .0 . Permittee Signature:
•
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.
J``'i 13 2006 1:37PM GENESIS HOME TECHNOLOGIES 5036433300 p.l
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Reoot�•od
City of Tigard p ! te/B OG • ' Permit No. t __fY_1- dad
13125 SW Hall Blvd., Tigard, OR 97223 !J�1� 13 2006 Plan Review
Phone: 503.639.4171 Fart: 503.598.1960 .:;1:M 4yn t :. laste/ay: Other Permit:
Inspection Line: 503.639.4175 • t 1 � _- Date koady/By: 19;" 68 gee page 2 lor
Internet: www.ol,tdgard.or.us CITY OF TIGAR - " - Notified/Method: / Supplemental Infarmation • a
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4 New construction ❑ Addition /alteration/replacement Please check all that apply:
1:1 Demolition El Other: ['Service over 225 amps, comm 'I ❑Harerdoua location
y u Demolition
t fN YF iOtt'11 i ! net t )t rr ;r.14w9efv,f nla74n i
t, �r', P' it Y ti 1 ❑service over 320 amps —raring ❑Buildng over 10,000 sq. ft.
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1 1- and 2 fbrnily dwelling ❑ Commercial/industrial ❑ Accessory building OSyatern over 600 volts nominal units in one structure
El Multi•ibmily 12 Master builder ❑Other. ['Building over three stories 'Pleaders, 400 amps or more
,, } t r+ . u.r n,urIlr >r t t,v1M1Ar,•17t) builder ¢Sat L LYVI 3 refs ` sr , i i F ' I tE ' ❑Occupant load over 99 persons ❑Manutasctured structures or
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Job no.: Job site address: • • A 4111.711IIIIIVIIM ['Health-care facility ❑ Other:
iGiC / i . Submit sets of plans with any ofthe above.
City /State/ZIP: v4 / A q 7 9 Z 1�. The above are not applicable to temporary construction service.
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d7 114il'711; Z §�F ir i r tea Fa t t ,r 1 •' ? irAl t
Suite/bldgJapt• no.: Protect name: t ra. 1 IC of l iT. f. ,i, ,1 w.,,,tt {k,r.,a „4oa,u, A�t � i u„ Rif /ilxa4�Yi'
Description Qty. Fen Thiel •'
Cross street/directions to j ob site: New residential single- or amid-family dwelling emit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: _ 1 J : , Lot no.: // Ea. add'l 500 sq. R. or portion 33.40 1
Limited energy, residential / 75.00 'l5 2
Fax map /parcel no.: Limited energy, non- residential 75,00 2
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dwelling, service and/or feeder 90.90 2
L'O9 /4z i- s Services or feeders installation, alteration, and/or relocation
a4 L `- 200 amps or less 80.30 _2
t l y i si I � in� i ltn't acxv t. is7uaN�.3111:1 (¢ ;ttsr %Ft1f1 47r, "CS!{jitci li�Y „1, , 14— ,� 4 ,, . 6It4 l;i f j ?` ioiferk`J)it...A� l ko. -., ..? 201 ttmps t0400 arrtp6 106,85 2 i. ri ki tilt, J �1 0 1 " t .7 4 1 v NPW 11f;¢ k ;i�rdenSfY'�k,N !1 r ■ 1 4 4 i11M1f�YSAkfI: 41 iim...11 .fri _ 1 ; 11t.44.4:1.04 , . . , 401 amps to 600 amps 160,60 2
Name; ,I91 11./X01"/. .6 elAe..- 601 amps to 1,000 amps 240.60 2
Address Over 1,000 amps or volts 454.65 2
f 0 Reconnect only 66.85 2
City /State /ZIP: a ,, G „ 87 6 1 3 Temporary services or feeders installation, alteration, and /or
relocation
Phone: (5 ) /, > 7 Fax: ( ) 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 amp; 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 si '., attire: Date: Branch circuits - new, alteration, or extension, per panel
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service or Feeder fee, each 665 2
Business name: branch circuit
$. Pee for branch circuits
Contact name: I without service or feeder fee,
each branch circuit 46.83 2
Address: Each add'I branch circuit 6.65 2
City/State /ZIP: Miscellaneous (service or feeder not included)
Phone ( ) I Fax: : ( ) Pump or irrigation circle 53.40 ' 2
Signor outline lighting 53.40 2
E-mail: Signal circuits) or limited
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YrLAIC' �Oh} 1!] �i7wit, r. li :u�tlG.�xY.iii."'>r..lt't 4l:Y(: lit n;. sT'! y+ 1: r•..fyka7luuv15�1.tt�ilrt„M7,i. f CHI+ F,, 1;, 1! k9• i�} 5r7> . {+t'nSMRd:�'aib3f.Jw,.YtM1.�F� extension. Describe: FLIP 2 2
Business name:
Address: Each additional Inspection over allowable In any of the above
Per inspection 62.50
City /State /ZIP: Investigation per hour (1 hr min) 62.50
Phi ( ) I Fax: ( ) Industrieil plant per hour 73.75
CC GENESIS HOME TECHNOLOGIES Subtotal .6.-- et
Sul 9450 SW Gemini Drive Beaverton OR 97008 E'Iffir review (25 % of permit fee)
Phn- 50 - 643 -1704 Fax- 503 -1343 -3300 . - f so
Fri .: State surcharge (8% of permit tee) , . 67 .,,, CCB 128098, CLE28 -989, o s
2885 -J LE t TOTAL PERMIT FEE- 8
Au This permit application expires if a permit La not obtained within 180
� days after It has been accepted as complete
-
Print name: . Jab 4 ( _ A Date: - ,/ tB • Fee methodology set by Td- County Building Industry Srevtoe Board
" Number of inspections per permit allowed.
1: t3ul1dlnsVerinitsSFr .C-Permiutpp. I2'o3 440-461sra0r02?COM/wen
•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: FLR200600024
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7n006
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 1/19/2006 TIME: 7:03AM PAGE: 79
SITE ADDRESS: 13104 SW HAZELCREST WAY CLASS OF WORK:
SUBDIVISION SUMMIT RIDGE LOT #: 071 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE
DESCRIPTION: All encompassing low voltage.
OWNER: DON IVIORISSETIE COMMUNITIES LLC, PHONE #: 503-387-7538
CONTRACTOR: GENESIS HOME TECHNOLOGIES PHONE #: 603-613-1704
Inspection Request Scheduled For: Date: 1/1g/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
136 Low voltage 025225-01 503-601701
Corrections/Comments/Instructions:
k l)
C0 K17Y /q o
14:ASS ART1.AL APPROVAL CANCEL ri NO ACCESS
fl FAIL C FOR INSPECTION ADDITIONAL FEES ASSESSED
/
Inspector: Date: /O Phone #: (503) 718-