Permit V
� , r CITY OF TIGARD
ELECTRICAL RESTRICTED ENERGY PERMIT
" ° COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00169
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/7/2007
PARCEL: 1 S134DB -10700
SITE ADDRESS: 11396 SW MEGAN TERR ZONING: R -4.5
SUBDIVISION: DAKOTA GLEN LOT: 009 JURISDICTION: TIG
PROJECT: DAKOTA GLEN
Project Description: Central vacuun system.
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: LL ENCOMP : X HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: :
TOTAL # OF SYSTEMS:
Owner: Contractor:
DON MORISSETTE HOMES INC ALL WEATHERIZATION
4230 GALEWOOD ST SUITE 100 3030 SE 59TH
LAKE OSWEGO, OR 97035 HILLSBORO, OR 97123
Phone: 503- 387 -7538 Contact #: PRI 503- 649 -6542
FAX 503- 649 -2680
Reg #: LIC 46969
FEES
Description Date Amount
•
[ELPRMT] ELR Permit 6/7/2007 $75.00
[TAX] 8% State Surcha 6/7/2007 $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 ou 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 or 1.800.332.2344.
Issued By: �q�u� Permittee Signature:
\,
OWNER INSTALLATION ONL
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.
v V I
Electrical Pe Ap ra FOR OFFICE USE ONLY 1
; , HIV
City of irtgard i. Rec eived /a /� L Permit No01 —1190/1, 13125 SW Hall.Blvd., Ti gard,OR 97223 'P Date /B lY '� / �J �� � •••
J � ( : Plan Revi w
Y�
Phone: 503.639.4171 , Fax: 5031598.1960 r/ 200 7 D aey i „ Other Permit:
Inspection Line: 503.639.4175 a
CI 1-y � a h r^ryl l'll� Date /By: . i ' _ Date Ready/By: runs See Page 2 for
Internet: wwvy.ci.tigard,j r.us eta, �_ r + t''�L� D Notified/Method: ® Supplemental Information
N New construction °: ❑ Addition /alter: tion /replacement Please check all that apply:
❑ Demolition Other: ['Service over 225 amps, comm'l ['Hazardous location
❑Service over 320 amps _rating ❑ Buildng over 10,000 sq. ft.,
a t �p a " s �'" of 1- and 2-family dwellings 4 or more new residential
[ f I- and 2- family dwelling ❑ Commercial /i o dustrial ❑ Accesso'.y building ['System over 600 volts nominal units in one structure
❑ Multi - family ❑Master builde ❑ Other:
['Building over three stories ['Feeders, 400 amps or more
� ❑Occupant load over 99 persons ❑Manufactured structures or
w d ; 8. ` a ' , t
pro ❑Egress /lighting plan RV park
Job no.:
3452 '7 Job .ite address: /; ®� q ❑Health -care facility . ❑Other:
p Submit 2 sets of plans with any of the above.
City /State /ZIP: Cri CV� The above are not Tplicable to temporary construction service.
Suite /bldg. /apt. no.: Project name: AM:
Description Qty. Fee. 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: ._ I ... �..r _ _�_ k iot no.: Ea. add'I 500 sq. ft. or portion 33.40 1
-11
Limited energy, residential / 75.00 75' 2
Tax map /parcel no
ErgitiNanaignEZERMZETESEEMMINtal ` Limited energy, non - residential 75.00 2
Each manufactured or modular
f / dwelling, service and/or feeder 90.90 7 2
2C- i' - r,d V 4 UiJ y"_- '.. e, ✓Y•' I Services or feeders installation, alteration, and /or relocation
I 200 amps or less 80.30 2
i il ® `' ® ; f 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: J 1 rkO r I .s-e -*-e 641 erS 601 amps to 1,000 amps 240.60 2
Address: L i Z 3Q 1 1 e t� AJ • . U S ,1--• Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
d I —
City /State /ZIP:
Le Vk� ,S W t? q q 7 (7_ S Temporary services or feeders installation, alteration, and /or
el relocation
Phone:
(�d ) -8. - 7 -1 F.x (5 ) 8.7 L)i i< 200 amps or less 66.85 1
Owner installation: This installation is being m.de on property that I o'vn which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, o exchange, accor• ing to ORS 447, 449, 6170, and 701. 401 amps to 600 amps 133.75 2
Owner signature:. `i; Date: :I . Branch circuits — new, alteration, or extension, per panel
' q ' . y A. Fee for branch circuits with
Business name: j ` . service or feeder fee, each
A t t , 4-Hep 1 44 4 : 0 , 1 , branch circuit 6.65 2
B. Fee for branch circuits
Contact name: c„ r o . ro without service or feeder fee, 46.85 2
Address: '1.:4,. f first branch circuit
3 0 S 5 � �" j . Each add'l branch circuit ' 6.65 • 2
�I City/State /ZIP: i 6 o O I �irzc I Miscellaneous (service or feeder not included)
Phone: ( ) I a F. ( ) b Pump or irrigation circle 53.40 2
�� 6 i -7 7 .l �� Sign or outline lighting 53.40 2
E -mail: i, I. Signal circuit(s) or limited-
,.,., § h e: w, I° energy panel, alteration, or
extension. Describe: Page 2 2
Business name: 4)i �, le 1 Zu 0, c - 1 -
Address: SO Each additional inspection over allowable in any of the above
/6, S 97 Per inspection 62.50
City/State /ZIP: 11,1/5 6 p r od 6e % 7 3 Investigation per hour (1 hr min) 62.50
Phone: ( �-) f / Z I F ; : (�j'o) C � dp ?6E.0 Industrial plant per hour 73.75
I , Y � t � i
. CCB Lie.: f 6 6- q= l;lectrical Lie.: Suprv. Lie.: Subtotal t7
` 1
Suprv. Electrician signature, re• ulred: i Plan review (25% of permit fee)
Print name: Date: f--- State surcharge (8% of permit fee) C
� r it v L ; TOTAL PERMIT FEE f
6°
Authorized signature::; - - -'. - . i This permit application expires if a permit is not obtained within 180
1 days after it has been accepted as complete
Print name: Date: 1 • Fee methodology set by Tri- County Building Industry Service Board
• • Number of inspections per permit allowed.
is WuitdinglPermits lELC- PermitApp.doc 12/03 i 440-4615T0 0 /02 /COM /WEB
i
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CITY OF TIGARD .‘
BUILDING DIVISION PERMIT #: ELR2007 -00169
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/7/2007
Phone: (503) 639 -4171 /omm i
Inspection Requests (24 Hrs.): (503) 639 -4175 3 1. .
INSPECTION WORKSHEET FOR DATE: 7/20/2007 TIME: 7 :03AM PAGE: 66
SITE ADDRESS: 11396 SW MEGAN TERR CLASS OF WORK:
SUBDIVISION: DAKOTA GLEN LOT #: 009 TYPE OF USE:
PROJECT NAME: DAKOTA GLEN
DESCRIPTION: Central vacuum system.
OWNER: DON MORISSEI 1E HOMES INC, PHONE #: 503- 387 -7638
CONTRACTOR: ALL WEATHERIZATION PHONE #: 503-649-6542
Inspection Request Scheduled For: Date: 7/20/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 052395-01 503-969-2047 N
Corrections /Comments/ Instructions:
•
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ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL I I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED t---*" ,Inspector: Date:? -2 Phone #: (503) 718-
. r ,