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Permit CITY TI GARD ELECTRICAL RESTRICTED ENERGY PERMIT Atio �i DEVELOPMENT SERVICES PERMIT #: ELR2005 DATE ISSUED: 11 /7/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2 S 109 DA - 12600 SITE ADDRESS: 12931 SW KOSTEL LN ZONING: R - SUBDIVISION: SUMMIT RIDGE NO. 2 LOT: 115 JURISDICTION: TIG Project Description: Low voltage, central vac. Job #3536. 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: X FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL # OF SYSTEMS: Owner: Contractor: DON MORISSETTE COMMUNITIES ALL WEATHERIZATION 4230 SW GALEWOOD ST. STE 100 3030 SE 59TH LAKE OSWEGO, OR 97035 HILLSBORO, OR 97123 Phone: 503- 387 -7538 Phone: 503- 649 -6542 Reg #: LIC 46969 FEES Description Date Amount REQUIRED ITEMS AND REPORTS [ELPRMT] ELR Permit 11/7/2005 $75.00 [TAX] 8% State Surcha 11/7/2005 $6.00 [ELPRMT] Investigation 11/7/2005 $75.00 Total $156.00 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: f r /► Permittee Signature: ATV 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. 11/07/2005 10:42 FAX - a001 /003 .t I rmiti t- 'nPUCsll :it r of Tigard ; �M - „iia _ , 3125 SW Ball Blvd, T Q +te/13 : Perm TIo.: / j1 igard, Oil 97223 L , C� _ _ • sq _/ 303,639 :4171 Fax: 3 )9;598.1960 s oo ,,,, t , nepec*ion Line: 303,639,4173, �13� 2 "1I i P a »Review Other Dlae/By: aternet www.ci.tigard.or.ua , �` 11.,.. te No ed/Meth 1 8 BN Page 2tor 7 �s p , t� Notified/Method: „.. � aXft�4tJffj `. } :' } t r 'f4 1t, FM1F .�s1i ib1 •�� irt� L..:'1 TIr ARV i. : :'. 71 �� + =7 i E ” e .�r✓.e d ,ro .. .. .• 11 ,�• l ( $UQIi�e�tai,�nfeflpaf(On �,41,t {r. , , ,, g.i,ilig, r {F.1.. :. :..? :! l; t I t 1 { /r 1 r i '10 rf ;I +T i ?i d r 1 it ri • e t. }.a, + ... t 1, (J i,t Id fin . "ik ' nt,4 j lt + y i+> '.,,i. ' } + 11 .S ' i / r tt, (1: q l iP t r f t> + hill t 1�r�; ' New construction ` ' Wad- a /re p l acement ts..,f.. , t. ; Please ohs : J . . , 1 t , t ' „ +J, y ?/ tY+la.,1t s, !b`k t A ddi>x 0 .. +., ,� . L ! �,�1 il(fl: �I(U95�'• Demolition al 'at apply: j De ❑ Other: ❑Service over 225 amps, oomm'l ❑Hezardo a location �'l 1u j��+ tt 7 7 1 t y'�i { ^ `S t � Y i s �t,S.i.t11 ^ riir'3�f>!ij4 1 ":i6,��l Ilt ?f>i i }i4 J)u + 7 ry : � � � ti ' : ; &, . . • !r � ti � � ° J 1 j . F 1 ! . '';'..i::',;1',.•.;'• -. t + i / {ir �it� *s fl �l a rt li1 Q Service over 310 amps- rating QBuildng oVar 10,000 IN' ft., , r.1 1 (, l ,; t • , ,! } l ., , . t, o f I - 4 nd 1 - fumjt dwellings 4 or more new residenial tt 1- and 2- family dwellin: r' I Com mercia /industtvd ■ Accessary building CI system over 600 volt. nominal unit, in one'truaum Multi fasirily Q Master burldar (� lJthex QBuilding over three stories ©Feeden,.400 amps or morn Y }ith /4 pp , ,s "lb w +1+ r �i . 4,v ed. + V•. + f a :. r _ y • 1 QOeeupant load over 99 persons ❑Msnullctured rtmc(urea or ! +)iilali WAN ,l }E / °l4..t °i ! t 1 t {! + ,! 1 1 i l t . 1 i t 7 - �( ° • -• t , - +i' t ' � � ' UtJ 1 yi tail,+ , ik;64, , : , ,,l gi °Egress/lighting plan RV park Db no.: S �2 3 r, •.site address: Q lloalth•caro facility []Other: ily /S katel7lF'; � ' 1 Submit 1, sots of plans with any of the above, e r Tha above are not app / ioable to temporary construction sarviae, tlite/bl / _ tlg apt. no.: Project name: fi t:;'a,!la + it $7,A ! , �t� :;tilt i �,� , r , sai I..IS Jt ; � s t�; i� ! '} : ! � � ,. n � � ,.. l 1, �S..Lr.+i.�[t ,4 $i {„4rn1 ,�4 r �!r rose steel/directions to j0 site: (Ad/ /j'i f im Qt: Y.w Tet.t •• D New residential single- or stroll/- flmiRy Ilwellins unit. Includes attached garage, abdivisiou: 1,000 sq. ft, Or lea 145.15 4 -' 'M f �l r Lot no,; I Ea. add'1500 sq. ft. or portion 33.40 1 ex map/parcel no.: / Limited energy, residential 75.00 / 2 CC u it tl f ' tiih h ri'';` ;, � pry''! , :rya a t :+ •: + , t Limited energy, � i! 1] t�J ��/ 1 Ij) ii3ls :l�b�l!3`�,�.��i.'fR } +Sff'S��� - � �, �Al• t i� .1 ;I f{ •tut i +�� � i ; t ,ii r9.� t�=,t��s , � l { s�. �fr non-residential '1, .x -1t 0.1�Uk.11,n a i.rl ,4iiCS . : it Eaohtnannpactured or modular -h• If l V .,, dwelling, service and/or feeder 90.90 2 J ot,/ v � I Services or Ibetlern itutallatlon, alteration, and/or relocation f 1 tti r u m+ rl r +ai 1 , , r tkta , n+ , . ' If {{ , ;1 [e� a 4 1 , j t �•,11V.1° //.,4 w + u r 200 amp to 40 a 80.30 ■ i%i: 1141r %..,,e n. ;,try} '4,;, ,41. ,tkk r f ' if +i j k(� .2 J I ! - a 1 111 1 + r '(j , t t 4 " 6, ) ,y , k ,,I � ; ' t i ''a 201 t0 400 amps 2 I r . 15 t a,: r •,YIN4 t +i �1:4 n ,� � :t � � ;. �. „!.,!ii..11t,1 SJiVA�1�4 bra P 106.83 2 tine: p + r r 401 amps to 600 artier 160.60 2 e • ■ L.L. c 601 , to 1,000 amps !dress: 3o . G. ,� ",0 • 240.60 2 • Over 1,000 wraps or volts 454.65 2 ly /StattlLlP: t5 J Reconnect only 66,95 2 1 Temporary services or theta, Installation, alteration, and/or one: ( '3) 3a7 ?5 32 Fax: ($t3) 'k? ?A I S relocation Inner installation: "This in llation is being made on not 200 amps o leas 66.85 1 ended for sale, lease, rent, cr exchange, according to property , 449, 670, and 701 201 amps to 400 amps 100.30 2 Viter signature 401 amps to 600 amps 133.75 'OM tt , Date Branch cireulta — new, alteration, rtrion per peas/ - 2 , 4� >yfC i� i CI r� ii+t il)��' �� / P,i+ f! t r ' A. Faa tt, oreZ , :... ).., r,l,.nti, .i } :fi,,.i +,1 s�i i! i It , :Itl I t i , 1.i :; t l o/ „ , �11s`.ra fbr br►nolt circuits with slams name: _ service or feeder fee, each 4 ' or ♦ _ branch circuit 6.65 2 nWct name: ! r a Fee for branch circuits � , 4 C C. rII. wIIhosil service or feeder fee, dreg :3a 5 - V 4 ` . c each branch circuit 46.85 2 Each 'WWI branch ciratit 6.65 y /tsllp; d o� 7 tag Mlecellaneone (service or feeder not included) 2 - )ne: (,-G ) 6c, _i et .. ,- , r. ( 2 I Fax: ( 9,3 ) 6411 2‘60 Pump or irrigation ainla $3.40 2 flail: / Mo }Dn _ Sign or outline lighting 33.40 2 pry ! vyr t' av t :.,. !s R t 1 0eA Signal oimuit(s) or limited - lkbl+ rd rut,.. a.�) iJfi tttl# / 10.4 l ° ` ''1 ''1 {t 4r:..railti;i M,. ': 'Vsi l�i�ti Uiitl-' '�,t+4 tiis.;i.`�ti'•'4 ;t e'nergY Panel, 4„...,1t4444°"' or sizings name: L ,1 d , 4 ,t r extension. 1)oraribo: Paget 2 dress: d r Each additional Inspection over allowable in an of the above y /$tdtC/TIP: O � /; � � �� Pet impaction 62.50 'y �a `� Inv per how (t hr mi,$) 62.50 !nn. 5 t ) 6 i 1 6 7 Fax: ( ) / ` 2Zg j indudrial lent .eK hour 73 75 13 Ltc.: Sll fit , ; ,o S it l f r i s ,' h CO $',I I.1 t ' i..li, 1 � ;. !' " "' I F r �6 ` 6 lectricalL Suprv. Lic.: z 3 } f i " fin!: ' 1 't'� :Z;;k} t r sinters/ tIV. Electrician signature, ! hired: Plan review (25% of permit fe it name Staid aucnher Date: ttti <A'x of parrnit t ea) horded signature: - TOTAL PERMIT FEE 1 w Thus p.m* appilcattwt 'spirts Ira pram is slos s1$UY»d wtwta 150 — it name: r day, miter k h.. bees weeeptMl ea eaa.pt.le 'i Ci(/ ,r Date:/011— p, A Fee methodology net by Tri•Cou»ty Building Industry Service Board I ' a+ numbs; of have: Con s as oesmlt allowed