Permit t3
CITY TI GARD ELECTRICAL RESTRICTED ENERGY PERMIT
•
■ DEVELOPMENT SERVICES . PERMIT #: ELR2005 - 00153
4111t1 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 6/13/2005
PARCEL: 2S 109DA - SR2 111
SITE ADDRESS: 12998 SW KOSTEL LN ZONING: R -7
SUBDIVISION: SUMMIT RIDGE NO. 2 LOT: 111 JURISDICTION: TIG
Project Description: 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 ENCOM : X HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS:
Owner: Contractor:
DON MORISSETTE COMMUNITIES LLC GENESIS HOME TECHNOLOGIES
4230 GALEWOOD ST. STE. 100 8104 SW NIMBUS AVE #4A
LAKE OSWEGO, OR 97035 BEAVERTON, OR 97008
Phone: 50.3- 387 -7538 Phone: 503- 643 -1704
Reg #: LIC 128098
ELE 26- 989CLE
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 6/13/2005 $75.00
[TAX] 8% State Surcha 6/13/2005 $6.00
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC at 503 - 246 -6699.
Issued By: Permittee Signature: £-� (rjT
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503 = 639= 4175 - b 7:00 am ;-for inspection that-business da
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
3t 2005 10:06AM GENESIS HOME TECHNOLOGIES 5036433300 p.3
4
Electrical Permit Avnlication ri►c 01,1.1( 1, 4. <rvl.l
City of Tigard V D Received 0 /,J ' �vJ` Permit No,: CLg,AOC?sp 61,�3
13125 SW Hall Blvd., Tigard, OR 9724:1E Plan Review
Phone. 503 639A171 Fax: 503:598.1960 '' n +1 i ' Date/By: other Permit;
Inspection Line: 503.639.4175 q r) ^/ r al 7 . _L Date Ready/By: El See Page 2 for
Internet: www.oi.tigard.Or.Ua i UV' 1 J Notified/method: } 1 ( Supplemental Information
.... . n. ,., . ,, � w +� , ... ,r �r,'7n91 S-:7:: . . H. ': IV' rr,..' "; e. a 'l;. ry.:. :Y:: i.�a v . Y': iN } : ;i x
�'�'+ bYvl,�, wr• � _ . ;, ,..
i d,:.. ,fit ay(� :q74 .8:1. � ; 76v 75 4 +, .r.. '!� :
, �, 16 ,., '1. < r l:ggV �r{ }}11 ,. � & �Ar� u . yy 4 i
{ Jp: yl }fM4FQM1 S ;1 ',11 > o wx T.. 8. w�, � , ,r r M1 , , ;�w, }� •
11 � .Tri, n ES. �} > �x .r 4l'i x$ .,-,i '1 � 2q 4'9. v, .rk,. ;r h, Pt 1, rf!{, •u4 .li... ,' �•ii ,yp)i itl Y . t� nrr Cv r}��,,.t r V a : b4 :. G 4 >`rA' Aq ttrigS
�I �s ,r vdti +41l} it '`vu lV.M! } w.0.W. 4 � AvAtwi 4,5 Slisr%E. x ,.4, t+tt iii 1 41 i 4 G2u.AtIL . ∎ Phi) A"Nr44 44.41 1 `' W A {x r lr' { u'4tfiii�M1lt ,S %-mime nronrmr! { rnfori. •� n $1 q5'"' 1 ; mcrr o �t1 m:', } Sft '
+ : u / Please check all that apply:
to New construction ❑ Additio a ar:l 6/r leRe` '� pp
❑ Demolition [] S I,D `-' ❑Service over 225 amps, comm ❑Hazardous location
❑Service over 320 amps - rating ❑Bulldng over 10,000 sq. ft.,
>5 ++ wtia „ p, �� r t 1 , t, ter, uv, Ai ara G' w , `"'�'�1 �"li' w ✓oa a.s¢lw + }vvar 4'd/ sM1Jr? vts, a � { A g � r !
S1, rP7� { } {lrt a; /, {+,� ] �t14�i, r �� i4� + ,, . ,g q+ i + a r �1 r )i > iV ya li of 1- and 2 -famil idential
Ya, �A���! ��S1f7M. wH7Ar: i��ia5+/:. � y : Aa�Yt11, 1FLf'„ x 21�YiA u Tk1F .H AdfYY+�'��Way�S�arv,� +�,nk,.au4, lY �w ui'. :u Y {6�Hw''Je����G,k��/ ��417 Y dwellings 4 or more new re
124 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
El Multi famll ❑ Mastor builder ❑ Other;
Building over three atones ❑peeders, 400 amps or more
�; 7 M Si lit ,� " + i rtvvki td7 nl•n(I rr1 a,Ay I as}v cr n mwx v Other l, ,, I •, ❑Occupant load over 99 persons ❑Manufactured structures or
tit° kl.+
ll;,yHSr J6 , n., i l , i. AiI E 1� r: A e $ Vox H1"dRtlk3 :. „ ��,1 ❑E ress/hg1itin lan RV park
f.re $P f{ N6Av,: 1�" sIP? VNPYJ !111YS�YJ,E,f:k,l.r"!. it�ilttfat\O,�Aatlex4un� nYV�Y•ix n, xtt ,.vYS,vYri,'nit,GkW.•X?aai:r C rL.i g d` gP
Job no.: Job site address: 29 - - - ❑Heulth -cam need ity ❑Other;
' Submit .1 sets of plans with any of the above,
` r J The above are not applicable to temporary construction service.
�{, ��),ro�+rri n 5, 1 v IAh + $ T '�8r r am n s � i � ;� '�SaS
Suite/bldg. /apt,no.: Project name:
§t; 1ltir01 f r*Tii• } x ', ,:::Ngif}!;'ln7ral'i�wAY, 4R 01;', l
Dwcrlpttan L ree. 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: ` Lot no.: / Ea, aril 500 sq. ft, or portion 33:40 1
Limited energy, residential 75:00 i Oy 2
Tax map/parcel no.; �s y j yf f { j t ��g��� Limited energy, non- Each manufactured or modular
75:00 2 1
��� Nt vA,4A'1+���ILIr l �k! i++pp�iit ':�ty��' k xnadxrrvA,unn x } eau { �xnu+tii�'�J!SO$ar r lAt�eCial !r"1 { �`! 1 {SI�•l�' , 4 81 „
�Gem,uuwtn s a%N � � � Y 9:. •' .1 n r � r � 4 x e� + 1 + t S.i,ty f rA + t t.
dwelling, service and/or feeder - 90.90 2
r ..:. c Services or feeders installation, alteration, and/or relocation
i
200 amps or less 80.30 2 1
v rr,rp pp m tl.n,twty o,N on l w ,,, i rl r ito r + yy x � �' fifi{t j y IX +, W1'r+, ` } :wa::
3: A'wcid 201 amps to 400 amps 106:85 2
' /r v i p lit, x R Z 1. b AG' A n u . llillfs6i �Y!f i �q ag iut� : J ob "� rip � ' :: ::k ry, �ri:,A,.:4,l l E
��, � 11Sr,: �v..e ve�rnr�4•vvvv ax:runt,nwn. Kd�, 1y:GtwrMJV ; ( �3' , Sl.: li P.�.2tre>vw rxdx�:swni5,�.,, IAnk�'JIYI� fln{alsw>.. Y 401 amps to 600 amps 160,60 2
EME
J , ! . ,; 601 amps to 1.000 amps 240,60 2_
Address: - / D D Over 1,000 amps or volts 454.65 __ 2
Reconnect only 66,85 2 1
Temporary services or feeder. installation, alteration, and /or
relocation
Phone; ti 3 ) , -
-
. 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 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
,v 11: Y i�i re + ?14;; \i ' ty q � x I s vl}�8 i v r4 ?, lil 4� 8xgz m4a '.r'YUYPtA "Sr ,., r
s, ti� �l l; (iz t}v�r∎ ,„; h , , + ;,.. G ,( 0 v � ,n,,,, p l i .., . n i ' 't } rA A. service for branch circuits ea with
ch
"i1Ja. l i f �� rs:: �m,i.rsmaar�.><ax.faNaVrcrdG.x 1 wJ �! e,ntvr.v�SJlw�rivcxr, twaowM1l . 1'�J � service or feeder fee. each
Business name: branch circuit 6,65 2
B. Fee for branch circuits
Contact name: • without service or feeder fee,
46,85 2
each branch circuit
Address: ,
Each add'I branch circuit 6.65 _ 2
City/State/ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) Fax: ; ( ) Sign or outline lighting 53.40 2 -
E- rnaiL: Signal circuit(s) or limited -
Si „ ” " t "rid" , 1 v "'' Y r yt G 4t +' lr a: , nx n 'm�v�, L r 1 m � �! t r'vq ylr r u ti �ilF 1•, energy el, alteration. or
��1:J4:�t1��,::�,�Als iti�� � s...,,,rs ,,�?c.� .'� ny l
extension. Describe: Page 2 2
Business name:
-
Addres:: Each additional Inspection over allowable In any of the above
Per inspection 62.50
• Ci GENESIS HOME TECHNOLOGIES Investigation per hour (I l'umin) 62.50
8104 SW Nimbus Ave, #4A Beaverton, OR 97008 Industrial rant •er hour 73 95
Ph
Phn- 503 -643 -1704 Fax- 503- 643 -3300 _ I ;Sl i��n a� 4r r ( °w S 1:T �` lw �>a ° i>�,i;"' p Q
Y n a+� a v+. �n r ! w, .a :.: , � ..0:4.,, . ,a..��', r.�..�.,.a�r`�,�.�ui !,v.��i��H3�i0
Ct CCB 128098, CLE26 -989, subtotal 76-- 00
2885-JLE
SL Plan review (25% of permit fee)
/_ State surcharge (8%ofpermit fee) Zo � o
.'r / t' Date: Ge, Ares
TOTAL PERMIT FEE je / tte
Authorized signature: This permit *Weirton explrea If a periinttlo aotob<slned within 180
days after It has been accepted as complete
Print name, Date: s Fee methodology set by Trt•County Building Industry Service Board
•O Number of inspections per maul allowed.
I: 18ulidingTemIttELC-PrtnItApp.doe 12103 44041515T(i0l02/COM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2006 -00153
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 613/2005
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/1912006 TIME: 7:07AM PAGE: 39
SITE ADDRESS: 12998 SW KOSTE( LW CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE NO. 2 LOT #: 111 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE NO. 2
DESCRIPTION: L vo
OWNER: DON MORISSE I I E COMMUNITIES LAC, PHONE #: 50.3..397_7538
CONTRACTOR: GENESIS HOME TECHNOLOGIES PHONE #: 503-643-1704
Inspection Request Scheduled For: Date: 8/19/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 013918-06 603- 209-4837 N
Corrections /Comments /Instructions:
•
6, 11•00.11.11:71111'
•
g■ PASS gy, _ PARTIAL APPROVAL _ [I1 CANCEL ___ __ _ ___ n_N.O_ ACCESS
_
FAIL yALL FOR INSPECTION n ADDITIONAL FEES ASSESSED /
Inspector: Date: D < / dJ Phone #: (503) 718 -