Permit 'CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00077
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/16/2007
PARCEL: 25111 CB -01749
SITE ADDRESS: 10104 SW LADY MARION DR ZONING: R - 3.5
SUBDIVISION: HOOD VIEW LOT: 2 JURISDICTION: TIG
PROJECT: BROWN
Project Description: Low voltage for all encompassing.
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:
RICHARD BROWN GENESIS HOME TECHNOLOGIES
12670 SW 68TH AVE #300 9450 SW GEMINI DR
TIGARD, OR 97223 BEAVERTON, OR 97008
Phone: 503- 620 -8860 Contact #: PRI 503- 643 -1704
FAX 503- 643 -3300
Reg #: ELE 26- 989CLE
FEES LIC 128098
Description Date Amount
[ELPRMT] ELR Permit 3/16/2007 $75.00
[TAX] 8% State Surchar€ 3/16/2007 $6.00 REQUIRED ITEMS AND REPORTS
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable
laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work
is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center.
Those rules are_ et forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at
503.24 . 699 or 1. 0.332.2344.
Issue By: 06244/Lxi Permittee Signature. ��' , � ! dilor /�y ----�,
,
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mar 14 2007 1 1 : 1 3F1M GENESIS HOME TECHNOLOGIES 5036433300 p . 1
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City of Tigard Receive d 2 .
1:latent : -...' / Gr'? Permit No.: EL ) „ i 0 7 ..... 6(507 7
11 ,..., 4 II 0125 SW Ilan Blvd., Tigrucl. OR 97223, Plan 'Review
Phone: 503.639.4171 Fax: 5O3598 . 5 1 i'. 2007 Datef3 : Other ?emit;
, ler
I 1 t , A p. I ., Inspection Line: 503,639.4175 Date Ready/13y; Ituisj 21 See Page 2 tor
Internet WWW.14iard-ang°v . ' II' A ‘V & 4 .,- ; ,,,--korctll 5 NatifirdTh4cthmil ( 2 Supplemental Information
MI ONFElpireVitiVFOTrI l lIF I N 7 iiirlaiiiiragrfnROgrttllOgri "-;;; "h'et'' ' . 1 '0' r'X''',71.Ir'r: i:74Ret :1 - '';" :".'''''
ad mi0,,,t ' , 41 , ,:,:,, '4.:•,.„$".;,. .4.fs' PM Nth A. ,,i( ;WM «:::,50.:iatiaa 1_ . as liwaidttatft..kniethl.,.1%., ' - : Z'ar - :: ...: ' l' ald ''' ‘ '• - - - --='": ' Tik+0
Kt New construction 0 Additrdii/altirition/replacement Please check all that apply (submit a ants of plans wilts= checked below):
060:vice or feeder 400 amps or mare 0 Building over three stories.
0 Demolition 1:1 Other; where the available fault current p Marinas and boatyards.
IRO PRIMP.E§Rttrli742FNMIRrr e rZi r l.g. 4 77 2 1t eliaMMig dll, exceed; 10,000 amps at 150 voila or D Floating handl/tip',
, .; ,,,,awsi; stove.......LlLfw nst wettvok . . treatos.. t.o. tixo;;.. less to ground, or exceeds L4,000 ClCommarclat•utto agriculntral
■:411 1.- and 2-family dwelling 0 Commercial/industrial 0 Accessory building amp; for all other installations, buildings
C:1 Multi-famil 0 Master builder 0 Other: CIFirs pomp, ClIonail I ation of 7$ VA or
Kfil .,, 8 Emergency system, larger separately derived system-
Addition of new motor load of
1.001-1P or mon. oornin‘n.y..
Job no Job site address: c I
• 4 _ _ . II ! .- 0., • • CI Six or more residential units. El Recreational vehicle parks,
111== r II I .■ .1r1RMEFAIIIMMIM 0 Health-care facilities.
0 BaSardeus locations, MI Supply voltage for more than
600 volts nominal.
Suite/bldg./apt. no.: Project name: 0 Service or feeder 600 amps or more.
r :L .. :. ';.• '' ','•''!''' t'' ' ' ' " '''''‘'' - N
Cross street/directions to job site Demi . , on 0 i
New residential mingle- or multi-family dwelling unit.
. Includes attached garage.
Subdivision: * ' lieu) Lot no.: a 1,000 sq ft. or less 145.15 4
at• e4.1 Ea. add'i 500 sq. ft. or portion 33.40 1
Tax map/parcel no.: g -‚ ., Limited energy, residential
"av ra , 'a i.a7 Di,i.,MR 1.7,013"•,$ '''"" • ,' a r..
ERSIMEE;;NRRit,§WrIArrfrElrefig,°Y.rt .., ,,., 6 . ,i1,,,,
t•ph 7.1 ..4.--. ■ {••14 A•••i54,04om 79% +1':obt ' ' ' 1 1VA' 40:0,400'r CW•ga,M•tistrofh.ASZL'N, (with above act. ft.) 75.00 2
Limited energy, multi-family
residential (with above sq.ft.1 _ 75.00 2
allf=MMMIA11111111WEINI Services or feeders Installation, end/or relocation
EL( u. - , ,_, AZIPERM Mh..-r 200 amps or less 80.30 2
rErRifitiriVT9S4`"N^IV47"^"V'TVVIEraWFWVM,111'ltr,M'AfiKtR45l1; 201 amps to 4130 amfs 106.85
2
\-40 ve zs..:...:. Aat..:.*4- svInbituatqagii.gita , ,,,a44 , if,.. •, ).„... 41'1,4-L
NEMO 401 amps to 600 amps 160.60 2
'
' 44 1 6' " ' A, it• A e A 601 amps to 1,000 amps 240.60 2
Over 1,000 amps or volts 454.65 2
INZEEM1111112M111M.11.1 Temporary services or feeders Installation, alteration, and/or
il 4. " . relocation
Phone: ( 57),3) LAD - 1 1,' 1 2 0 Fax: ( ) 200 amps or less 66.85 I
Owner installation: This installation is being made oa property that 1 own which is not 201 snipe to 401) amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps . 133.75 2
Branch eh-cults - slew, elteratiot or ortenairm, per panel
Owner signature: Date: A. Pee for branch circuits with
1:0i";:::44 above service or feeder fee,
41ZAK,41c,54,Q+0,4 „,1,5i.,,,,:,,te,11,,','4,-„,,,,,.,444 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
without service or feeder fee,
Contact name: first branch circuit 46.85 2
.
Address: , Each edd'l branch circuit - „ . 6.65 2
Miscellaneous (service or feeder net included)
City/State/ZIP: Each manufactured or modular
90.90 2
dwelling, service and/or feeder
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E-mail: Pump or Irrigation circle 53.40 2
g S4n ix milinn lighting 53.40 2
Signal circuit(s) or limited-
Business name: energy panel, alteration, or
Address: extension. Describe: ( Page 2 2
City/State/ZIP; Each Oditional inspection over allowable in an of the above
Per inyection 62.50
Phone: ( ) Fax: ( ) Investigation per hour (1 kr min) 62.50
CCB L GENESIS HOME TECHNOLOGIES Industrial .1aurt .er hour 73,75
9450 SW Gemini Drive Beaverton, OR 97008 'IMMERE43
Suprv. Phn- 503-R43.1 704 Fax- 503-643-3300 Subtord: --
Print n; 4-Ifit .t fy r i...-• COB 128098, CLE26-989, Plan review (2596 of permit fee):
2885-J LE State surcharge (851 of permit fee);
Author TOTAL PERMIT F1313:
This permit application expires If a permit is not obtained NFIthin 180
Print name; ... . 3, 4 1A .4TAIMIE Date: .... after It has been accepted as complete.
._
* Numhor of inipoctiona allowed per permit.
L'aulliliesTennitOELC-rennitArp.do: 05/2)/06 440
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007- 00077
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/16/2007
Phone: (503) 639 -4171 z A 4 i iplp iI ,
Inspection Requests (24 Hrs.): (503) 639 -4175 ..:' '!..
INSPECTION WORKSHEET FOR DATE: 4/6/2007 TIME: 7 :04AM PAGE: 57
SITE ADDRESS: 10104 SW LADY MARION DR CLASS OF WORK:
SUBDIVISION: HOOD VIEW LOT #: 2 TYPE OF USE:
PROJECT NAME: BROWN
DESCRIPTION: Low voltage for all encompassing.
OWNER: BROWN, RICHARD PHONE #: 503-820.8060
CONTRACTOR: GENESIS HOME TECHNOLOGIES PHONE #: 503-643 -17W
Inspection Request Scheduled For: Date: 4 /6/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 046062 -01 503-643-1704 N
Corrections /Comments/ Instructions:
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I PASS I I PARTIAL_AP_P_ROVAL—___ —_ 0_CANCEL— _ NO ACCESS_ _
7(FAIL CALL FOR INSPECTION .❑ ADDITIONAL FEES ASSESSED
Inspector: Iv ()e7 L-- Date: '"t f ((fJ Phone #: (503) 718 -100