Permit n CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00318
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 8/21/2007
PARCEL: 2 S 109AC - 06000
SITE ADDRESS: 13284 SW NICOLE LN ZONING: R -7
SUBDIVISION: WILSON RIDGE NO. 2 LOT: 028 JURISDICTION: TIG
PROJECT: WILSON RIDGE NO. 2
Project Description: Limited energy - all encompassing security/intercom.
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:
STONE BRIDGE HOMES NW, LLC GENESIS HOME TECHNOLOGIES
16869 SW 60TH #305 9450 SW GEMINI DR
LAKE OSWEGO, OR 97035 BEAVERTON, OR 97008
Phone: 503- 387 -7577 Contact #: PRI 503- 643 -1704
FAX 503- 643 -3300
FEES Reg #: ELE 26- 989CLE
LIC 128098
Description Date Amount
[ELPRMT] ELR Permit 8/21/2007 $75.00
[TAX] 8% State Surcha 8/21/2007 $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 set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direc • estions to OUNC at 503.246.6699 or 1.800.332.2344.
r
•
Issued B / J /j 1.. /' `/ / ' Permittee Signature: j Le, k 11 raj: fin
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.
•
i at1g *0 2007 11:48FIM GENESIS HOME TECHNOLOGIES 5036433300 p.1
Electrical Permit Application, � v, \JE'�
City of Tigard ReC0 D„teBY• 1V0d ? D P�ertnit NO.' Z�
I - S ax..24 -'--t 3/�'
13125 SW Hall BM.. Tigard. 0 97223 plan Review
I Phone: 503.639,4171 Fax: 503.598.1 (QCC '2 2 0 0 DateMv: Permit: ,; , , Inspection Line: SI 503.639.417S U' Date Reedy /By: • • See Page 2 for
Internet www.ttgard- or.gov II V NIG P►R D _ �— I Supplemental tnrornuttton
n. r-., :a T i t l '°r 7" 1 nn� 1 nc S , . S . _v ' l .: r 5 •cam ° s }r :r ' --- -= ' �''S -- '-'''' r• { _. _
.�,- .�.. r.(t4.. -._. .. . .. amt.. . . v. . .ru „ �v,.,.. i ue{f..r,..2_t_. .. _ _ a .r� z }_ .. ... .3:.
1 : New construction ❑ Additltnl/al • i on/replacement Please check all that apply (submit Z sub of plans wlira m checked below):
Q 9erate or feeder 400 amps or mare D Building over Owe nodes.
■ Demolition ❑ Other Whets the eve teble faelt current 13 Marisa, and
'y �� ^ T :.. 1 - x 2,i. 4 ) ' > .... j - I ... tistm i7 l_t :1!_iS_ len ao a ground, r more a 14,0 0 13 Corn a r 1 r 1ew o gramrd, or ez aede 14,000 D Coe,n}eavithuac agricultural
I - and 2- family dwelling ❑ Commercial/indnstrial ❑ Accessory building amps for ell otherinstattesotu. buildings.
■ Multi - family . ❑ Master builder ❑ Other: O P)re pump. O Installation of 75 KVA or
W. t.` " ?r� m . •*. '^.� ,t..• rten *l
en larger !separately aratel derived system
�� ♦.L.:.. S1 l. !,rX�l V I I X V S !C 1 Y 1 �[/ [ ^C' � R 1 ; 3 I f ��•• J •� -.^y � °^ � dB vad y
� m
x�Zt ! cg ''f"'^� ""' -i ...: . 1 , `,.f , ti.:j' D Addition of new motor load of ci "A•,,.95,,, 1.2..14",
Job no.: rob site address: a N I i O OOHP or more, occupancy.
. - D psis or more realdeetlal outs. D Recreatloisal vehicle perks.
City/State/ZIP: , / ` . a all- D 1.leahh -care facilities. D Supply voltage for more than D 1leeardeue faradorra. 600 volts nominal.
Suite/bldgJapt.no.: Project name: CI Servicvor knew 600 amps orsnore.
Cross street/directions to job site: 1 ns a . .r7, - �>>'.,:.. 1P {r `;'� • ,
c)". are. Tear
New retddentlal single. or multi- family dwelling unit.
Includes attached garage.
Subdivision: 4 LSbeJ \tr3 (54- , Lot no, 1,000 sq. it or less 147.13 4
- Be. add' 1 500 sq. ft. or portion 39.40 1
Tax map/parcel no.:
Kl- ,.. r, < •li *.,:;,.),?-,;..< }r ; (r 7 b'^ "}n •, to/ ;17 o f = t(w hove et , LI) tsel
[ I Li residential
� r� ...S.,?-s.. 1,":-.r c.?.::: f. X.. .r . . .t. ...�;�.5 }!,-.',.. S.!,.,a, x� f.:. •`- . t. :( ). n rs. IWItlt above aQ• ft/ 75.00 2
e� 14— (ci �� t� Limited energy, multi•flandly 75.00 a
alt T�-) I to (L44 — ' �sieovtn. FA 5a$1w4 residential (with above aq. ft.)
S Services or feeders Installation alteration, and/or relocation
e..7 it 5 200 amps m less 80.30 2
( r ,.� . ^ \ ,. ' r .r it � 1 ..1;,{:r« . x,_L,: * _ ,4-=-5 : 0u+, -:l s : 7: tS 201 antes m 400 amps 106.85 a
ll* - ♦ 401 amps to 600 turps 160.60 2
Q • a 1 601 amps m L000 amps 2 2
$(p9
Address; , W laSIt Prvet_ 4 OS Over 1.000 amps or volts 1 454.65 2
City/State/ZIP: 1,164 ef its$µ et. 11 0 3c Temporary services or feeders brstalletlon, alteration, and/or
relocation
Phone: ( . ) 3$'i .1577 • 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 10030 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449.670, and 701. 401 amps to 599 amps 133.7. 2
Branch circuits - rue, alteration, or extension. per panel
Owner signature; Deno: A. Fee for branch circuits with
1; e a { c n . ni.1 '. above service : 4 t' 1, : is r h I V, ., � rt. <t SS-` 432: ; 7 � '�..S.r' r 1 ` l
`I ' .. ;,t t?.. fe 7P6 Ot feeds! tet �,
?;� „:1 . c te r,,.. +. t,c.. / a, • • . 10 ••,). n, it , m c $.0 .�.4v. «as 6.65 2 each branch Circuit
Business name: B. Pee for branch circuits
without service or feeder fee,
Contact name: first branch circuit 46.85 2
Address: Bach add'l branch circuit 6.65 _ 2
Miscellaneous (service or feeder not included)
City /StateIZIP: Bach manufactured or modular I
Phone: ( ) Fax: : ( ) dwelling, service and/or feeder
90.90 J
Reconnect only 66.85 2
13-mail: Pump or irrigation circle 53.40 2
a - � �} c r p,, or outline lighting 93,40 2
n p
v — . . �' ' S.�:''. � }■_. �S S �tAl ._ .. .. �.. _ A'..7 �1 J 1 }. 4::...�C rF Ta. � Sign � ,!
Business name: Signal circuit(s) or limited-
energy panel, alteration, or r
Address:
extension. Describe: ! Pag Z 2
City/State/ZIP: Each additional inspection over allowable in an of the obove
Per Inspection 62.50
Phone: ( ) Pax: ( ) Investigation per hour ti hr min) 62.50
C GENESIS HOME TECHNOLOGIES Industrial plant per hour 73.75
9450 SW Gemini 9 008 .... - : y _. ��..
nil Dr1ve Beaverton, OR 7 :�F� _,. :�1,:� °, ,� :�:. -. =�: � '� '�`� =
S
Phn 503 43 Fax- 503- 643 -3300 Subtotal: b, t�
clo ..c ,,, a ,,—. CCB 1 CLE2 6.989, Plan review (2596 of permit fee):
P •
2885 -JLE State surcharge (8 9b of permit fix): Ip, 0 a7
A TOTAI. PERMIT FEE: gl 1,OD
Print name: Date: - This permit application expires If a permit Is trot obtained 'within 180 • $ ate: ., - p - 07 dare after It has been accepted eacamplera.
'r Number of Inspections allowed per petmlL
t: taandloytr4aniutELC- PermlWrpo,c osa34oe edO.4ourt1IIoseoWwaa
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: Fl. 00318
1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/21/2007
Phone: (503) 639 -4171 /"ne y €�
Inspection Requests (24 Hrs.): (503) 639 -4175 IL
INSPECTION WORKSHEET FOR DATE: 8/29/2007 TIME: 7:00AM PAGE: 53
SITE ADDRESS: 13284 SW NICOLE LN CLASS OF WORK:
SUBDIVISION: WILSON RIDGE NO. 2 LOT #: 028 TYPE OF USE:
PROJECT NAME: WILSON RIDGE NO.2
DESCRIPTION: Limited energy - all encompassing security /intercom
OWNER: STONE BRIDGE HOMES NW, LLC, PHONE #: 503 - 387 -797
CONTRACTOR: ermseRiDgE R@ om PHONE #: 503.643
Inspection Request Scheduled For: Date: 8/29/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 054790.01 503.643 -1704 N
Corrections /Comments /Instructions: , t
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i‘K PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ► Dater ‘q I$ Phone #: (503) 718 -