Permit p . "
CITY T I G A R D ELECTRICAL RESTRICTED ENERGY PERMIT
DEVELOPMENT SERVICES PERMIT #: ELR2005 - 00086
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 4/14/2005
PARCEL: 2S 109DA - 08800
SITE ADDRESS: 12928 SW SUMMIT RIDGE ST ZONING: R -7
SUBDIVISION: SUMMIT RIDGE LOT: 082 JURISDICTION: TIG
Project Description: 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 ENCOM : X HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS:
Owner: Contractor:
DON MORISSETTE COMMUNITIES LLC GENESIS HOME TECHNOLOGIES
4230 GALEWOOD ST 8104 SW NIMBUS AVE #4A
LAKE OSWEGO, OR 97035 BEAVERTON, OR 97008
Phone: 503- 387 -7538 Phone: 503 - 643 -1704
Reg #: LIC 128098
ELE 26- 989CLE
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 4/14/2005 $75.00
[TAX] 8% State Surcha 4/14/2005 $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: Sc.e., App
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.
Ap 13 2005 11:42RM GENESIS HOME TECHNOLOGIES 5036433300 p.2
r
Electrical Permit "1 ' V .rEP I•I)I ■ II•IC I II,1
City of Tigard Received . `� /���� Permit No.• C 1.4z1W 000A 1
13125 SW Hell Blvd., Tigard, OR 9 ,•• .r 1 2005 3 9 005 Plan Review
Phone: 503 639.4171 Fax: 503.5 ..' • . • 1 J '' ,�.f)'I I i' Dete■By. Other Permit:
Inspection Lint: 503.639.4175 :. �. . ., 1 .,. Date Rcady/By: huh: 21 See Page 2 for
lntcrnck www.ci.tiprd.or,uB CITY OF TIGARD Notittied/Metbod: - 'r j ( Supplamaetal information
'7`; i -i 41 T�' ; 11 ,S u.)7, 1 „- . . �1, 1r'��,µ.) /.'r1�7;(1i ..,, ,R VN ",''rt��lt�i” �rti,u + r. } • r r :r ; er4 , .t , .I,u :, ',hf
Pt.n' l ;: [ (4 :1i r iDi {, 0 ,,1 ,i t r .((.v. ,�ii`� r Y 1P+ti �y} f S' / ,, �} ,r „r� 7;`� .,, • { e , ; ,.,
�� J ,. :. I i r r' ti1 , C,�i '�{k''+�i,VS [�I�'�,�1�1 i�al ii'11'irp` 'C 1a i , :iS , , lei. r> �.'r fi r. �, o 4'1 . � `'i 4•r�.".'' ° gn
��,.. ��.,., 1. 41....!..,, I• �•. tr. t<,,..,.•1- .1..1[ixa„ /,.c.�,.. f�[ : , w f H `.�il „u. rt i t � ; r rq( innl ll �rTf! ° r.' .. i,__. .c ` vT`-r'r .., ,Yidi:', =A , ..
1 :1 New construction ❑ Addition/alteration/replacement Please check ell that apply.
❑ Demolition ❑Other ❑Service over 223 am m ❑
autos, com'I Hexardous location
, 1r. 1 ,nSV rp rt . , Y ,„ i A ,`• a , • > ['Service over amps rating QBldldng over 10,000 sq. f1
a i.l ti '(I ' [:
lr 'I , �n 1 in o f ) Ib 'it r l',6«4 ) r 17 ! u 1 / ,' r C i , t a 4' mid '
i
..,., 6 i„e�:a1 1 ,. + :,. ° f' t , ,. ,� - � ' . i±t , . .,. ; ,r iSrR �l,`tr . . . a .. I . !.� , �.,.�: , v , : �Ss'.5.+ of 1- d 2-family �7' dwCltinga 4 or mom new residential
i:.4 1- and 2 - Ssrnlly dwell ❑ Commereial/in ❑ Accessary building Osystem over 600 volts nominal units in one structure
['Building over throe stories ❑Faders, 400 amps or more
❑ Multi fgtnily ❑ Master builder ❑ Other QOccupant load over 99 persons OMenufhctured structures or
Ea ' ., 5 - , op 1'l "fir ,! t w ? r , ■ ' 7 > t. > l ',t A' ? r �d,'!+�ny-- 1•r1r r ' ^ k � ,� { } 1 i i��, 'ti } 1 ■
.. r: ' ., „lfi, ), e o : u.f) ° 1 ' .,. , wo oft e. l`r -ss.A 4' rn!,Iln. .. :, ....,h f n lr. 1 . � , ( • ' 1! (in�ll10. , IS1iP i l l .kl. 1 .1 {l )H,�tll. ,,rya - i ❑E�C5 s/llgtlting plan RV p ark si r. , .,
Job no.: y Job site address: 2 :- J AHm j care ofp a y Oar. • �� �� Submit � seta of plans with any of the above.
City/State/ZIP: � r The above are not applicable temporary construciron service
J / i1111(�4{I,,.',.i :r, rnli firir �L1 ,: 5>',t>' , °ir .2. :.1 i g..Y'1'.:,': 1 '; '; :.3
Suite/bldg./apt. no.; Project name:
Description Orr. Fee. Tow --
Cross street/directions to job site: New residential single- or multl- famlly dwelling unit.
Includes attached garage.
1,000 sq. it. or less 145.15 4
Subdivision: Lot no.: 62. Ea. add'I 500 sq. it, or portion 33.40 1
” Fi _�, - Limited energy, residential / 75.00 lc a 2
Tax map/parcel no ?C)y Limited energy. non - residential 75.00 2
!rA,:� 11;1 : f - -, ao V . -. . nr `� f i4) r id `, ts lt . , n , 9 p y >
;- Z � i ., 1 ,',e.,,.,....-,,,,,,,,,, 1
. .. ..„ ; n ! 1 �r: .,,,,/, ,, 1 �v,, ?, /,, A':;. �',, " Each manufactured or modular
- dwelling, service and/or feeder 90.90 2
�% 1 ! Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
lam% r x r ,r / �/ '
C i 4 ,R i ' r li ) i) i �; ,, i 4 t : r .rr;, 1 5i 201 amps to 400 106.65 2
����, 1!' , t r 1 r u i ,' . 1111 Y 1 n, c i � t: SO' � a t , p p
,r'.S'i, r,d:i.o. :. . !' :3,,.... i !1•rn..,:,{'. ( vy „.1,, 4 , ,x,, rt 1 , 1,111, , b 1l.,,,Qi$i�Sk04 i;[
401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
• • ✓ ' Over 1,000 amps or volts 454.65 2
,, Reconnect only 66.85 2
City/State/ZIP; r , . , _ i /L - , , -- / Temporary services or faden iaslalladon, alteration, and/or
Phone: (5'Q ) i Fax: ( ) relocation
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 eireaita- new, alteration, or extension, per panel
” Iw i, r ( \;-. t 1:1'1 1 ` { 1 1
' I fi'4 I . A6 i,T C A^ VC , 11ro ; ,, r 1 5 5 V • tl , , t , , ' £ n l r, ll t t f /� a ) 9.. ,, , N , ; A. Fee for branch circuits with
( 1, .,..... ,. , i ,. :,.. , 4
, ;l , 3 ._.t �' ,. . i; � . L_� 4 .. : . , : u ._; < ,. . e. , . ... ui service or feeder fee, each
Business name: branch circuit 6.65 2
B. Fee fbr branch circuits
Contact name: without service or feeder fee,
each branch circuit 46.65 2
Adder Each edd't 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 -mail: yy ( L{ Signal ciroult(s) or limited -
I %. !at Z.Vg3i1;y!,;�)t E;i5�lti i r iri:....a.,;17 :'..,�t i::.. ,i '�.. s :'' f1�.3�N[[ki<7,.i .iR�f. ii l A1 �$i.1 c, i lli%iri,E mere' panel, RITBratian, nr
( 1 F Y1. 1 � ni n4i i Mrri
extension, Describe: Page 2 2
Business name: _
Adcir�q• _ _ _ Each additional inspection over allowable In an of the above
Per inspection 62.50
Cis; GENESIS HOME TECHNOLOGIES lnve tip hour hr min) 62.50
er 8104 SW Nimbus Ave. #4A Beaverton OR 97008 Industnal plant per hour 73 75
P
Phn- 503- 43 -1704 Fax- 503 -643 -3300 )`4 rs�°F °"� a 5 )ir'�
�.,1,,'�R.T.,m r'u.,�iRiF:l,,.;,.y �•,!`.'. ,.nr; Jx.,�,�! ,)! . ,. _.e : f, Il t :, r. ! . ?.ir }.L:r.�i� ���'i1�S.�.14� i
CC &lot CCB 128098, CLE26 -989,
Subtotal • e j ' °�
Sul. 7 °� 2885 -J LE Plan review (2554) of permit fee)
�/ State surcharge (8% of permit fee) 4 °,
• , / r Date: — I S' ors
TOTAL PERMIT FEE 81, 0 o
Authorized signature: This permit application expires Ifs penult Is not obtained within 180
days after It has been accepted as complete
Print nine: Date: • Fee methodology set by Tri•County BulIdlng Iadusoy Service Board
” Number of inspections per permit allowed.
isturbidmgWermitstELC•Pnmitaim deo 52100 440- 4615T(I0/et/COM'W118
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2005 -00066
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/14/2005
Phone: (503) 639 - 41714 L4, ill
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/30/2005 TIME: 7:06AM PAGE: 73
SITE ADDRESS: 12926 SW SUMMIT RIDGE ST CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 0B2 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE
DESCRIPTION: All encompassing.
OWNER: DON MORISSETTE COMMUNITIES LLC, PHONE #: 503- 367 -7536
CONTRACTOR: GENESIS HOME TECHNOLOGIES PHONE #: 503. 643.1704
Inspection Request Scheduled For: Date: 6/30/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
\199` Electrical final 010524 -06 503 - 209.4637 N
Corrections/Comments/Instructions:
CC
1142 .
in PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: '''' Date: 4 1-3 o` Phone #: (503) 718-