Permit a `'r
pril CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2006 -00286
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/27/2006
PARCEL: 1 S134DB -DG003
SITE ADDRESS: 11279 SW 110TH PL ZONING: R - 4.5
SUBDIVISION: DAKOTA GLEN LOT: 003 JURISDICTION: TIG
Project Description: Central Vacuum System.
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 HOMES, INC.
4230 GALEWOOD ST # 100
LAKE OSWEGO, OR 97035
Phone: 503- 387 -7538 Contact #:
FEES Reg #:
Description Date Amount
[ELPRMT] ELR Permit 11/27/200E $75.00
[TAX] 8% State Surcha 11/27/200E $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 direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: 5�� Permittee Signature:
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sal 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.
Electrical Pe' m ;� , '
u �-! FOR OFFICE USE ONLY
City Of Tigard 's Received _ -
13125 SW Hall Blvd., T i �V 2 • 2006 Date/B _ PermitN G 1 t �
g Plan Review f
ard,0. 972 � � �_ .) (N
Phone; 503.639.4171 'Fax: 503 598.1 / /rer 0. , i�' t�
Inspection Line: 503.639.4175 d�k� � Date/By: Other Permit:
CI OF TI ' ARD -:; ' °' I I , Date Read /By: L uria:
Internet www cI tigard or us / I Fl See Page 2 for
ar
` 1LDtNG D ISION Notified/Method: Supplemental Information
r1�,�r. �i}}''�����r�� '�'"�"''��h t^°fiyyy`*": f a x ri �r R� a.. at y � � i_ M
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(] New construction ❑ Addition /alter; tion /replacement ' Please check all that apply:
, comm
'l over 225 am s'1
P ❑Hazardous location
0 Demolition ;t ❑ Other:
d eg f, l � 4 p{ g, .abA7Y1 "� E 41 t,tC f 31 D ; y j70 l , I r c, m. N i ., ^xx ,, , ❑Service over 320 amps - rating ❑Buildn over 10,000 s . ft.,
11 1V d . 1 @;! d ( c 't , ��11; � i . key g q
u,� °��- r,,:u -:6..; �fi n , _ � j� �. ;, ��?,.,���,:�;,�� � ��? �$)� �M of 1 -and 2- family dwellings 4 or more new residential
cia I- and 2- family dwelling 0 Commercial /i dustiial 0 Accesso'y building ❑System over 600 volts nominal units in one structure
If
Buildin amps or more
❑ Multi - family ❑ Master bullde ❑ Other: ❑ e over three stories ❑ Feeders, 400 am p
u,' « gr ' Yt r' �v t ❑Occupant load over 99 persons ❑Manufactured structures or
' iYii�{li {i1x�X� k;' 1 ° �� J `''J ��tn��.au.i.i{ ty,,l`, +�rEEktGle'iS> rE�i`i.�'b #''r#1 r�'�,q sF P RV park
+E a nom.. d a e ;� ❑Egress /lighting plan P
Job no.: _ 8 Z l �, Job , ite address:. / i 2 71 < I i 1-1- ❑Health -care facility ❑Other.
•
Submit 2 sets of plans with any of the above.
City /State /ZIP: - a>, rri■ O2 The above are not applicable to temporary construction service.
Suite/bldg./apt.
4i §F� drt1.�z � ° t rsa n x 9r au s
no.: I t v.» k; .:a gr a t; bP),p c ! r ,ii1 i r.>` . M , Y 'K5
_ Project name:
i■• Description Qty. Fee. Total *
Cross street/directionsi job s te: Narr 0,, vt)1_,,. ,,� New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: 4 Yl q „ 614,... I Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: V Limited energy, residential / 75.00 7s 2
ifiii "7 r + �� r a 1 s � + �� , W ; r Limited energy, non - residential 75.00 2
i s .�,. t ,i a v- kttt ir� Fi l i° �p ia� f�,���t� i . ' E�' r ,� }�, *g ih 0 � lay _:
a:'.`d. °, s� a re. - „b�.'•. +..,�. �. �:.. .. ,.r.y-
.'+?°::',,,,k °I.i:?.r. ,:s,.M,ws,is.•. Each manufactured or modular
CC n +P0. V f /C� Uhf y x,�, , a ,� L_ dwelling, service and/or feeder 90.90 2
a - g_yy:' Services or feeders installation, alteration, and/or relocation
' gg;;� _ g �s- } 200 amps or less 80.30 2
t" � 1 $ µ j �k're1,�,�, S l +Z N , ii �' ` ytS ' '� ! n++}i, li\. Zg tr t a ' '' ' ^� a'4 vii,` 201 amps to 400 amps
»,a. �"$tY.ttYlt!B"- r!:�.•iS " "2 ,� l,r \E e ?? ei r,4 r f lx �tl'���t nt d. ro, P 106.85 2
401 amps to 600 amps 160.60 2
Name: ,
• i MI eE 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
3Q � ' Q � ,..4.) � � S .. Reconnect only 66.85 2
City /State /ZIP: /��1 ve W� OS
` y Q q 70 ) , . Temporary services or feeders installation, alteration, and /or
Phone: ( V I relocation
j )� 1 F:x:(
`•'' / $"d3 ) 3 6.7 )ti / 200 amps or less 1 66.85 1
Owner installation: This installation is being m. de on property that I o; n which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, o exchange, accor• ing to ORS 447, 449, 0, and 701. ..
Owner signature: 401 amps to 600 amps 133.75 2
x t Date: Branch circuits - new, alteration, or extension, per panel
¢ v " g. n �� 1 t a ( � µt r�' n t lft ` f t 'u a `• •`` ',- tj' ' V 1 r , �t �� , > 1.4 ,�t q, A. Fee for branch circuits with r P P
,w.,..."aM-'t4 +. u•t, x, T, . >.v,.v, Ii n Id nA�b 7 t'n M
.ui .3..... °'fi , ♦ ::1 r.::1uu:.'.:v.1Fr x..[u or A''''...
Business name: A i t1 branch circuit
fee, each
6.65 2
4_148f; - {-ia+V � ov� F- ,v C..
Contact name: ^� B. Fee for branch circuits .
-%+(t� t 1 G tX f O without service or feeder fee, 46.85 2
Address: :; 5 ii.-1 first branch circuit -
I �' } Each add'I branch circuit 6.65 2
City/State /ZIP: • 041 60 P 0 O • q 11 Z, Miscellaneous (service or feeder not included)
Phone: (573) i 2 F ( � ) Pump or irrigation circle 53.40 2
E-mail:
�' 6 ' N I 6y : Zt5'24g..6 Sign or outline lighting 53.40 2
ir;k f ff { r nr r� Signal circuit(s) or limited -
l} t li3satt ` is t 6 ct .yBo1 viti `r !4 ', `'.. ii t.lsx, `t lttiOV4,'!'v ,. energy panel, alteratiol>, or
Business name: 1 + extensio Desc ribe : Page 2 2
Address: $ � � it, Each additional inspection over allowable in any of the above
45 Per inspection 62.50
City/State/ZIP: � r
li'J bozo de 77 _3 Investigation per hour (I hr min) 62.50
i Industrial plant
: ( 92) 6r F; 03) i p per hour 73 75
CCII : ( _I • (� 6ci f ,. 80 .: `ff E ; e tl . ,R ?t� • I o DA t�' AMMAY
Phone ELZ
: lectrical Lic.: ' . '
�6 7 ' 74. I Suprv. Li Subtotal 3
Suprv. Electrician sigr'ature, re. uired: 1 Plan review (25%of permit fee) t qf
Print name: .- Date: State surcharge (8% of permit fee) C `
�f J// L � �' State
PERMIT FEE 1 r 60
Authorized signature:'+• 4 %4 i
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: Date: I I -. /0 i 06 • Fee methodology set by Tri- County Building Industry Service Board
•• Number of inspections per permit allowed.
i:\ Building \Permits\ELC- PermitApp.doc 12/03 1 444.4615T(10/02/COM/WHm
,-* 1' • - .
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2006 -00286 '
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/27/2006
Phone: (503) 639- 4171�'lII
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 3/28 /2007 TIME: 7:00AM PAGE: 48
SITE ADDRESS: 11279 SW 110TH PL CLASS OF WORK:
SUBDIVISION: DAKOTA GLEN LOT #: 003 TYPE OF USE:
PROJECT NAME: DAKOTA GLEN
DESCRIPTION: Central Vacuum System.
OWNER: DON MORISSETTE HOMES, INC., PHONE #: 503.387 -7538
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3/28/2007 Pour Time:
Code # I nspection Description Confirm # Contact # Message
199 Electrical final 045569 -01 503-209-4837 N
Corrections /Comments /Instructions:
. 2 . : .
C .
PASS n P'." IAL APPRO . ❑ CANCEL ❑ NO ACCESS
❑ FAIL in ' ALL FOR ( • N MI ADDITION FEES ' SESSED
ft Inspector: Date: 7 Phone #: (503) 718
)4'