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Permit • MP ' C ITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00032 'TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/5/2007 PARCEL: 2S 109AA -04900 SITE ADDRESS: 14145 SW 128TH PL ZONING: R -7 SUBDIVISION: ELK HORN RIDGE ESTATES LOT: 015 JURISDICTION: TIG Project Description: All encompassing 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 ENCOMP : X HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL # OF SYSTEMS: Owner: Contractor: MATT HURYCH GENESIS HOME TECHNOLOGIES 14145 SW 128TH PL 9450 SW GEMINI DR TIGARD, OR 97224 BEAVERTON, OR 97008 Phone: 503- 718 -1000 Contact #: PRI 503- 643 -1704 FAX 503- 643 -3300 FEES Reg #: ELE 26- 989CLE LIC 128098 Description Date Amount [ELPRMT] ELR Permit 2/5/2007 $75.00 [TAX] 8% State Surchar€ 2/5/2007 $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 ar- .: • rth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain co ies of these rules or direct questions to OUNC at 503.246.• . •9 or 1.800. .2. . • Issuer' By: 1_,4 Permittee Signatu e: /, , _A/1p OWNER INSTALLATION ONL 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. Feb 02 2007 11:50RM GENESIS HOME TECHNOLOGIES 5036433300 p.1 Electrical Ferm4t Application I t )1 t rl' I I( I. I 1 `, F 4041 1 oral City of Ti - E‘ EL sa 7 � A/ 97223 Photo: 503- 639.4171 Fax: 503.598.1960 r'`'u" +"f�r¢ I ` � Datefy: Other Penna. Inspection Line: 303.639,4175 r"3 0 �:.. � -3: ' 1 - Date ReadYBY: 7o ...... .) See Page 2 for Internet: www.ci.tigard.or.us t - I NotitSed/Method, t G _ supplemental information .,i j y r t , i 1 "� . r_ :m 1� ?cy. _, "' � @a �x. x ,�y:Yx: hu .>�L ya�i Ii: P?'; h s r ati'y yr �.i , (" ". , � „� 'r, 't 1' �K : � ' `ih :d i,';',4 - F -. „ 4 t 1g ` tP 4 ' " j;r;: ; 1' n i t rt , � {t 1 t y . ? C i�� ' i cf �C i t I ` ' 4 �i. 5 1� ,) � t �t� i ) .' , l I� rip i, IV, ' I k h M . a :. , ril l -' .F Cb ,i/ ,t 1 `v. , Sr; ! 0 . e: ,' � M i .'ir gn A{ >'i Iti Atli.�� .c• •...11lf:lf:ii4!�Fr nk t,tt4tiii.t0 .tyiitjo!rt7 ti iX�lhr: . l ..tt4:bit fl• '�i'di . g ., ,!, d:3.1, fISili I E � t 3m. .ri...., E. tIrit,t _ cYld•Ott.:,L'r+.r. r:9ats ,sL'i »hit .'4i 4,8 ❑ New construction ! Ad diti 'o'Naiterttfion/repldenient Please . cheek all that apply: �> 1 , i° ❑Service over 225 amps, Comm'] []Hazardous location ❑ Demolition El ❑service over 320 amps — rating ❑ Buildng over 10,000 sq. ft 1'�t� ! d 7 r1�, i ry l r C i9 1 S k ' 7 r ray .,,,lU .m.„„ `pir ycr,ttr,rro E tiO L: Via, .1.1l scot 4t 09 . 1 1 1liiatui 1 1ri1l rt. alt , i,d (lid; H 171 t , . :. rpi rai 1118 Fl in lee W 1 t* A )4# of 1- and 2•fam!!y dwellings 4 or more new residential k31,. 11 1 - and 2- family dwelling El Commercial /industrial ❑ Accessory building ❑ Sysn3m over 600 volts nominal units In one structure ['Building over three stories ❑Feeders, 400 amps or more ❑ Multi-family E Master builder ❑ Other: t a r" r a l 1 i ['Occupant load over 99 persons OManufacturcd structures or �Vr t ! � . ry . y tn n v a c l itr e p 1uY ag t q rp mky�. p tt} Ic �b tr�CSa ." ) shd,Y,a x .G �'� o- 7 y� r • n �r �1 ��j ii 1C�i � i 1i,' 1Aiu 4f *sc aws.. ,.4,s v1hrY`wn Amt. � itr'h'a• fetgoloArtA9�5moti fir. itittlAt, Ak .` 1M, ak A:! ❑E jr essillgbting plan RV park ciao' ❑Health -care facility ['Other. t Job no.: Job site address: / r ( 1 S' sI) JZ� , L.. submit i sets of plans with any of the above. City/ State/ZIP: .e ®�� r 17 z Z. 4/ The above are not applicable to temporary conetruollon swvioe_ Suite/bldg. /apt. no.: I ` Project name: . t r' ril N9a 1 IlFff h` `,.t'i A zZ M '` _ _" Description Qty, yw. =MI •' Cross street/directions to job site: New residential single or multi famlly dwelling unit. Includes attached garage, 1,000 sq, ft. or less 145.15 4 Subdivision: 6 . i Lot no,: / S Ea. add'1500 sq, fi. or portion 33,40 1 I. Sri - Limited energy. residential / 75.00 9S 2 Tax map/parcel no Limited energy, non - residential 75.00 2 + y '� 1r�gnc z �aW1�Yp"c >s,t �,�Sx rxxjcnr+trr� "i , � t�x, "���+,+' ua. F �. ;.''�.r. E OSIM r; » i i '. .1(,. t; +,#Qt',Rt E �� .e a ` ' R& �1 w.dta'l lk Each manufactured or modular dwelling service and/or feeder 90.90 V 2 ' .� 'ill 1 - .. • Serylcei or feeder' installation, alteration, and/or relocation 200 amps or less 80.30 2 +y S�t _ � 1 tt fl. tkifriLia - e I bQra ° n�auiii 41 1 )Alaikli like l« rbtZ F i .l 201 to 6 00 a mps 106,85' 2 i 401 am to 600 amps _ 160,60 2 Name: 4,/ 601 amps to 1,000 amps 240.60 2 • � 1 i Address: 1 fi e 44 12 e'rn p L Over 1.000 amps or volts 454.65 2 ^� ' ° Reconnect only 66.85 2 - - City / State/ZIP: f l 6 d „04 £P it, -4 7 Z 2 C{ Temporary services or feeders lnstalladon, alteration, and/or relocation Phone: (5 ) 11 $ - / 0 0 h I Fax ( _ ) 200 amps or leas 66.85 1 Owner installation' This installation is being made on property that I own which is not 201 amps to 400 soups 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 ga a ? 1 , ,.- ry �" r ., n.ee :: � 4 } �yt{P ,9 � ti P'o(t . it p L' 'ref 1 • iti .`^' r �l�*+ 4 : ,... } R7uaa g ft q ■ ' tiny °py . t ' p y ^� S , S y F p a` , 7 � t A.I''ee for ilran(311 clroults IVI }�1 r s „ 111ll5, tW Ala¢ sa1E151r.1?;tl'iI Y2a�Y,4 x,aswFi6' .S i .,Leal apzhat. r'iy ,'I1A:„.14..,.. FJd�u'fJ1t t ! service or feeder fee, each 6.65 2 Business name: branch circuit B, Fee for branch circuits - Contact name! w/ti,oul service or feeder the, each branch circuit 46.85 2 Address: . Each branch circuit 6.65 2 City /State/ZIP: Miscellaneous (service or feeder not Included) Pump or irrigation circle 53,40 2 Phone: ( ) I Fax: • ( ) Sign or outline lighting 53.40 2 E-mail: 7 LF� Signal circuit(s) or limited - infi g 11 ��''���� "t �#a i, �, � e " ,v `uE ,al ,i,�� KI r.? . ' , �'yas St�h :� 1 � ' i i� 'J energy panel, alteration, or # extension. Describe: Page 2 2 Business name: _ Address: Each additional Inspection over allowable in any of the above Per inspection 62,50 City/Stale/ZIP: Investigation per hour Cu lee min) 62,50 Phone: ( ) Fax: ( ) Industrial plain er hour 73.75 -- ' >I a1'r`3n t:,.,itt.3«.ifi;, ,: ;xt.. ..Y., :Pa . , €; ae q tr a'i r 'a CCl GENESIS HOME TECHNOLOGIES Subtotal 75 9450 SW Gemini Drive Beaverton, OR 97008 Plan review (25 %of permit &e) Sup Phn- 503 643 -1704 Fax- 603-643-3300 e o Prir. serss c- r .—.• COB 128098, CLE26 -989, State surcharge (S %ofpormit fee) f,7 0 2885,1LE TOTAL PERMIT FEE g / 60 Aut This permit application expires if a permit is not obtained within 180 day+t after it has been accepted as complete Print name: j la K. yyl � Q tiz. Dane: 2 - Z - ©? • Fee methodology set by 7ti- Conroy Building IMostly Service Board `• Number of inspections per permit allowed, it Buildiesperrnite■tiLe- PamitAeo.eoo 11/03 4404615T(1tteCOM/WEB ..„._ -6:7_,- • - _ CITY OF TIGARD . .. . res. BUILDING DIVISION . PERMIT #: 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/12/2007 Phone: (503) 639-4171 A l 1 og Inspection Requests (24 Hrs.): (503) 639-4175 u a t INSPECTION WORKSHEET FOR DATE: 218/2007 TIME: 7:03AM PAGE: 18 SITE ADDRESS: 14145 SW 128TH PL CLASS OF WORK: SUBDIVISION: ELK HORN RIDGE ESTATES LOT #: 015 TYPE OF USE: PROJECT NAME: HURYCH DESCRIPTION: Convert crawl space to theater. 1130106, ADDING (1) FEEDER. OWNER: HURYCH, MATT PHONE #: 503-718-1000 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 2f8/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 135 Low voltage - CA3li4 Ct2 503-413-9870 N i tAbtl4V-01 Corrections/Comments/Instructions: ID PASS fl PARTIAL APPROVAL fl CANCEL fl NO ACCESS 0 FAIL H CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED , Inspector: t -- INc N ii LE Date: -1 lc T1 Phone #: (503) 718- 2,4qco „ ,