Permit ttR
1 1
17! CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00104
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 4/20/2007
PARCEL: 2 S 109AC -02900
SITE ADDRESS: 13407 SW ANGUS CT ZONING: R -7
SUBDIVISION: WILSON RIDGE LOT: 003 JURISDICTION: TIG
PROJECT: WILSON RIDGE
Project Description: Low voltage
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: X AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: X BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: X CLOCK: MEDICAL:
HVAC: X DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: X FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: LL ENCOMP X HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS:
Owner: Contractor:
DON MORISSETTE HOMES ALL WEATHERIZATION
4230 GALEWOOD ST. STE 100 3030 SE 59TH
LAKE OSWEGO, OR 97035 HILLSBORO, OR 97123
Phone: 503- 387 -7538 Contact #: PRI 503- 649 -6542
FAX 503- 649 -2680
Reg #: LIC 46969
FEES
Description Date Amount
[ELPRMT] ELR Permit 4/20/2007 $75.00
[TAX] 8% State Surcha 4/20/2007 $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 direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: j444 , ��� � Permittee Signature: /1/4
OWNER INSTALLATION ONLY j
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.
A `�
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E lectrical Per .applicatio
hOR <)FI'ICE USI.ORL. \' '.
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City of Tigard , 0 2.1 WO par N
ed Permit .
13125 SW Hall Blvd., Tigard, Oli 97223
(( nG t l , ri f »aaReview
Phone: 503.639.4171 = 'ax: 503 598.1960 Gil /44; r�� �� By ,
OtherPermir.
Inspection Line: 503.639.4175 rP� 6 Ha Ready/B mdse
Internet www ct tagard or us ENV El See Page 2 for
Nou6ed/Method: Supplemental Information
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u«..t�i u"atgei:gi.'r. z!..ldiiii ?er iaS l' e l+., 33 4 ��, #� 4 .. ari a �+ &,..,: . : "Al t. ' ¢ {` : .r ' s =.' :- t - k3a. . } .. : x 9 �, ..s
k .. ,r x..6.. 5 fi;,rm,�4�..:�v} r. }.? 'v , rk`,;. Y a it $ '. l K,r pr t ,t ms s ' t 8Ki "Y atM , f 4 5 '°1 1 �; � _,i1 C �( . z. , F
�- a�? 3an.t � ;it :, * <� . .a�a. «.i� «y .°f�'�".ti�n���„ � °£ , �t��� �k.;..x �,�s tw 9 �' r�€ �£ ��, �, �HI: �'fi.E "�;s:5�?Rr.'�"' -a�`�,
t New construction ❑ Addition /alter:tion /replacement Please check all that apply:
❑ Demolition ❑Other ❑Service over 225 amps, comm'l ❑Hazardous location
i 6 +,° ,yi r,,) , ' a� .: t' , , �„ , .px t : t , a ., r ❑Service over 320 am s - ratio sq. ft.,
to i;: l Fat �t w: ) • tth ��Tk. D rating ❑ or more over 10,000 nti
�F z .. T' � :�,_ ^ , C k ) 1 ' �. k / e� ; of I- and 2- family dwellings 4 or more new residential
1 1- and 2- family ch4elling ❑ Commercial /industrial ❑ AccessoIy building ❑System over 600 volts nominal units in one structure
❑ Multi -family ❑Master bullde ❑Other ❑Building over three stories ❑Feeders, 400 amps or more
!' fF ` I a zr o- t� s z ❑Occupant load over 99 persons OManufactured structures or
E �� is a ) 1g38AAAe 14 th s a;4 a i 't4r-� a w I • ,
F- , uz,z z „�,o �re,..�: J ..,.R� ❑Egress/lighting plan RV park
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Job no.: 37 j Job .ite address: / j l ❑Health -cre facility . ❑Other:
I ✓ e b � � Submit 2 sets of plans with any of the above.
City /State /ZIP: ' a te The above are not applicable to temporary construction service.
Suite /bldg. /apt. no I Project name:��� in tX aIr ra.c'', {ah.
nercription Qty. Fee. Total
Cross street/direction to job site: 6 (1 ]_ New residential single- or multi - family dwelling unit.
Includes attached garage.
I l 1,000 sq. ft. or less 145.15 4
Subdivision: jl/ t ( r.J t U l/, I . I of no.: - Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: I V Limited energy, residential / 75.00 7s 2
:
CCrr'',, ,,��� Limited energy, non - residential 75.00 2
tft'�. �°4 aS 7
�. .+�,z^'i nM1��i*4:�((iJ '� 0 :; f .: 1}�If �� Y,,f : S V. ; , wx i a, y . : .�
\ Ao f *7
�. mat s.. .�r >4�3,�;: r��, n .. 4...t3M�, ,1 q, „ ?<, , : f ..; Y. ,.z .3 Each manufactured or modular
CC- n . -k` 1 /� dwelling, service and/or feeder 90.90 2
V , �� 4 Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
, v 7 3 5`1 '3 A ,i 1 i T q : , i 7i. r t a'. ax �� ; ' .7,-, 3
.ta`a ale al : r �� 1 4, " a t 1I rki ' y t a•°as a4r s �, i� i 11 201 amps to 400 amps 106.85 2
gy r t :..�mu,t.�,,xx�S.°a...._ x&;'d 3�,;;'�.za�, @'uF > 401 amps to 600 amps 160.60 2
Name: , • u r t
M ia 601 amps to 1,000 amps 240.60 2
Address: Li 2 3Q t 1 € / I.tJ ,. 1 S Over 1,000 amps or volts 454.65 2
City /State /ZIP: 4,.6-i? V Reconnect only 66.85 2
V.� as t✓e-4 q 70 Temporary services or feeders installation, alteration, and /or
Phone: U relocation
( j a j ) �� '� k F . x. ($ 3 ) fS? ti / A- 200 amps or less 66.85 1
Owner installation: "If his inst. llation is being made on property that I o, n which is not 201 amps to 400 amps 100.30 I 2
intended for sale, lease, rent, o exchange, accor• ing to ORS 447, 449, . 0, and 701.
401 amps to 600 amps 133.75 2
Owner signature Date Branch circuits - new, alteration, or extension, per panel
�d t✓ f�"e �w a $ '�€.^s,�sz +'# � � }f a ^ < s��u� ,
. to to x. g a ) a a ` # a �� i rr s 0 k� , Ctw ss ,1 `y i'r "; ` 4.; A. Feor branch c
'`�Adz.. , �a � � � � �i"a 7 N r3E t � 4 «t�s�,c,,.�� nix,:
servi f ce or feecder fee ircuits wish
, each 6.65 2
Business name: A 14 'Vs . 4 Er I , 4-;4,4v soh ,vc branch circuit
Contact name: 13. Fee for branch circuits
�(?/y 0 +1 G k f without service or feeder fee, 46.85 2
Address: o first branch circuit
S � a' Each add9 branch circuit 6.65 2
City/State/ZIP: p
y ' � 60 , U 0 • q 11 2s Miscellaneous (service or feeder not included)
Phone: (x ( 2 F. Pump or irrigation circle 53.40 2
E -mail
6 + N I . . ( ) 6y /.'
; 1 &� Sign or outline lighting 53.40 2
Signal circuit(s) or limited -
J ga �i 6,r NT` , �Iz, �T `,F zs`a a ' ' �, s s t , 1 a
"'� $ � ���- °��'<.�.�.. ���� , t, `� P ���''�4, „� �j , q ?� tension. D e cr
s alteratio or
be: Page 2 2
Business name: ex energy panel
Address: ._O 1 3 4 S1.� Each additional inspection over allowable in any of the above
f ' Per inspection 62.50
City/State /ZIP:
�� 6 0 +2.o / C
'7/r 3 Investigation per hour (1 hr min) 62.50
6 F : ( ) a Industrial plant per hour 73.75
Phone: ( 7 /! Z I �e� �! &D
` l c wt" �Y ° fr' o- r e p'` 1 "` t' S' °ti4 Is 1
, ?'E� :fir A2 r 91 �' �+ �� ����' I Yd�I�. �Na .A��f
CCB Lie.: f ' 6 electrical Lie.: Suprv. Li.:
r Subtotal 7 4.)
Suprv. Electrician sigli'ature, re•uired:�
Plan review (25% of permit fee)
Print Warne: L� Date: � O�
State surcharge (8% of permit fee) C `
�r ix ■ u li 0 k' t_- � TOTAL PERMIT FEE 6°
Authorized signature: / � -.._ l
x. , "' This permit application expires if a permit is not obtained within 180
.< - 1 days after it has been accepted as complete
Print name: Date: 1 • Fee methodology set by Tri- County Building Industry Service Board
i "Number of inspections per permit allowed.
i :\ Building \Permits\ELC- PermitApp.doc I2J03 i 44¢- 46I5T(10 /02 /COM/WEB
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