Permit rr CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00113
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TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/1/2007
PARCEL: 1S134DB-11300
SITE ADDRESS: 11026 SW BRENDEN LN ZONING: R - 4.5
SUBDIVISION: DAKOTA GLEN LOT: 015 JURISDICTION: TIG
PROJECT: DAKOTA GLEN
Project Description: Limited energy, all encompassing structured wire, security and audio.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: X AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: X BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: LL ENCOMP : X HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS:
Owner: Contractor:
DON MORISSETTE HOMES GENESIS HOME TECHNOLOGIES
4230 GALEWOOD ST. STE 100 9450 SW GEMINI DR
LAKE OSWEGO, OR 97035 BEAVERTON, OR 97008
Phone: 503- 387 -7538 Contact #: PRI 503- 643 -1704
FAX 503- 643 -3300
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FEES Reg #: ELE 26- 989CLE
LIC 128098
Description Date Amount
[ELPRMT] ELR Permit 5/1/2007 $75.00
[TAX] 8% State Surcha 5/1/2007 $6.00 REQUIRED ITEMS AND REPORTS
Total $81.00
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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: � ! Permittee Signature: 5,0 / pp/ C ct f ivr�
OWNER INSTALLATION ONLY /'
The installation is being made on property I own which is not intended for sale, lease, or rent.
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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.
Apr 30 2007 12:46PM GENESIS HOME TECHNOLOGIES 5036433300 p.1
Electrical Permit Annlicatiiin -� ' s 1,olt f 11'1 t4.l,, l,tii- t >NI y
tea,,, 1 4 'Received
City of Tigard " Date/ B Pemut No -: ��4 %200 Q I13
# 13125 SW Hall Blvd., Tigard, 0 97223 Plan Review
Phone: 303.639,4171 Pax: 503,598.1950 )D zl 2007 Date/Bv • Other Permit:
a r r A t Inspection Lme: 503,639.4173 P(r R Date Roady(Sy: GI See Page 2 for
Internet: www.tigard or.gov Notified/Method: Supplemental Information
{� . , . , ";'• aaW^, 'a4:VdY . 1 : ' �O'.Sn pv.. . s .� , � •,1�p•� v a 1 ., � 4 Y�F � � r i n {^' f x Ww' g m r" �i 1 � � r�i� rl �R
,74 � ` Ma k t . 'ar n . w4 n dfl 'd go . ; SIS r al (, . _.a .. ,16.1 y s ...67,—,LA: „ ,n."s.,., tkl ; .. p1..;,
t ^ '` Y ¢ ,, t i a i A�
I4 New construction ❑ Additioi eration/repl'a in4n , ' PY . Please aback all rhat apply (snack-thaw!: m c of plane witea c, c . ' ow):
� . -, .. ❑ Service or fteder400 amps or more ❑ Building over three stories.
■ Demolition ❑ Other: where the available fault current ❑ Matins mad boatyards.
, r tx "t;S �t'€+�f" �•r+* � �T; „ �ti� e,.ar � g 1 �C � exceeds (0 DtJ<7 am pa at 150 volts or ❑ Floating buildings.
F ¢ kft^ l e i o t c af),, pa'H rr a r n r ,hu P Y
;, t ,,h„ ` #7 `�i�!h r s 12„+.aw�r rrFiaam.i. a ii itvg; +..'la ro, v S....4, • t.1 a .z. less to ground, or exceeds 10,000 Q Commercial - use agricultural
P 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
• Multi -famil 0 Master builder ❑ Other: f] Fire pump. ❑ Installation of 75 KVA or
c r.- „ goov,, • rt z wt rriaic, ■ , t+• 0 Emergency syatem larger
e 1 . p � t ; y , } i dx E '►S x � $ a 4 ; r • i . 6 s ^ y �y f y " a l A d ad of DOW motor load of ❑ larger
ae rate) *rived
.' �, - a',l P•ICkel :c7$ "� S .40'''.'.∎ t r ) + !: ` ' 11 �S t 4. r• i t • ❑
Job no Job site address; • room or more, cvcu panrey ,
_, 4 a • • _. ❑ Six or more reed/natal units. ❑ Rocreationel vehicle parks
W l ' Ykd (, ❑ Hedth•oare ca iitiea, ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt.no.: Project name: ❑ Service or feeder 600am•
en w i TEEPtkLA:4 .N i o i ^ -. •r. r•' .' ".,... % Cross street/directions to job site: DM p on Orr, . son. Total
New residential single- or multi -family dwelling unit.
Includes attached garage,
Subdivision: n , IMAINIII. Lot no.: (5 1,000 sq. ft, or less 145.15 4
Ea, add'I 500 sq ft. or portion 33.40 1
Tax map/parcel no.; Limited energy, residential
`, rc: sw r rf''” j;p, aittg ? z t. 75.00 2
i ce ' l ���t `ft ` t b ` , bi . 44, . uvi w^ ,,414.0, .. - w lua:UtAt kA to c 7! t4 (with abOVe B4• ft)
Mill Limited energy, multi - family 75.00 2
- r i , A i - NMI. residential (with above eq. f!.)
Services or feeders installatio alteration, and/or 64t.(4 y � �t VIM= 200 amps or less 8030 2
P { { v ;5 r wrze u?�� , ,w ,} w ;G c . Ofl r * tl
F l i lt Lud ,�§i 1 h ",, Vt$I ,,, i t ^ 491:(le . a a l ! 2 amps to 400 snips 106.85 2 • 401 amps to 600 amps 160.60 2
Name: .m 4 l� + ■
� 601 amps to 1.000 amps 240.60 2
Address: 2 .0 • 1./1 W $ .. •I. U
- A Over 1,000 amps or volts 454.65 2
Temporery services or feeders installation, altaratlen, and/or
relocation
Phone: (a))) , . .• Fax: ( ) 200 amps or less 1 66.85 1
Ovrner installation: This installation is being made on property that I own which is not 1 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 599 amps 133.75 2
Drench circuits - new, alteration, or extenslon, panel
Owner signature; _ Date; A. Per for branch circuits with
9 above Service or fee
t ' e �y ;n�+'i T¢° ul t� te f y i ' n t " M ' rr.!'NS "t:i ' der fee
U. ,1i f s G4.441 .uamnaa l? : .As Y; '60age Nia
ii t `,,,l1gE•: b..a 6.65 2
each branch circuit _
Business name: B. Fee for branch circuits
service without feeder fee,
Contact name: first branch circuit 46.85 2
Address: - Each addl branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/ State / ZIP: Each manufactured or modular 90,90 2
dwelling, service and/or feeder
Phone: ( ) Fax:: ( ) Reconnect only 66.85 2
E-mail: Pump or irrigation circle .53.40 2
n .a " sr. a ,. ,,;, .r'' " "9 : , s a wv "3.M1 r i, It 53.40 2
Oi � t ,r i AMEI1" 7u 4 i7 t „• L- t ., 5 Bid. t uF= i tl . Sign a outline lighting
t"' 4 ►4 � �' �cfoh?.,, S.i:s�t� �u�»•,w.''�w���1.4��S1.�l��i .r ,,.,��.
Signal circuits) or limited-
Business name: energy panel, alteration, or oe
Address. extension. Describe: 2 Page 2 f 2
City /State/ZIP; Each additional inspection over Allowable In any of the above
Per inspection 62.50
Phone: ( ) Fax: ( ) Investigation per hour (1 hr min) 62.50
CCS GENESIS HOME TECHNOLOGIES Industrial • lent •erhour 7335
9450 SW Gemini Drive Beaverton, OR 97008 itlit =- 7,3 x r sg- H '` -M .iii 1' -`,
Supra Phn- 503 -643 -1704 Fax- 503- 643 -3300 Subtotal: .S .—e
Print
` '�1 , ex—.. COB 128098, CLE26 -9B9, S tate surchar Plan review (25% 'of permit fee):
2885-J LE ge (5% of permit fee): 4 at
Autht TOTAL PERMIT FEE: 43 i te.-
Print name: � i sill
Date: 0
This permit d ys a a fter it has been ac as complete.
within 180
• Number of inspections allowed per permit.
rallWintPomdle:Et .C•PennitApp.do: 003016 . 44G- 4614r(t1/05MCOMAVfB
` CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007-00113
Ilk 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/1/2007
Phone: (503.) 639 -4171 ,1-4"141141111
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 5/3/2007 TIME: 7:00AM PAGE: 41
SITE ADDRESS: 11026 SW BRENDEN LN CLASS OF WORK:
SUBDIVISION: DAKOTA GLEN LOT #: 015 TYPE OF USE:
PROJECT NAME: DAKOTA GLEN
DESCRIPTION: Limited energy, all encompassing structured wire, security and audio.
OWNER: DON MORISSETTE HOMES, PHONE #: . 503- 387 -7538
CONTRACTOR: GENESIS HOME TECHNOLOGIES PHONE #: 503- 643 -1704
Inspection Request Scheduled For: Date: 5/3/2007 Pour Time:
Code # Inspection Description Confirm -- Contact # Message
135 Low voltage 047572 01 503 -643 -1704 N
Corrections/Comments/Instructions:
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A PASS PARTIAL APPROVAL ❑ CANCEL I NO ACCESS
1 I FAIL 1 I CALL FOR INSPECTION I ADDITIONAL FEES ASSESSED
Inspector: CT 1A 6 V Le Date: V 2 -` 1 :ri Phone #: (503) 718 - 1- ` H i c)
t