Permit CITY TI GARD ELECTRICAL RESTRICTED ENERGY PERMIT
411p, DEVELOPMENT SERVICES PERMIT #: ELR2005 - 00365
'� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/21/2005
PARCEL: 2S109DA -05500
SITE ADDRESS: 15186 SW GREENFIELD DR ZONING: R -7
SUBDIVISION: SUMMIT RIDGE LOT: 032 JURISDICTION: TIG
Project Description: Central Vac. Job #3475.
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 COMMUNITIES, LLC ALL WEATHERIZATION
4230 GALEWOOD ST. STE. 100 3030 SE 59TH
LAKE OSWEGO, OR 97035 HILLSBORO, OR 97123
Phone: 503- 387 -7538 Phone: 503- 649 -6542
Reg #: LIC 46969
FEES
Description Date Amount
REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 10/21/200E $75.00
[TAX] 8% State Surcha 10/21/200` $6.00
[ELPRMT] Investigation 10/21/200E $75.00
Total $156.00
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: f/ �1.,e. Permittee Signature: y _� C?3\t) r,
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.
10/20/2005 14:41 FAX a 004 /009
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home: 303.639.4171 Fax: 3 88719 ,�,, P tc/By:
dspeioa Line: 603,639.4175
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4 New constructio^ 1 I *11611Y4 r.i l 1 f,.dt ..ti4i \I Tait: � }frylN 19'' 2'• • '� � ) ft� ttt Pteue oheok u ! appy:
Demolition • [ � O41 p servics lecemt 225
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iel/indtivh•► ■ b QSyatem over 600 volts R wits in duro
,, ,•, y i El Master builder [3 Other: QBuilding over three stories 0 Feeders, 400 amps or more
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75 .7a1. isite address: / A �Q f v- e l c P ❑Health - ogre facility (QOther:
Submit 2, mots of plans with any of the above.
ity /State/ZIP: y ,•, Q The above are tots linable to to
lritt�/b / t. no. � 1�ft, 11 n , ; ;k applicable construction service.
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roes streed/d'aeetions to job Site: °w "�' " "' qtr tae r «,u •.
New residential single- or multi- family dwelling emit.
include,' attached gera�,
zbdiviaiou:
1,000 Sq. ft. or lees 145.15 4
M (2,- , • Lot no.: 3 'Z Ea. add 300 sq. ft. or portion 33.40 1
ax map/parcel no 0 Limited saargy, residenlial 75.00 / 2 • ;t4'NF% alt ++(s��J'''( 7 t 17f � )g s I y r11riadarltr
i.;4),)�iit t i f li i7 il Fn{ ,J �ij all i B t ,a I ✓ 1 1, �i' _01 11..1 '1 i f j T - ; t 1 S a \ t 1 }i- i , t r, r P'''' v.' 11, o� 11 ltgY. ""eatdardia) 75,04 2
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K: 1. , dwelling. service and/or feeder 90.90
2
/i�` V Service or feeders installation, s
�O t,/ (�o I ' tloalteration, srtdlorrelocatlon
�7 y { 4t' 200 80.30 2
amps or leas 80.
ra'�St l��l)i..�'WI'1 1!�I j •`I Ili :`�.Im� " \�• {:.1 5• t ,l, � .1 .n,� ^ „ Y, ;5r47 °Y ...i - ,
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�-L . 601 amps *o 1,000 amps 240.60 2
!dress: 3o .& - - n .• Over 1,000 amps or volts 454.65 2
ty /9tattYGlP: Reoonneot only 66.83 ! 2
t : e � C Temporary services or readers !Retaliation, sl*mrsdlon, and/or
Iona: (.3) '3�� ; 7c 35? i Fax: (5Z3 ) l �7 14 I relocation
weer Installation: this in ifllation is being ade on 200 amps a teas 66. 1
ended for sale, lease, rent,,cr exchange, a to O S , 449, 6 0 and 701. 201 amp to 400 amps 100 83 2
NDer signature: Date: 401 amps to 600 amps 233.73 2
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, r�! i i )' r Branch circuits -`new, alteration, or extension, p r panel
'i kil dil 16), �., ),'!salt . /i 11 f 456 \ 1.41 t A a t 1 , � I ,
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trimness name: - service or fa«!er fee, each Aih it/ o n i branch circuit 6.65 2
intact tutee: W Pee for branch circuits
� ' �/ i I G ►L. wi hour service or fb•der foe,
dress: • 0 i L + L each branch circuit 46.85 2
r Each add'{ branch circuit 6.65 2
/ /state P: {Cc' �le
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one: ( 5 ? ) (, l C.fc{ 2 f Fart :: ( .,563 ) G s L i " 2 & ' Pump or irriplron °irate 53.40 2
nail: "Sere' . ,vi inn [ A t , emu` Sign or outline iigltti 53.40 2
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sitlevs trams: • ,` If d fie extension. Describer Page 2 2
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dress' O .z- '11. C, Each additional iRrpectlon over allowable In mayor the above
Per y /State/ZIP: f fri te. � eh q 13 1n, 62,50
li ` 1C� 1 Inv hourp br. min) 62.50
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ay. Electrician signature. i aired: Plan review (25% of paten fee)
nt name: 8tata rlrmhar
Date:
6e (5% of patak tba)
lhoriced signature: L t TOTAL AL PERMIT PER 1
vs Thu permit sppticauen aspires its portal* is art smarms wiWtn sae
nt name: , d.y. utter It has bew..a.pted es s•..sipMt•
/../ ri L" C Datc:tp- • • p methodology met by Trl•Cow ty Building Industry Servioo Board
•• Numb*: of 4»o.ctlona oar hermit allowed.