Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
T•"T1 DEVELOPMENT SERVICES PERMIT #: ELR2005 - 00278
-1611. 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/14/2005
PARCEL: 2S 109DA -03100
SITE ADDRESS: 15327 SW GREENFIELD DR ZONING: R -7
SUBDIVISION: SUMMIT RIDGE LOT: 008 JURISDICTION: TIG
Project Description: Central Vac.
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 SUITE 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 9/14/2005 $75.00
[TAX] 8% State Surcha 9/14/2005 $6.00
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.
Issued By: �Q � Permittee Signature: SL-c, 91
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.
5 O
09/13/2005 11: E-1\i E [3- a1001/003
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Cit y of Tigard R.coi .... 0 - N - 0 , ft ; Permit ,„ ,.., No . -e „ 6 • -"
" /
Dateia :
13125 Iittil Blvd., Tig,a.rd, OP. 9:.1274, ,.., Tie tai) ,4 Nan Review
Phone': 503.639.4171
Fax 51)3.Y44.11AM .,
'''''''110 I s Dabm : Othe-Pemit:
inspection Line; 503.639.4175! ENJON413 ENVISION ij, - i
..4.... - ,,. Data I:toady/By: Aim i Ed So Page 2 tor
Internet: www.oi.tigarti.or.us : NotirleWethott: v- Supplemental Information
L c ,.,p.'0,`I ifir
fertgliarilf liriVa mnitarerpTirarpst.:.40.,., , ,,,,,,,,,
New construction , 0 Addition/alteration/replacement Please check all that apply:
OService over 225 amps, comml Eiliazardous location
0 Dernoliti011 ' . 0 Other:
OService over 320 amps rating ElBuildng over 10,000 sq. ft.,
illiett ' ' '3 k ait i Wg!l lr l i n c qi .i ' 1 1:1 ;111 / . .i r gri t niVriViartararftv\li' of 1- and 2.family dWellinga 4 or Moro now residential
.1) , , i,J, m e,;: tr.,.. .,,. , • ", ,,:,: ,a.,Y,i?,o,..1 it,l.thel,..t ,,,,„ ,,, , „,,,,
5 1- and 2-family dwellin: 0 Commerchillindwitrial 0 Accessory Wilding °System over 600 volts nominal units in one otructure
ID Building over three stories OFeaders, 400 amps or more
0 Multi-fluidly
1 0 Other:
Occupant load over 99 persons El stru
Manufactured ctures or
0 mast" build". . ... . El
.7 i ' . .o■ 'V , u; 'n' "-re' a M 1 r1") 4 ' )
{
l`P 0 • ,, -1 '." 4.30)filkl ,i,4,
,.., , !. , ..k, , :! , 1, „ill : I Iv ',, tf:k CiEgrossAielting Plan RV park
Job no.: 35 ci Yubsite address: 15 3 2 7 . .::,./ e ,fsr,,l0 0r- 0 liealth.care facility 0 Other:
- _ Subtnit 2, sots of plans with any of the above.
City/State/ZIP: 0 a
The above are not applicable t temporary construction erve. sic
_ •
Salt - glti,:l. 1,.• l' ,/,‘ ..., .k;14. 't :, 0. ;. r '.0:
Salta/bldg./apt. no,: Project name:
III
Descriplicat QM F• Toed
Dross street/directions to j oh site: New residential single. or multi-family dwelling unit.
- Includes attached r.go.
1,000 s ft. dr loot 145.15 4
Jubdi vision: S, A, a e _ Lot no.: e:e Ea, add'l 500 sq, ft, caution 33.40 1
r map/parcel no.: i
Limited energy, residential t 75.00 / 2
ax
Limited energy, nowrosidential 75.00 2
Sri :.1.1 i i `,Iarn'il ,19TrIiriVF.?:;,1„Ti7,?q,,;tmri,111,wir,11,151inn'MP Each manufactured er modular
dwelling service and/or feeder 90.90 , 2
C V) 'kek t , V:4, _ I //alai ?, Services or feeders installation, alteration, rind/or relocation
-
200 amps or lean 80.30 ,.. 2
l anitaint 0 1 2, 72 , a71 4 1:743SIRWRIPPIMPgiil l 0 1 ' 1 1 1 c 1 WINtfelrg ' 2°1 an " t9"°11mPs 106.85 .. 2
401 ampa to 600 amps 160.60 2
qame: a, v ., ! iez . ) . [ 71 5:; „, tik . t , t c ..„ il I, 601 tunps to 1,000 amps 240.60 2 _
__
Over 1,000 amps or volts 454.65 2
k a d ress: q z 3 o (,•4i I I- ('J/ 5i am Reconnect only 66.85 2
7lity/State/ZIP: J- 1 OC, i -
' I' ^. Temporary services or feeders installation, alteration, and/or
....-.......- i
relocation
'hone; (sT) ) . , ") '?c .. U Fax: ( ) - .
200 amp a or lass 66.85 1
Dwner Installation: This in i ; • is being'inade on property that I own which is not 201 amps to 400 snips 1 100.30 2
ntended for sale, lease, rentcir exchange, according to ORS 447, 449, 670, and 701.
)wner signature: ' Date: 401 amps to 600 amps 133.75
Branch circuits .-. new, alteration, or extension, per panel -2.---
I ntentReg i '<g r elgt i Ontifigilifika l : 1 511 1 .1 . Y. I Vic.' ,1 4 1 :::1 ; , ' S:' 11 . 1 ,Mii.niflrit A. F°e fc bra"h circuits With
service or &odor foo, PrICII
6.65 2
3usinessLIe: 4-1 k.. ,r \ z.,.. ,.-■ (64 . 114- 1 C: branch circuit
B. Fee for branch circuits
:lontact name:
le., ry (.4 44 be, l'.. tOcp ...., without service or feeder fee, 46.85 2
_I each branch circuit .
-ddress: ' -.. 4 .-1 - tt, C, f -
''' '
Each add'I branch circuit 6.65J 2
.". -
:.ity/State/ZIP: 1,-h // 6 60 it OP i 7) 2- N Miscellaneous (service or feeder not Included)
Pump or tnietion circle 53.40 2
'hone: (5-0 ) (,L,j e 6 5 -1, Fax: : ( () 6 ki 1 2,6 0 Sign or outline lighting 53.40 • 2
?.-mail: • _
Signal oircult(a) or limited-
i k-:' .4';° , k ): Vtil 7 id: +:46 : 4 WARif - V , 7 0 1,3„Wirl i ., 1 ,;:lrinitnEEMONininalina' 10 0 °n ' m• rage 2 2
3usiness name: IA• ei l e -1 \ -\ -,,, TO 6 _
ddress:
Each additional inspection over allowable in any of the above _
V
- S1) - 5e) %c;-S7lit- CI Per inspection 62.50
;ity/State/ZIP: 7 7/ 2 3 Investi per hour (1 hr Min) 62.50
-
/ ,.. Induotrial plant per hour 73.75
lhone: ( 5)) 6_,L, 1 6 ei-Li-t, .. Fax: (S ) 6 Ge 1
:
"Cl Lic.: 3/4 4 6 1 [I Electrioal Lic.: 111m1ic.: suirtotai
- -
lunrv. Electrician signature, iequirecl: Plan review (2$% of pampa foe)
i a
....--,
.......- -..---.....
State surcharge; (8% of parmit fee)
'Tint name: Date:
TCYrAL Plt11.Mrr PEE
„..... ei fs ..
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Wthoriv..ed sigrintum .... __-____
This permit appliCattell Whit tr ft p4rffilt IA net btain4 thin 189
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= dap) ftfttrr ft hwer. kowen smc.rptoti ..s eon:whet*
,..-...,........,:"."--"
'rint mune: (,..---:- el./ Oti t, (A 1)."-- I Date: 11 / , 0,, . Fee methodology set by Tri•County Building Industry aervice Board
v Number of impactiuns DOT pennit all owed.
-------- .. 'it7- ,__,
CITY OF TIGARD
BUILDING DIVISION PERMIT #: �(� j- �4 c_. �
, 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 11 �n4 m � lp �p
Inspection Requests (24 Hrs.): (503) 639 -4175 ���' °�'_�.. l..
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: [3 t CLASS OF WORK:
SUBDIVISION: #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
•
Inspection Request Scheduled For: Date: / j / 7 O Pour Time:
Code # Inspection Description Confirm # Contact # Message
r 9 7 10 tebtkie c ?- 4 6 - g3
Corrections /Comments/ Instructions:
V /•\ -
1
PASS ❑ PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
I I FAIL ' ❑ CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: i 1 Date: ii--/ dV Phone #: (503) 718-