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Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT DEVELOPMENT SERVICES PERMIT #: ELR2005 -00111 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 5/12/2005 PARCEL: 2S 109DA -04900 SITE ADDRESS: 15316 SW GREENFIELD DR ZONING: R -7 SUBDIVISION: SUMMIT RIDGE LOT: 026 JURISDICTION: TIG Project Description: Vacuum System. 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 # 100 3030 SE 59TH LAKE OSWEGO, OR 97035 HILLSBORO, OR 97123 Phone: 503- 387 -7538 Phone: 503 -64 -6542 Reg #: LIC 46969 FEES Description Date Amount REQUIRED ITEMS AND REPORTS [ELPRMT] ELR Permit 5/12/2005 $75.00 [TAX] 8% State Surcha 5/12/2005 $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: %� �. Permittee Signature: j�� cay `�� 0 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. 05/12/2005 14:40 FAX 07] 002 /004 --- it :Olt011'1(11-S1:U \l..l City of Tigard x7eivyed: OCR // 1 13125 SW Hall Blvd., Tigard, OR 97223 Date/B �1� -M Permit No.: LO�s Phone: 503.639.4171 Fax; 503.598.1960 MAY i Plan Review Inspection Line: 503.639.4175 1 li I + ' j I Date/B Other Permit: Internet: www.ci.tigard.or.us a Notifie etho .,� Data Ready/By: j d/M �// - fd Sce P+�ge 2 for i'�iJ;R . - - i '. d. l /Jf Supplemental lnformelSon . '.,� '�r�.i ,,,,,,,,.., 2 i. � cf _ s :. ; •: . - ,..r ,. ,. _...v.,... �3� :K: ,n. s'R'�.7 S r t, [tQ4 ew construction ❑ A check � + en Pleas c all that apply: [] Demolition Other: ['Service over 225 amps, corm ❑Hazardotia location . � , � ''.T: - ::f0i::' - Service " ? � ;ry - rvica over 320 am s —rating to :�:: - Bulling 1G'`- In over �'• P v r l ❑ 0 000 r' +" S g .....,: 4 » Iii'. - sq. ' of 1 qnd 2- famil dwellings 4 of more new residential `I 1- and 2- family dwelling ❑ Commercial/industrial 0 Accessory building 0System over 600 volts nominal units in one structure Multi - family ❑ Master builder [] Other: ['Building over three stories ❑Feeders, 400 amps or more - _ ;de,.3zX! G >•, - QccU t load '',: _ ❑ pan oa 1 ovor 99 persons ['Manufactured structures or ir; �`JOB�' ,:. ,.....;.�.. 1 �_,,.,,,:., : ' >'..`> :... _ . - ❑ gresa/ligittiagplan RV park Job no.: 1 Job site additSS: �' j �.' /ire > ❑ Health-care facility 0 Other: City /3tate/Z1P: T, 6 aa e p . ? - ^ r t i v Submit 2 sets of plans with any of the above, a r U c.; ` The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: Project name: ^!.0:',::. E< ` r; ;; �, , - .. °,-SCFI$ �:.�; _.::;, 1 .m-4 tlanr. I Qty. I Fee. :• I .. Total . . ,, Cross street/directions to job site: j3,.- I j `IA I /2 New residential single- or multi-family dwelling unit. Includes attached garage. 1,000 sq. ft. or less 145.15 4 Subdivision: SL, in inn ,'- . A , .3.04, 1 Lot no.: 2_ & E. add') 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: " i Limited energy, residential 75.00 _ 2 "a.::.' : • rz��� •: ;;��.' 75 00 2 energy, non- residential _ Each manufactured or modular dwelling, service and/or feeder 90.90 2 Iry • —� I —3-!_, v4..��u' 5 LA e, Fes,.. Services or feeders installation, alteration, and/or relocation O amps orless 80.30 l�.'I? .. .- ''.�: 201 am to 40 am P 106.85 - - 5 2 _ p '1�. ldatile: ..,.. " 401 amps to 600 amps 160.60 2 , c } /! O r t V .' 't C_ 0Irh , a., t L ti 1- 601 amps to 1,000 amps 240.60 2 Address: Lf ? 7 v L 1 i Woof . 7 ! Over 1,000 amps or volts 454.65 2 City /State/ZFP: Reconnect only 66.85 2 f „,a kc 0 4> �"' - , C $ Temporary services or feeders Installation, alteration, and /or Phone: (5)) 3 91 7 s' Fax: ( ) relocation or Owner installation: This installation is being made on property that I own which is not 20 amps to 400 00.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 201 amps to 400 amps 100.30 2 401 amps to 600 amps 133.75 2 Owner signature: Date: eo :i _ t',. Branch circuits new, alteration, or extension, per panel ii i k � r ;,; '.;l . ,:; 1Jp " �k�Y„'�;e#I�i*�? A. Fee for coifs with Business name: service or feeder fee, each As 1 I bt/ea, He,` zu (Obi i f .}.t^vt -s::, ; branch circuit 6.65 2 Contact name; B. Fce for branch circuits C.r. M e.,-, k � ,. without service or feeder fee, Address: �[1 . � S 1 - k - fi each branch circuit ` 2 Each add'! branch circuit 6.65 2 City /State/ZIP: 1_1 f l I s.f. r'a 0 pe � � "7 I a - Miseetlwteous (service or feeder not included) ) f ` F Pump or irrigation circle 53.40 2 Phone: (,,-/,, Cc" � �� �.. t F ax::( t ,, 3) 6i / o Dir; E-mail: s Sign or outline lighting 83.40 2 C.:,...;. -,.a:; _ •.4.;•:; ., ....., Signal oireuit(s) or limited - l�t]G'- , � ; �v� , , . 4'� ,�.: ::� ' ' . - gy el, alteration Business name: A %`' I : 1 ``i'i , ' V '' e De scribe : or Page 2 2 Address: '2 Each additional inspection over allowable In any of the above mot.. `© /." "• -/ 6- •- Par inspection 62.50 amity /State/ZTI': t w 1 ` i 7 Investigation per hour (1 hr mill) 62.50 3) 4 �,.� 7 Fax: ( ^Z ) G Industrial plant per X 75 Phone:( :303 Lie.: l i' Electrical Li.: :.`; [ ;r.: L _ ::ItX. sUr',P Subtotal ESi.w. i . i ;,:a r (y e Suprv. Lie.: Sbtot Suprv. Electrician signature, required: Plan review (25% of permit fee) State surcharge (8% of permit fee � _ ?Tint name: Date: - U kuthorfaed sr aturz: : ; !,. _.•- .._.,...... _.........,_....... - - TOTAL PERMIT FEE pp p . ✓ Thia por•mit application expires If a permit is not obtained within 180 ?rlrrt name: days alter it boa been accepted a a s complete L i'rl r ✓); 601, 3 1'V •., Date: 45- / 3 .. 0 . a Fee methodology set by Tri•Counnty Building Industry Service Board e• Number of inspections eer oemilt allowed. illii. OF TIGARD 1 BUILDING DIVISION PERMIT #: ELR2005 -00111 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/12/2005 Phone: (503) 639 -4171 pq��yp�mlitiI It Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 7/15/2005 TIME: 7 :11AM PAGE: 48 SITE ADDRESS: 15316 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 026 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: Vacuum System. OWNER: DON MORISSETTE COMMUNITIES LLC, PHONE #: 503.387..7538 CONTRACTOR: ALL WEATIIERIZATION PHONE #: 503 -64 -6542 Inspection Request Scheduled For: Date: 7/15/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 011510 -01 503 - 209.4837 N Corrections /Comments /Instructions: PASS _ PARTIAL APPROVAL ❑ CANCEL 111 NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED p � N (C D ate: ' 1 , 0 1 b 5 Phone #: (503) 718 - Inspector: