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Permit C ITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT I DEVELOPMENT SERVICES PERMIT #: ELR2005 -00142 , j 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 6/2/2005 PARCEL: 2S 109DA -03600 SITE ADDRESS: 15421 SW GREENFIELD DR ZONING: R -7 SUBDIVISION: SUMMIT RIDGE LOT: 013 JURISDICTION: TIG Project Description: Installation of 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 4320 GALEWOOD ST #100 3030 SE 59TH LAKE OSWEGO, OR 97035 HILLSBORO, OR 97123 Phone: Phone: 503 -64 -6542 Reg #: LIC 46969 FEES Description Date Amount REQUIRED ITEMS AND REPORTS [ELPRMT] ELR Permit 6/2/2005 $75.00 [TAX] 8% State Surcha 6/2/2005 $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: • /��T Permittee Signature: 5� s 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. 06/01/2005 14:49 FAX U003/007 r, s '., £le�tracal Permit ,;, a, ( ED ,i her l: i :51; O`1.1 City of Tigard Received / Tigard, ard, OR 97223 Date/By: � Pem,it Na g Plan Review -., - D.� t(-,./-,A0).5.--M/Y1._/ 13125 S W Hall Blvd,, Phone: 503.639.4171 Fax: 503.598. r 6 .. Other Permit Inspection Line: 503.639.4175. \ juvi 0 2 � '� Date/R `— � e or Internet: www.ci.tigard.or.us ;,, L; .... ,..... Supplemental Information ti ar � .. . ataltcedyll3y: r � � � & � Notified/Method: 5ee Pgga 2 for � � Su pplom tr, f t ' i [ ��aa [¢¢ . , ri) cw construction T8 tist� : ,- „a s „ . �� 1 that p .',A ^ >:' ; . , ,' : , B e� L placelnent Please check all that apply: ❑ Demolition III Outer: °Service over 225 amps, corttm'1 ❑Hazardous location s,e :rr cr ,.,.::. >:_ ,,.�.'. ❑ a over 320 am p s - rating •.a. • ldn over p ❑ 1 000 s g 0 . ft., t D .1. • � ?:; ' :; � � ' � . �.,., „ ,:,.�.- ;.,.,.;.;,� :.. ,�. al. and 2-family dwellings 4 or more new residential ' 1- and 2- family dwelling ❑ Cornmercial/industrial ❑ Accessory building ❑SYstem over 600 volts nominal unite in one sWetur'e Ell Multi-family ;; ;; .:..r:,. . ....::..,., ,,V: ID Mast Other: �• Q Ot uilding over three stories ©Feeders, 400 amps or more `9f1 :,:;- . ,: r: ' , :;:; ;' y ,, ; ,. ❑Occupant load over 99 persons ❑ Manufactured structures or :,�''�`;'` ,:.,<.,, „.. .�:�,r... ;`r:,i:`�i', "':;:':' ❑Egross/lightipg RV park Job no.: Job site address: rr i,.,::: ; ❑ Health -taro facility ❑other: L_____ m! / t ��'t I v � � Submit 2 sets of plans with any of the above. City /State/ZIP: . -•0 j .., rd C: . . T he above are not applicable to ter t � � ��� � Pp temporary construction service. ldg. /apt. P name: , °.i�'',:+,r r iY , : ,: g , ,: :;;; > : : . Suitta/b no.: ! ...h;- ..' .. ...,.:. ; ", reject ir.;`.';;;:- ° ;a;,::;. 1f' ] r;.,',.+ + Cross street/directions to job site: ' : 9 ;- t ' n Description L Qty. I Rea J Taal J ! i :/ New residenga e s gam e- or enu,if- family dwelling writ. Includes attached garage, 1,000 sq. ft, or lens 145.15 4 Subdivision: G En a dd'! 500 s it. or J[- ' ,nn.M r ! r' <<� ��. (Lot no.: / � q• portion 33.40 1 p fax map /parcel no.: t Limited energy, residential 75.00 1 2 } y�� -a' Limit energy, non - residential `t � ^` >•' s : Y '75.00 2 - 1. , t, +,�'.: ,;:,.•'. E manuf or modul ar C C' vl }- -. \ L%ti L `� dwelling, service and/or feeder 90.90 2 ? 4 }� w Services or Peelers installation, alteration, and/or relocation 200 amps or loss 80.30 2 0: **�; : if;:i' s., ' t;; it-'',';riitkx`, +i:''>A1 ;:':'>; �'i� 2 la sto 0 1:� _:��`,�',_ - .,�,��,, <• rr - �r.+ %3�� :�il�: tss;: y� :,; *:,'��;i ". {- ,:at.;rv:::_ . m p _ 4 Osttt 106.65 2 ''',: < 4 � ::;:'`,: • +�::,', ?'. ? + - +,t, ^fir,,.; tf.� : ,.�:. /: Name: /J " ^ 401 a mp p s to 600 amps 160,60 2 Ci r, 4riJ• r i 4 t 1 • .. ,=� 1 -? i 7�i1l, 601 ampere 1,000 amps 240.60 2 Address: 4-'( Z 6' t ;- •) � IA , 1/6 • ; , - 51-- Over 1,000 wraps or volts 454.65 2 City /State/ZIP: a Reconnect only 66.85 2 ��� it( C �y)Lti l t= (� rC.... Temporary services or feeders installation, alteration, and/or Phone: (e5 L?� ' 7 t ) Ax: ( ) 200 snips or less 66.85 1 Owner installati .- : This installation n is being made on property that X on which is not intended for stile, lease, rent,'or exchange, according to ORS 447, 449, 670, and 701. 201 amps to 60 0 amps 100.30 2 401 amps to 600 amps 133.75 2 Owner : D u si - .> , signature: e- 4i ry Branch circuits -new, alteration, or extension, per panel .x, ^;�F. ^,`i icy,•, .t;. a ; r m +• p r . : �� .,`.�`�'`^ ,erii , 4 • '', - A Fee �+ �. ��` - 't. ,i"s•,::;�,:,:,;wr for branch circuits with Business name: service or feeder fee, each 2 C< branch circuit 6.65 Contact name: e r` 13. Fee for branch circuits Y4l; /1 /11.,G 111 without service or feeder fee, 46,85 2 Address: r each branch circuit �' 5,3 r 7 �E` 5 ‘ l ( ✓ Each add'! branch circuit 6.65 2 City/State/ZIP: /-11/ c / , 6 ( C • �/ • 1 7 Miscellaneous (service or feeder not included) Phone: (5 -r:2) l'i 1 (r7 �z� L �kax:: ( s �-� ) (,- 2 c :�- Pump or irrigation circle 53.40 2 E-mail: Sign or outline lighting 53.40 2 t ,. Signal eirccult(s) or limited- • , r . O ..,,...:...+. „ . , r -,::, , , .. e nergy P441!3_1, alteration, or Business name: S extension, Descri Page 2 2 Address: e �i r�6 vC Each additional inspection over allowable in any of the above Per inspection 62.50 City/State/ZIP: 4 ,7v L 1/6-1,A.-- Investigation per hour (1 hr min) 62.50 Phone: ( ) Sr..*:--- t„•,: Fax ( ) Industrial plant per hour 73.75 CCB Lic.: q C+ t , e7 Electrical Lic.: Suprv. Lie.: t it � ' to subtotal Suprv. Electrician signature, required: Plan review (25% of permit fee) Print name: Date: state surcharge (8°.S of permit fee) , - TOTAL PERMIT FEE Z i C.71.) Authorized signature: / ----,------------ "' m " r T d ile permit application expires if a permit is not obtslno within Igo Print name: cloys Leer tt iw beer. accepted as complete �er5 nit), `L t,C i- Date: 5 s ) / -- 05- a Fee methodology set by Tri - County Building Industry Service Board ./ O° Number of inspections oar permit allowed CITY OF TIGARD BUILDING DIVISION PERMIT #: ELR2005- 00142 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6171005 Phone: (503) 639 -4171 e� ir°uNP!IPUIGIj�hl'\ Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 7/20/2006 TIME: 7 :11AM PAGE: 33 SITE ADDRESS: 15421 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 013 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: Installation of vacuum system. OWNER: DON MORISSEI I E COMMUNITIES, LLC, PHONE #: CONTRACTOR: ALL WEATHERIZATION PHONE #: 503.5 6542 Inspection Request Scheduled For: Date: 7/20/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final •''``� - 603-209-4837 N Corrections /Comments/ Instructions: W ' 0 PASS • - A APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL P ' LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED /7 Inspector: Date: C9-- hone #: (503) 718-