Permit •
CITY T I G A R D ELECTRICAL RESTRICTED ENERGY PERMIT
PERMIT #: ELR2005 -00106
1, 164111 DEVELOPMENT SERVICES DATE ISSUED: 5/10/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 109 DA -04400
SITE ADDRESS: 15436 SW GREENFIELD DR ZONING: R -7
SUBDIVISION: SUMMIT RIDGE LOT: 021 JURISDICTION: TIG
Project Description: All Encompassing low voltage.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: X AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: X BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: X CLOCK: MEDICAL:
HVAC: X DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: X FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: ALL ENCOMP : X HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
DON MORISSETTE COMMUNITIES LLC GENESIS HOME TECHNOLOGIES
4230 GALEWOOD ST # 100 8104 SW NIMBUS AVE #4A
LAKE OSWEGO, OR 97035 BEAVERTON, OR 97008
Phone: 503- 387 -7538 Phone: 503- 643 -1704
Reg #: L1C 128098
ELE 26- 989CLE
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 5/10/2005 $75.00
[TAX] 8% State Surcharl 5/10/2005 $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- 01 -0100. You may obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699.
Issued By: � ,� / e z. Permittee Signature: (rn f p 1 c
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.
Ma 10 2005 8:15AM GENESIS HOME TECHNOLOGIES 5036433300 p.2
tit
El Permit A, 8 , . ft►it (11 11(• t , ,r. (
1� Revived .- Permit No.
City of Tigard 1 O 005 D v 5 0 G lido —Ow oL,
13125 SW Hail Blvd.. Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax 503.598.1960 VW" ,G ' ' 4 . Date /By, Other Perntit
Inspection Line; 503.639.4175 � F e E� . ' I'� Date Remy /By: h, r ii Bee Para b for
Internet; www.cl,tigard.or.us GI-C\ G 0\\AS • _ Notified /Method: I / G supplemental Information
`�1 % .( •d)�(rt1 " � t I q'r'1 "�ti iCA�? ,� x x.r S Vr la,rr,� A4 d�1vY�l Y�^ t� °t ,� ^ 4 . ,^ - � Vv'I ^ � ^r�. d � + �' �(� � f ° ,,M( 1'y1ay�yyv'V vYwlmy y � g ��l r,��, y+, •m. .:�}�, aQ
t Sx� r YI YNK�'h N . M A i1lr'4!• 1 ( Sry} f p t�� I.H Q $ Y T p $ $ jIM1 9 }���(} S �{ t 1{ { ( `V A IBS'+ I � 45' � � t �ft U R I1+ 'k �A r,u S4 Y I Ap � 1'
.�' A}: .oUE �, kor, yiki2� 4�A�S1n vane dIRA ,86. ' e 'WI? IS. 114`iC}�V 1 � '�'aS' � � 31. l J 7 04 ,k''lu''''' 6 611 "' "JauR. W "M"2".1' f t' 7
Ij New construction ❑ Addition /alteration/replacement Please check all that apply:
E Demolition El Other: ❑Service over 225 amps, corning []Hazardous location
; a ntitn'N nvasP e u,~a `S 1'W,v�rY r te nyarysr !arfwt it;YatttrgrY+wlv1Y Y� ; ,t DS ervice over 320 amps — rating ❑ Buildng over 10,000 sq. ft.,
i r � . �d $ I, u x A d d •. w .aka r of t- and 2- famlty dwellings 4 or more new reeidcatial
;C§f'Sltn3iaaggaZgi � ixisI awaaiticat i k sulmtiilac;iwitaeirtiotbali ,1 1 A.
A 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
C1 Multi - family ❑Master builder ❑Other; ❑Building over three stories ❑Feeders, 400 amps or more
+• F' v , , ^!I SxSya'ni luau 7' uv:ta dsy xus te rg u�t t' m�.Swva er Ini�,y an n'Yip �wx:.vut � , ['Occupant load over 99 persons ❑I4' structures or
park
actured
y '. a, t y f a� sl t a , fU E ess /h hti
i � b 1 3 �J �e;;;lx� aeas rn ilnottN.Itynvon- u ; mLoYat iliktt ata
- l,b � O A, Q >� g t► YP lan RV
/ ❑Health -oars facility [Other: .
Job no,: lob site address: J .�'�p �P�.c r �� /�.� Submits sets of plans with any of the above.
City /State /Z[P: •4g ®�� UU The above are not applicable to temporary construction service.
1 � w,rv
I
Y - \ i0Y uawv �xS' Yd'I , o °rX t~� � �1!
Suite/bldg. /apt. no.: Prgiect name: a�vi� � t � arrcl,,,, a �t l +r +lS �
Deacriptlnn Qty. Fee. Tend **
Cross street/directions to job site: New residential stogie- or multi- family dwelling unit.
Includes attached garage.
1,000 sq. tt, or less 145.15 4
Subdivision: JM
o,•1 Ei " r Lot no.: z 1 Ea, add'I 500 sq. f, or portion 33,40 1
Limited energy, residential / 75.00 /15 #! 2
Tax map /parcel no.:
w , ' t , obs,axlt<'a�ysvvncPnm'Mm�'w Yvr�,w � va t S9
Llmhed ene n on - residential 75100 2 i
' I �� '_: fi t;, „�a:. � NEEMEN N , .' Each manutmctured or modular
, f � m 4 iv ro.aaVlaaaaur�Yn rYY1'ni^! wrlwl tn'7�ws }. 1.. ' S .� .i' 1
' / /} dwelling, service and/or feeder 90.90 , 2
r( '21L'P1 / t e .'Se J#4 Services or feeders installation, alteration, and /or relocation
1
, � / / 200 amps or less 80,30 2
^wpi t, flaw.rli r�7xwt ow ap' re; n a y g „ n i t t �' 201 am B to 400 0ri1 A 106,85 2
,e � t �s a r h 11. k.. 1h.! P p
{���$>�,',. +,,jr.+ ,utu Ixvn � asrix n ' f tf i,aro... st�t1+!uraxxds 1. Y I.r,''t 401 ltlTtp3LO600amps 160.60 2
Name: 064 1 /Z�is�e /in e_5 601 amps to 1,000 amps 240.60 2
Address: 4 D C ;QI€ G36 —) ..>l4 / 610 Over 1,000 amps or volts 454.65 2
�} Reconnect only 66,85 2
Clty / State/ZIP: Z,x/ . 0,-2 e ) D �,, <g),� 4,70./5' Temporary services or feeders installation, alteration, and /or
'V relocation
Phone: (Off j:97,7,<$0 Fax: ( ) 200 amps or less 66,85 1
Owner installation: This installation is being made on property that I own which is not 201 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 600 amps 133,75 2 1
Owner signature: Date: Branch c_ircu — new, alteration, or extension, per panel
' ti"" 1'1x'S,aYX 5M' Y�`4'Lln p��.T�';� i �33�; x 'oK "°ll >t+ria�n4m,Nx 4'dd�+n rvvr�dxpx�xx � r :} A. Fee POr branch circuits with
r " a . l•„w i'Y 'z hs li lil � 9a lslCg �t " lz �" llxo<a�x: vat serv or feeder &a, each
6.65 2
Business name: branch circuit
13. Fee for branch circuits
Contact name: without service or feeder fee.
Address: each branch circuit 46,85 2
Each add'I branch circuit 6.65 2
City /State/ZIP: Miscellaneous (service or feeder not Included)
Pump or irrigation circle 53.40 2 i
Phone: ( ) I Fax; : ( ) Sign or outline lighting 53,40 2
E- mail: y� Signal circuit(s) or limited-
„ket �i� ,' 'i," ..4Kii ARI'�:d"„',4� ,1'*'„. ' t2�1,, ll,� dl: {, 't n'fi4'ig 1' II� ener6Ypanel' alteration, or
'extension. Describe: Page 2 2
Business name:
Addrr�sa_ Each additional Inspection over allowable In any of the above
Per inspection 62,50
Cit. GENESIS HOME TECHNOLOGIES investigation per hour (1 hr min) 62.50
- 8104 SW Nimbus Ave, #4A Beaverton, OR 97008 Industrial plant .er hour 73,75
Phi: - Phn- 503- 43 -1704 Fax- 503 -643 - 3300 .. 4.: !' d.'It f al ° :, qN1`+ :t t , :i+1 :. .." ar a , :-r ra a T t $ h P ,: "iv,,,,,,, a ;,1 i t
CC `...ot CCB 128098, CLE26 -969, Subtotal 76 V
2885 -JLE
Su l. Planreview(25%ofpermitfee)
State surcharge (8% of permit fee) Ze dO
Print name: - 7: 4 �,. in 47971^Z I Date: c,Ir� ` (25' TOTAL PERMIT FEE �� e:16 Authorized signature: This permit epplicadon expires If a permit Is not obtained Within 1.9D
days after It has been accepted as complete
Print name: Date: a Fee methodology set by Tri- County Building industry Service Board
•' Number of lnepeetlona per permit allowed.
is\ Huddina\P. rmiti\ELC.Per.hAppfloc 12/0 440- 161ST(10N7/COWWE1t
•
CITY OF TIGARD
BUILDING DIVISION'' PERMIT #:
ELR2005 -00106
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/10/2005
Phone: (503) 639 -4171 . �. ���n�lp„�,��1�li
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7/15/2005 TIME: 7 :11AM PAGE: 45
SITE ADDRESS: 15436 SW GREENFIELD DR CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 021 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE
DESCRIPTION: All Encompassing low voltage.
OWNER: DON MORISSEI FE COMMUNITIES LLC, PHONE #: 5Q3. 387 -7538
CONTRACTOR: GENESIS HOME TECHNOLOGIES PHONE #: 503 -543 -1704
Inspection Request Scheduled For: Date: 7/15/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 011510 -02 503-209-4837 N
Corrections /Comments / Instructions:
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED --- Inspector: N V 4 ' '- Z Date: f Phone #: (503) 718-