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Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT DEVELOPMENT SERVICES PERMIT #: ELR2005 - 00188 Ade 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 7/12/2005 PARCEL: 2S 109DB -02800 SITE ADDRESS: 13097 SW HAZELCREST WY ZONING: R -7 SUBDIVISION: SUMMIT RIDGE LOT: 066 JURISDICTION: UR Project Description: All encompassing. A. RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATAITELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: ALL ENCOM : X HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL # OF SYSTEMS: Owner: Contractor: DON MORISSETTE COMMUNITIES LLC GENESIS HOME TECHNOLOGIES 4230 GALEWOOD ST. STE. 100 8104 SW NIMBUS AVE #4A LAKE OSWEGO, OR 97035 BEAVERTON, OR 97008 Phone: 50.3- 387 -7538 Phone: 503- 643 -1704 Reg #: LIC 128098 ELE 26- 989CLE FEES Description Date Amount REQUIRED ITEMS AND REPORTS [UELPMT] ELR Permit 7/12/2005 $75.00 [UTAX] 8% State Surc 7/12/2005 $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: ;77, .7. � =� Permittee Signature: _Lc.. ,..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. Jul 11 2005 1:16PM GENESIS HOME TECHNOLOGIES 5036433300 p.2 Electrical Permit ADDlication, 0. - _ 1 . i ► 1 ; I ill . l tit r't,N I:1 Received _ City of Tigard 7 — '�� -D�2 P e rmit N o. : � ' DateBy. ` l A , I`FX (� v� 1J 1 13125 SW Halt Blvd,, Tigard, OR 97223,E Plan ice, Phone: 503.639.4171 Fax; 503.598.:1960 ] o0� ..,,,,„,,,i0 rnlrh;B`:it i'' Date/By. OlherPermlt Inspection Line: 503.639.4175 ...X,/ :' -ai: - .1— Date Ready/By: rurls; --I Six Page 2for Internet: www.ol.tigerd•or.ua ` `\ �� ,!"�Q ':r NotifledlMethod: ! Lk" � SupplementalInformation k;.f , .ti ,�s �., . r,�'w[m. 4a +e'q -r :�U'CPr:(GiXttl%%N d0 .0Q HhVfn' "N,yM if ; 71;SN r, ;ar+ fi f ,.. i ^lRSi t�,tlN ^ ■Ji" 5 'c � �xe � • r' •.tr.. ,/ b7 . r i r ). r . r 5 �:' &' ,:i! 5 -XrM 6,�4 . rf,R n,n: ,i,. 43 Z. ' t $' , 5 l n, : / `1 ix ..VA '' . - ,S{,erc ro Mr Yd r rr • •;�' i , ,a " ,, 1 - " tvh h "U3� , r:�,. ; ,� t h. � 1 �. r > • , ' t v 6 liyn v r AZ 6�' '.+ ;S r ll• U. '4 N :.. b .. mlli '�4 f !' ' i t �S 1, ulad I,� x 5! abl w Lo l 8 • ,g (t I... . N{ y . t, , 'S�,S 4 ,,%,„ , r , .. >,••14'�v •lA d , n5 '1' Y wr�llv��� kn��' �o�aNLSaF�` at;. ti� .. �u� � :��51�.����h �� ��4h 1 lCW4l �f{.L t��. iii ,tsul8�ildf�uuutw�uwtJx�e��'! ��• r a � d r t t r�V� V� "gib } �Yi� � Nr�kS���SI�i(��± ������1'� � � � � ¢ n � !n' i ,6 1 nisi �vn ib "����1�3�'tia: }5 rkSUV.r �TffrleAtu Ai tViY Aa t) t FK: �kYu 1wnr' t� m; n>. o��.. �:: S� r uddilhGt�Sg�W !���a�,.l,4N,.�e��.�'A�"�44u KI New construction ❑ Addition alteret bn % replacement Please check all that apply; ❑ ❑ Demolition p � ❑Other ;\�,o\\ n p f U n DScrvice over 225 amps, ( am control locution /� ".. t)�W 1 , fiV , Y ' l � '! , } M hf `� 5��7 lS ^'��1VOy0Aw1P,0�' Fr. �'AI� �{ {�1 qf�.: iW 4K9 }(� 4i14M5 }45S 5. 5j.( ?Y 4.t;1 rPr,✓1�'S�f�'S. 1. Y •�r�',., ❑Service over 320 amps —rating ❑Oil ildne over 10, 000 sq. ft., , :; ?tF�4 1t(ilS hl�, .0 y,s 1 ii; %n x •, , 1� 4 r. n r r ,1„ kt @ 1210 , 1 e `y5 I ,,At i i ..rl ttl� at. and 2- fiunily dwellings 4 or more new residential 1. S1 A11v5 e at!: 5.,. nkx.. �$2rt,'1r i;i.:ldderi)olkroon »tw �faa ^anN:pr av�, i,r�ltndn� JSlNld,. a.V`ri}pi$�iSkA�Ai'S ntxnl5u„� SJuu nuA.,ar..4 w aw:, g V.1 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ©System over 600 volts nominal units in one structure ❑Mu!ti- family ❑Master builder ❑ Other: ❑Building over three storks ' CIFeeders, 400 amps ar more •T5ti'� i f„ i x 1 j ' •ir.(q} Virx,545N1Y��!'SNSYitNrhVr Yr z t 1 .i1r :Tt'C "Y IRp }' „ r'+�j V}V '� M ; { A'x'�5 Occupant load over 99 persons ❑Manu�ute4 structures or • .yrp�'yp g NLdp cos Alt , l ly q % ' , { ° }tip : ! , , y .', b v �; 1 : 1�' �u „,t7Y � `, �� � l i'§ q, , Egress /1I htingplan RV park 'YUYttYRiIaIX� Sa • -��� Y( il' �x� M k�1] a1{ �- ' ���'".1 MJt�.. 9 x. Y. A{ wri�. wY.i7HNg55N551'V/M15W.51' /.9K �:' f0.1:$AYG auW � a i f� A � f'. f�Dl'r' ❑ Job no Job site address: X09 7 ❑Health -care facility ❑Other. Submit 2 acts of plans with any of the above. City /State/ZIP: , -, ea. The above are not applicable to temporary construction service. Suite/bldg. /apt. no., Project name; {t� e7'3x. i : �.ltl n iii, • a w;i4 :J.,.i¢C1F, ". , „.:ar e. ' gi rM r s . t i 2ii iat Deaerlatias Qty. F.., Total •' Cross street/directions to job site: New residential shale- or multi - family dwelling unit, Includes attached garage. 1,000 sq, ft, or less 145.15 4 Subdivision: .0.11.10 � r Lot no,: Ea. add'1 500 sq. ft. or portion , 33.40 I Allil Limited energy, residential ( 75.00 751e 2 - Tax map/parcel no.: Limited en non - residential 75.00 2 _ i; :iel o 'WS . ` . •at' M,� 0 � ^ +nar a 3, ,i n �w,ty �t�� Y� ` lit'. 1 xY r :'•.r il' Ji 0:i r r f i, y r a x "f d t ititill6,. A M atoi>I'I 0,4 li g� 1 4 GYM ' i si Each manufactured or modular C15i1 W a,cuL`a�,xi. �:�a'� 1,19'c�uc^z.n tikk tY' VimurUlhxrxxa .H.e., >SN5tY1,VA,l xYdNr �1t17f5 iNwrnvku�m V nar !�n : dwelling, service and/or feeder 9090 2 • / AP = Services or feeders installation, alteration, and/or relocation /" 200 amps or less 80.30 2 s , �; e r a x„ ,�ro �� t 0,; : : ' g . wriratx x1ri1 r r i fi t} f r 201 am s to 400 alit ° ` :go A,A °Yr � 1 2. « moon o AA; Q n,) .n , ; � rgc � :U.4. � t t 401 am to 600 am ps 1.s 106,65 2 60,60 2 ,S > inan •,m -ww.r �rrum. £onwuYmi� 4 W ? i 601 amps to 1,000 amps 240.60 2 ` .51g- 0 Over 1,000 amps or volts 454:65 2 j City /State /ZIP: : f Reconnect only 66,83 2 ®'' 1 / Temporary services or (sedate Installation, alteration, and/or Phone: ( 9I) ; — ■ p er; ( ) relocation do 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 Owner signature: Date: - Branch circuits — new, alteration, or extension, ' er , anel A • ' 6'41. 1p' ;inµ. , �' ; ui; :r lgl n t avon�u an ' n ` : x�y' tl{ wu Y ,, eVP0 ` S, l �i } d ” xuain�:i,WK'7 •y Y' Weryt^ x with :5 � 4�rn � �`•¢41,Nt AC...,,'6 i uS4., .S;sK�uo 4:00u'8 .N: , t �JS 1 n, $ogi 1 AC t� " u.N.4., ∎, v^S ,41:1 1 vti d'k A FCC service branch circuits each service or feeder fee, each 6,65 2 Business name: branch circuit B. Fee for branch circuits Contact name: without service or feeder fee, 46,85 2 each branch circuit Address: Each add'! branch circuit 6.65 2 City/State/ZIP: Miscellaneous (service or feeder not included) Phone: ( ) Fax: : ( ) Pump or irrigation circle 53.40 2 Sign or outline lighting 53.40 2 E -mail: - r`n'� t a�,n 3 'A "" "'h4 °+N 5 y r v Signa olreUit(6} or limited- 'till J'g btl4 Zg, 't {µ,��k��r S Cr v� ti f9�1 :1 s l�ti�5r• r. i u�ytt�µ' ; o 4 0 5 . , N t55t {'1 Ptprl R'y� , t ry %� t' in y � i w +a ane alteration 9 { V�d Yr.tm ' 4f���Yt;,�i ll9� 1�j ��'�Jr,V1'tihh11�7�F,�?.Cir: � lb miautin a�i�rw::.e.,t,tk��'N�17k� d`b� ��7 ! UO � WM'i�SSA SI ,''r���b'SNS�.t����Y:d:��i ��� p I ' r or �,� v. zJ1 I31 t w r r r t � Business name: extension. Describe: Page 2 2 Each additional inspection over allowable In any of the above Address:_ -_ _.. . - Per inspection 62.50 City GENESIS HOME TECHNOLOGIES Investigation par hour (1 hr min) 62.50 9450 SW Gemini Drive Beaverton, OR 97008 Industrial .tans .er hour 73.75 Phor Phn- 50 •643 -1704 Fax- 503 -643 -3300 y ^5'a t "^ ,°'r� qq��rr P t av� "���x a� ',ts x q n p ti r p g4yyt7 J -•. �`ei i'�4.�'�F1vCrtt,.n „Nle�u,�.,- .. ,$,,:. m �rnM'r: "w,,t.,,rM.�.m a ,��D..ti ,StaKS�:.a�FF1�dS8kR ..�kts4�'t� t CCB 128098 CLE26 -989, Subtotal 7 1' � Sup 2 885 -J L E Plan review (25% of permit fee) 1 Date: ■ � � s- State surcharge (8% of permit fee) G 0 Q 4 TOTAL PERMIT FEE g Authorized signature: This permit application expires ire permit Is not obt■ within 180 Jaye after It has been accepted as complete Print name: Date: • Poe methodology set byTri- County Building Industry Service Board • • Number of inspections per permit allowed, lAeuilding \PemenELC- PermaApp.doe 1203 440 4616T(ls/02 /COM/wEa CITY OF TIGARD BUILDING DIVISION '� PERMIT #: ELR200 &.00188 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/12/2008 ` Phone: (503) 639 -4171 . Inspection Requests (24 Hrs.): (503) 639 -4175 _..._.: INSPECTION WORKSHEET FOR DATE:' 7/20/2005 TIME: 7 : 11AM PAGE: 59 SITE ADDRESS: 13097 SW HAZELCREST WY CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 066 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: All encompassing. OWNER: DON MORISSE.I I E COMMUNITIES LLC, PHONE #: 50.3-387-7539 CONTRACTOR: GENESIS HOME TECHNOLOGIES PHONE #: 503 - 643.1704 Inspection Request Scheduled For: Date: 7/20/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message LOIN volts z 011740 -01 503 - 519-6452 N • Corre .• s /Comments /Instru 'ons: /moor ''. '— i� e PC: R-0 r'-1 KC p C.-(- -c-L_e= e- U (TY P/9 -■/61- C Q. 8 • _ %., PASS if; PARTIAL APPROVAL El CANCEL El NO ACCESS V FAIL CALL FOR INSPECTION ❑ ADDITION "\ ' EES ASSESSED Inspector: _ Date: 7 Phone #: (503) 718 - Mil