Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
:. COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00120
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/9/2007
PARCEL: 2S 110BA - 05400
SITE ADDRESS: 11825 SW WILDWOOD ST ZONING: R -
SUBDIVISION: SHADOW HILLS LOT: 011 JURISDICTION: TIG
PROJECT: TROY
Project Description: Limited energy, all encompassing structure wire for audio.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: X AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS:
Owner: Contractor:
TROY MATT GENESIS HOME TECHNOLOGIES
MATT TROY 9450 SW GEMINI DR
15284 GREENFIELD BEAVERTON, OR 97008
TIGARD, OR 97224
Phone: 503- 307 -3908 Contact #: PRI 503- 643 -1704
FAX 503 - 643 -3300
FEES Reg #: ELE 26- 989CLE
LIC 128098
Description Date Amount
[ELPRMT] ELR Permit 5/9/2007 $75.00
[TAX] 8% State Surcha 5/9/2007 $6.00 REQUIRED ITEMS AND REPORTS
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 or 1.800.332.2344.
Issued By: �,�� ; /// Permittee Signature: 4p, r7
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.
May 09 2007 6:53AM GENESIS HOME TECHNOLOGIES 5036433300 p.1
-;;' tectrical Permit ADDlica tiibn I,. si: i 11.1 I : I ,i•: rNI;
` C it y of Tigard Received 1 No.: Eta 2 ^ op 12.0 _ ; cov
F. 13123 SW Hell Blvd., Tigard, OR 97 � • Pion Review
Phone: 503.639.4171 Pax: 503.5913.1 'ALL Datdelr Other Permit
t , ., Inspection Line: 503.639.4175 M - 9 2007 Date Ready/By: hem I See Page s for
j. interne: www.tigard-or•gov NottfleWlrtemo4: Supplemental Irrfbrowthas
S::''. , ,r ) c 'k 1 1 • ..T') 7 1,u.] ..t. Cott T rr) i �'"�• � r - . m r .. r ;r r ?E IZ # .F L- .t 1 r31 - �-•:��,
�...LL b l . • )> 211,. y � � ` ar_ y t r Q ' r '(�f 114 • . ,i --1-7 } �.+.,.. -7-."-`,; ,.. i ,.:_'a. .
w.44.,; !t't:'�1LS�..iLii:T •i.. ,•Y.. wTYl� a. }.i�lr_r:.1 \�:iri Lli � ,,.+�� } F •�� :I,Nii �- �._3�••- ��IN�'�y -! �. _I, �.•:•1 t. y:
❑ New construction 1', Addition/alterati ±1i: ,3 1 • ' Please cheek all that apply (aubwdt a Tau of plane wattles checked below):
0 Service or feeder 400 amps or more 0 Building over ibee stades.
❑ Demolition ❑ Other: where the available fault current 0 Marine and boatyards.
4 '-7 • ∎ 5f ,s � i .'0 � •3 w. �` r'-r' h ' r •.s ", ' s?.) %] v exceeds 10.000 amps at 150 volts or 0 Flaan ngbuildings.
, f* r-•- 1 N.I 1 y 1 1 1 { 1 a, x 4 1 i i . fi • f{ R r -
1 1 r
r u n •w�. : .�. - _ = •.Yn i_ -4 1t.:.'tlr�LCgT.: J.i�m.i r'�rn • .. ...r+3 4 r: «a+•„r. -1 •1•..• -..3 . . .•. --- rata to ground, or exceeds 14.0110 Cl G'atotDn:1B1-roc aglCGh9Ial
I's 1 - and 2 - family dwelling ❑ Commercial/industrial ❑ Accessory building amps for an other leatallmlonm. buildings.
❑ Multi farnil ❑ Master builder ❑ Other: 1319m lip. 0 tnaeallatloc of 75 KVA or
riu s r 1 -rte- , , �'ti'� c ;!g'.",-Z!1?-1,, 4 y', []Emergency system. larger separately derived aystern
y -��, , 11 , t_ � I ,'''17.." t ` ..7 f i a te
e.; ..-s .0'...ci....'i+ �1]., -.5 y.4 s• ....:_)_ _..2 _ -,.4„ r�, . 1. : !..._ a .._- ,..•.: Y:,, 0Addidon of raw motor load of 0 " ..H„ , .1.2". 9.3 ...
Job 11Q.: Job site address: 1 . JI 11:017 or more. occupancy.
1 I Q . .. , 0 Si:l or residential units. Q Recreational vehicle parka.
Cit
y /StatellIP: OHealth -cue faciThies. ❑ Supply voltage for mom than
, , . ,` ■ - 0 Haaardous locatlom• 600 voila nominal.
Sulte:/b1dg. /apt. no.: Project name: ❑ Service or feeder 600 am • • or mare.
r.r� r 'T7F a- ; trt' A 7 7+ra
� ti r'{��r t t•�' r/L r,r � � x .r r- .,i.,•• ru w n... i a
° � .i ,b
Cross street/directions to Job trite: * non Wri 1 .1'+�1111117r= •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1.000 sq. ft. or less 143.15_ 4
T87[ 1>1a 1 RD.: Ea. add' L 500 K. ft. or portion 33.40 1
P/1 Li mited energy, residential 75.00 2
-. 1 .� { >S �, , ) ;-` 4 n ✓Yx,. , 1 1 ∎7 fir .- -+5'23 N1r r 1 . -7 c,:
'l
r . , l? ':r .4.:.!.:r" , r'y 'J... . :". ' n '" ^ -! T sr 3 r ; :' 4 Y . + r . r orar :JJ ' , 1rr ` ' ti . , 7t r!. (with above ac f t )
.. s ue. r.� _ . _...�,.. u _ ., sc...,.,: +- Limited energy. tadd- family
75.00 2
- � � � , I ' ,' m r � • I ; residential (with shave sq. ft.)
Services or feeders ins tnllatian,alteratlan, and/or relocation
1 . 200 amps or lase 80.30 2
fi ghP ^ ,. a '' .Ai ; 1
:- ,s { � q ; u � - d T ., .1 =.x�a . >a .., , - .:3 201 amps to 400 106.85 2
1c. .r..• c•...ti. -fi .... ) �.w x...a.::;ii x . x -�-. u ��t
Name: . 401 amps to 600 amps 160.60 2
g A r
601 amps to 1.000 amps 240.60 2 113 Over 1.000 amps or volts 454.65 2
FMIWPMGIIIIIBIIIIIMMIIIII Temporary service. or feeders tnetallatton, alteration, and/or
W • 0. e' relocation
Phone: ( Dt) • - ` 1 .1 Fax: ( ) 200 amp or leas 66.85 1
Owner Installatlom 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 599 amps 133.75 2
Date: Branch circuits - new. alteration, or ertou don, per panel
Owner signature: A. Pee for branch circuits with
w 1+Y z ' i t o , 1 :.1 r. 3 + 1...,1,,;..;;,...4,..-.,43,,,,..041..,.'4.4 . r ,a, +. "'r` 41+ . :,. , ...fT Y �i:�i 7W }; r ,. 4 3. R ^ 7 . 1lE ? u Yy . .,r ;i {� rI it' above service or feeder f80.
c . {,,!v ^:.... . , .. _ .n,'. .t . 1. s,..� • :,... !..bni,nwYLO,xc 6.65 2
`- -� .• each branch circuit _ .
Business name: B. Pee for branch cireuite
Contact name; whiten, service or feeder fee. 46.95 2
first branch circuit
Address: Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State/ : Each manufactured or modular 9090 2
dwelling, service and/or feeder
Phone: ( ) Fax:: ( ) Reconnect only _ 66.85 2
E -mail: Pump or irrigat circle 53.40 2
' + ti;; k `4N 5 r i a , T 3 : tin < i or outline lighting 53.40 2
.�,`ii` q { > ;; ->z��..:.� � I , . i � ,,.. � ,.;�.�' � �" S
... �..._ : .... ... _..fi n... . rl., r.....�...,... }l..1, .,, �i :. T+c.,• nr_ ��.., d� ..¢c.ti.:,...;.n•�`�'^
Business name: energy circuit(s) or limited -
energy panel. alteration. or A
Address: extension. Describe: ( Page 2 f 2
City/State/DP: Each additional inspection over allowable In :. of the above
Per inspection 6250
Phone: ( ) Fax: ( ) Investigation per hour (1 hrnen) 6250
CCY GENESIS HOME TECHNOLOGIES Induatrial plant peorhotrr 7375
9450 SW Gemini Drive Beaverton, OR 97008 , Viii a ,ta s, = . t R ', c :` ` f F',la; `13 ;'•- .:r1{ +i` ` ?' t. : 'i.ec
Sup
Phn- 503- -1704 Fax- 503 -843 -3300. Subtotal: 7S =
Prin} . e r a.... CCB 128098, CLE28.989, Plan review (25% of permit foe):
2885 -JLE State surcharge (896 of permit fee): .
Auti TOTAL PERMIT FEE: ; I
e permit application expires If a penult Is not obtained within 180
Print name: Date: �{ - D rile days after It Ins been aae�ed ds complete.
• Number of inspections allowed per permit
LA1341rtivawennlIsZ..P4mulAppdoe alf23/06 44046351111 I0OMMBB
,CITY OF TIGARD .
' BUILDING DIVISION PERMIT #: ELR2007 -00120
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/9/2007
Phone: (503) 639 -4171 �
Inspection Requests (24 Hrs.): (503) 639 -4175 ^ _
INSPECTION WORKSHEET FOR DATE: 5/15/2007 TIME: 7:00AM PAGE: 86
SITE ADDRESS: 11825 SW WILDWOOD ST CLASS OF WORK:
SUBDIVISION: SHADOW HILLS LOT #: 011 TYPE OF USE:
PROJECT NAME: TROY .
DESCRIPTION: Limited energy, all encompassing structure wire for audio.
OWNER: M 8
MATT, TROY PHONE #: 503- 307 -390
CONTRACTOR: GENESIS HOME TECHNOLOGIES PHONE #: 503. 643.1704
Inspection Request Scheduled For: Date: 5/15/2007 Pour Time:
Code # Inspection Description Confirm # : act # Message ,,,,,,),
135 Low voltage 048259 -01 503 - 643.1704 Y
o re tions /Comments /Instructions:
±______ .
. 0 •
•
6
. ((:)/ .
SS ❑ RTIAL APP • % AL ❑ CANCEL ❑ NO ACCESS
❑ FAIL % CALL ` • . ' ION ❑ ADDITIONAL FEES ASSESSED • i _
/ I
Inspector:- . !12 Date: a ' , O 7 Phone #: (503) 718