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Permit
• CITY OF TIGARD ELECTRICAL PERMIT ° OF PERMIT #: ELC2006 -00670 COMMUNITY DEVELOPMENT DATE ISSUED: 11/27/2006 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 25101 AA -09800 SITE ADDRESS: 12570 SW 69TH AVE ZONING: MUE SUBDIVISION: PP1996 - 024 LOT : 002 JURISDICTION: TIG Project Description: GEORGE FOX. (15) branch circuits. Job # 6297. RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL /PANEL: MANF HM/ SVCI FDR: 601 +amps -1000 volts: MINOR LABEL (10): SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: W /SERVICE OR FEEDER: 1 PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: JT ROTH DEVELOPMENT JEROME ELECTRIC 12600 SW 72ND AVE, STE 200 PO BOX 751 TIGARD, OR 97223 HILLSBORO, OR 97123 Phone: 503 - 639 -2639 Contact #: FAX 503 - 648 -9723 PRI 503 - 648 -5144 FEES Description Date Amount Reg #: ELE 34 -119C [ELPRMT] ELC Permit 11/27/200( $139.95 LIC 158119 [TAX] 8% State Surcharge 11/27/200( $11.19 SUP 28775 Total $151.14 REQUIRED ITEMS AND REPORTS 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: 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. ;.11/27/2006 08:41 5036489723 JERMOE ELECTRIC INC PAGE 03 • 04/30/2004 08;31 FAX 8038881960 CITY OF TIGARA I g la 0o1 • RECEIVED ;kccnnical Permit Application - FOR OFFICE USE t�'N i' ' F Z OOb i.::,: - City of Tigard d,oa 97 1e UV m � � ,. >l;/, > at No r /. 13125 Sv Ran Blvd.,TiN 7 ITY 0r' T'GAR - �, ' � 0 phone: 03639-6171 For S03-508.1 NG r , ice .: r % ' ' °r A 303.639a17s ILCN laapOCtaCtl ,,1 �.. T't Bee Pale 2 er • •- a r. 11tSeerle0 www.c d&iz .Orela NoQEaQ7lAerkee 9t.ppl urwa a1 L.ror asn _r rr_ •,�� .�r•n; •, .,n r _ ^,r..Y� - S= ';c.,••, - x'�.; ..,�� .�: rr_ ^T�:itT �, �. - r 1 � F 1 �'7 �,. n ( 'l t ' .' - „1 is k. T C. p 'j .. ; . _ ,� (,. T:c , I;^ 3. ° < „�, Z G,;'t r - •�1 ;, :;'. v'1`l.. i.'y . � :, - 'fib , ,. a 1i1"� -4440,-.4.1:7 ' 1 �t : a i, � ;'' 4 ' 'Ip,ir� ;.yi � lt'J,. _ , ., h`� _..e l:.� �. +� � ' :Yr �.Y4 u:" , 0 New constiuetiol : 71 Additiydalto on/replacanent Please o • -'k all drat apply: ❑ Demolition D Other. . []s - • •over 325 amps, comm'1 pl'1az'prdous location Le ; :xo`�R • ;;,.. 7, - ., = i !:� . ::::71., , ,-47 . .:. :: �i {::'•'c_ v ^ 1 IZ 1. Qg�` ova 120ur�1 -1'Jlg i.�trikIng over 1 0 r �bi.ft, . kt.., _ t. ;. Si r• '. , ,; �,-- [4 ..L ": , r f r [ �Lr�ti �..°)' 1 ' . R: 'Tail. pal • P 9• 4 or �� . . , 1 ,9 I ,� . . i p� ,1 � _ y: . � r , r fa I,,�� E ■7 � � �,,,�� ��- of !- • � 2-4011 dwe>ifn tows new renidattial • l- and 2 dwelling ■ Accessory building O : over . 600 volt, nominal lab in one grown 0 Mule, y El Master builder 0 Other: 0 = ,1 , over tree swim pFeedera, 400 amps or more r a ;:�, x t , 1 G.ra; a: , ,. r . r • r I, DOoo • tat load over 99 persons DMan a red miswrite nr } f t • 4.`' -1rk1 1 f i f ri , Ff:t 1 i [ . L r ' r r'� ' 1' .i, i [ cl s,ti,,, , �+ f,C ..�, , �+i / .i h ... �., },.� Ir+,. r�:, t .l �.,. I of f :�J. ^�.c r .tu .t-r r,�. (�, Y,n � ti J [ h.i.. _...1 ) :�..� 1 l( I }'. f,.t,l..� Mr. ' 8° 8 plan RV park 'aback: l/� Qli rob site address; • 1 2510 $v / i"� , tb-v,av Autrey with any ai above. c (2 21 t ti OR 0 112 'pee als4ve aces not applicable to temporary construction service, Suite/bldg./44 no. Project nrame: / .. ` I' • : `A" " 7 fr; n .a•- 1 r. r, •• e • �� f�F: ;- � ���)���.IZrU+Cir +il jl�l�.t'��3.�'� �..�' i�� -� .!u7��;. h. Dematuas cop Pa. race, OM tieeddirections to job site: Maw resideatiel single -or multi- family dinning mat. • includes attach erase. _ 1,000 sq. A. or less 14$.l s 4 Subdivision Fa. add'1 S00 . tt or . • .'on 33.40 � late aasplpateel no.: 75.00 SIB .---‘..--I r - :f:, -, , ;,. r � `a :). „ r ;�: -moo --- q, 9, t I ° , - I �i� 1 , 1,) .. I- i " l y r l=•): - ;i7 ,I t o A r( , inr I t' I. l i �. Z , r f i 1' a ... , !.. 11 L--N. nr.sRU \1 1, . 9[r.', J,. cMb a:r _ 'az , , , �s: 9,. -t. ram �� . ... 90.90 8ereless or Teodoro Installation, alteration, and/or relocation 200 anqs crlesa Mil 80.30 Ell "` {:r'1N -i i : : C c ,. u;.n*^nc : : ;.7.. t °.{� „,r, :11,�1 , Mfr.. 201 •stp400 ..t 106.65 ti F" j I' � 1 la �,j )�1 i ' � J 1, � ,i - ` �-f f!Ir ' � + i � t � I + ) n r ; �' [ " ; � y'+1: { �� ,1 • , rt,. ni ....a k t.__ r? J :ff ; <'r� . �., ..r .�-,ItR1.C: i.r' .,n .1 , ;'_. .. E�. , r,. i 441 .i to600 a ,.f 11.1 16160 �© Natnc • t _/3 601 '•' to 1.000 - 240.60 Ell Address: 1 QQ W • ✓ 75112 , OQ X 1.004 •. •• tsrv0115 MI 494.65 .1111111© Rtoconnsot only 0 66.85 -© CttitStA[e/T1P: - n cg. t , • Twrylorary services or readers lostalfation, attvatioo, and/or Phone: ( r ) 6 7 . ' ., . , 01 Flop ( • • ) co!gL4- On C3 I 200 autos or leas 66.8$ II Owner Installation: 'Ilda instalindon to WAS made an lagolleril tilt 1 own whteh•19 not 201 amps to 400 anpi. 10030 intended airsale, lease, rag, ., urbane, wording to ORS 4447, 449, 670, sired 701. 401 t0 600 1• I 133.75 Omara1s11annts L/ 4 Dane: B ,. • ,,, +• - .a ,at . ti. a, err - 'n•. , err • sal • '" i ., C '_ r yr • .a` -*; � r1;: 'ylh -7: '�1_;; ;; 7� ' . ,t : :Ii� r� �z > ! ..i + ' Gory ;- rr A. Fee f r ., circuits suim b_l � r l ;1 � -?•?- ;. `P\ ,. II.. 1 S y r .,. , , ti 1 . . I , / l I I ` 111.x. .. � O -..-.'-•1' . i• - '' ... -,. � . v., r .t_ •rl � rru ri.,t C c .._ . ..1_. {�r :r: - ..:�.t.. -. a�Ciar�tT neb circuit 6.65 � Buchan naIDm "r bea a. Fee Ear branch *culls ttat name Ceons AV; c .V'-SC • • ' wllhora service or feeder foe, 111111 46.83 4(9,535 Address; 1AG, Qp 14-v. 3/ 0O - e in . citestgarzie; 1 ► , Aj(tk # PI 1 Q 2 Mkcala ,mus service er feeder yet lra611166 ) . • - 0 & 0 q . Fa>C 1( • ) M 33.4 � Saar7: swat •• t(s) orlirrdted- II � ] � r y , , '(�,, • � t' �, ! , 1 . p. c + 1. {;t +ylL" � � i�•t.., Y j .: ' l�ai: C. v: S: iII +� � _c'ht�r -'t5 t�-', U�, °.r. l I',ar! dY,teflalOr1. 130aCrli7C Pam 2 131tallleai.n ®a'. _ . 11 - - _ • N Q AM+eac PO Box 7 51 . _ , „ 62.50 =III= Q\ c ityismtall: H i 11 s b or o •. 0 R 9 712 3 'avast -• dos • hour tt 1st wird (5.0 ) MI 6x'5° In i/ Phoae: (50 /648 -5144 . • Fax: T iE f •�1 i„tJ.i;'ri,' ,:Y.zar i�.�'.'-¢ °J.i 1 • � -, ! . 'r . '�:,: u1 t7 lice:,, - 2 �_'�:.r �_ f 1 of r ccg La 5 S 119 Eleattieal Lico3 4 -119 C Supt. Lie.: � , : . - • nap =waw CIS% Of'Wa i flee) \ Sttpiv. Blectridptt , mMilked: e • / -- Mato aurcharte ( 814 Of Permit Da) 1 1 . I .' r i Ptd l l nt 1 David A Jerome ,y.-I .tg?v ToT#.LFarr> I . ri' boon d r"a"" ippao aara sc a, to splru if a e co w al t r Pula d within 180 . er ma at meow WO a )'tlat bate: • p medeiogyea yTrI•Counci , . ;; r . es IT istisioectioas per rotate acree .i. MildkehtldattiargrAAPPan Win us �rsgtotn[OOSwraa / 11'2 5, Wk. ; Ii1 �, CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2006- 00670 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/2712006 Phone: (503) 639 -4171 loj �l Inspection Requests (24 Hrs.): (503) 639 -4175 ::.. INSPECTION WORKSHEET FOR DATE: 12/22/2006 TIME: 7:OOAM PAGE: 24 SITE ADDRESS: 12570 SW 69TH AVE CLASS OF WORK: SUBDIVISION: PP1996.024 LOT #: 002 TYPE OF USE: PROJECT NAME: GEORGE FOX UNIVERSITY DESCRIPTION: GEORGE FOX. (15) branch circuits. Job # 6297. OWNER: JT ROTH DEVELOPMENT, PHONE #: 503-639 -2639 CONTRACTOR: JEROME ELECTRIC PHONE #: 503 - 648.5144 Inspection Request Scheduled For: Date: 12122/2006 Pour Time: Inspectio -scription Confirm # Contact # Message 199 Electrical final 041461 -01 503 - 648 -5144 Y Corr- r' — -. ents /Instructions: ►-�3 1 -3 VI N AIL ai c— watii ,PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: / W Phone #: (503) 718- /0_ CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2005 -00670 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/27/2006 Phone: (503) 639 -4171 4.1sti Inspection Requests (24 Hrs.): (503) 639 -4175 LL. INSPECTION WORKSHEET FOR DATE: 11/30/2006 TIME: 7:00AM PAGE: 79 SITE ADDRESS: 12570 SW 69TH AVE CLASS OF WORK: SUBDIVISION: PP1996 - 024 LOT #: 002 TYPE OF USE: PROJECT NAME: GEORGE FOX UNIVERSITY DESCRIPTION: GEORGE FOX. (15) branch circuits. Job # 6297. OWNER: JT ROTH DEVELOPMENT, PHONE #: 503 CONTRACTOR: JEROME ELECTRIC PHONE #: 5Q3-648-5144 Inspection Request Scheduled For: Date: 11/30/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 125 Wall cover 040405 -01 503-648.5144 Y 1 36 ca ‘1.10e4 tz.rct Corrections /Comments /In ructions: 4•ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS il FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: N 0 6 Date: k1 c 301010 Phone #: (503) 718 -1-0