Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00120
DEVELOPMENT SERVICES DATE ISSUED: 2/17/2006
`�' I-IIII 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 110DC -01000
SITE ADDRESS: 11145 SW MEADOWBROOK DR 6 ZONING: R -25
SUBDIVISION: WILLOW BROOK FARM LOT : 014 JURISDICTION: TIG
Project Description: Unit 6, install service for washer and dryer.
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/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 1 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:
SUMMERFIELD ASSOCIATES, LLC JET ELECTRIC INC.
% HSC REAL ESTATE PO BOX 20765
1500 SW 1ST SUITE 1020 PORTLAND, OR 97294
PORTLAND, OR 97201
Phone: 503 - 546 -5712 Contact #: PRI 503 - 258 -1715
FAX 503 - 258 -1716
FEES
Description Date Amount Reg #: ELE 26 - 1068C
[ELPRMT] ELC Permit 2/17/2006 $24.25 LIC 141920
[TAX] 8% State Surcharge 2/17/2006 $1.94 SUP 4517S
Total $26.19 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 1-6100
Issued By: t , r Jt,) Permittee Signature:/
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.
02/10/2006 11:49 FAX 5035981960 CITY OF TIGARD 1 002
Electrical Permit Appli FOR OFFICE USF ONLY
• Renewed � , �� P ermit No.: i1,C, , • , . 00 1 a'0
City of Tigard onus : �...,
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 u ; - f j, l � i, Dat _
�B Other • il:
��{{ + 1 Date Ready/By: a?' Ell See Pap i fur .
Inspection Line: 503.699.4175 s"_+r ' :_�
Internet: www.tigard- or•gov Nod fied/Method: „ - , Supplomcntel tnfarmution
•
:
.
_ ..TYPE OE O • ; :WRK. ` :': ; : :.r•. • •• :: • ._: •• ` :4LAN•.RE'VTEW: ;; .••.: .. :,
❑ New construction 0 A ition/alteration/replacemcnt Please cheek all that apply:
❑Service over 225 amps, comnt'l ❑Hazardous location
ID Demolition Outer
❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
• - • -: • . CATEGORY t OF CONSTRUCTION : ' . ..: • : • of 1- and 2- family dwellings 4 or more new residential
❑ 1- d 2 -family dwelling ❑ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑Building over three stories ❑Feeders, 400 amps or more
u)ti- family ❑ Master builder ❑ Other: ❑Occupant load over 99 persons []Manufactured structures or .
JOI1 SITE INFORMATION AND LOCATION _ . - ❑Egress/1ighting plan RV park .
•
— 1 ❑Health -cam facility ['Other •
Job no.:
Job site address: Z ATE cJ !t7�4`�e .
-_ ., - _- Submit 2 sets of plans with any of the above.
•
City /State /ZIP. t &,' tam C ■ i ' ;22,,, ' The above are not applicable to temporary construction service. - •
�i 1 :FEE•.SCHEDUI:Ei.. •
Suite/bldg. /apt. no.:(A 0 -("ip Project namerw I ELo D.rioon I Q t y . I Fee, 1 Tni.I I '-
Cross street/directions to job site: Vu >�+Yl II..Ia t"�u N ' New residential single - or multi family dwelling unit.
Li � Includes attached garage. •
C j 0- er9 ti-C • 1.000 sq. R or less J 145.15 4
Subdivision: Lot no.: Ea, add'l 500 sq. ft. or portion_ 33.40 I
Limited energy, residential 75.00 2
Tax map /parcel no.: Limited energy, non - residential 75.00 2
. . DESCRIPTION OF WORK -. .. Each manufactured or modular
dwelling, service and/or feeder 90.90 2
G4EC2r9-- c....41/41-- 4'00 t >f" Vq - J 1 L'Ai ,' ti73 Services or feeders Installation, alteration, and/or relocation
/ 200 amps or less 80.30 2
'Dvim� 7 ��' 201 amps to 400 amps 106.85 _ 2
. ®'iROPERTY: OWNER . I ❑TENANT .• : -; • 401 amps to 600 amps 160.60 2
Name:La .c j;,(;,, 01 ' 601 amps to 1,000 amps 240.60 •2
� ' Over 1,000 amps or volts 454.65 2
Address: i5UC"� pip- e' - I- 'kVi ;5 toirt iOZc 2
j Reconnect only 66.85
City/State/ZIP: •w , r , , : si c ` 7 i Temporary services or feeders installation, alteration, and /or :
relocation
Phone: (.9D3) 5 . , r 5 2._ Fax: VG3) -4-, ° . 0 - 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, per panel
Y APPLICANT : CON PER : A. Fcc for branch circuits with
• • ' . service or feeder fee, each 6.65 2
Business name: 5 le_[ ,j, ) C� '. a P- i s cl d MC, brunch circuit
t B. Fee for branch circuits
Contact name: �-ij -, without service or feeder fee, ( 46 85 ,
Ara branch circuit
Address: 15 q01-2 Nei lbl - is _ . Each add'I branch circuit I � 6.65 2 -
City /State/ZIP: i, Pe-(. y -s - c 4-�. Miscellaneous (service or feeder not Included)
i Pump or irrigation circle 53.40 2
Phone: (6c.) + I Z� Fax:: >) • - • 'r Sign or outline lighting 53.40 2
E -mail: C hetct i✓ e5ky + e n-a-. i-rt_ CG S+ Signal circuit(s) or limited-
CONTRACTOR: energy panel, alteration, or
• _ extension. Describe: Page 2 2
Business name: e-i- V ; c___--r12.-k. c._ 1 4 -
Each additional Inspection over allowable In any of the above
Address:
ID.- 0 . 1.. aCo 7 _ Per inspection I 62.50
City/State/ZIP: Pars\ `.ctl i (j 1 7 __,Cj 4. Investigation per hour (I hr min) 62.50
Phone: A5 -- i 7 i 5 Fax: 663) 25B —i71 4 Industrial plant per hour 73.75
; - ' ELEi,C tRICAL PERMIT `FEES• _ 4_
CCB Lie.: i Li 1 el I Electrical Lic.: (, • -1 pc,c< ..I Suprv. Lie.: ><{ so S Subtotal a • A.,
Suprv. Electrician signature, required: Plan review (25% of permit fee)
State surcharge (8% of permit fee) / . q 4
Print namen7 Nierr (..jptpjt I Date:; `^ I io l 04,
TOTAL 9
I TOTAL PERMIT FEE
Authorized Signature: This permit application expires If a permit is not obtained within I80
days after It has been accepted as complete
Print name: Date: • Fee methodology set by Tri.County Building industry Service Board
_ Number of inspections per permit allowed.
Imildittecmri ,a \ELC.PcnnitAeo.doc 17/30/05 - 440.4615T(10 /o2/COMtwes
CITY OF TIGARD
BUILDING DIVISION PERMIT #: Ef.4�.Ot15 ur) i afl
13125 SW Hall Blvd., Tigard, OR 97223 �• DATE ISSUED: 2/17 /2006
Phone: (503) 639 -4171 f A
Inspection Requests (24 Hrs.): (503) 639-4175 _:4N11
INSPECTION WORKSHEET FOR DATE: 2/27/2006 TIME: 7:01AM PAGE: 94
SITE ADDRESS: 11145 SW MEADOWBROOK DR 6 CLASS OF WORK:
SUBDIVISION: WILLOW BROOK FARM LOT #: 014 TYPE OF USE:
PROJECT NAME: SUMMF_RFIELD APARUMENTS
DESCRIPTION: llnit 6, invtall service for washer and dryer.
OWNER: SUMMERFIELD ASSOCIATES, Li C, PHONE #: 503 - 546 -5.712
CONTRACTOR: JET ELECTRIC INC. PHONE #: 503 - 258 -1716
Inspection Request Scheduled For: I :te: 2127/7006 Pour Time:
Code # Inspection Description Conti # Contact # Message
X12200 Electrical rough -in 0275B8 -►' 5113.31O7187 1'
Corrections /Com nt�tructions:
►,Ii PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 6- . ') by `-4 Date: 2-1 2 1 h D Phone #: (503) 718- Aqt .62___
CITY OF TIGARD
BUILDING DIVISION PERMIT #: EL�<2(1tiC; CSC) t(i
►
13125 SW Hall Blvd., Tigard, OR 97223 i _ DATE ISSUED: 2/17/200G
Phone: (503) 639 -4171 *OW 1
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 2/24/2006 TIME: 7 :03AM PAGE: iii
SITE ADDRESS: 11145 SW MEADOI+ROOK DR 6 CLASS OF WORK:
SUBDIVISION: WILLOW BROOK FARM LOT # 014 TYPE OF USE:
PROJECT NAME: SUM MERFIELD APARTMENTS
DESCRIPTION: Unit 6, install service For washer and dryer.
OWNER: SUMMERFIELD ASSOCIATES, LLG, PHONE #: 503-1-;46-5712
CONTRACTOR: S IC( ELECTRIC INC. PHONE #: 50 258 -1715
Inspection Request Scheduled For: Date 2/24/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 Electrical rough -in 027472 -02 503-310.7187 N
Corrections /Comments/ Instructions:
❑ PASS ❑ PARTIAL APPROVAL yi ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Cy Date: Z-' VA ' Phone #: (503) 718-