Permit :CITY OF TI YARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00119
F �l 1 DEVELOPMENT SERVICES DATE ISSUED: 2/17/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S110DC -01000
SITE ADDRESS: 11135 SW MEADOWBROOK DR 1 ZONING: R -25
SUBDIVISION: WILLOW BROOK FARM LOT : 014 JURISDICTION: TIG
Project Description: Unit 1, 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 45175
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 OA 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 -8 332
Issued By: , �� Permittee Signature: etY),
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 @J002
Electrical Permit Application FOR OFFICE USF ONLY
City of Tigard ost Pernik x,
ata ! 0�!
13125 SW Hall Blvd., Tigard, OR 97223 AII. Plan Review Other Permit:
Phone: 503.639.4171 Fax: 503.598.1960 at—
{ ` r ,4 ; ' P Jr i . DatrlB
•
Inspection Line: 503.639.4175 ±tf �'I I.. Date ReadyBy: �.'� 10 Scc Page 2 fur •
Internet: www.tigard- or.gov Nodfied/Method: ALL Supplemental Information •
•
: .
:.TYPE OF :WORK. _; _
.. ..,.. . : •:. _ ;:•. :.: .._: :PLAN ii;l:'VTEW::: ...: : :
0 New construction ❑ A •tion/alteration /replacement Please check all that apply:
❑ Demolition Other. ['Service over 225 amps, comm'1 ❑Hazardous location
❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
• ' • . CATEGORY' 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
ulti- family ❑ Master builder. ❑ Other: ['Occupant load over 99 persons ❑Manufactured structures or .
JOB SITE •INFORMATION AND LOCATION _ , ❑Cgress/lighting plan RV park •
•
Q ❑Health -Care facility ❑Other. • •
•
Job no.; Job site address: 35 �� 1tQ 77p g/1oo K. -D/L. Submit 2 sets of plans with any of the above.
City /State /ZIP _ .. 1 , i 1 09. ct 7;22.4- The above arc not applicable to temporary construction service.
t
/
.a . no. . :FEE* . SCHEDULE: • •
Suita/bld . •
•
_ g p �l►�It ' Project name C 71J�tE DeurlOtlon I QtY• I Fie, I cowl ' ■• .
Cross street/directions to job site: v` 3 Rt lk -Vi e.ADC - P5 )1A- New residential single - or multi - family dwelling unit.
Includes attached garage.
O CV- WC C - • 1,000 sq. R• or less 145,15 _ 4
Subdivision: Lot no.: Ea. add'I 500 so, ft. or portion 33.40 I
1 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
�"���
E C-41/41...- (� 400 V? OF* I 1 b-► Ik8t" Services or feeders Installation, alteration, and/or relocation
200 amps or Icss 80.30 2
sr 201 amps to 400 amps 106.85 2
. Pi • ROPERTY: -OWNER • ❑TENANT : : -
401 amps to 600 amps 160.60 2
Name: n.re t ,L'] r p or j;L(, � ' 601 Drops to 1,000 amps 240.60 2
-r-
Address: 150a) - , W' "r;t :. s + OE ; L2 _ 02 Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City /State/ZIP: 7 • : ` • i■ 72.0 1 Temporary services or feeders installation, alteration, and /or :
relocation
Phone: (c) 6 — 5112. Fax: t30) -(-4.; ° _ 0 200 amps or Icss 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
w APPLICANT • • 1 : CO N.T A C.T. PERSON. A. Fcc for branch circuits with
. service or feeder fee, each 6.65 2
Business name: 6 t l� �t. -� ,. c c. — -4 4C.. branch circuit
B. Fee for branch circuits
Contact name; - r pp > . without service or feeder fee, i 46.85 2
first branch circuit _
Address: [ v f`• T . j I-1 e. jj ) tk\ ieW £ Each add'I branch circuit I 6.65 2
Miscellaneous (service or feeder not Included)
City /Stste/ZII�:i��+ ; ( , ,,5 Rte- Pump or irrigation circle 53.40 2
Phone; ( ) 6' 114 ' Z� Fax (c 4 J 4�, '1�� Sign, or outline lighting 53.40 2
E- mail: C hetcl (i "fiit.,t.1 twig . Cost., Signalcircuit(s)orlimited-
CONTRACTOR: energy panel, alteration, or
extension. Describe: Page 2 2
Business name: e- Eu= c r 2 , T. 4
Address: Each additional Inspection over allowable In any of the above
T' m _ -�C� - aC O 7 ` r _ Pcr inspection 62.50
City /State /ZIP: p ,,� L p > o 6 1 72-9 4. Investigation per hour (I hr min) 62.50
r
Phone: Fax: 6y)) 245 1 7 I d 5 Industrial :..- plan per ELECTRICAL hour 73.75 w
�� � -_ i Z l 5 I • L• :PERMIT `F.EES
CCB Lie. : I t,I gel Electrical Li C, •- /ct,r, Suprv. Lie.: 14 5 77 5 _ Subtotal Lt , a.
Supty. Electrician signature, required: Plan review (25% of permit fee)
State surchurge (8% of permit fee) ( .Ty
Print na me liE�e <-�R j Date: a L lD 104' TOTAL PERMIT FEE 4 r 1'
Authorized signature: Thie permit application expires if a permit it not obtained within ISO
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.
INauildin5 V'crmite1ELC•PcrmitAPPA 12/30/05 4444615Ttl0/02/COM/wee
CITY OF TIGARD .-
BUILDING DIVISION PERMIT #: ELC200 &.00119
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/17/2006
Phone: (503) 639 -4171 4uFut
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 2/27/2006 TIME: 7:01AM PAGE: X
SITE ADDRESS: .11135 SW MEADOWE3ROOK DR 1 CLASS OF WORK:
SUBDIVISION: WILLOW BROOK FARM LOT #: 014 TYPE OF USE:
PROJECT NAME: SUMMERFIELD APA•TMENTS
DESCRIPTION: Unit 1, install service fo asher and dryer.
OWNER: SUMMERFIELD ASSOCIA - S, LLC, PHONE #: 603 -ri € / 1?
CONTRACTOR: JET ELECTRIC INC: PHONE #: 503-258- 1716
Inspection Request Scheduled For: D. e: 2/27/2006 Pour Time:
Code # Inspection Description Confir # Contact # Message
120 Electiica! rough -in 027588- 503- 3107187 N
M E-\ NAB. 134 Pao
Correc ions /Commen s/ nstructions:
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL El NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ST ' v A L-E Date: l Z.' 6 Phone #: (503) a. 't 718- D
CITY OF TIGARD
BUILDING DIVISION PERMIT #: EL 0200 00119
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 21.170.006
Phone: (503) 639 -4171e
Inspection Requests (24 Hrs.): (503) 639 -4175 �'I L
INSPECTION WORKSHEET FOR DATE: 2/24/2006 TIME: 7:03AM PAGE: 102
SITE ADDRESS: 11135 SW MEADOWBROOK DR 1 CLASS OF WORK:
SUBDIVISION: WILLOW BROOK FARM LOT #: 014 TYPE OF USE:
PROJECT NAME: SUMMERFIELD APARTMENTS
DESCRIPTION: Unit 1, install service for washer and dryer.
OWNER: SUMMERFIELD ASSOCIATES, LLC, PHONE #: 5034.1:46-5/12
CONTRACTOR: JET ELECTRIC INC. PHONE #: 503
Inspection Request Scheduled For: Date 2/2A/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 Electrical rough -in 027472 -01 503- 310.7187 Y
Corrections/Comments/Instructions:
❑ PASS ❑ PARTIAL APPROVAL CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
"L ` l- --
Inspector: � Date: �.. � CID Phone #: (503) 718-