Permit &,CiTY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00124
416' DEVELOPMENT SERVICES DATE ISSUED: 2/17 /2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S110DC -01000
SITE ADDRESS: 11075 SW MEADOWBROOK DR 1 ZONING: R -25
SUBDIVISION: WILLOW BROOK FARM LOT : 014 JURISDICTION: TIG
Project Description: Units 1 & 2, install services for washers and dryers.
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: 3 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 $26.19 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws.
All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at
503 - 246 -6699 or 1 -800 -3 2 -2344. �
Issued By: 93�. ,�V Permittee Signature: I
OWNER INSTALLATION ONLY u
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO: •
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
02/10/206 11:49 FAX 5035981960 CITY OF TIGARD �J 002
Electrical Permit Application FOR OFFICE IfSE ONLY
City of Tigard D Lg` MOM" OM" PermitNo.: fi,(,��p(p, -
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Odte stria:
Phone: 503.639.4171 Fax: 503.598.1960 �� �� {{ � � 1 I •Inspe Line: 503.639.4175 �+!''tr� Date Ready/By: to See Pagc 2 fur
Internet: www.tigard- or.gov Non find/Method: Supplements' inrormetioo
' • :,TYP$, OE;:WORK...: ::- .
0 New construction ❑ A ition/alteration/replacemcnt Please check all that apply:
['Service over 225 amps, comm'1 ❑'Hazardous location
❑Demolition Other.
[]Service over 320 amps - rating ❑Buildag over 10,000 sq. ft., • •
' . CATEGORY 01? .CONSTRUCTION : • ::: , • • :. . • of 1- and 2-family dwellings 4 or more new residential .
•
❑ 1-Ind 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 ❑Egess/lightingplan RV park •
❑Health -cart facility - ['Other: •
Job no.: Job site address: `10'! 5 H }japLJ ()0 {4 s� Submit 2 s of plans with any of the above.
City /State/Z P -f 09- ci 7 ,22-4- u ti1V7 1 t. The above arc not applicable to temporary construction service. - .
- :FEE•. SCHEDt1LE:.
Suite/bldg. /apt. no. cr I * / •Jett name. .► DrecdDdOa I Qty. I Fee. I TnWI I •• _ L.
Cross street/directions to job site: u p_�.,6 ttt` rg�� c� � New residential single - or multi- family dwelling unit.
T `1>� ew'ry r �-"'' ` _Includes attached garage.
O C) qg WE a t- 1.000 sq. R or less 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
r'� pp i dwelling, service and/or feeder __ 90,90 2
ELEC- '45.�� 400 ( 1t-.L 1 OF- I � iks if al.- Services or feeders installation, alteration, and/or relocation
im/ 200 amps or less 80.30 2
•n 7� 201 amps to 400 amps 106.85 2
. ( ROPERTY.'01' OWNER . I ❑ TENANT ., • ?:• •. ::.:; • 401 amps to 600 amps ! 160.60 2
•
Name: "1"4ee n-t,L'7„0 HSC,. 601 amps to 1,000 amps 240.60 2
* k�C�Gr' tr� S �i.c. .
Address: i5 `� PIP- -- AVE SL7�1"t' 1O Over 1,000 amps or volts 454.65 2
j Reconnect only 66.85 2
City/State/ZIP: p er . C , 7 2.C, j Temporary services or feeders installation, alteration, and /or : •
relocation
Phone: 0;53) 544 -- 5 2._ Fax: (`VGA -4,; ° 5 0 i 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
. PLICANT • , I : . 62: C ON.TACT PERSON • • . A. Fcc for branch circuits with
• _ service or feeder fce, each 6.65 2
Business name: 6 IA41 j) C c,..1 - - c .m r ic) I MC.-5 brunch circuit
B. Fee for branch circuits
Contact name: t 2-- without service or feeder fee, i 46.85 2
t 5 So t D s Each d'I bra circuit circuit _
Address: 1`t. t, .o Each add'I branch circuit 6.65 2
Cit j , . J fr 9,4-7._ Miscellaneous (service or feeder Ilt Included)
Pump or irrigation circle 53.40 2
Phone: ( ) gdei.. P j t. Z5 Fax:: >) 5 46, -IA sz> Sign or outline lighting 53.40 _ 2
E- mail: Gh4Ci e.- ( 5I�q u ons ▪ 51r c,'f'tviq. .GGtA+ Signal circuit(s) or limited-
• CONTRACTOR: energy panel, alteration, or
extension. Describe: Page 2 2
Business name: ::\ - e-- - E u ; ��2.-.. c.__ 4
Each additional Inspection over allowable In any of the above
Address:
P. gi) • 'S(. - 7 E Per inspection 62.50
City/State /ZIP: P j L p cy i D op-- q3 2-91- Investigation per hour (I hr min) 62.50
t Industrial plant per ho 73.75 _
Phone: -i715 I hour Fax: tom) �r t. 7
ELECTRICAL. :PERMIT' FEES"
CCB Lie.; I y l c) Electrical Lic.: • 4,- 1 Suprv. Lic.: 1 5 77 5 Subtotal ac ..
Suprv. Electrician signature, required: Plan review (25% of permit. fee)
State surcharge (B% of permit fee) ' .9
Print name. ,<�p.. Date: a i0 4"
:PC�E'Tri✓ TOTAL PERMIT FEE i t '
Authorized signature: This permit application expires If a permit if oat obtal d within 18
days after It has been accepted as complete
Print name: Date: • Fee methodology set by Tri.Counry Building Industry Service Board
Number of inspections per permit allowed.
I: Building U`amile\ELC.PennitAVVAoc 12/10/05 440.46151110 /02/COMIWee
.
CITY OF TIGARD - -_ • -eac
BUILDING DIVISION PERMIT #: ap0(a - 1
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 ago I
Inspection Requests (24 Hrs.): (503) 639 -4175 ...' 11
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: ine" "`'K CLASS OF WORK:
SUBDIVISION: \ , LOT #: TYPE OF USE:
PROJECT NAME: 1 V15 �1 `
DESCRIPTION: 1' VI.
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3-(0- D ' Pour Time:
Code # Inspection Description Confirm # Contact # Message
17_ 3,-7/r7
Corrections /Commen /Instructions:
• . , C>3 ---
\AC\ V 0—
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ' 6q Date: k W Phone #: (503) 718 -114"
CITY OF TIGARD • ,
BUILDING DIVISION PERMIT #: EL C2006 0012A
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/17/200G
Phone: (503) 639 - 4171A I
Inspection Requests (24 Hrs.): (503) 639 -4175 - --
INSPECTION WORKSHEET FOR DATE: 2/24/2006 TIME: 7:03AM PAGE: f 40
SITE ADDRESS: 11075 SW MEADOINBROOK DR 1 CLASS OF WORK:
SUBDIVISION: WILLOW BROOK FARM LOT #: 014 TYPE OF USE:
PROJECT NAME: SUMMFRFIELD APARTMENTS
DESCRIPTION: Units 1 & 2, install services for washers and dryers.
OWNER: SUMMERFIELD ASSOCIATES, LLC, PHONE #: 503.546,67.y)
CONTRACTOR: JET ELECTRIC INC. PHONE #: 503.258 -171 °a
Inspection Request Scheduled For: Date: ?124/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 Electrical rough -in 027472 -05 503 - 310 -7107 N
Corrections/Comments/Instructions:
❑ PASS ❑ PARTIAL APPROVAL CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: (1'L--- Date: ZIA' o6 Phone #: (503) 718-