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Permit
ti CITY OF TIGARD ELECTRICAL PERMIT PERMIT i m DEVELOPMENT SERVICES DATE ISSUED: 2% 7/2 0600122 f I I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171 PARCEL: 2S1 10 DC -01000 SITE ADDRESS: 11160 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 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 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 800 -3 2 -2344. Issued By: II 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 0002 • Electrical Permit Application FOR OFFICE USE ONLY City of Tigard Received B: i ' 11 b(i (p,o Permi (, -,i ,�- oatdB + y 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Other 'ennit: Phone: 503.639.4171 Fax: 503.598.1960 "'' i ";' �I ' � /' Date/By. I Inspection Line: 503.639.4175 .� ?. 'L.. Date Ready/By: El Sac Page 2 fur . Internet: www.tigard- or.gov NotifiaUMethod: - Supplemental Information • , , 7... FLA1V RE VIEW .• ' •.. ❑ New construction [] A tion/alteration/replacemcnt Please check all that apply ❑Service over 225 amps, comm'1 ❑Hazardous location ❑ Demolition Other: []Service over 320 amps - rating ❑ Buildng over 10,000 sq. I2., - • : . • . 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 toad ove 99 persons []Manufactured structures or • 406 SITE INFORMATION AND LOCATION _ • : ❑Egress/lighting plan RV park • — q ❑Health -Cart facility ❑Other. , • Job no.: Job site address: 0,,,d0 - - Co- • w &200 D./ C/ Submit 2 sets of plans with any of the above. • City/State/ZIP. S 6 . r tio (` 2 The above arc not applicable to temporary construction service. - :FEE•. SCHEDIJLE :. I Suite/bldg. /apt. no.: L 4 Project name :5't ilt e .ir Dexdodon I WY' I Fee. I TalaL I " - Cross street/directions to ob site: ``\\ New residential single - or multi- family dwelling unit. J Vu �r[+�'��1� -l�lJ j�� Includes attached garage. • O C:- C V41 _ 1.000 sq. R or less ' 145.1$ 4 Subdivision, Lot no.: Ea. add'l 500 so. ft. or portion ` 33.40 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 I 1 dwelling, service and/or feeder_ 90.90 3 G ( __1 �, c. 1„V'P '..' l 1 balks "8L' Services or feeders Installation, alteration, and/or relocation ' 200 amps or less 80.30 2 TENANT 201 amps m 400 amps 106.8$ 2 ROPERT OW NER • : .. 401 amps to 600 amps 160.60 __ 2 • Name: a ``' l ' 601 amps to 1,000 amps 240.60 • 2 Address • 15C:C� 3 � F'1 ��-�- -Ave S t.2 i O Z. over 1,000 amps or volts 454.65 2 j Reconnect only 66.85 2 City/State/ZIP: p -,� Cl?—. c 7 2..0 i Temporary services or feeders installation, alteration, and /or relocation Phone: (9:53) 6 it , r 57i Fax: t)ls - L U ' 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 r • PLICANT CONTACT PERSON A. Fcc for branch circuits with service or feeder fee, each 6.65 2 Business name: 5 ptt .1) C.D ,,, ': U"1—st i 1 mc.. brunch circuit • ` � B. Fee for branch circuits Contact name: CAA , without service or feeder fee, ' 46.85 first branch circuit Address: [ 5 qO 3 1`I i b1 L 11/416. . Each add' I branch circuit I 6.65 2 City/State/ZIP: tz e - L D .Si- QS,4-2— Miscellaneous (service or feeder not Included) i Pump or irrigation circle t 53.40 2 Phone: ) ge% P g ‘3_, Fax :: 0X)) 46 --1 ' ,t Sign or outline lighting 53.40 2 E -mail: C hAdi ` _ . L • n.' t c - W • , _ 14.4 Signal circuit(s) or limited. CONTRACTOR: energy panel, alteration, or extension. Describe: Page 2 2 Business name: - E I r . L'-12 C — _L „. 4 Each additional Inspection over allowable In any of the above Address: P„, C • ex ri . O 7 fir Per inspection 62.50 City /State /ZIP: Po ,1 LK1.1 C) ( . q 7 2cl 4. _ Investi per hour (I hr min) 62.50 ^� '5 - I Industrial plant per hour 73.75 Phone: t A Fax: ek 3) - 2tj o” ! 7 ( 4 i b 1 ELECCRiCAL.:PERMfr `F.EES• • l CCB Lic.: I y i,:1 2 Electrical Lic.: 4v•- 1pt,c4 Suprv. Lic.: 1451'7 s _ Subtotal & ' 2e, Suprv. Electrician signature, required: Plan review (25% of permit fee) State surcharge (8% of permit fee) ' .9 4 Print name�p 'R}V Date: '^I I ' 104, TOTAL PERMIT FEE At , Authorized signature: This permit application expires ice permit is not obtained within I8D days after It has been accepted as complete Prin name: Date: • Pee methodology set by Tri -County Building Tndusrry Service Board Number of inspections per permit allowed. IMeuildinsV `amits\ELC•PcrmitApv.dec 12/50105 44046U53(l0/02/COM/WB8 CITY OF TIGARD . - BUILDING DIVISION PERMIT #: Eu:4006, 00122 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/17/200G Phone: (503) 639 -4171 ��,. 11 41:1 1t\ Inspection Requests (24 Hrs.): (503) 639 -4175 ._�� INSPECTION WORKSHEET • •R DATE: 2/27/2006 TIME: 7:01AM PAGE: 92 SITE ADDRESS: 11 160 SW ADOV ROOK DR 6 CLASS OF WORK: SUBDIVISION: WILLOW f3R • K FARM LOT #: 014 TYPE OF USE: PROJECT NAME: SUMMERFIELi APARTMENTS DESCRIPTION: Unit 6, install set • © for washer and dryer. OWNER: SUMMERFIELD AS CIATES, LLC, PHONE #: 503- 545 -6712 CONTRACTOR: J0 ELECTRIC INC. PHONE #: 501 -268 17Th Inspection Request Scheduled For: Date 2 /27/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 120 ..h -in 127581:1-03 503- 310-7181 N Corrections /Co -1 i . tions: R PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 6 — d 1\105 Date:. Z1 66 Phone #: (503) 718 - [0