Permit T • CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00121
i is DEVELOPMENT SERVICES DATE ISSUED: 2/17/2006
" `�' �! 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S1 10 D C -01000
SITE ADDRESS: 11155 SW MEADOWBROOK DR 2 ZONING: R -25
SUBDIVISION: WILLOW BROOK FARM LOT : 014 JURISDICTION: TIG
Project Description: Unit 2, 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: SIGNAUPANEL:
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- 800 - 332 -2344. .
Issued By: 4 ti L k_, �, Permittee Signature: 613 2. , C /YL
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 11002
Electrical Permit Application FOR OFFICE USF ONLY
City of Tigard Min IN 0 AM Permit No.: t _ ,,, 6 (ge 0 I I I
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Other Permit:
Gt: l� \
Phone: 503.639.4171 Fax 503.598.1960 ,5,:, :n � � � �� • ,.
Inspection Line: 503.639.4175 , ,! 13' •'• 'I I Date Ready/By: 0 Sec page 2 fur
Internet: www.tigatd- or.5ov Notified/Method: — .. Supplemental Information
TYPE. OF _;
a New construction ❑ A ition/alteration/replacemcnt P lease check all that apply.
['Service over 225 amps, comm'l ❑Hazardous location
❑ Demolition ILVOther. ❑Service over 320 amps - Iating ❑Berildag over 10,000 sq. ft., . •
' . CATEGORY' OF 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 0 Other: ['Occupant load over 99 persons []Manufactured structures or
' SOB SITE INFORMATION AND LOCATION . ❑E1ess/lighting RV park
• ['Health-care facility ❑Other. '
Job no.; Job site address:, 1 55 _ H fybp ex) l U2. Submit ? sets of plans with any of the above.
tt
City /State /ZIPc, r )r .t i 09— 6 1 7 2.1{- The above arc not applicable to temporary construction service.
: : F•EE* . SCHEDULE :. •
Suite/bldg./apt. no. :043 I - r �, Project namer�v: reLr17 Ouerlodon I Qty. I. pee, I Tnwt I ••
Cross street/directions to job site: ``\. , New residential single- or multi- family dwelling unit. .
VL,tu�;w'�Y� Includes attached garage.
GF- C% C. WC 1 1.000 sq. Rorless j 145.15 4
Subdivision: J Lot no.: Ea. add'l 500 sq, 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
dwelling, service and/or feeder _ 90.90 2
EI.EC._`r(Z c- 140
0 —t:1.P V i % balks It ' Services or feeders installation, alteration, and/or relocation
! 200 amps or Ices 8030 2
sp 7 �� . 201 amps to 400 amps 106.85 2
�ROPERTY OWNER . TENANT . • 2 .
_ 401 amps to 600 amps 160.60
Name:r A�
.K+cet se A� L.LJ.L 44;41 601 amps to 1,000 amps 240.60 • 2
Address: 15 3\64 h p __ •••-r- AVE j 5 2 1 O Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City /State/ZIP: ergz-r/ 7 2-c i Temporary services or feeders installation, alteration, and /or
i C relocation
Phone: (te53) r 51( -- I Fax CO) -& P 5 .3 O 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
APPLICANT COKTACI' PERSON • A. Fee for branch circuits with
. service or feeder fce, each 6.65 2
Business name: 5 t D Ctrl - _,-- ,, U • it : : 4 INC— branch circuit
B. Fee for branch circuits
Contact name: ( ` -L., Z without service or feeder fee, ( 46.85 2
first branch circuit
Address: 15 qQ ', 0 (BI - 6 . Each add'I branch circuit 6.65 2
City/ State/ZIP: IZA • ,. , el . ,S I Q • , Mlsceuancous (service or feeder not Included)
Pump or irrigation circle 53.40 2
Phone: ) 4 i 2,5 Fax :: s) v • - ;; Sign or outline lighting 53.40 2
E -mail: C h 4,4 r✓ . •q ` • n. tES . _ rLI Signal circuit(s) or limited-
_ . CONTRACTOR: energy panel, alteration, or
• -- extension. Describe: Page 2 2
Business name: ` j e �- E V ; c T(7-k 4 —
Address: r s v •� 7� Each additional Inspection over allowable In any of the above —
1' Per inspection 62.50
City/State /ZIP: po1j- L -Lg'C� i) op_ q 7 Z.Gi 4. Investigation per hour (I hr min) 62.50
,.a r Industrial plant per hots J 73.75
Phone: (6c , �6 i Z i ;� Fax: ) �r -- i 7 I ELECTRICAL. :PERMIT
FEES"
l CCB Lic.• Iy gc Ele ctrical Lic.: q(�.,I > Suprv. Lie.: ii 0 5 - Subtotal ( ,
Suprv. Electrician signature, required: Plan review (25% of permit fee)
State surcharge (8% of permit fee) / •
Print name �e - (-, N I Date: a I i ,, l v�
t TOTAL PERMIT FEE r 1 I
Authorized signature: This permit application exppires If a permit is not obtained within I
days after It has been accepted as comptete
print name: Date: • Fee methodology set by Tri- County Building Industry Service Board
Number of inspections per permit allowed.
l: tauilding\Pcrmitr\ELC•PcrmitApv. 12/70/05 440.4615T(10/02/COM/WE8
CITY OF TIGARD
BUILDING DIVISION PERMIT #: El_ C2006- 00121
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/17/200'3
Phone: (503) 639 -4171 pt i
Inspection Requests (24 Hrs.): (503) 639 -4175 _
INSPECTION WORKSHEET FOR DATE: 2/27/2006 TIME: 7:01AM PAGE: 93
SITE ADDRESS: 111(5 SW MEADOW BROOK DR 2 CLASS OF WORK:
SUBDIVISION: WILLOW BROOK FARM LOT #: 014 TYPE OF USE:
PROJECT NAME: SUMMERFIELD APARTMENTS
DESCRIPTION: Unit 2, install service for washer and dryer.
OWNER: SUMMERFIELD ASSOCIATES, LLC, PHONE #: 503 -546 -5712
CONTRACTOR: JET ELECTRIC INC. PHONE #: 503 - 258 -1715
Inspection Request Scheduled For: Date: 2/27/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
12() Electrical rough -in 027588 -02 503-310-7187 N
t °1% FINAL-
Corrections/Comments/Instructions:
P El PARTIAL APPROVAL ❑ CANCEL 111 NO ACCESS
❑ AIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: &• Iv 6 Date: 1 1 2 . 7 (G 6 Phone #: (503) 718- IVA
i r ,
CITY OF TIGARD _
BUILDING DIVISION PERMIT # : ELC2006-.0 0 12 1
. - . 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: . } /171(1()t5
Phone: (503) 639 -4171 4 4+ll iii
Inspection Requests (24 Hrs.): (503) 639 -4175 F_
INSPECTION WORKSHEET FOR DATE: 2'24/2006 TIME: 1:03Am PAGE: 1
SITE ADDRESS: 111 SW MEADOWSROOK DR 2 CLASS OF WORK:
SUBDIVISION: WILLOW BROOK FARM LOT #: 014 TYPE OF USE:
PROJECT NAME: SUMMERFIELD APARTMENTS
DESCRIPTION: Unit 2, install service for washer and dryer.
OWNER: SUMMERFIELD ASSOCIATES, I_L.C, PHONE #: 503 - 546 -5112
CONTRACTOR: JET ELECTRIC INC. PHONE #: 5033258-1710
Inspection Request Scheduled For: Date: 2/24/7006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 Electrical rough -in 027472 -03 503-310-7187 N
Corrections /Comments /Instructions:
❑ PASS ❑ PARTIAL APPROVAL CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 6L. Date: 1 2 1 0 Phone #: (503) 718-