Permit ..CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00128
�I��i D EVELOPMENT SERVICES DATE ISSUED: 2/17/2006
•
` --- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S110DD -00109
SITE ADDRESS: 11053 SW SUMMERFIELD DR 2 ZONING: R -25
SUBDIVISION: SUMMERFIELD APARTMENTS LOT : 013 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: 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 1 -8 44. _
Issued By: � 332 - , Permittee Signature: / • I - .
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 R1002
E1earial Permit Application FOR 01 F IC:E USE ONLY
City of Tigard Egipl l 0 0 A' 0 PermitNo.: , L.,4 1 0f9 0 0 Vii
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Other Permit:
Phone: 503.639.4171 Fax: 503.598,1960 4�k"��`ifi t I '''‘ Date/B
inspection Line: 503.639.4175 _Wile, •''f .. Date Ready/By: BI Sec Page 2 ter
Intern= www.tigard- or,gov Noti fied/MCthed: Supplemental information
• ; : ; TYPE . OF. • , • ... .. . . • K LAN :
REV.IEW::
•
❑ New construction ❑ A •tion/alteration/replacemcnt Please check all that apply.
Other.
['Service over 225 amps, comni'l ❑Hazardous location
❑ Demolition
_ ❑Service over 320 amps - rating ❑ B ft., uildng over 10,000 sq. .,
" • • . CATEGORY' OF CONSTRUCTION • : _ ' .:i :: ' " • of 1- and 2- family dwellings 4 or more new residential
•
❑ l;plad 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
Igkulti-family _ ❑ Master builder ❑ Other ['Occupant load over 99 persons DManufactured structures or •
JOB SITE INFORMATION AND LOCATION - ❑Ey�ess/lighting plan RV park •
• ['Health-care facility ❑Other: .•
Job no.: Job site address: l 10 63 N. NM tL ti b DIG Submit 2 sets of plans with any of the above.
•
City/State /ZIP (& ,- td , . C a, • The above arc not applicable to temporary construction service.
-
: FEE . SCHEDULE; . .
Suite/bldg. /apt. n 0.:(,0i•r , Project name:C_ . ' �� 4,4‘ e e Description n qty. . are. To,.l ••
Cross Street/directi0.ns to job site: u h A �- ttca c.),,., Y` New residcntial single - or mold- family dwelling unit.
includes attached garage -
O C:- Wc1_ "- 1.000 sq. it or less 145.1$ 4
Subdivision: Lot no.: Ea. add'I 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
pp dwellin • , service and/or feeder 90.90 2
G Tom, i-P via- 0 1 Cd03 t18' Services or feeders installation, alteration, and /or relocation
200 amps or Icss 80.30 2
• „ ----:r-•'' - 201 amps to 400 amps 106.85 2 •
•
f!] • ROPERTY: OWNER . 0 TEN , . „:
401 amps to 600 amps 160.60 2
Name: &a... t ap 'gip , .. M i.i.C. Y`' 4c.... ki, 601 amps to 1,000 amps 240.60 2
Address: �� _ Over 1,000 amps or volts 454.65 2
15 , 1F-�' t �� + tie ' 1 - o Reconnect only 66.85 2
City/State /ZIP: 'R , e. c Amp d-. 72.0 1 Temporary services or feeders installation, alteration, and /or
relocation
Phone: (t fj) ,r t , - 5 i 2..• Fax: 01)) : ° - 3 200 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
w APPLICANT CONTACT PER • A. Fcc for branch circuits with
service or feeder fce, each 6.65 2
BUS' ness name: branch circuit ic, B. Fee for branch circuits
name: Contact / J♦ L -
without service or feeder fee, ( 46.85 2
fi rst branch circuit
Address: 1.5 qo 52., Ne. (51 - 4.. A 6 • Each add'I branch circuit ( 6.65 2
City /Stace/Z1P:Q�e
9t , 2--- Miscellaneous (service or feeder not Included)
i Pump or irrigation circle 53.40 2
Phone: (�) Z yilf\--
x:: OGS) . _ ', �; Sign or outline lighting 53.40 2
E -mail: C h44 (✓ ` . _ _ . E: • n. - t (. tcs • . rte Sidra] circuit(s) or limited-
CONTRACTOR: energy panel alteration, or
extension. Describe: Page 2 2
Business name: E ■2�Cr
Address: b Each additional Inspection over allowable In any of the above
i' ii • 0 7� Per inspection 62.50
City /State/ZIP: 'I) Cj i • Investigation per hour (I hr min) 62.50
L�ty : Op_ I � C1 industrial plant per hour 73.75
Phone: A6 C (
' ELECTRICAL. :PERMIT •FEES*
CCJ3 Lie.: 1,4 g e l Subtotal 2 , g �
Suprv. Electrician signature, required: ��tir Plan review (25% of permit fee) tY1
State surcharge (8% of permit fee)
Print name. , t1E'n-E u - 1 i Date: a 1E.-; 04, TO AL PERlv111' FEE 9
4�
Authorized signature: This permit apptiratioa expires ifs permit it not ohm ued rvlthin
days after It has been accepted as complete
Print name: Date: • Fee methodology set by Tri-County Building Tndusny Service Board
Number of irupectioes per permit allowed.
1; \Building\`cm,iis \ELC•Pcrmit up.dee 12/50/05 440-4615T(10/02/COMIWCO
CITY OF TIGARD EZ-C_ Q/
BUILDING DIVISION PERMIT #: 2-066. — )/ O
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 j1
Inspection Requests (24 Hrs.): (503) 639 -4175 ..
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: / / 5-3 Q � r CLASS OF WORK:
SUBDIVISION: LOT TYPE T E OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3 - (o - o ( Pour Time:
Code # Inspection D,�scription Confirm # Contact # Message
( o -� �. 3/6 F7
` reons /Comme is /Ins ctipns. S C \ e NAL.
/A A
9,
X PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
G "8 L ‘
Inspector: Date: 3 i oi Phone #: (503) 718 -4