Permit I, it
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CITY OF TIGARD ELECTRICAL PERMIT
° i PERMIT #: ELC2008-00602
' COMMUNITY DEVELOPMENT DATE ISSUED: 10/24/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S11ICD -01700
SITE ADDRESS: 15641 SW SUMMERFIELD LN ZONING: R -7
SUBDIVISION: SUMMERFIELD NO.7 LOT : 348 JURISDICTION: TIG
PROJECT: BREHMER
Project Description: Panel upgrade.
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: 1 W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 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:
DARWIN BREHMER ALL AMERICAN ELECTRICAL CONTRACTORS
DIANE SMITH PO BOX 1426
15641 SW SUMMERFIELD LN GRESHAM, OR 97030
TIGARD, OR 97224
Phone: Contact #: PRI 503 - 657 -4351
FAX 503 -496 -3995
FEES
Description Date Amount Reg #: ELE 26 -1144C
[ELPRMT] ELC Permit 10/24/2001 $80.30 LIC 152990
[TAX] 12% State 10/24/2001 $9.64 SUP 4731S
Total $89.94 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
suspend or more thalr 80 •a . ATTENTION: Oregon law requires you to follow rules adopted b the Oregon Utility Notification Center.
Those ules are set forth in .AR 9 • =101 -0010 through OAR 952 -001 -0100. You may obtain i of hese rules or direct que t OUNC at
503. 6.6699 or 1.800. , ,` ' P ermittee Signatu • �
Iss d By: �. f •
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: ' ' / / ter ; i 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.
Electrical Permit Application 1 i ,(> I I I k I i\ I 1(
City of Tigard RECEIVED Received Permit No.:
Plan /A �y GI A OOp "Gi0(UO
'� 13125 SW Hall Blvd., Tigard, OR Phone: 503.639.4171 Fax: 503.598.1960 1 2008 2008
Date/By: Other Permit
Inspection Line: 503.639.4175 Q C T 2 4 D R 1 H s« Page 2 for
Internet: www.tigard-or.gov Notifed/Mahod: (� I S�pkoeutai Id
TYPE . OFrC r �tE1 0TIGARI�
❑ New construction Addition tPe0 Please etc all that apply (submit j sets of plans w /items checked below):
❑ Demolition Other: 0 Service or fender 400 amps or more ❑ Building over three stories.
where the available fault current 0 Marinas and boatyards.
. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 0 Commercial -use agricultural
',.1 and 2- family dwelling ❑ Commercial/industrial 0 Accessory building arms for all other installations. buildings.
Multi- family ❑ Master builder 0 Other: 0 Fire pump. 0 Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION O Emergency system. larger separately system.
❑ Addition of new sneerer load of ❑ "A" "E E ". . "1-2", "l.3"
-2 ". "l a ".
1 I J i� 100HP or more. occupancy.
Jots no.: Job site address:
! S (% LI I -S : `'l Y •• S i.:1/4 i+1, 1111Fv Fit L ri ❑Six or more residential units. ❑ Recreational nal vehicle parks.
City/State /ZIP: ` Z Z ' ❑ Health-care facilities. ❑ Supply voltage for more than
.) - _ v c. l / ('> 62- -? D Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name jQ � d il../ek Sit/ / 7i/ 0 service or feeder 600 amps or mare.
FEE SCHEDULE .
Cross street/directions to job site: Description I Qty. I Fee. I T.w 1
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft or less 145.15 4
Tax map/parcel no.: — Ea. add'I 500 sq. ft. or portion 33.40 I
P Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) r 75 2
Limited energy, multi - family 75.00 2
f) O '�- wt. ft /4& l l,L f C) Vr4G(.Q residential (with above sq. ft.) ,
Services or feeders instaWtion on, and/or relocation
200 amps or less i 80.30 86 , 3 6 2
0 PROPERTY OWNER I ., 0 TENANT 201 amps to 400 amps 106.85 2
Name: 0El r t. `U .tl0Hf2 N — Dr /t,t.) f oN G _ 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: i ict q I At Hi-MI6 g , , -.A.J Over 1,000 amps or volts 454.65 2
City/State /ZIP: �ee /H2 b c:12_ 47 7 2-21 Temporary services or feeders Installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not _ 2 01 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 599 amps 133.75 _ 2
Owner signature: Date: Branch circuits- new, alteration, or extension. Qtr panel
A. Fee for branch circuits with
❑ APPLICANT l ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
. Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
first branch circuit
Address: Each add'1 branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle _ 53.40 2
. CONTRACTOR Sign or outline lighting 53.40 2
' 641`% L ieCi !2 r � A (• , Signal panel, or alteration, limited.
Business name:
11 •- W Lid Iz�L2 > �� ( C (,(� l F ti S energy panel, alteration, or
e xtension. Describe: Page 2 2
Address: - P, (f) , T-3 �� / 471 ? ‘; _
City/State /ZIP: v Gi 4-2,--1 C9 GL . 703 > Each additional inspection over allowable in a of the abort
Per inspection 62.50
Phone: (S 3)) () 5 7- 3 I 'I Fax: (�d3) ._ f�/ 9(4 —3(i9 5 Investigation per hour (1 hr min) 62.50
e Steic.: i , 2 ci k 0 I Electrical Lic.: Z c _ J y4 ( Suprv. Lie.: `t 7 3 -5 Industrial plant per how 73.75
p Electhcian signature, required: �' ) /f / i I o ELECl7tFCA1' PEItII FREE 7 • r✓ , ylfri/ w % may , - Subtotal: pQ�, 30
V 1
Print name: b . \
� t ., („ �
- 1 yiA� ', Dat % c/, / � c � Plan review (25 %ofpermnfa): , i
il / t G% State surcharge (12% of permit fee): Ct a (e
Authorized signature: "/ ' F� / TOTAL PERMIT FEE: ,...,OCI 9 y
v✓ 1.,..:. c i Tots Perm* appBeabon expires ifs permit In sot obtbed maths 150
Print name: (., (. ,:, t l + v Li,2 / let et I Date: 1 e / / J y/Q L days after It has been acc pled as complete.
/ ! • Number of inspections allowed per permit.
I: \BeiWing1PenoitslELC?ermitApp.doe 05/23X16 440-4615Tn1/05/COMAVE.B
Z00 0 NVDI131V 11V ELb6T66£0S XVd ZO:80 8002 /t'Z /OT
CITY OF TIGARD
BUILDING DIVISION PERMIT #:
EL C2008-00602
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/44/4008
Phone: (503) 639 -4171 � � j � I
Inspection Requests (24 Hrs.): (503) 639 -4175 `_..
INSPECTION WORKSHEET FOR DATE: 10/30!2008 TIME: 7:00AM PAGE: 28
SITE ADDRESS: 16641 SW SUMMERFIELD LW CLASS OF WORK:
SUBDIVISION: SUMMERFIELD NO.7 LOT #: 348 TYPE OF USE:
PROJECT NAME: BREHMER
DESCRIPTION: Panel upgrade.
OWNER: BREHMER, DARWIN — 'A� ' PHONE #: 603. t0.SQ •
CONTRACTOR: ALL AMERICAN ELECTRICAL CONTRACTORS Gf(ECr PHONE #: 503.657 -4351
Inspection Request Scheduled For: Date: 10/30/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
1 o .r - - - ice 077345-01 503849 -9146 Y
(3 1 Ct ections /Comments Instructs I ns:
\ - ' ' -
\ ' ' ■
E K ,' j ‘‘' I 1 i \ \\
PAS ` ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
• FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G'' N Ve . Date: 1 0 di Phone #: (503) 718- al-pc,
City of Tigard, Oregon Page 1 of 2
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I Search 11 Property I I Planning I Crimes I Transportation [II Utilities I Aerials I EOC I
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15641 SW SUMMERFIELD LN
Property Summary
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Property Owner Info
Tax ID Number: 2S111CD01700
Tax Account Number: R507099
Site Address: 15641 SW SUMMERFIELD LN
Site City:
Site ZIP: 97224
Owner: BREHMER, DARWIN S &
Owner 2: SMITH, DIANE F
Owner 3: 15641 SW SUMMERFIELD LN
Owner Address:
Owner City: TIGARD
Owner State: OR
Owner ZIP: 97224
Acres: 0.10
Sq Ft: 4,356.0
Bldg SF: 1,356.00
Bldg Value: $ 89,430
Land Value: $ 222,080
Total Value: $ 311,510
http: // tiggisiw /mox52_multimap /index.cfm ?fuseaction = property. summary&CFID = 40029 &CFTOKEN =... 10/28/2008
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2008 -00602
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/24/2008
Phone: (503) 639 -4171 , : , ;Iii { II
Inspection Requests (24 Hrs.): (503) 639 -4175 - F-
INSPECTION WORKSHEET FOR DATE: 10/28 /2008 TIME: 7 :01AM PAGE: 3
SITE ADDRESS 15641 SW SUMMERFIELD LW CLASS OF WORK:
SUBDIVISION SUMMERFIELD NO.7 LOT #: 348 TYPE OF USE:
PROJECT NAME BREMNER
DESCRIPTION: PaHiel upgrade.
OWNER BREHMER, DARWIN PHONE #:
CONTRACTOR: ALL AMERICAN ELECTRICAL CONTRACTORS PHONE #: 503- 657 -4351
Inspection Request Scheduled For: Date 10/28/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
115 Electrical service 077231 -01 503 - 849-9146 N
Corrections /Comments /Instructions:
e A AS t-0 Z p ()ca ci
to LLEO 03 %9c 9141
Lot L.L4 kz- 6 c-6th u f_
. )
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL %.4
)k,AIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: CEr IV it% Date: I 7- a4 Phone #: (503) 718- 2114(0