Permit CITY OF TIGARD . ELECTRICAL PERMIT
• . ' 4 COMMUNITY DEVELOPMENT PERMIT #: ELC2008-00577
DATE ISSUED: 10/9/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 110DD -06600
SITE ADDRESS: 10650 SW SUMMERFIELD DR ZONING: R -7
SUBDIVISION: SUMMERFIELD NO.4 LOT : F JURISDICTION: TIG
PROJECT: SUMMERFIELD CIVIC ASSOCIATION
Project Description: (3) branch circuits in locker room.
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: 1 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 2 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:
SUMMERFIELD CIVIC DEKORTE ELECTRIC INC.
ASSOCIATION 4115 SE CLINTON ST #1
10650 SW SUMMERFIELD DR PORTLAND, OR 97202
TIGARD, OR 97224
Phone: Contact #: PRI 503- 288 -2211
FAX 503 - 288 -2231
FEES
Description Date Amount Reg #: ELE 34 -54IC
[ELPRMT] ELC Permit 10/9/2008 $60.15 LIC 159954
[TAX] 12% State Surchar 10/9/2008 $7.22 SUP 4075S
Total $67.37 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: 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.
10/09/2008 01:42 FAX 5032882211 , .r. 1 " ,1 Korte Electric, Inc. Z002
- lectnc Arm fication . . -. .Fori OFFICE USE:ONLY: ' ' . ' : • : ' '•
-r !
a Tigard, OR 9722 Millrff it o ilrAirli Perm N '
A - / Sj 7
13125 SW Hll Blvd.. 30CV,/ , Plan Review
' 1 Pltonm 503-659.4171 Fax: 503.598.1 0 i (VI Eleetal: Other Permit.
9:•i c,..;,..;.i;.;6 InsPO: I40e: 503.639.4175 % Va DOG Ready,Sy: et Ste Page 2 tor
. " friteaut. wwwrisani-or.ov .\ S
, as Ofiftalltstolhoct , Supplemental Information
t ,_ vsortm —
:' '' 7f*, 14 ., V;ig:::::::1,).):' LY:)•:‘::.:.',!'!...!k>.f40g41*..411‘,V401:t!i?".7.:'
0 New construction Ai O
Additionin" A 1 . ' PIC= du& 411 dui 444 (sMultil Islas pilau. ' ducked beld4
ID Danolition 1:1 ookcr , ck\Q'k)
0 SaViCC at taLla 400 amps or room 0 Building OVI2r dime st,tini.
attar tbe available !auk ammo Cl Mariaas in boatyura,
t"..14. , :;i , 1■ , i, 5 'il.`44'..Y 7 :i.,: . : 15 ;';3;; ,. tkitekiiii . ,,t;:iit./.....iikttiiif .; , 04,-, .,,t ....-ds 10,001i amps ar isu votes or 0 Floatiog buildings,
lac to ground, or asreerks USW 0 Coustaaicis&osc agricultural
0 1- and 2-family dvA:iling ACommaciaLindus-trial 13 Accessory building rays fix Al oil= iostallationc beoldinas.
0 Mulli-fumily 0 Master Wilda- 1:1 Other O= pomp Ci Inciallarioo of 75 KVA or
larger sA:Ca:arty deriv:d sysiem
i iA .•- i:?? , . , :gg,i'igig , V , ;: . 4. 0 * : *0. 4 .. , 4**,X1*.i.'.**<*.0.0** . K:6:; , ; , ..?...,' , , , : , 6,',.'A:;::::ic:sY,', E=F s sa load of 0 A - 1-2". - 1-3"
Job no,0 8. Sp ! Job site address: i rx 50 $ • % C 1001iio or mar.
s - I( . )11471 Tit-ler-lipid ..- os, or snore resitleariat units. 0 atzererafonal vehicle pidks.
City/State/ZIP: --- 0 ea-c
9 i f d •• ..-. ,P Hlthare faeilialiN. Supply voltage f or loo t a ham
600 VOW Ilatuilad.
Suite/bldg./apt no.: . Project nanse cr ''( A il t ;,. °Semen or (nailer 600 amps ur moo:.
, ..L : ,:::ii,;!:;,' ..,C.: lEE: E7 SE 5 . E. 1 filLE'i:iP ;!.: :. z;,V
Cross atectidireetions to job s itel .., 11117501 Tossl 1 •
New resideotivl sank- or roulti-tamAy dwelling unit.
Includes attached garage_
Subdivi..4oa: i Lot no I,000 sq. IL or less i45, 15 4
no.:
, Ea- add 500 sa. ft. or portion 33.40 1
Tax amp/parcel ...
Limited imam residential
;.';‘.•:•Flrgki.i. g .'1:41..:40 :Kajf 10 .k4 00 r. 40 . 1 , 4 *!. t .:i . :wtoligav:::N: i !. ;? :;it : ;:', , ,u: - :ig . W::. , 3'.:: , --a-1 ....... 75.00 2
- Limited ascrgy, multi-family
____ezrArz___ C.4? .C“../4 1.4/1 9 .—Z... ,C risidrauial faith alio= sq. fc) 75.00 2
Services or feeders insullation and/or relocation
OM -
200 amps or 1ms , 8030 r 2
#Y:4'49)P4..00..01 201 amps to 400 amps 106.85 I 2
t ,
401 amps to 60V amps .160.60 2
SIA.4-n,vierie14 CAA/ ie.. kS5bC-4.402-74i0-K 601 amps co 1,000 amps 24_60 2
Address; .
,
Over 1000 amps or woks 454.65 2
—
0131'51=r/1P: Temporary services or feeders installation, aeration, sonUor
relocation
Phone: ( ) I Fav: ( ) 200 amps or 1ms 66.85 1
OWIltr installation: This imaallation is being mall.- on property th I own w hi c h i not 20% =Os to 400 amps 100.30 2
intended for sale, lease, rem, or exchange, according to ORS 447, 449, 670, and 701_ 401 =Fs co 599 =Pt . 133.75 2
Branch circuits — um, alteration, or curnsion, per panel
Owner signature: Dale:
A. Fcc for brands drags with
, 2
F 0504:0 :004 abovc senicc or recd fccr .
6.65
cads branch circuit
Business name:
13. Foe for branch circuits
without service Or 1 - 0 : 0 ct rce 1 46.85 yi
Contact name:
2
first branch circuit •
Address: Each addi branch circuit 2 6.65 /3. 2
Miscellantsons (service or feeder not included)
City/StateiZIP:
Each ntanuLlctured or modular ,
90,90 2
ds...2,11in =Tice andlor ftsedcr
Mont: ( ) Fax: : ( ..1
Reconnect only 66.85 7--
2
E-mail: Pump or irrigation circle 53.40 2
;:,.)'.0,1tOlti1471 Sign Of OWE= lighting 53.40 2
Signal circuit(s) or limited-
, Business ma= DriCorte Electric, Inc..
energy panel, alteration, Of
Address; 4115 SE Clinton Si_ 01 extension. Describe: Page 2 2
City/StateiZIP: Portland, OR 97202 • Each additinnal inspection over allowable in arty of She above
PC1 inspcction 6250
Phone: (503)283-2211 I Far: (503) 233-2231
lovestigatiou per h tu rn
our rt iro 1 62.50
I ,
CCB Lie.: 159954 425% of permit fee)
I &f/4
Electrical ' '_- 34-541C I Suprv. Lie.: 40755 -! Industrial prima per hour 73.75
'''.....:'.Nt
'..,i
I .
Suprv. Electrician signature, required:
&thit ( 10 Cso
i' min" :
Prim name: Ken Dek.ette Date I 0 • 0 ; Pim
State surcharge (l2% orpemiii fee): I I. W
. Authorized signature:
TOTAL PERMIT FEE: 1 1 0 , ) 0
_ _
This penult application =pints an permit is not wing:nod within ISO
i Print name: Date. after it as bobs ZEirp4cd as cosopktr.. .
•
CITY OF TIGARD BUILDING DIVISION PERMIT #: ac2008 -00577
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10i9/" ►.;�
Phone: (503) 639 -4171 ���� ILI
Inspection Requests (24 Hrs.): (503) 639 -4175 L.
INSPECTION WORKSHEET FOR DATE: 11/24/2008 TIME: 7:02AM IIIIIV 7
SITE ADDRESS: 10650 SW SUMMERFIELD DR CLASS OF WORK:
SUBDIVISION: SUMMERFIELD NO.4 LOT #: F TYPE OF USE:
PROJECT NAME: SUMMERFIELD CIVIC ASSOCIATION
DESCRIPTION: (3) branch circuits in locker room.
OWNER: SUMMERFIELD CIVIC, PHONE #:
CONTRACTOR: DEKORTE ELECTRIC INC. PHONE it 503.288 -2211
Inspection Request Scheduled For: Date: 11/24/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 078442 -01 503.516 -1566 N
Corrections /Comments /Instructions: j
SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED .
Inspector: Date: /(— Z / cP Phone #: (503) 718- _______Ili____
CITY OF TIGARD - `-.'
BUILDING DIVISION PERMIT #: El C2008.00577
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/9/2000
Phone: (503) 639 -4171 �9 ����
Inspection Requests (24 Hrs.): (503) 639 -4175 �' � __..
INSPECTION WORKSHEET FOR DATE: 10/14/2008 TIME: 7:00AM PAGE: 19
SITE ADDRESS: 10f50 SW SUMMERFIELI) DR CLASS OF WORK:
SUBDIVISION: SUMMERFII=LD NO.4 LOT #: F TYPE OF USE:
PROJECT NAME SUMMERFIE1D CIVIC ASSOCIATION
DESCRIPTION: (3) branch circuits in locker room.
OWNER: SMMERFIELD CIVIC, PHONE #:
CONTRACTOR DEKORTE ELECTRIC INC. PHONE #: 503 2$8„ ?211
Inspection Request Scheduled For: Date 10/14/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
125 . Wall over 076661 -01 503.516 -1566 Y
Corrections /Comments /Instructions:
L
0 '
` ,r-o w►,.. CLw , `�'(V e w. A ce P cJ
r 1 4 Cl: a CA4-y,4 6_`( 100_, r./4 p _ge-/%e-c-ij
....k-riis ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 10 --(7 -p Phone #: (503) 718-