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Permit V . 44 CITY F T'IGAR ELECTRICAL PERMIT f. COMMUNITY DEVELOPMENT Permit #: ELC2010 -00021 ,e t "y Date Issued: 01/13/2010 T It, `ai 13125•SW Hall 'Blvd., Tigard OR 97223 503:639.4171 Parcel: 2S110AB00400 Jurisdiction: Tigard Site address: 14300 SW' AVE 7 Subdivision: THE COLONIES APARTMENTS Lot: 0 Project: The Colonies Project, Description: Reconnect only Owner: FEES HOUSING AUTHORITY OF WASHINGTON Quantity Description Date Amount ATTN: HENRY ALVAREZ, 111 NE LINCOLN STE #200L 1 ea Reconnect Only 01/13/2010 $67.84 1 ea 12% State Surcharge - 01/13/2010 $8.14. PHONE: 503 - 846 -4794 Electrical • Contractor: PHONE: FAX: Type:of Use: MF Class of Work: ALT Type of Const:' Occupancy Grp: • Total $75.98 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done ccordance —with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days ATTENTION: Oregon =law r- • . res you to follow the . rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR • 95 - 001 -0010 through OAR 952 -0b 1100 Y• may obtain a copy of the rules or direct questions to OUNC by calling 50 46:6699 or 1.800.332.2 44 -, Issued By: // Permittee Signature: \ _44_1 �.� �� 6 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' 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 "' ` ° FFIC E. k,SF ON Li" 'FOR O Received ® i 0 city Of Tigard Re e iv . Pennrt No.: O a: 131 5'SW: Hall Blvd., Tigard,'OR 97223 Plan Review I N °' Phone: 503.639.4171. Fax: 503.598.1960 Other Permit: Date /B : . T I GA RDN Inspection Line: 503.639.417 Date Ready /B Ju y: r is: la See Page T,for 1nternett www.tigard=or.gov Notified/Method Supplemental; Information TYPE QF WORKS � 1 : E � r tPLAN RE IEW 1 1 Please c heck all That apply (subm 2 sets of p w /hems checked b elow)_, ❑ New construction ❑ Addition /alteration /replacement ❑Service or feeder 400 amps or more ❑ Building over stories. • ❑ Demolition Other'W e,r haS been ofd V e Le m where the available fault current ❑ Marinas and boatyards. xi 51r l OA OE O©NAIZUOTION `n� k rt t exceeds 10,000 amps at 150 volts or ❑ Floating buildings. " " less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ 1 - and family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings. j4 Multi family ❑ Master builder ❑ Other: ['Fire pump. ❑ Installation of 75 KVA or r e Igenc fsy larger Separately d d system. ❑ - system. 1 „rive � JOB SITE INFORMATION . AND LOCATIO N ' � El Add1 ion o n w m otor l o f ❑ ` "E `1 -2 " "1 -3" ��t�R ns.dxx, nrn,,..,s. , , a , , , ....,. �:: .. . ... . .... .. ...... .... ,, _ ,, , - " \ r Job no.: • Job site address: 14300 SW '11241 Nye • 4-6 -1- 1001 -IP or more. occup ❑Six ormore residential units. ❑ Recreational vehicle parks City /State /ZIP: - 11gor� t o1. 1 7 2Z4 • ❑ Health -care facilities. ❑ Supply voltage for more than Jj ❑Hazardous locations. 600 "volts nominal. Suite /bldg. /apt. no.:. 6.- Project name: — r he__ le__ Cal o niec ❑ Service or feeder 600 amps or more „ , ,FEE SCiIEDUL.` E . cF . . Cross street/directions to'job site: Gaard6 i q( \ f , 4— GG Description 1 Qty. 1 Fee + 1 1 Total 1 1J f 1,, _ ' tt New residential single- or multi - family dwelling unit. ;�-�/� V ” 1 1 . th ) /'Z bliX -�lL.. . Cp1,6Yi.t.c>s Includes attached garage. 1 Subdivision: Lot no.: 1;000 sq. ft. or less 168. 4 Ea. add'l 500 sq. ft. or portion 33.92 1 Tax map /parcel no Limited ener 67.84 2 • DESCRIPTION 1OF 3 WORK 1 Y ir ` _ (with above g q_ f jidential i < ,.,,,� t i4l tea- ,.', ..._... . ; '' . . (, f ' L Limited energy, multi-family 67.84 2 1 ns pax - rim I-t : have, J r Jer — 1 4 riiG 40 Ca, I residential (with above sq ft.) Services_or feeders installation, alteration, and /or relocation ` P6 200 amps or less 100:70 2 F .t f> €. 00:6 ERliNti NER F , It , [ ;_. a s a TE NANT , : , „ N _ i _� ; , , 201, amps to 400 amps 133.56 2 Name: ` -�` /. I'- fin (..71 !"1i ! I o us I1�c h1-h 401. amps to 600 amps 200.34 2 �yQSYIIr J 60Lampsto1,000amps 301.04 2 Address`. i1 NE 1eb h , MS Lt 3 Over 1,000 amps or volts 552 2 • 5, • ei ZO _ 1 1 Temporary services or feeders installation,'alteration, and /or City /State /ZIP: ' ( itsbaro 1= 12 724 relocation ' Phone: (5D% )&410 _ 41cti Fax: (503) MU) —4 -1q5 - 200 amps,or less 59.36 1 Owner installation.T l is:,histallation is being made on property that own which is not 201 ,amps to 400 amps 125.08 2 intended for sale, lease,, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2 Branch •circuits— new, alteration, or extension, per panel Owner signature 41,41 06, ' Date: I/04 / 10 Fee for br anch circuits w e A . with i i _' - �A PP L I C A N T� � s �.- K , c PER above service or feeder fee b , � .. •-, ,,.,.,�� ,.� � ., 7.42 2 . each branch circuit Business The Cr) 1 t11 1 e5 B. Fee for branch circuits Contact name: Car I1 without service feeder tee, 56.18 2 . t 1 , first branch circuit Address: 1 4210 O 514 1, 2 t.h Each'add I branch circuit 7.42 2 Miscellaneous (service or feeder not included) City/State /ZIP: , I Each manufactured or modular �l rG� t O 1� 1 1 '229 67.84 2 dwelling, service and /or feeder Phone: (53 ) C Fa ( ) t D (a` 740 Gj ba3 tog 1 - 8T'31 Reconnect only 67.84 &? g i t 2 E -mail CO,�;p,I�11eS --Cl Pump or'irrigation circle 67.84 2 ptse comcas� n -ct CONTRACTOR t ' t ? S outl l 67.84 2 r „ .., � �,i � w,.....,.. ' ., _sr xis,,. Business narrte: - Signalcircuit(s) limited- ircuit(s) or limi energy panel, alteration, or Address: extension. Describe: Page 2 2 City/State /ZIP: Each additional, inspection over allowable in any of the above Per'inspection 66.25 Phone: ( ) Fax:( ) Investigation per hour (1 hr min) 66.25 CCB Lic.: Electrical Lic.: Suprv. Lic.: Industrial plant per hour 78 18 g ELECTRIOAL. PERMIT.FEES s ,6 . ,��f Suprv. Electrician signature, required: Subtotal: 6 el Print :name: Date: Plan review (25% of permit fee): -a State surcharge (12% of permit fee): 3, ref Authorized;signature: TOTAL PERMIT FEE: 75--. 9 g This permit application expires ifa permit is :not obtained within 180 Print name: Date:' days after it has been accepted as!complete. * Number of inspections allowed per pennit. 1: i Building \Permits\ELC- PermitA15p.doc' 10/01/09 440- 4615T(11/05 /COM/WEB