Permit CITY OF TI G A R D ELECTRICAL PERMIT
PERMIT #: ELC2001 -00639
t ,t'li� DEVELOPMENT I
a r S O ERVICES 639 -4171 DATE ISSUED: 12/18/01
13125 PARCEL: 1S133CD-00100
SITE ADDRESS: 11575 SW 135TH AVE 029
SUBDIVISION: SUNFLOWER APARTMENTS ZONING: R -25
BLOCK: LOT : JURISDICTION: TIG
Project Description: Installation of underground power supply for cable TV.
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:
PFI SUNFLOWER LIMITED INC POWER TECHNOLOGY
BY LNR AFFORDABLE HOUSING INC PO BOX 1766
PACIFIC FIRST CENTER BUILDING OREGON CITY, OR 97045
PORTLAND, OR 97204
Phone: Phone: 503 - 657 -0315
Reg #: LIC 129287
ELE 3 -511C
SUP 3575S
FEES Required Inspections
Type By Date Amount Receipt Underground Cover
PRMT CTR 12/18/01 $80.30 2720010000( Elect'I Service
Elect'I Final
5PCT CTR 12/18/01 $6.42 2720010000(
Total $86.72
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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -6699 or 1 -800- 332 -2344.
Permit Signature: (7 042/9 Issued By: ;d� diw jr /
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: C!O - DATE:
LICENSE NO: 3' 75 S
Call 639 -4175 by 7:00pm for an inspection the next business day
Dec 13 01 11:30a Nanc Jones 503 6 5 7 - 0 9 4 2 p . 3
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j& City of Tigard Projectlappl. no.:
Cir , iy , Address: 13125 SW Wall Blvd, Tigoa rt 97 223 Data loved: 1476 I Racelpt no.: I
Phone: (503) 639-4111 ---- -- -- ,
Fa: (503) 598-1960 " . c. - -
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Land use approv 21 : .
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. 0 1 & 2 family dwelling or accessory leCommercinliindustrial 0 Multi-flunily 0 Tenant iraptoverneat ,
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ri ---(7;e--ialE-aloil: 1 1000 sq. it ot len .
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i Name (rint): 201 amp to 400 mope I
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r" 1 401 anaps to 000 WV i - 2
Mailing addlew
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i City: i State: _ I zi.P: 1)v 100G wax or volt: 1
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1 Phitne: _ ---- 1Fax - - I E-rnaii: Ileconnectonty • —._--.1._
, Owner inmanation: The imstalln is beins made on property T0 t Tcsaparary SCrritti Or ream-r
;mutt:sr:co, ae.r.r. 67E-,--te,,w,i.tu I
l which is not intended for sale, lease, rent, or exchange according to
ss
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ORS 447, 455, 479, 670, 701. ZOE) =pt. or 10
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201 ynpn to 400 map/ 2 - 1
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Ownefs signature Date: 401 to 600 ••• 3 L-1....=1 •
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Of extensIon per Pant
Name:
A. Fu. for branch rircoits with purchase. of
i t A.ddress: r.zr::= er feeder re.; mit bmnors etratit I I ______ I_ 2 i
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I City; I State: i ZIP: 9. For. Far:ranch circeio without potcheso 1 I I I
- . or service or rtror billOCh eiretai:
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1 D Scnkc over 3 env-rating of 1 &"?.. M 1 I ocAricn Ezcil sign or outline lightins
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1 $4.14 sacs Gilpin= with any or the azaute. t' investiEatton ft:. 1
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,are) Notice: Ibis pesroit applicati Permit &C . on -
I expire!: iroporrait 13 not obtained' 1
Fliel revivi (at ,,,-- %) ' , . : .-,
t cza 4 -- -,41 ... -- _ ' _:, i__ r..■-' ' l: ' thin MO days after it has been Slat . ( . 4 - - S) •-• .- '' -I . - '....
E..vitt..3
accepted as complete. TOT Fa,
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