Permit A- - CITY O TIGARD PERMIT
PERMIT #: ELC2002 -00034
.
DEVELOPMENT i
E r So R9 (503) 97223 39 -4171 ICES DATE ISSUED: 2/5/02 Hall PARCEL: 1S133CA-01200
SITE ADDRESS: 11431 SW 135TH AVE UNITS 166 -174
SUBDIVISION: SUNFLOWER APARTMENTS ZONING: R -25
BLOCK: LOT : JURISDICTION: TIG
Project Description: Underground power and 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 Elect'I Service
PRMT CTR 2/5/02 $80.30 2720020000( Elect'I Final
5PCT CTR 2/5/02 $6.42 2720020000( , , MED
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
Permit Signature: A51, g Issued By: „ Ar
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: CT) Cc _1(2.1 DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
Jan 29 02 09:47a Nancy Jones 503 657 -0942 p.1
r , 5.
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Electrical Permit A lication EC . . .
EC VED Date received: / a9 0a) Permit no.: E&t. to.2,r6003
' rdti ) f ;. m e.
1=': l it City of Tigard Projectlappl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, 2 99200 Date issued: By: Receipt no.:
Phone: (503) 639 -4171 A IV
Fax: (503) 598 -1960 ,ii: ca8 g o, fl Case file no.: Payment type:
Land use approval:
TYPE OF PERMIT ;
0 1 & 2 family dwelling or accessory Cg(Commercial/industrial 0 Multi- family ❑ Tenant improvement
0 New construction ❑ Addit ion /alteration/replacement 0 Other: ❑ Partial
JOB SITE INFORMATION .
Job address: fit`
1 `jt3 � �il) (r' � Bldg. no.: Suite no.: Tax map/tax lot/account no.:
Lot: I Block: Subdivision: Ac ee.../:, -13
Project name: R}.t al lahck BCxe.:.3 Description and gcation of work on premises: (Ali c, el el retold. et _.
Estimated date of completion/inspection: ' . • 0 (1' ' • f TV
t �""_ c
CONTRACTOR APPLICATION • FEE SCHEDULE
Job no: (O ) - )3 Fee Max
Business name: POW
Li ^, T� C. no �iJ ;_i '���G :. Description Qty. (ea) Total no. insp
1 Newresidential -single or multi - family per
Address: ID c) 60) t1(O�r dwelling m t.Includesattached
City: (Urec.lbvi Ci+- I State: c I ZIP: 11u-in Serviceincluded:
Phone: (.p51 - D ,- i 5 I Fax(ioSi - O c e - al E -mail: 1000 sq. ft. or less 4
1 I Each additional 500 sq. ft. or portion thereof
CCB no.: I I Elec. b us. lic. no: 3 - 5 ( (�
Limited energy, residential 2
City metro lie. no.: 0000 5((") Limited energy, non-residential 2
- :// • n 1A 4 i l O f 0 Each manufactured home or modular dwelling
Signature of supervising le trician (required) Date i ( Service and/or feeder 2
Sup. elect. name (pnnt): l : /- a t u .0 License no* S Servicesorfeeders— installation,
alteration or relocation:
PROPERTY OWNER 200 amps or less I 3 O.3 2
Nance (print): 201 amps to 400 amps 2
Mailing address: 401 amps to 600 amps 2
601 amps to 1000 amps 2
City: I State: I ZIP: Over 1000 amps or volts 2
Phone: I Fax: 1E Reconnect only I
Owner installation: The installation is being made on property I own Temporary services or feeders -
which is not intended for sale, lease, rent, or exchange according to ��llation ,alteration,orrelocalio t +
ORS 447, 455, 479, 670, 701. 200 amps or less i " ' 2
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 amps 2
ENGINEER Branch circuits - new, alteration,
Name: or extension per panel;
A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: I State: 1 ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, fiml branch circuit: 2
Phone: Fax: E-mail: Each additional branch circuit:
`- " PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included):
0 Service over 225 amps- commercial U Health -care facility Each pump or irrigation circle 2
U Service over 32U amps - rating of 1&2 Li Hazardous location Each sign outline lighting 2
family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
U System over 600 volts nominal more residential units in one structure alteration, or extension* 2
0 Building over three stories U Feeders, 400 amps or mom *Description:
0 Occupant load over 99 persons U Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
U Egressllighungplan Cl Other. Per inspection I ( I (_
Submit sets of plans with any of the above. investigation fee
The above are not applicable to temporary construction service. Other
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'Not all jurixlictioas accept credit cards, please call jurisdiction for more information. Notice: This permit application
Permit fee $ 80. 30
O Visa [(MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit .: , number: 6H 1(o 9111 1CO5 (a 59 01/ /tT} within 180 days after it has been State surcharge (8 %) .... $ (..o 4 ` Z.
• t �i ...ft. - Expires accepted as complete. TOTAL $ . 8(r�, 7
i [;te of o older as shown on credit card
tm , ...iL_ 4-- $ )94 72-
` C .holder signature Amount i 440 - 4615 (binn /COM)
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