Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2002 -00066
l � DEVELOPMENT SERVICES DATE ISSUED: 2/20/02
I
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S 104BA -08500
SITE ADDRESS: 13755 SW LIDEN DR
SUBDIVISION: CASTLE HILL #2 • ZONING: R -25
BLOCK: LOT : 120 JURISDICTION: TIG
Project Description: Installation of underround 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:
WILLIAMSON, J L + CHRISTY M POWER TECHNOLOGY
13755 SW LIDEN DR PO BOX 1766
TIGARD, OR 97223 OREGON CITY, OR 97045
Phone: Phone: 503- 657 -0315
Reg #: LIC 129287
ELE 3 -511C
SUP 3575S
FEES Required Inspections
Type By Date Amount Receipt Rough -in
PRMT CTR 2/20/02 $80.30 2720020000( Underground Cover
Elect'I Service
5PCT CTR 2/20/02 $6.42 2720020000( Elect'l Final
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: 6-- � , Issued By: azziaa ,
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: () 6 (r) - 4 re ar° -C.( DATE:
LICENSE NO: 5 -�
Call 639 -4175 by 7:00pm for an inspection the next business day
Feb 15 02 11:54a Nancy Jones 503 657 -0942 p.2
.4.- Electrical 'tA li n
Date received: 1/� - �. V Permit no. - p00 Ci of Ti d C E ��
,�1,�;' 11 ' , City Tigard Projtxt/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Bjt�ig�rd. IA10223 Date issued: By� 1 Receipt no.:
Phone: (503) 639 -4171 r 11 5 ((((JJ
Fax: (503) 598 - 1960 Case file no.: Payment type:
Land use approvaaUILDING DIVPSIQN
"11 t'I: OF 1'1
0 1 & 2 family dwelling or accessory 4"Commercial/industrial 0 Multi- family O Tenant improvement
O New construction 0 Addition/alteration/replacement 0 Other. 0 Partial
Job address:I3755 su) _ 1-1 DEN, f r• (y 4 r Bldg. no.: Suite no.: Tax map/tax lot/account no.:
Lot: f Block: Subdivision:
Project name: n A-0- n l ke.s I Description and L. ation of work on premises: t In d 1 r( L t rd pa le i
Estimated date of completion/inspection: _ _ 0 • • tat . /1e,
CONTRAC APPLICATION FL S(IIFDI!LF
Job no: C DOQ - O 1 Fee Max
f`,� Description Qty. (en.) Total no. insp
Business name: - PC)WP 1 er j`1 no 1o5` Inc, reewresidentlal- ear®tHH v
� r mltyp
Address: B (-(alp j dnellingamd.Includesetmd.edpeage.
City: ore tern c. I I State :Ce 17.1P: C �Qy5 Service included
Phone:L - O 3 (� Fa>( 1..0cN4E -mail: 1000 sq. fl. or less 4
CCB no.: .49 c� $ i 1 Elec. bus. lic. no: A - 511 Each additional 500 sq. ft, or portion thereof
Limited energy, residential 2
City/ etro lie. no.: ()QQ�i
O( O Limitedene
Ill � energy, non-residential 2
Yll M (n ILLi n +-i i ,:41/d./0:2_ Each manufactured home or modular dwelling
Signature of supervisin: el • tri ian required Date Service and/or feeder 2
Sup. elect_ name (print): ii�nIm mJ License no: ,. - G senloesorfeeders- tttslallation,
alteration or relocation:
PROI'FR11 OWNER ZOO amps or less I rb,3) ) 2
Name (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: 'Fax: 1E-mail: Reconnectonly 1
Owner installation: The installation is being made on property I own Temporary vertices or feeders -
which is not intended for sale, lease, rent, or exchange according to installation, alteration, or relocation:
ORS 447, 455. 479, 670, 701. 200 amps or less 2
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 am • 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 Stale: • I ZIP: B. Fee for branch circuits without purchase
Phone: Fax E - mail of service or feeder fee, first branch circuit: 2
Each additional branch circuit:
PLAN REVIEW (l'leaw check all that apply) Misc. (Senieeor feeder not lacladed):
0 Service over 225 amps - commercial O Health-care facility Each pump or irrigation circle 2
O Service over 320 amps - rating of 1&2 0 Hazardous location Each sign or outline lighting 2
family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel.
Cl System over 600 volts nominal more residential units in one structure alteration, or extension* 2
0 Building over three stories O Feeders, 400 amps or more *Description:
O Occupant load over 99 persons O Manufactured structures or RV park Each additional inspection over the allowable In any of the above:
O Egress/lightingplan Cl Other. Per inspection I I I I
Submit — sets of plans with any of the above. Investigation fee
The above are not applicable to temporary coition service. Other
' Not all ju isdictioas accept credit cards. please call jurisdiction for more iofonnation. Notice: This permit application Permit fee $ C) • S.
Cl visa $eMasterCard expires if a permit is not obtained Plan review (at _ %) $
Cre c,,.. number. ._ 41Ia t 111( 1005 6f1 9/ /CM within 180 days after it has been State surcharge (8%) $
o
. it, I it K'S . Ex
accepted as complete. TOTAL $ • 71
as -.po on credit card Q L -7 - —
• signature Amount 4404615 (6r00/COM)