Permit CITY OF TI G A R D ELECTRICAL PERMIT
PERMIT #: ELC2001 -00268
, �y DEVELOPMENT SERVICES DATE ISSUED: 5/23/01
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S103AA -00101
SITE ADDRESS: 10865 SW WALNUT ST
SUBDIVISION: Q_ Za � S ZONING: R -4.5
BLOCK: P LOT : JURISDICTION: TIG
Project Description: UNDERGROUND CABLE POWER SUPPLY
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:
SCHOOL DISTRICT NO 23 J POWER TECHNOLOGY
13137 SW PACIFIC HWY 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 Underground Cover
PRMT CTR 5/23/01 $80.30 2720010000( Elect'I Final
5PCT CTR 5/23/01 $6.42 2720010000( iRE
Total $86,72
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws.
All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 9 2 -0 1 -0010 through AR 952 -001 You may obtain copies of these rules or direct questions to OUNC at (503)
246-6699 or 1 -800- 332 -23 .
Permit Signature: Wv r5 Issued By: ll
` / ,, OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
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Electrical Permit Application
lDatercwhed: 6 I Pc t so.: . 't r , y
L. A
.. I City of Tigard Pcejec q>pLas.: t date
ah t A6dtese 13125 SW Hall Blvd. regard, OR 972 Due issued: By: Receipt no.:
Phone: (303) 639.4L7l
Fax: (S03) 598- 1960 Cate 6k as.: Paymenttypc
Land use approval:
TYPE OF PERMIT
O 1 & 2 finally dwelling or accessory JrConinierciallindustrial 0 Multi- family 0 Tenant improvement
O New coastrucdoe O Addition1slceratto&m$accment 0 Other 0 Partial
JOB SITE t`rO ltsIA1 - 10\
:. ' INN Bldg, no.: Suite no.: Tax map lax tot/account no.:
Lot: Block: Subdivision:
Proja uame: careira1 ie . n. r 'l L moral F:timaootl date of compleoioafmtpoai n •
�: I_ _i..0 / • 11 11 •
CONTRAC °OR aPPLi CATION . FEE SCIIEDLLE
B e
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- • 1 t:.111111 Stale: w e., 71P: ' 0 sattaerdaot,t
Phone: , - 03 _ o • a . i��� ; . 1000u3.11. wise 4
Cat era_ • . ■ Mee. bras. lie, nee
Each addi "maw 500 • ' or • ttneef __
Ilrne 1k. no.: _ g C • Limited energy.resides:id __� 2
• • • • O . Limhadeaeur.00e- newcas l Ell__ 2
ilrgrA // II 11 • 0 each m.nu6mtad home ormo ardwd 111■■
roe Sendaisod/or
Stga.ba.laastpdu c 11n1 • u alrirI e . a< i : .., 2
Ptt0PERT1' OWNER 200
200 un• Arias 11.11 2
Name (print 201 •• or 400 sour . MI Mill= 2
B deem
.. to . ■ , .... �� 2
fly: Stab ZIP: Or 601 to 1100 MN NMI 2
oty: Fad er1000 proofs • __� 2
email: Remo=eaty INN 1111._ 1
Owner The iasaliadon is being made on pmpelty 1 own Tetpatarfeanls.rrreamn-
wadi Is not intended the p14 lease, Rut, or according m othsow Pb ; p 4 ' 2
ORS 447, 45.5. 479, 670, 701. .
Orrae�s .
DM: saws u4100 sews ME r k .;.!4 2
4011o600 MIN NM 2
L' CINEEIt — Snarl .. - rewodaraliso.
Now er el�daapaputt
Address A. Fen for bomb drada Ida punk= or
=woe atteder sods bonds circuit 2
C r, State: 71P: B. - for tooth aeofawittiest Rohm
Plum. }M: Elm& • afsasia*atadako%Rot Wench eitepir: 111111111 2
PLAN HL \iL % (Plonse cheer, all MA app!) - - ■■111 2
0 Service ova= iorgseommaodd 0ltealm� .
0 � as n outhg of 162 0 Rsu doorber ha Bash signor mom liah� _ MIN ME
0 osa600twmaoaitat Q paw 10,000 quit &a Amor ei�rcalds) s Salad energy piod. 11111111111 room as3dmtislmdsis one someone altirstion,aroseuriote 2
0 l3taldragoradttaesteeia 0FordeetNO amps ormolu
O Mod99 __
C2 em p1 1 O Meaofacmiedat or liaaadilkaea - .wrfYsoMwet6blaq.ttAe.6atee
Stttt�9f _ satrstf Perlman NM NM INN
Ilan whY sa Od le shore.
Ms 'Wean appind*m - ...,. auttatdeasmite. Oder
liar s4Jeti.rugomsew oeatmek /tans us *bark. sw a ir_.1a Nedra This permit appSestioe Permit fee ......... S
OVlaa 0 MapeeCord =ghee if a retail it eat alataiaed• Plan review (at 9b) $ •
Cosa am weber 'Albin 1R0 &Ss after it has ban State +) .... S
�sae - iiscm dnsasmoltcud _ 1 OeEp�B TOTAL 1111. .....5_ _
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