13460 SW GENESIS LOOP 12�,�4 SW Genesis Loop
ELECTRICAL PERMIT
CITY OF TIGARD PERMIT#: ELC2001-00542
DEVELOPMUIT SERVICES LATE ISSUED: 11/7/01
13125 SW Hall Olvd., Ticiard, OR 97223 (503) 639-4171 PARCEL..: 2S103DB-02600
o,TE ADDRESS: 13460 SW GENESIS LP 70NING: R-4.5
SUBDIVISION: GENESIS
LOT : 002 JURISDICTION: TIG
BLOCK:
Proiect Description: Installation of underground power suppiv for cable TV. Job No. West 2001-24
TEMP SRVCIFEEDER _ MISCELLANEOUS
RESIDENTIAL UNIT -- _ PUMPIIRRIGAT;ON:
1000 -; OR LESS: 0 - 200 amp:
EACH ADD'L 5005F:
201 - 400 arnp: ZAGNIOUT LINE LTG:LIMITED ENERGY: 401 - 600 amp: SIGfvAI_IPQ.NEL:
�MANF HMI SVC/ FDR:
601+amps - 1000 volts: MINOR LABEL (10):
_ SERVICE/FEEDER _ BRANCH CIRCUITS _ ADD'L INSPECTIONS
WISERVICE OR FEEDER: — PER INSPECTION:
0 - 200 amp: 1 PER HOUR:
201 - 400 amp: 1st W/O SRVC OFA FDR:
EA AL)Z�'L BRNCH CIRC: IN PLANT:
4G1 - 600 amp:
PLAN REVIEW SECTION
601 - 1000 amp: _ _______
>=4 RES UNITS: — > 600 VOLT NOMINAL:
1000+ amplvolt:nlyCLASS AREAISPEC UCC: __
Reconnect o : _ SVC/FDR >= 225 AMPS:
Contractor:
Owncr: POWER TECHNOLOGY
BARNETT, JERRY +ARLEEN
13460 SE GENESIS LOOP PO BOX 176C-
OREGON
76EOREGON CITY,OR 97045
TIGARD, OR 97223
Phone: 503-657-0315
Phone: Reg#: LIC 129287
ELE 3-511C
SUP 35'r 5S
FEES Required Inspections
Type By Date Amount Receipt Elect's Service
PRMT CTR 1117/C1 $80.30 2720010000(
Elect'I Final
5PCT CTR 11/7101 $6.42 2720010000(
Total $86.72
This Permit is issued subject to tt Q regulations contain,.d in the Tigard Municipal Code,Stkte of OR. Specialty Codes and all other applicable
laws. All work will be done in acoordance with approve 1 plans. This permit will expire K work is not started within 180 days of issuance,or if
work is suspended for more than i80 days. ATTENTION Oregon law requires you to follow rules adoptedby
the of Oregon
Utility
d.ectification
questions to
Center. Those rules are set forth in OAR 952.-001-0010 through OAR 952.001-0080. You�rottaiq. P
- Isso@ Fy
Permit Signature:
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not irtended for sale, lease, or rent.
DATE:-- -
OWNER'S SIGNATURE. — —
CON* RACTOR INSTALLA WON ONLY _
-------- - -
SIGNATURE OF SU11PR. ELFC'N: --�-������--
GATE: --
LICENSE NO: _ �l�J �`�� .—_^ --------------------------__._�— -
Call 639-4175 by 7MOpm for an inspection the next business day
11/02%2001 09:24 FAX 5015981960 CITY OF TIGARD Z002
]VIectdcal Permit Application
'i^' Daurecelvcd: // � O/ Permit no.:f OUsy
RcCE111E[) —
Pmcct/a 1 nn: Ettpuedau.
City of Tigard jpP•
Ciry of ri•ard Address: 13125 SW Hall Blvd,Tigard,OR 9%23 Dalt issued By, Receipt na.:
Phone: (503)639-4171 i ! '��' I Payment, e
Case fila no. type:
I
Fax: (503) 598.1960 _
CoWly.
Land use approval:
I!I�i 1-01'N f.NT
O 1 &2 family dwelling or accessory (commercial/industnal J.MWti-f undy Z)Teoant improvement
Z)New conslfuctioo O Addition/altetation/replacemcnt >Mel: ❑Partial
lob undress: t c�Cl✓rli Bldg.no Suitt no,:— Tsx ma taz lot/account nim:
Lor Block: Subdivision: — - —
Projectname: Descnpnnn and location of work on premises:
Estimated dale of tom letio ins 77-
-tion: ' T
JOr 110: 7 �c - _ Fee Mrd
nacrt►tien (a) rural no.his
9ustnegs name: UVt' - x.4'11'1[:111` Ve»ttadentiol�tnldr K.rrna.mih pa
Adtitess: ��r , l u d»tur�curJl.tscAulr»arotAedvr.fe.
slate _1 Sertiainelwkd 4
City: C. i - 10tw W n or Ira+
F
r
Phone: �.a�i1 F.no. r ) � Each eddwona1300 sq ft or portion tmmof -
�R no.. EIC[.Isru.Ge.n0 J.L� Ltrnitcdcrisgy,rcaidential 2
City/1 C1rOhC..no.: �� Llmhedeneegy,mutitepdenoal
_ �—
ach manutaeruied home or modular dwelling
Ssrviceand/or feeder 2
signature of su Ivi-r el c ( ucd) Date
. - �.�•� Seniceaortee rte- rads{oa.
Sup.deer name( nnq C L t 1 L"� Ucense alkratkr.or re)atttAlon:
200 amps or less p(t U t
201 amps 10 400 amps 2
Name(Print), -- 401 s l0 600 amps 1
MgWng address: _-___ --_ 1 amq eo 1000 amps 2
State TZ1P- Over 1000 amps m volt, '
city: —_
_�--�.---_-.- Ruomecwnly t
Plloae; I ax. F•tltail:
Tetnpoesry renied or le arta-
Ovvner mstallahon:The utstallaritm Is heing made on property 1 own Inwslbr<on alle+riow,orrrlention:
wlsich is not intended for sale,Icase,rent,or exchange according to inti amp
ampr toot leu 2
ORS 447,455,479,670.701 1 s 400 amp, 2
Owners signature; Dale. 401 to 600 SAVI 2
Srsnebeirreth nr»,ahersl{ea,
or eslension per panel•
Name; A Fee lot hinnch circuitswith pomils3c of
-
Address. service or treder ter.,each branch cucuit 2
_
State: _ ZIP: _ _� . Foe for bnmcA circmu without purthsse
of service or feeder fee,first branch thrall 2
Phoue:
-Trix. mail __— q__�
Fich additional branch cirm,
Ire.(Sar.ieeorfood"gotMelo ):
Each pump or imganoa tittle --
a Seivice over 121 amp+cummert ial W Health-tae f acdity Each sign w outhris 1 i htin 2
J Sierviceover 32nntnp,rating Of lag 13 Huardourloation — -- --- -
ftm;4 dwelling O Hulldtnc ever 10.000 square het tour or signal tircmt(f1 or a linated enemy panel.
O System over 600 vola norotmj more warder al atoll in one siniclufe alteration,or eatennon•
2
O Budding over three shone, J Faders.40n amp or mote elks:n tion
O OecopuN 1,:.:nvu 99 persons O Mmufartwed strucmtr,or RV p:,k Lark seldhl Uupoetlon swt the alN0shub .M)of ern arevt:
O>partAighhn�plan O ► -- - per t" _l�_
So6ntll _ nets of plan"h stir of Ire above. tuvesdlauon fcc _. __.
The above on not applicsbN to Itt71 cNOAfMlrta�aer.lee.--_ Other -L i _-
- —
,_- — T p p Pemnt fee.....,.... _ ...... _
Not W,tw'harNedom autp astir r D.We esa juitheicum tot mae mfatmauas
Notice: rl is permit application ��review(at
O Visa exues if o permit is not obtained �--�T
within 190 days after it his been State 6urcharte(8%) S ��I -1.w--
Ceee 1 4 p`m� v �rvpna TOTAL ..........1; _L)aG.. 7.,
` � 11GJ acrxpteA as twmDlete
7drt-:t airown � J kc
440a615I161fYCOM1
J
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