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15960 Sew Oak Meadow Ln
���� /O� �I���� _ ELECTRICAL PERMIT
PERMIT#: EI_C2.001-00550
DEVELOPMENT SERVICES DATE ISSUED: 11/7/01
13125 SW Hall Blvd., Tiaard, OR 97223 (503) 639-4171 PARCEL: 2S1 11DC-12700
SITE ADDRESS: 15960 SW OAK MEADOW LN
SUBDIVISION: SUMMERFIELD NO.11 ZONING: R-7
BLOCK: LOT : 623 JURIbnl(,TION: TIG
Proiect Description: Installation of underground power supply for cable TV. Job No. West 2u01-25
RESIDENTIAL UNIT _TEMP SRVC/FEE_UERS _ MISCELLANEOU_ S
1000 SF OR LESS: — — 0 - 200 amp: �s PUMP/IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG: ,
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
YAANF HMI SVC/ FOR: 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+ amolvolt- >=4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only_ SVG'FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
STONEKING. RAYMOND D AND POWER TECHNOLOGY
GERALDINE J PO BOX 1766
1040 CEDAR ST OREGON CITY,OR 97045
LAKE OSWEGO, OR 97034
Phone: Phone: 503-657-0315
Reg#: LIC 129287
ELE 3-511 C
SUP 3575S
FEES Required Inspections _
Type By Date Amount Receipt Elect'I Service
PRMT CTR 11/7,101 $80 30 2.720010000(
Elect'I Final
5PCT CTR 11/7/01 $6.42 2720010000(
Total —$86.72
This Permit is issvpdsubject to the regulations contained in the Tigard Municipal Lode.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 w!thin 180 days of issuance, or if
work is suspended for more than 180 days. ATTENTION: Oregon law requires you!o follow rules adopted by the Oregon Utility Notification
Center Those rules are set forth in OAR 952-001-0010(nrough OAR 952-001-.,080. rouMay-obtain copies of these rules or direct questions to
Permit Signature: Issue ,9y:
OWN:R INSTALLATION ONLY
l he installation is being made on property I own whic) is not intended for sale, lease, or rent.
OWNER'S SIGNATURE _ _________._a___ DATE:__
CONTRACTOR INSTALLATION ONLY _^
SIGNATURE OF SUPR. ELEC'N: s.'VJz7�
LICENSE NO: 7
Call 639-4175 by 7:00pm for an inspection the next business day
t%02i2001 09:24 FAX 50� 03S68198U- CITY OF 1'116mv
F,lecrtr;:a?Per AppWation
City of Tigard Yrojecyappl.no.: alreaoe:
Cin o/Tigard Addnfs 13121 SW Hall Blvd,Tigard,OV 97423 �t¢ia,�: Sy: Reaslptao.:
phone: (503)639-x171
Fax: (50:+) 599 1960 case file no_ payment type:
Land use approval:
U 1 &2 family dwelling or 4,z essory Gy/c(xornesnal/indusinal O MWd•frtaflly O Tenon improvement
U N/ew consll'uexioa U Addition&Iteration/replaoe nent O Other. O partW
Job address:6"l W CAIL- Uj i 4 bldg.no.: I Sone lousecount am:
t ter. Block: Sabditrision: —
1'rojer tnate: Description and location Ot work on ws: T�
F�ula►ated,irlc of cont etlo ins c earl: T
.ion ta0: _ Fin No
Business Warne: i►�-,I i t U_ narcr.prton qrr. lea aQ
_ _.11� j— _ "Icw re+iAngW.A�!•K wra•.Iwly i►er —
Addrtles:--�(�—�Q�(p lL _ :iwotir.�oiM.larlr�.•wEacper,er.4t.
�—
!",,vrindAn&
Phune C F 1 u'1'�. &mttfl: IOun ua h or lw _�
CCb no.: Ise.bOa.hrC.n0' r act,ddlaas- SW
a�R er genian rhareot
_ L'.nitedettaryy,reii4endal _ 2
caey/ wrolic.,no,; Uri ��i Ll erorcy,00mrerid•a5N — 2
y�, S ,1 t :, U,') V acfi m•nur•ennad haiae or moduli dweUinX
sianalom of slipar•i i ( _—�.i13d� _ _... Sern�a nndkx feedrn 2
Sup.dtet.name nor) f� 1 1 1ltar . .
15•� 5erolxaof I-irl"ll•tiea,
akentlea or roleea/ow
tOn amps or leu Q2
20,.np�w r0o uryn —2
401 Io 600 mrgrr 2
Ma111n address: __._
_---� __-- , ----- - �1 ami+m 1000 amps _ 3
city: State .or 1 0: stags or volts 1
Phone: ��al� mall: Recowactonly t
Owner inerallation:The insialiation is tieing made on prxrperty I own •ani•a eereataat- i
which is not intended for sale,knee.rent or exehaaae&'cording to IreaaNaUafl,at�•rtro.orntanttw
ORS 447,455,479,670,701. ]OOompt or'en _ 2
7 1 ae+pe ru A00�Iap!� 2
Ownees a 4nstu c: _ Elate: 401 to 60J s Z
Dtanrb,circa h-new,ah mea
or•intoalon per pact
Name: A Fa for Munch ciaNt�wldlpgdlax o!
Address: Ielrlae or leedar fee,eaab bnrleh circuk 1
Roe ebt br4rkft au.-Au wN11Ma purehaw
-- of letrin or foodr;(ON nes Itnueh cireietr 2
Phone: Fax: a mail: P.ech addidoeal branch coni.
Mite(Sw.ieeorr�•1ne�erhtthdattl
d Service Aver W ampf-cortlrneraal Q IiediMare f•eNiiy Baht pump or imeatwa et►elc- - --- 2
)$enioeovr: FJamp ra"ofl4' []Hacntdw•loanon E,isi atoadlaelialiriea Ej��
I w �...--- -- - -- -
fam In dwellin�t O HuUdVre ovr 10.(100•gore len fbv.tx �;inti dteon(fl tx a NmNed cr>h y paati.
]5yuam over 600 vola nonny more re.rdrnt;itl unl r 1n nrrr ttnrctum aliraad011,a eslaaaloa•
l 1 auddins over ibme stomn :J Per&4%.41M1 until w nmre • -
A L'Occapantload ma"perfons DMfnriwimedtamemeirnkVj,%* 41ftelie-�
O':4—tAt htilnto a O Chlxr __- Per int on (�Sub".—vett of Flamm INA any of she sane. iw adon a a l -
7111 antra ere!eras applkable to Its terry e+aaMrtleltw service. r
permit flee.....................S
fQ/l coaly OW Usti t coft owe ur Mm4n.,AN mote a.Men i'oe Notice:Nil pemit apphombon
am" afntumcmd expires if a permit is not obuined Plall teviaw(at %)
%) S
(:Ital1 CAt�mmelr _ _ N Abin 1 a0 days■Acr 011111111-4111 Stale etteeharge FR) .-S
r" ar"ted as complrte TOTAL.......... ............$
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440,4615(MM1ICOM)