Permit CITV T' GA R D
PERMIT #: ELC2001 -00218
illl DEVELOPMENT o
SERVICES 1639 -4171 DATE ISSUED: 04/30/2001
- 13125 SW Hall B
PARCEL: 1S136AD-06502
SITE ADDRESS: 10925 SW 69TH AVE
SUBDIVISION: WAY LEE ZONING: C -G
BLOCK: LOT : 001 JURISDICTION: TIG
Project Description: Installation of (1) branch circuit to HVAC.
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: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 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:
WAY W LEE ALOHA ELECTRIC INC
GENERAL CONTRACTOR 11919 N JANTZEN AVE
5210 SE 26TH STE 216
PORTLAND, OR 97202 PORTLAND, OR 97217
Phone: Phone: 503 - 289 -7060
Reg #: ELE 34 -224C
LIC 54799
SUP 2426S
FEES Required Inspections
Type By Date Amount Receipt Ceiling Cover
PRMT CTR 04/30/2001 $46.85 2720010000( Elect Final
5PCT CTR 04/30/2001 $3.74 2720010000(
Total $50.59 EXPIR
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 co pies of these rules or direct questions to OUNC at (503)
246 -6699 or 1 -800- 332 -2344. L
Permit Signature: 1 ,1 . 2-t QCI frH �1 -� ��� Issued By: /ad A e Ze .../
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: rf)-) DATE:
LICENSE NO: "- ° S
Call 639 -4175 by 7:OOpm for an inspection the next business day
_ 10:48 .FAX 5038847297' City of Tigard < j "' 0 �QOZ
Electrical Pe Application
Daterece Pemlit n o.. •1ovi� -
�
/�� c am, /';
RE , ' ?i' City of Tigard : Projcct/appl.no.. Expire date:
ity ofTigar Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By: Receiptno.:
Phone: (303) 639 -4171
APR 5 P 2 n ®f Fax: (503) 598 -1960 Case rile no.: Payment type: •
COP,4P,10r�1r ,..,,1 Land use approval: '
0 1 & 2 family dwelling or accessory Commercial /industrial 0 Multi•farnily 0 Tenant improvement
0 N ew con / j� Addidaltc 0 Othe 0 Part
JOB SI1'E INFORMATION
Job address:ie' - S(J G 7 7ft¢i/6 Bldg. no.: Suite no.: Tax map/tax lot/account no.:
Lot: Block: Subdivision:
_ P r o j e c t name: d I L Z t 1 O 6 4 41 1 scription and location of work on premises: / e d - / / / k & " / ( T ) / » C u,r1 / / - E/ L '
Es date of completion/inspection; 8 a Ai ' t 4RRet~) M
CON I ItACTOR APPLICATION • ' FEL SCHEDULE,
Job no: .(09.■ Fee WI •
Business name: 4 L p /e p C -�"°a Qty. (� Total no. ittsp
Address: /7q / At.), J tJ /TYNE .9-t (' lvew teaiamhWad-single attached ap fa age per
City: / 4 ./) 1 State: 1 ZIP: 7 7,i/ 7 Saviceincludtat
Phone :503 aZ7 706e7 [Fax: Stp16 1 E -mail: l000% h. or less 4
Each additional 300 aq. ft: or portion thereof
CCB no.: $1? ?.7 1 Elec. bus. tic. no 3 -a2q c Limited energy + rosieendal 2
City/ • • tic. no.: a
Limited ea ,non- tvaidential -
2
,
rife..49 r4lrif ''•• Each manufactured home or modular dwelling
Si • tae of supervising electrician fromired) Date Service and/or feeder 2
Sup. elect. name (print)! ACtAlc , s i t ga.r: License no•, Services w feeders - lestaltstian,
PHOI'l:11T1' 011'NEH alteration orreloeatlon.
200 amps or leas 2
Name (print): 201 amps to 400 amps 2
Mailing address: • — 401 srnps ro 600 amps
601 amps to 1000 amps 2
City: State Z1P: Over moo amps or wits
Phone: JFax: E-mail: Roraima** j
eoo
Owner installation: The installation is being made on property I own Tcmporaryservioeearfoedeslr• .
which is not intended for sale, lease, rent, or exchange according to_ �a�tke, altered"
oom
ORS 447, 455, 479, 670, 701. 200 amps a l eas 2
i
201 amps to 400 amps 2
■Owner's signature: Date: 401 to 600 amps . 2!
=battens - sew, trhtp'alion,
Name: or exteroioa per mutt
A. Fee for branch circuits with purchase of
Address: service or feeder fa, each branch circuit 2
City: State: • ZIP: H. Fee for brunch omits without pntebase /A/ Q
of service or feeder foe, fast branch circuit: 1 - iv 2
Phone: Fax: E-mail:. Each additional branch circuit:
PLAN REVIEW (Please. check aII ill at applv ) Misc. (Sa*viecesfeedtrnatiadodod); *-.."-5,............
O Service over 225 amps-oommeroial 0 HealUreare facillty Each pomp or irrigation circle 2
O Service ova 320 amps-rating of lR2 0 Hazardous locution Each signofoaUincligbd 2
familydwcUings 0 Building over 10,000 square feet (bur or Signal crcutt(s) era hmued energy panel,
0 System °M600 volts nominal more residential units in one structure alteration, or extension* 2
O Building over throe stories 0 Feeders, 400 amps or more • Description: -
0 Occupant Toad ever 99 persons 0 Manufactured sanctum or RV pant Each odditieaal `
[eapodioa over the allowable is soli' of flla abtwes •
O Egie 0 Other: Painspeaion 1 i i I ,".--
Sgbmit sets of plans with any orthe above. Investigation fee
The above are not applicable to temporary construction service. . Other
1 application Permit fcc
N i,ottd
a an *Wisdom leapt erect! cards peace all jurisdiction ear arse information. Notice: This permit $ -
O visa 0 MasterCard expires if a permit is not obtained Plan review (at — %) $
Cledir card timbal L
, within 1130 days after it has been State surcharge (8 %) .... $
°'p 11O ' accepted as complete. TOTAL $ S
— Name a< t u thaws oo audit erect :
EXPIRED
State
AMNIA
440 4613 ta+vNCOaq
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