Permit CITY OF T I GA R D ELECTRICAL PERMIT
PERMIT #: ELC2001 -00546
DEVE Hall O PMEN Tigard. O
SERVICES ) 639-4171
DATE ISSUED: 11/7/01
' 13125 /
PARCEL: 2S112BD -00100
SITE ADDRESS: -07580 W BONITA RD
SUBDIVISION: TIFFANY COURT APT. Q /�� ZONING: R -12
BLOCK: / � � �� r i. OT : 065 JURISDICTION: TIG
Project Description: Installation of underground power supply for cable TV. Job No. West 2001 -24
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:
BOROS, STEFAN A + FIVIA POWER TECHNOLOGY
PO BOX 1890 PO BOX 1766
GRESHAM, OR 97030 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 Elect'I Service
PRMT CTR 11/7/01 $80.30 2720010000( Elect'I Final
5PCT. CTR 11/7/01 $6.42 2720010000(
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 rul dopted by the Oregon Utility Notification
Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. Yo ay obtain c Ries of these rules or direct questions to
Permit Signature: sir ,�. I ssue d fi r: � �
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
4 I r i-..; .4_ a tsumf - DATE:
SIGNATURE OF SUPR. ELEC N:
LICENSE NO: 3-575
Call 639 -4175 by 7:OOpm for an inspection the next business day
11/02/2001 09:24 FAX 5035981900 OF 1 , e,k/v4
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�l Per tApp - Y _
rt+ Datereceivod: /1 D/ Permit no . Et / - :
1 City : j � �'i4 ®f 1 ]� (� ����1 � Projccdappl.no.: Expire date:
Ciry oj%igard Address: 13125 SW Hall B T i g ard, OR 97223 Date issued: By: Receipt no.;
Phone: (503) 639 no.:
Payment type:
Fax: (503) 598 -1960 �� 3 V ` /.0t,' 1 Case
Land use approval ......_.,. ,
(;1wnivIU:Vi I ULVL - I IrLIiI
1V1 1 •C O[ :1 rR'111 - ` _ - __ -- w . , - a_`.. '=
f _ • leCommereiah/indnsttial O Multi D Tenant improvement
O 1 & 2 family dwelling or accessory
D New construction 0 Addition/alteration/replacement 0 Other: 0 partial •
- =-= -T - -- - di) It> fill: 1N1,012 iS
._.,� = .r� •
B ld no.: u . tnap/tax lot/account no.:
Jobaddress. - j � �� (,t) .but • �: • d. Bldg. Site no.: Tax
Lot: Block: Subdivision: •
Project name: it rr ! r %iA Description and location of work on premises: U % M VP' ,0 Y . • .[
B 7r i v
Estimated date of completi ttspechon d I ... '-''''..-'-r. _,
-f . ((70- I WWt 1 O12 \PPLi t \ i Co i _ • t ! { tiC 11 1 111)5! - :
Fie
dos na: Y _ �a7 ���, Qty. (w.) WO Business name: p t(;>JQiI`- r� riiiS�irJ!1•"+�: Newt l-d[ngleoroat> deb per ER
Address: 'a0 .0 to , dwelling oak lachadmatta dgon • •
geNelIMANI i State0te- :Ir RIIIII Service indutlett 4
s � 1000 M, ft. orless
Phone' , • ` I� : - � Yi � � , m .. 500 ..fr. or ponionthereof _� ® _
CCB no.: •. a . Elec• btu. lie. n0: I IC.. Limited energy. residential r1.111_ 2
City/ area lic.,no Co d-0 Limited energy, non- residential —_� 2
Tl' �. . , ►.11' � l t • 03 0 1 E..ch mannfacamd home or modular dwcUmg Mill.
Dam Service. =Nor feeder 2
Stgnanut of supervising of I i ( O .�a � Services oe feeders- installation, it � 201 amps to 400 amps f � ►1g1�1'l[rJ�La� =Lr,I aidototlonworleratoeaflort: . 'RU1'I IiTI U1 R 2ooampsu � t r
2
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Name (print): 401 amps to 600 amps - 2
Mailing address: 60) amps to 1000 amps 'MIIIIM
�
lt1
City: State: 23P: over 00 amps orvolts • 111.1.1111.1.
Phone: Fax: E-mail: : R econnect only r�� 1
Owner installation: The in�alla�n is being made de on Property orarYarrvicesthe(codas-
pecty I own htslonativa ,almration,orrelocatwa:
which is not intended for sale, lease, rent, or exchange according to 1111
zon amps or leas 2
ORS 447, 455, 479, 670. 701. I t amps to 400 amps M =� 2
Owner's st nature: Date 401 to 600 .1 2 •
° " °i I N(' , I"JEI; _ R 777-7- '- Branehcircuib- new, alteration,
oretttcild011 per pack
Name A. Fee for bench circuits with putchasc of
Address:
service or feeder fee, each branch circuit 2
State: ZIP B. Pee for brunch circuits without purchase
City: ' of service or feeder fast brunch circuit: 2
Phone E foe, Each additional bunch •__
Mee. 2reotlnl9adad): 1111111111 Pt.•�t`t 12L1�1! t) , �l'tca.c r :il. i{I ill tt .tl�lil •} - _ � 2
t] Healt�'efacilily Bxbpomp orurigatioacircle D Service over32Samps- manof1 Each sign or outline lighting I�__ 2
D fami l y e w a3Z0aolparatiegofl�2 D 111111111111 fdmilydweUinga O RaUdingovettO ,000 squar f fowex Signal s ►cn {t(s) 2
D System over600 votes nominal =re residential units in one swcrore
. altamion, or extension°
p Bulldisigevermore stories 0 Feeders. 400 amps or more 'De • ,
0 Occupant load over 99 persons 9 Manufactured nrucotma or AV pa & En& additional =Poetbn =sr the ollowt,b1 is any of the above:
0 Eglinilfith1ingP1an .O Other.. - Pains ;on l♦ IMIN1111•111111■
Submit sets of gams wltfa any °fate above. lnvestigationfce
The above arisen applicable to tesupprary constructing smite. Ober
Permit fee $ Zak i
Not art iarladlcnans =apt re dit mama. please eon luSistke6os for tone infer aaio0. Notice: This permit application
o Vas review (at — 96) $
n D MaateiCard expires if a permit is not obtained'
/ within 180 days after it has been $tate surcharge (8 %) .... $ '
credit bad sandier — Expires wed as'complere• TOTAL $ $tn. 7 3
art •°t cardholder as strewn an credo card g '
Gseshotdm sip:Mare Amount - , 440 -4615 (f, OtfCOM)
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