Permit CITY OF TIGARD ELECTRICAL PERMIT
11111 I COMMUNITY DEVELOPMENT Permit #: ELC2009 -00363
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/21/2009
Parcel: 2S 110AB00400
Jurisdiction: Tigard
Site address: 14220 SW 112TH AVE 3
Subdivision: THE COLONIES APARTMENTS Lot: 0
Project: Colonies Apartments
Project Description: Repair meter base.
Owner: FEES
HOUSING AUTHORITY OF WASHINGTON Quantity Description Date Amount
ATTN: HENRY ALVAREZ, 111 NE LINCOLN STE
#200L 1 ea Services or Feeders - 200 07/21/2009 $80.30
amps or less
PHONE: 1 ea 12% State Surcharge - 07/21/2009 $9.64
Electrical
Contractor:
OREGON ELECTRIC CONSTRUCTION INC
1010 SE 11TH AVE
PORTLAND, OR 97124
PHONE: 503 - 234 -9900
FAX: 503- 535 -2763
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $89.94
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 thr ugh OAR 952 - 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
I/ 1
Issued By: �� Y Q ■ o (�
y: � : N\ f ? Permittee Signature:
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' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
r
4. -0 -09 07:13 FROM- OREGON ELECTRIC -MAIN 5032349900 T -966 P.001 /001 F -374
Electrical Permit Application 1:01: OFFICE VSE ()NE.)
City of Tigard RECEIVED Received J, Permit No.:
,
• I
111.% •
a 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
6 . Phone: 503.639.417I Fax: 503.598.19 L 2 0 2009 Date/By; Other Permit:
Y I (; A K L) Inspection Line: 503.639.4175 Date Ready/Br Inns: ® See Page 2 far
Internet: www.tigard- or.gov Notified/Method - VC Supplemental Information
� � CITY 0 F TIGARD
TYPE OF �+ 3 G DIVISION - PLAN REVIEW
.. ❑ New construction ® Addition /altee Please check all ihat apply (submit Z sets ofplans wiitems checked below):
17 Service or feeder 400 amps or more El Building over three stories,
Li Demolition Oihcr. Demolition where the available &lilt current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION : exceeds 10,000 amps at 150 volts or ❑ Floating buildings,
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION El Emergency system, t u yvr sepsruely derived system_ •
C] Addition of new motor load of ❑ "A ", "E , "1.2" ' 1 -
Job no.: 74187 I Job site address: 14220 SW 11X AVE IOOHP or more. occupancy.
0 Six or more residential units. 0 Recreational vehicle parks.
City /State/ZIP: TIGARD OR 97224 ❑ Health-care facilities. 0 Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg./apt no.: I Project name: COLONIES APTS ❑ Service or feeder 600 amps or more.
Cross street/directions to job site: nac*iptise FEE SCHEDULE
1 Q9'- 1 Bee I '1btW I •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: _ I Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft or portion 33.40 1
map/parcel ap /parcel no-: Limited energy, residential
75.00 2
DESCRIPTION OP WORK • (with above aq, ft.) _ . ,
Limited energy, multi-family
REPAIR METER BASE residential (wit ab ove sQ. . 75.00 2
Services or feeders installation alt ratios and/or relocai ,
200 amps or less 80,30 co , +) 2
❑ PROPERTY OWNER ' • ❑ TENANT - 201 amps to 400 amps 106.85 , 2
Name: amps to 600 amp 160.60 2 •
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) I Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701_ 401 amps to 599 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel -
A. Fee for branch circuits with
. ❑ APPLICANT I • ❑ CONTACT PERSON . ^w above service or feeder fee,
each branch circuit 6.65 2
Business name: B. Fee for branch circuits .
without service or feeder fee,
Contact name: 46.85 2
first branch circuit
Address: Each add'l branch circuit 6.65 2
- . Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular 90,90 2
dwelling, service and/or feeder
Phone: ( ) [Fax: : ( ) Reconnect only 66.8 2
E -mail:
Pump or irrigation circle 53,40 2
'CONTRACTOR - Sign or outline lighting 53.40 2
Business name: OREGON ELECTRIC GROUP Signal circuit(s) or limited-
energy panel, alteration, or
Address: 1010 SE 11 AVE extension_ Describe: Paget 2
City/State/ZIP: PORTLAND OR 97214 Each additional inspection over allowable in any of the above
Per inspection I 62.50
Phone: (503) 234 -9900 I Fax: (503) 535 -2763 Investietion per hour (1 ter min) 62.50
CCB Lic.: 203 Electrical Lic.: 26 -95C Suprv, Lie,: 4549S industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician Signature, require Subtotal: %, 8
Print name: RICHARD MCELLIOTT ,Date: 7-17-09 Plan review (25% of permit fee):
State surcharge (12% of permit fee): 8 J
Authorized signature: .f.. \ - `•S' �� \ M •
go .5 " TOTAL PERMIT FEE: a' I
Print name: RICHARD MCELLIOTT Date: 7 -17 -09 This permit applicatiue expires If a permit is not obtained within 1
days after It ha been acCeptcd as complete.
- Numbnr of it ,ettions allowed per permit_
I:\Duildiner micraLGpermtt /� App.dos 0523106 a .. t t q 44 p.4517g1 VosiCDMMEB r
(ie.->___----
CITY OF TIGARD ELECTRICAL PERMIT
11 1 I . COMMUNITY DEVELOPMENT Permit #: ELC2009 -00363
13125 S Hall B lvd., Tigard OR 97223 503.639.4171 Date Issued: 07/21/2009
TIGARD g Parcel: 2S 110AB00400
Jurisdiction: Tigard
Site address: 14220 SW 112TH AVE 3
Subdivision: THE COLONIES APARTMENTS Lot: 0
Project: Colonies Apartments
Project Description: Repair meter base.
Owner: FEES
HOUSING AUTHORITY OF WASHINGTON Quantity Description Date Amount
ATTN: HENRY ALVAREZ, 111 NE LINCOLN STE
#200L 1 ea Services or Feeders - 200 07/21/2009 $80.30
amps or less
PHONE: 1 ea 12% State Surcharge - 07/21/2009 $9.64
Electrical
Contractor:
OREGON ELECTRIC CONSTRUCTION INC
1010 SE 11TH AVE
PORTLAND, OR 97124
PHONE: 503 - 234 -9900
FAX: 503 - 535 -2763
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $89.94
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through OAR 952- 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: Permittee Signature:
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' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
,
•
J -17-09 15:31 FROM- OREGON E.ECTR1C -MAIN
n.e DC�t to 1L�rIIE.`1<' �;Ge an hrleCT1'>(C Insl llatlpjZ -966 P.001/002 F -385
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Y 4 U/ N
REOUE TING. SUPERVISING.ELECTRICIAN INFORMATION . - '
Name of sUpeavising electrician- !R !CHARD MCELLIOT7
Date of request: _7M719
Supervising electrician's license number: 4549S Date installation wag completed: 711619
Electrical permit no.: If a temporary permit is posted at the fob site, please include a copy of it with this fa. m_
EMPLOYING ELECTRICAL 'CONTRACTOR INFORMATION .'
Name of electrical contractor: OR laoN ELECTRIC GROUP
License rto -: 26 -95C
Business address: 1010 SE 17 AVE
City: PORTLAND State: OR ZIP: 97214
Phone: 503 - 2349900 l ?ax: _ 503 -535 2763 E -mail: R.B.LADD @Oregon-
' .. ' • ' .CUSTO INFORM . .
Customer's name: COLONIES APPS
Customer's address: 14220 SW 1'I. rH AVE
City: TIGARD State: OR ZIP; 97224
Address of installation, if different than customer's address: — -
City: _ State: gyp.
I _ IISPECTI AUTHORITY INFORMATION
Authority having jurisdiction to inspec TIGARD
Address: _ Phone:
City: - State: ZIP:
' REC:f IVING. ELI= C TRIC' UTILITY INFORMATION
Name of electric utility receiving refL.est: PORTLAND GENERAL. ELECTRIC Phone:
Address: -r - -- - - �.
City: _ _ State: �_
REASON 'FOR REQUEST
A. Restori electrical service that v - interrupted or disconnected because of either a:
❑ Service change or _ ❑ Unc 5;ltrollable event, such as fire, flood, or severe weather;
or SZ. -e-�C C4 \ v- iflh.4A-2kr - Zc,. b e-
ft. Electrical service at a remote loci t°on needs to be:
CI Initialized ❑ Rest l'ed
__ "COMPLETION tN ANp S IGNATURIs . ,
Supervising electrician Electrical contractor
Note: After sending this form to the el(:ctric utility Note: By close of business on the first business day following
named above; you must send a copy of this form to: energizing of a completed installation in response to the above
(1) the electrical contractor, (2) the cu_;t :nmer, and request, you must: (1) notify the authority having jurisdiction.
(3 inspecti g a thonty. that the installation has been energized, and (2) request that the
Q,- •7 -17.D9 authority inspect the completed installation_
Supervising electrician's signature Date
Electric utility
Note: Please consider notifying the inspecting authority
identified in this request when an installation is energized
�_ before inspection.
el leaTeSa p
J1 ACS
440.0948 COM (ip/gg /CO
1761-d 100/100 d tr10 -1 -1108d trydZ9 :Z0 600Z -17Z -10