Permit III CITY OF TIGARD ELECTRICAL PERMIT
C2009
COMMUNITY DEVELOPMENT DATE PERMIT ISSUED: #: 2/2 00070
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 110AB -00400
SITE ADDRESS: 14260 SW 112TH AVE ZONING: R -12
SUBDIVISION: THE COLONIES APARTMENTS LOT : 1 -5 JURISDICTION: TIG
PROJECT: THE COLONIES APARTMENTS
Project Description: Replace (1) 200 amp panel.
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:
HOUSING AUTHORITY OF WASHINGTON OREGON ELECTRIC CONSTRUCTION INC
111 NE LINCOLN STE #200L 1010 SE 11TH AVE
HILLSBORO, OR 97124 PORTLAND, OR 97214
Phone: Contact #: FAX 503 - 535 -2763
PRI 503 - 234 -9900
FEES
Description Date Amount Reg #: ELE 26 -95C
[ELPRMT] ELC Permit 2/23/2009 $80.30 LIP 203
[TAX] 12% State Surchar 2/23/2009 $9.64 SUP 4549S
Total $89.94 REQUIRED ITEMS AND REPORTS
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 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: ( "Z�� � .. ..) 4 . 12 , S Q� y ' n a k )4� i Qii ,i Permittee Signature: 1 k: r\
OWNER INSTALLATION ONLY App ' 1" pp
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: 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.
ctxicai Perm Applicatio
DECEIVED hf lit (.114)1' h is is IISI: I)N1.,
Rer,�ivcd ` " t PcrntitNo.; a4 . 6,4,411T City of Tigard n n�rs ,
q 13125 SW Hall Blvd- Tigard, OR 97221�FB 2 3 2009 flan Review Other Permit: !'hone: 503 - 639.4171 Fux: 503.5'18.14 Notified , .w. ® s1v peat 2 for
II I
Inspection Line: 503.639A 175 TIGARD note Re/MethO l 0.7.) Supplemental information -
CTTYpFTIGARD Notified/Method:
Internet: www- tigitrd -0r.gov -
TYPE O °�� i 7 . ► • • PLAN REVIEW
Please chock all that apply t PLA sets of plena whtcros checked below);
Icw construction 0 Other rim/alteration/replacement 0 Service or fender 400 amps or more ❑ Building over three atones.
Other: where the available Fault current a Marinas and boatyards.
IemOhtiOn _ _ TI — exceeds 10,000 amps at 150 volts or [] Floating buildings.
CATEGORY OF CONSTRUCTION less to ground, or exceeds 14,000 0 Commercial -use agricultural
- and 2 family dwelling ❑ Commercial /industrial ID A CcesSO l•Y building arena for all other installations. buildings.
El Lire pump, ❑ Installation of 75 KVA or
J,u1ti family ❑ Master builder ❑ Other: _ 0 rsncrgcitcy system. tnstn scpontely derived system.
p
Addition of new moter load of 0 A. "E ". "1 -2 ". "1 -3
JOB SITE INFORMATION AND LOCATION 1001.1P or more occupancy.
Job site address: I L i ki Q iti.' i i Z ❑ Recreational vehicle parks.
n - � Sit ar more residential units. 0 Supply voltage for more than Health Iheilitica
• /S[atelZlP: • ( 1 r ❑ Hazardous locations.
600 volts nominal.
Service or feeder 600 amps or Marc. _
tlbldg. /apt. no.: 1 e, Project name: r ate -S • . FEE SCHEDULE .
nap-Isom Fee Tue,U
ss street/directions to job site: New residential single- or multi- family dwelling unit.
Includes attached garage. � ��
Lot no.: 1,000 sq. fl. or less
tdivision: Ea. add'l 500 s'. fl. or portion
Limited energy, residential I 75.00 gl
i trap /parcel no.: - _ - (with above s . tt.)
DESCRIPTION OF WORK Limited energy, multi - family t t
residential with above SQ. t1)
�`-Q ` \ CL Y 'C -\
Services or feeders instaaatio alteratio and/or relocation
200 amps or less 11011 8030 flip'
z01 amps to 400 amps 11660:8650
0 PROPERTY OWNER I - a TENANT _ 11113
401 amps t 600 amps
me:
601 amps to 1.000 amps in 240.60 Ell
Over 1,000 amps or volts Mill 454,65
Idress:
ty /State/z�P: Temporary services or feeders installation, alteration, and/or
relocation
tone: ( ) _ 66.85 1
200 amps or less
( ) 201 a mps to 400 amps 100.30 Ell
133.75 ��
i 401 amps to 599 earns
weer installation: This installation is being made on property that I own w hich is is not Branch circuits - new, alteration, or extension, per . and
for salt, lease, rent, or exchange, according to ORS 447, 449, 670, and h
Date: k Fee for branch circuits with
tivncr signature: se o service or feeder fee. 6.65 •
- APPLICANT � _ 0 CONTACT P ERSON each branch circuit
B. Fee for branch circuits
business name: without service or feeder fee, 46.85
• first branch circuit IMMO
:ontact name: Each add'I branch circuit Miscetianeous service or feeder not included
address: — Each ma nufactured or modular 1111 90,90 2itylStatelZlP: dweller _ervice and/or feeder 66.85 i i Fax:: ( ) Reconnect only 5 85 ?honC: ( ) 53 AO
E -mail: =
CONTRACTOR Signal circuit(s) or limited
Q1ergy panel, a lteration, or Page 2
Business name: ___ ')C c,- l extension. Des be
�,
Address: I 0 1 0 S z t 1 _ �
ry moo v \41.+ -r� C) I2- 62.50 1.1.1.11 Ci / e: (s
City/State/ZIP.
Phone: (yZ13 `a _ 4 5 pv
Fax: (SjJ).3 l C� 7 73.75
S uprv- Lic.: G- ./SW c 7 5
ELECTRICAL PP,RMIT Furs
CCB Lic.: • ` Electrical L C5 Subtotal: lire 30
Suprv. Electrician signatur , `` `` P lan review (25 %ot'perinit fee):
' . �t Date: . -� �D State surcharge (12% of permit fcc): Ellarrem
Print name: Us ` � � �Q TOTAL PERMIT F E: :
Authorized signature: - rill , permit npplItatloa expiry If a permit is not obtained within 18
nate days after It has been a ccepted as complete.
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