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Permit CITY OF I R ELECTRICAL PERMIT P ERMIT #: ELC2002 -00070 1 4: DEVELOPMENT SERVICES DATE ISSUED: 2/21/02 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 1 S133CD -14900 SITE ADDRESS: 11597 SW TALLWOOD DR SUBDIVISION: PEBBLECREEK NO. 3 ZONING: R - BLOCK: LOT : 039 JURISDICTION: TIG Project Description: Lay underground power supply for cable TV. 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: GREENBERG, SONDRA J POWER TECHNOLOGY 11597 SW TALLWOOD DR PO BOX 1766 PORTLAND, OR 97223 OREGON CITY, OR 970 Phone: Phone: 503 657 - 0315 Reg #: LIC 129287 ELE 3-511C SUP 3575S • FEES Required Inspections Type By Date Amount Receipt Underground Cover PRMT CTR 2/21/02 $80.30 2720020000( Beal Service Rough -in 5PCT CTR 2/21/02 $6.42 2720020000( Elect'I Final 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 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 copies of these rules or direct questions to OUNC at (503) 246 -6699 or 1 -800- 332 -2344. Permit Signature: (1 ® Issued By: 4 40, i I U 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: 6, DATE: LICENSE NO: °-7 C Call 639 -4175 by 7:00pm for an inspection the next business day Feb 15 02 11:55a Nancy Jones 503 857 -0942 p. ( i i Y ., Elect rical Permit Application , . ; Date received: d J6/ Per mit no.: , ' 0,9 - /I r. ' ` R ECE I VED Pojec I p pl.o.: Expiredate: P City o Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: !" Receipt no.: Ciry nfTigard Phone: (503) 639 -4171 Pa men Fax: (503) 598 -1960 FEB 1 5 2002 Case fi no.: Y type: Land use approval: , CITY OE TIOARD _ 1111.11111.(H,,►h a ti t r - n. . � Z PL °O Pl R11ITf '' 9 � ' d ?' 1 - z OMulti- family O Tenant improvement 0 . m I & 2 family dwelling or accessory Comercial industrial 0 Partial 0 New construction 0 Addition/alteration/replacement O Other: : a ,.1 rI tl lOIttll�11O Job address ! 15 ? 5 - 101 1..Y.-Cd Dr r• Bldg. Suite no.: Tax map /tax lot/account no.: Lot: tstock: Subdivision: Project name: AREMINIIIME Description and 1 ... ation of work on premises: , A ILEW O' II L11, -j. 1"., Estimated date of completion/inspection: / .a . ( . 1 (ON'Iltt("FOR JPPl1 Fee Max Job no: • - O Description Qty. (ea) Total no. ins . Business name: II III U.Sti . F1 , (\ j'U') l Q j , vie. New residential - siocle or multi-fannty per Address: h'v apse 1( dwelling s adt. Includes attached garage. V 0 I D Cl ' t t State:se, ZIP: ©t 5 Servieeinetmied: �`- \ Y� ` 1000 sq. ft. or less Phone: • - O3 l F. ' 09 E -mail: 1 Each additional 500 sq. ft. or portion thereof 2 CCB no.: / , , gag] M �yl Ekee. bus. lic. no: ( Limited energy, residential -5 Crtyf e[r0 11C. no.: 000 Limited energy, nvu- residenial 2 LCVYVI 04 M (XI Aka— r ) / (- /O..L Each manufactured home or modular dwelling Date! Service and/or feeder Signature of name (print): el i ion required Services or feeders- installation, Sup, elecE. E�1fil ' f�% w alteration or relocation: ` ` I'12OPf_R 1 VO1 \L 200 amps or less ) 1 2. 201 amps to 400 amps 2 2 Name (print): 401 amps to 600 amps 2 Mailing address: 601 amps to 1000 amps 2 City: I State: I ZIP: Over 1000 amps or volts 1 Fax: I E - mail: Reconnect only - Phone: Tetnporaty serYices or feeders - Owner installation: The installation is being made on property I own T llation,alteration,orrelocation: which is not intended for sale, lease, rent, or exchange according to 200 amps or icss 2 2 ORS 447, 455, 479, 670, 701. 201 amps to 4 00 a mps - 2 Owner's signature: Date: - 401 to 600 amps ' lalt i s l\ l torch circuits - new, alteration, <ER or extension per panel: Name: A. Fee for branch circuits with purchase of 2. service or feeder fee, each branch circuit Address: State: I ZIP: B. Fee for branch circuits without purchase 2 City: of service or feeder fee, first branch circuit Phone: Fax: E-mail: Each additional branch circuit: 1" ' 1 PI is Ri V 1' (Plear k: cl that ap misc. (s erv1ce or feeder not included): - ' - Each pump or irrigation circle 2 U Service over 225amps-commercial D Health-care facility Each sign oroutlinelightin 2 0 Service over 320 amps - rating oft &2 0 Hazardous location Signal h s c n c r out or a ignited enerl energy panel, family dwellings 0 Building over 10,000 square feet four or 2 ❑ System over 600volts nominal more residential units in one structure alteration, or extension* 0 Building over three stories 0 Feeders, 400 amps or more *Description: 0 Occupant load over 99 persons Cl Manufactured structures or RV park Each additional inspection over the allowable in any of the above: I [I Earessltightingplan Cl Other. Per inspection I 1 Submit T sets of plats with any of the above. Investigation fee — Other The above are not applicable to temporary construction service. Permit fee $ • Not all jurisdicti'm accept credit cams. please cart jurisdiction for more information Notice: This permit application Plan (at ( review %) $ 0 Visa . Master.Ca expires if a permit is not obtained State evi (at (8 %) $ Credit number :5 t co Li lit Ior�55(.a39 9 / A within 180 days after it has been State s L $ 26. • ' a ' r t - G5 Expir accepted as complete. • '1:.. as shown on credit card Q / AIR L L. t /VL -I,'� S Ll{ o, 7,) 440-0615 (6AO/COM) 1 �: sigpature Amount J