Permit , q CITY OF TIGARD ELECTRICAL PERMIT
'''1' a : COMMUNITY DEVELOPMENT Permit #: ELC2010 00048
T IGARb' 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/02/2010
Parcel: 2S 110B D00901
Jurisdiction: Tigard
Site address: 12035 SW BULL MOUNTAIN RD
Subdivision: Lot: 0
Project: Whitney
Project Description: Add /alter (2) branch circuits for installation of a/c and outlet.
Owner: FEES
WHITNEY, PAUL Quantity Description Date Amount
12035 SW BULL MOUNTAIN RD
TIGARD, OR 97224 2 crt Branch Circuits 02/02/2010 $63.60
wo /Purchase Service or
PHONE: 503 - 620 -3502 Feeder
1 ea 12% State Surcharge - 02/02/2010 $7.63
Electrical
Contractor:
BEAR ELECTRIC
PO BOX 389
DONALD, OR 97020
PHONE: 503 - 678 -1355
FAX: 503 - 678 -1108
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $71.23
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 - 1 0100. You may ob -' a copy he rules o direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
0
Issued By: Vic �� � � �.,�V'J� Permittee Signature: Q
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.
,2oi0 c ,,J — �� - ��� Gvof L •
ELECTRICAL PERMIT
-
CITY OF IGARD
• COMMUNITY DEVELOPMENT Permit #: ELC2010 -00048
T I GAR .D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/02/2010
Parcel: 2S110BD00901
Jurisdiction: Tigard
Site address: 12035 SW BULL MOUNTAIN RD
Subdivision: Lot: 0
Project: Whitney
Project Description: Add /alter (2) branch circuits for installation of a/c and outlet. 2/10/10, adding (1) additional branch
circuit for dryer plug.
Owner: FEES
WHITNEY, PAUL Quantity Description Date Amount
12035 SW BULL MOUNTAIN RD
TIGARD, OR 97224 2 crt Branch Circuits 02/02/2010 $63.60
wo /Purchase Service or
PHONE: 503 - 620 -3502 Feeder
1 ea 12% State Surcharge - 02/02/2010 $7.63
Electrical
Contractor. 0 ea 12% State Surcharge - 02/10/2010 $0.89
BEAR ELECTRIC Electrical
PO BOX 389 1 crt Branch Circuits w /Purchase 02/10/2010 $7.42
DONALD, OR 97020 Service or Feeder
PHONE: 503 - 678 -1355
FAX: 503 - 678 -1108
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $79.54
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. ATTE IN Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -001 -00 through OAR 95 .' ' 0 You may obtain a copy of the rules or direct questions to OUNC by callin 46.6699 or 1.800.332.2344.
Issued Permittee Signa�r7re.
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.
3 JA-;- 28- 2010(THU) 16: 03 Bear Electric (FRX)5036781108 P. 001 /002
Electrical Permit Apnlic.ttion � f • FOROFFICEUSEONLY
i lC 'Ol o� g
City of Tigard Il u ,,. , c retrnit W
11125 Sal' I fall Blvd.. Tigard. '17_33 JAN 2 8 2010 Plan {te
1 . Phone: $01639,4171 1 503.598. I'1h0 Mil: iii% t)thct Pawn i " - o • e ` �
TICARD InspectiullLine:503.639.f175 CITY OFTIGARD 7. I nc„),:n. )t,r, R rage_(ur
Wallet: Avt W,ligard- or.gov Not ifrcd•:Method Sopplrmrntal Information
t --- --" r'
RI PI r,N1G DIVISION - - ._
' TE of ��an : • p[r1N REVIEW •
❑ yeu eunstnicli0u Addition /allrrcldonlrcplacenlcnt
Please check all that apply tutburii i .et. of plans % /items checked below):
❑ 5cn•icc ar fetdcr 40a mops nr mmc I] Roihlinlr o't:r 1rcc am ics.
❑I)etllolilinn 0 Qther: ,.heir dienvnilaldef•Natcunent 0Mad nn>:and botyards,
CATEGORY OI' CONSI-I c''ecds10.000ampsatI 0111natingbnitdins.
•
- loss to ground, ur exceed' 14,Ofa 0 Cmnrnerciat-uxc ngricalnnat
®l- : I :unilydtt'clling 0Colntltcrcinlliudustrial ❑ Accessorybuildiii amps furalI otherinstallation,, buildings.
0.htlti- liunily • ❑ Master builder 0 Other: 0f- rrc pump. 0In,t:,uuionof75 -
O S1 C>v'.IN% 0itllr� 1'10�i AND LOGS CIO\ ❑ itu larger l4parrtcly'uctiscd swells
❑M.ldinn orrtcsrminor laad of C A ". .'kr- "1 -3',
)nh nu.: lab site addrr.-ss Q y,.� Iuul IP ur mots, occupancy
(81/4 J,�� ,1► ❑ its nr ionic tcsidcmial amts 0 tteetemtunrl %chicle parks,
City/Slater /.II'. ` ) cR � 0I ealth-care facilities ❑ Suppl) vantage far mate than ,
S .�ti� �. a '� 0 111411dous locations. 660 snits nominal.
Suite/bldg. /apt. no.: Project name: 0 S4 rvicc nr feeder A nps of touts.
Cross street /directions•Injdhsite: ...1— '^siaLut.4___.._ —. Ll!i,- 1___v..•= 1_'r,t.t_t�
New residential single- ur nrulll- fatuity dwelling unit.
lnclndcs ntmehed garotte.
Suhdit'ision: _ l.of no•: 1.000 sti.10. ur Icss 1 61{.54 4
I:u. add'I 500 sit. IL or purtiun 33 92 1
1'ax tt,iip parcel no.: 1_itnited energy. lsidenlis' (7 81
AESCIilt!r10, `'01 Vt OIiffi „_,;, (ntlh abuse 44. tt.) r
Lint ited oncrgy, nialti- fiunily 67. &t
c ���� rrsidantlal is+ithatw +c u . O,)
Se rsicrprur feeders installalhm, ultrrudun. nntttorrclocntin
I C 2 '4e �t .Q, a .\- -\-'^ 200.anips ur iess 100.70 - _
• Q • 1'1tOP1l Y OWN112 ;Er 9i.K.1 \J'. 201 :,,spytoa0ntaia \, 133.56 ,
Name: 401 antes to 600.; nips _ °.00:34 2
60I amps to 1,0110 maps 301,04 \ 2
Address: Over 1.000 amns ui vults 552.26 2
CigfsI ter /.I P: Tenlporaryservicesnrf ceder. installation.11terlttfou,11ud /n r
relocation
Phone: ( ) Fax: ( ) 200 amps or leas . 59.36 • 1
Owner Installation: This installation is being made on property that I own which i. nut 20! amps l0 400 anlpa 135.01{ 2
iniendekl fur sale. lease, rr:nt. or =change. itecording to ORS 447.449, 670, and 701. 401 amps to 599 aloes 168-54 2
Ilranch circulty- nor. alteration, nrntension. per pond
Owner signature: Dmc: -__ . ....... .. ..... -- , A. FFee tur branch circuits rrah 1
each hrnnch fir fe_
0 APPLic.,q i' I _ - • 0 COITAL 1' pcitsos .. :those sery ice or rtfe eder r; c. 7.1 ~
BusiI1t ,5 nalne: 13.Fee for branch circuits �W
Contact 11:11 ➢1': without srxvit:c or feeder fee rl
D
l 6 ,,
fir hratich•circuit 5 .
r1tlt11'C> : Each WW1 branch eitettit 2
L
1tlsvcllnnenus (service ur feeder Hull ittdiitled)
City /StuiciZIP: Pach.nlanuI i hired nr modular fi7.84'
— d,%ellint, scntice antlkr Iceder
Ilion e: 1 ) 1'ax :: ( ) Reconnect only 67.141
_
li -Haul: _ •Pumporirrigationcitde 67.84 . 2
COti r1L CfOR, Sign er outline tightinp 47.84
Si nal circuil(s) or lintiied•
13usincs:; mans: terV • \ \� \' +� � � h. p noel, nitcndirin,or
cntx'v
Atltlr �3: �r x G cvtcnsian, Dcscrihe;. P ge. -'
City' /Stole/Zit': ee ���� ; � is �i� t;'')C _r_ 1:ach trn
additional inspection over alluble in-nnv ofdirabove
LA��.JJ � Per inspection 66:25
1'htm � c:1� �^ t Floc leas 3) • ,„,:cg.,,,... perhourit h ndn) — 66.25
2 0gsa. Sul r v. Lie.: p lant 1(
CCi3 1 -Ic.• l:Iec trictl i.ic.�2Ll - -��'�C I p �
_ _ ._ hldu >trinl perhour 71{ 1
r.I:ECI'RtCAt, .1'ti 1L11t 1„ I,LL'S , ..'i.
Saprv: Electrician signulrc, :required: r.. so . , . 'Subtotal � � »tdpCj
Print nw . r 1 1 Date: - 1 � 2Q ,(� — Phut review (25 ": of permit frc)'
WUi - lb :_ 4' •. X1 _ 2 ..: � SuiteSint:barge(12%ofpctniitfee) `
Authorized signature: TOTA _ P1 rr.r:: `1 L 31
7 - ��' This antic a PP I1ca lien CPIli it a prrrnil is nor oblainnl+.ttnlrt ISII
P
Print name: I)atC: dot• ahrr k bas be.•u ycrquerl+s wmplrse.
lun rofiiupcCUnitruliVaCd
'I.l_ nit ,tinid'umru'I1,C•rrnniiArp doc Iti:Y)UQN 44ii.41!∎1311nrHCn I". I:n
eQats EAs.c,-r ).nQ.- .
.. FEB^09 2010(TUE) 1d: 13 Bear Electric (FAX)5036781108 P. 001 /002
. •
•
Electrical Permit APPhicatiolp CE y ED FOR OFFICE USE ONLY
City ofTigard Restate �. • /d twmttNo: i�lD -qa9
!�
It ' !'lame 13125 S \t Hall Blvd.. Tgtar'I. OR 47::, Eg 0 9 2010 Put' 11n'cw
503.639.1171 Fa,: inj.$!18. 1
natrlh.. 'AuPomo:
T1 GA RD Inspection Line: 503.639.4175 ' Dare Itrad►'nt /um &7 See Pace 2 for
Werner w��w.tigard.or.gtn CITY OF TIGARD uelrtiedrileibaJ. I Sapplrmraul Information
_ 'n o
n iN6 vi VISION ' . • :. rI.A, i REVIEW
❑ New cnnstrucdan 53 Add it io tt/o1lcmtion /nu1lath:mtmt Please clock all lhal apply (submit a acts o r plans writem+ehededkiwi:
0Service « radna1W amps fir ur'ae O ltailding owe doer omits.
❑ Ucntoliliun ❑ Ulher.
wltete due atallabk Noll con D Wilms anal b'+tryatds,
• CATEGORY OF CON IltUCIYO? c.esvd. IQ,000 mops al 150 mills to 0I+luatiultbidWing
• - - leas to ground. or exceeds 14.0110 0Commercial•useat/titer/1 l
1711- and _ - family dwelling ❑Commercial/industrial ❑ Accessory building amps for all other imullatioas. buildings.
CY Multi- family ❑ Master builder ❑ Other. ❑yue pump. El Imlallalionof K A or
u - .. JOII SITE INFORMATION AND .LQG \'l'IQX 01•.mergenysystem. largerseparatelpderi.c4gatcm.
❑ Addiiimn°New matte load or 0 "A; - L, 1-2. "1 - 3'.
no.: Job silc odd r<'ss; /�� ,,�\ w , t0011Pe more. bin
malmsey.
Job no
I Vti?� Y v 1" �l�A �� \C1 Si au more residemiat units mil..
ID tlee'eational tebiele
Cil)ISliderl iP. Q I leallbcue Cu ❑ Supply tobaix for mere than
�� � I \.) ��T� 0ILiiirdonslowllons. 6001nitsnominal.
Suilc/bIdl hips. no.: Project name: CI Servieeor feeder 600 amps armom.
-
Crriss streeUdirections to job sire: at bu ' l ytb._l.__r_••. I' Tali; .L..2.._
Ncw.rcaldcntlal single. or mulli.fanttly dwelllit5 unit.
. Includes ulutcherlitaranc. —
Subdivision: • I Lot no.: 1.000.sq. ft. or leas 168.54 d
• Ea. midi 500 iii. IL ur portion 33.92 I
Tax ntap/parcel no.: . . Limited amp: residential . ,
•.b�d� •. 7_ .<_ -.. .. - "- .'DESCRIImON -O WflR ti:.._.7_... -.._. .T.,. ..ft�iatabaw :a:) e7.
s.i
Limited cncrp, mulli•fmnily b7.8J
A. . "� \ l . IS + 1• �' • - . • . . .residential fuuh aba,e $4: ii:) • .
C /� '' }} Services orreeJen Inuallalinn. alteratbm. antlior relocation
C� xC \ rr ` tt t \O- C'rD `"l$.1 3o0 amps orarss. 100.70 2
0' TEIAAIT 201•an►ps to 400 amps 133.56
:Name: •I01 animus 600amps • 200.34 '2
. 601 amps to 1.000 amps 301.01 2
Addrey: - Ovcr.1.00D,amps.orvolts 55226 2
City/State/ZIP: Tempura ry.servIces or feeders Insranutiuu. alierritloth uriJhnr'.
relocation
•
'!'Rolle: ( ) 1 1 :as: ( ) 200antps:ut:less 59.36 1
•Owner installation: This installation is being nt un property that I own which is not 2 amps to 400 amps 125.011
intended for sale. lease. run. or change. according to ORS •147.449.670. and 701. 4 01 iunpi to 599 mini . 168.54 _ , 2 ,
Branch circuits - new. al rem lino, ur.tt ten +inn. cr panel
Owner signature: _- -- Date: F circuits branch rr•lh
:• :'..CI:AYI'LICAT' . ' `. ' . : - .I • • Q I' • CO\TAC.TERSON ; • • .:`. ' A.
above service nr reeler fee.. 7.42 ,
• Melt branch circuit
lousiness name:. I)..Fce for branch circidts
Contact oat= witltoruscrvice.or feeder fee. Sb.18'
. rust branch circuit
Adiln-+ +: Lach-mtd'l brands circuit t 7.42 1, 412 2
111secllna curs (Strike. Or fader. Ito l Included) —
City /St ue/ZlP: • . Each manufactured ur modular•
lwellinl :•sen•ice and/or feeder 67214 2
'Phone: ( ) I Fax: ( ) Reconnect only • 67.84 2
E-mail: Pump or irrigluion circle 67.84 3
CO,YI IG%crOlt 5i81t'erautlinc lighting 67.81 2
13usinc�� name: - '� - 5i8rhulcircuiUslnrlimittxl•
C� Q, ie„ J energy panel, akcmlinn. ur •
M (].�,' eme
Address: rsion: Describe. . Page: 2
P V C �.J� -��� .
City /Stater/JP 0 eh ilk i A • Each- addltbrual- lospectlun over allowable Jo an, or t)re.ishus'e
- •• - Pcr.inspcclian • • 66.2$
. Phone :. ( ) , w .- Vim: ( - 6 • • • 1 - lnvcatlgntlon •per hour(' lit ado) 66.25
• CCD.Lie:: • I • lacclrical Lie.: -( i • Suprv, Lie.: ■ ' t idtlsltlnl (dual Per h 78.15
l \ " � '_ `E4EQ]i1GttPlsR;►tiJ EFF.Ss;' ` -;' • � untv..lilcc in cian sigrtptttt �� Nib. • '' • • • • . Sithiotal-. 47
( �ii - tt :revimv(2596ofpermit 'fec) :••
Print n • \• 11.% .t • .\ ' • r� Ji Date. • -CA d - ..' Pla
. Sratisurcharge (IS'surpeiroit- Picl : _,,Scq •
• Authorized signature. l TOTAL! PERMIT FEE: • U . Bk
1'rI11t I Dale: ' thispermbspoliationespires Ira permitisnot -u'blainedn
JJJ ' - daws.aner it bits been aurora It•comptete.
• . Nuenlm oriorpeetlims allancJ per permii: • •
•
• : i:;Jloird' i..Ju9!1.C.Pnm:'..ipd.t Id 0 1 . M9 ++0- '6111111.( J(O ''rn
•
•