Permit CITY OF TIGARD ELECTRICAL PERMIT
s COMMUNITY DEVELOPMENT Permit #: ELC2010 -00098
aT f G .ARL7 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/02/2010
Parcel: 2S114BAl2800
Jurisdiction: Tigard
Site address: 16435 SW COPPER CREEK DR
Subdivision: COPPER CREEK NO. 3 Lot: 93
Project: Darr
Project Description: Add /alter (2) branch circuits for a/c circuit and service outlet.
Owner: FEES
DARR, BYRON Quantity Description Date Amount
16435 SW COPPER CREEK DR
TIGARD, OR 97223 2 crt Branch Circuits 03/03/2010 $63.60
wo /Purchase Service or
PHONE: 503- 598 -8435 Feeder
1 ea 12% State Surcharge - 03/03/2010 $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 0 R 952 - 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.66 � 1 99or 1.800.332.2344. ,,�, /
Issued By: Permittee Signature: /A/ an / C'¢ -
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.
CaII 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.
MAR- 01- 2010(I10N) 13:10 Bear Electric (FAX)5036781108 P. 001 /002
- 1.
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Electrical Permit Application MAR 0 1 2010 1 r. iNu: fl \1.1'
City of Tigard �l r, . n.,.au.., • • r•Y`Q : • IPII " 13123 SW HallUlvd,Tiyvrtl,Olt97223 : . ...., PWlltavtew
A . Phone: 503.639.417 Fax 303.398. 1'10' ; ' ' ' ' Pasentr• Oahu Hamtl: (YkQe20 p .CaCS r r .�
TIC'.AItI? Inspection Lin= 503.639.4175 Pak Kcodrflif: m Sa I'arc2for
Internet: www.tigardbr.guv NnlitlnUhtetlai. IIMM Supplementallnforman.a
. ' • ',TIME. or 'MORK. .. :, .. P R V' rR :.,....:
yi IAIYg e ±elw d;r:
0 New construction S- Addition /niteration/nplaccmcnt Mom check oil O 1 Prply ( tutmsit loess orations w /ilema checked belw):
❑ DCnWIlliOn ❑ Other: ❑ ❑ll uilding over lhteestotin.
kcic Ihcavaiiabtc fault current 0 Marino and boatyards,
. . . ',- CAT.ECORI!;OF.. CON 1tUCfiON ,, . ,• '' , tumeas 10.000 mnaa at 150 volts at 0 Amino buiktitup.
Ina to pound, orrxecda 14,004 0 Commacialrue aptrnhunI
1. 1 -and 2- family dwelling ❑ Cotnmcrciulllndustriul ❑ Accessory building amps thrall mbar installations. Nadine&
❑.Multi- ftunlly 0 Master builder ( 1Other. 0 Firs pump, Qtnaauationar7s
,, t ,., -., 0Ennoaneysplan- larger.wpantdy darted arm.
01.;"!. ` ::,.. . ,;','JO14 ANU;,L'OGY[ION _..... , . ,..'r, , ; ;,:i to Addition or new TOW load or 0'
Job no.: 1Job Site addraz: 1aol1Ptx «qt r•
a k •... ^ C. 7 0 sh, or more tao Identlal wilt. 0Itecreational vehicle parks.
City /Stale/ZIP: � -� c .,, � q �� (� O Hcalavearefacilitin, °Supply
C ) V f � ` ! 0 ilaauduw location& 400 volts nominal.
Suitc/bldgJnpL no.: Project name QSavlaarkeder
:' '.b . :ltEDur.E.:1'';4' ;:r.v..:
Cross strceUtliret:tiuns tof ob site: nra.ran•n "I op, 1 v... 1 ,.,.t 1 • '
';New residential a1s, Ia or anal -madly dwelling unit.
Inc111des.attachml gamer..
Subdivision: Lot no.: 1.000 sq,11. or less 168.54 4
I u. odd1500 sq. It. or portion 33.92 I
Tux map/parcel n9,: Limited clergy. residential 67,84 _
`AESC1Urrior iOlt: ?WORK; . ,`' • .:'S lwithaboi q jl.)
- Limited energy. multi - family 61.84 _
1c I cQ. r
\� i Q.V
u•� Al S - 03 _\ 1_ ��a y \ C /
1 residential lnilltabowso it)
}.� Servlees or feeders ro
Installation, alien and/or relocatlo
f�, n
•--\ `Z�e 200 amps orless 100.70
• ' ?0 PROPk'RTY. OWNEIL..' ' •!: •„:•,,... • ' 1;-. .. :'i 201 •amps to 400 amps 19356 I
Name: 401 runs to 600 amps 200.34 2
601 4111118 10 L000 amps 301.04 2
Address: _ Oyer 1.000 amps or volts 552.26 2
City /Stall /.1!': 'Temporary services or feeders' Installation, alteration. and/or
relocation
Plume: ( ) l l'nx: ( ) 200 umpl or lese 49.36 1
Owner installation: This installation is being mode on property that I own which is not 201 amps W 400 mops 123.08 2
• intt:ndcd for sale, lease. rent. or exchange. according to ORS 447, 449. 670. and 701. 401 amps to 599 Imps - 1685, - 2
Owner signature: Date: A. circuits -new. atter:mil - I, or extension. per panel
A. l ce for branch circuits with
al ;APPLICANT.''': la'C011TACV.P..ERS0N .,' 1 above service er !Ceder ICC, ,
each branch circuit 7.4
Business name: 13. Fce for branch circuits 1 Q
without service or reciter 1 c, \ 56 :18g SlDr c ^_
Contact name: tiratbmndrelrcuit
•
Address l:acttadd•1 circuit 1 7.42 '1. '42 2
MIaceIlnnrnisa Pies or (realer not is dndes)
City/State/ZIP: tiach manufactured or modulo 67.84
throning, scwicc nntlh,r (ceder
Phone: ( ) Fax: ) Reconnect only 67.84 2
1:- tuail: Pumper Irrigation circle 67.114 2
. • .... •:...;,.. :CONTRACIVIt::.`.;. Sian or outline Hanna 67.84 2
t Signal circuit(a) or limitcd-
Business name:
r \ . 5. _ C energy panel, ulienuion, or
Address: •uenaian: IN3S1ib : Page ^_ ^_
City /Sluts:all': II ` O J EncluoddllnnalInspection orthc above
-
Per inspection 66.5
Plm503 Fax: (32))).--\%-- nc: I ? ) �� D \ 1,. � inveailpuddn per hour 11 hr min) 66.Z CCU 1,41.1 l iC)Q \C‘ Electrical Lic.: 2 ^I Suprv. Lic.: �% p Z Industrial plant per hour 78,1R
Suprv. Electrician signature. required: tee) ,
P Bn a1 ar ) Subtotals
` Plat rcvlcw (25% of permit fee):
Print none: ��► 1L. • , , tikli �• 1 Date: ` -10 `" Stale surcharge (tZXol permit
/
Authorized signature: TfyfAL PEANUT FEE: Rchuil-
t/
1'1,11 prrmlt ap(sneatlon aspires If a permit Is not ohtalnnt wUhtn Inn
Print thine: Date: dyes attar It its. titan aee.pin) as compute.
• Number of Inspections allowed per permit.
1 'Auda.na'1'.tmaN:t.C ram1Npp Imourn am- 4watt1InH,Cnsoolin 1