Permit a CITY OF TIGAR® ELECTRICAL PERMIT
AIL-- COMMUNITY DEVELOPMENT Permit #: ELC201000084
T(GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/18/2010
Parcel: 2S 111 AA05000
Jurisdiction: Tigard
Site address: 8680 SW INEZ ST
Subdivision: GREENSWARD PARK Lot: 24
Project: Handy
Project Description: Add /alter (2) branch circuits for a/c and service plug.
Owner: FEES
HANDY, KEN Quantity Description Date Amount
PO BOX 23802
TIGARD, OR 97281 2 crt Branch Circuits 02/18/2010 $63.60
wo /Purchase Service or
PHONE: 503 - 968 -1821 Feeder
1 ea 12% State Surcharge - 02/18/2010 $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 AR 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: lJ ll1Ck Y V1 j A.0 Perm ittee 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:
APP CONTRACTOR INSTALLATION ONLY J.Lp/1
SIGNATURE OF SUPR. ELEC' . Date:
LICENSE NO.
`^)pJt
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.
,
.FEB it 2010(THU) 09: 48 Bear Electric (FAX)5036781108 P. 001 /002
Electrical Permit Appli t1 ��En FOI O I ICS usF ONLY City' of Tigard L`�� Itr ""r't
_ 1 �,y c r)alcli, 1'crmltNa : 1CZ111c) • 0°0
13 125 SW Hall i lvd . Tigard, t q t e , O ' [ ' „ 1 Plan Itc.� . Q
I r Phunc: 503.639.4171 Fat.: 503 414rio t P enny -
I] .ne l ►, r�tR �Q n
TiGARO inspection Line: 503 ,639.4175 r ARD !hoc 1ira41!1h ho ■ ra Sce Page! fur
www.tigard-or.gov ww.tigard -oLrnv err' 1 �� , �i l�,►SinN Soto licd.:•tcthlvl: -- - tl� tiupplemenraiInformation
❑ New construction Er rWdilinnhtlternlinnfrcplut :emcm
mar, clecek 211 Mx nppty (snbolil j sets or pinrts.allcnu checked befoul
❑ Service or retcde'r.100 amoral. mute ❑ llulldina ma lino uot
❑ ))eltloliliml 0 Oilter: oleic the a.aduhle 61111: concur 0 %Ia'iras and lwaryarc1,.
CATEGORY OF' CONSTRUCTION cute& 10,000 amps at ISO .03 or 0 Pluming buildings.
iris to graiuit or c.cceds 1J.000 ❑ Cnntnerelal•u :c acricnlnlml
ig, 1- nntl 2- family dwelling ❑ Coromixeialtindris rill ❑ Accessory building min for 211 other ilnlanatinnf. bntidmo.
❑ Multi- that). ❑ Mlaiter builder ❑ Other: O Fire pump. ❑ Install:aimof 73 KV.t or
I] !Emergency system. kttgrr separately dtn■al .)item.
• 4011 sac INI:ORNIATION AND 1.00,Cf10N ❑ Athltttonof now motor load or ❑ "A' "C. "1 _ "."I.r.
Job no.: Job sift addrt 10011Pcr mote. occupant'.
p W - �V - ` JT . ❑ sit. or mote residentu ca
l ants 0 Itcu uonal taker parks
Citv(State1ZIP: Q 4 ❑ Iteahh. re facilities ❑ Supply %ohne for mow !Ion
C] I bvardata locations. salt sults nominal.
Suih:lhkI)1. /apr. 1m.: Project mime: 0 Sew ice or feeder 6lb Imps nrMOW.
. . 'rt :w' SCHEDULE •
Cross street /directions to job Site: II..MI.11.P 2tt• v... •ruby -
-- \cw rcrhlcnt(nl single- nr n uIlt•riunlly dwelling 111111. 1nc oltnched Ilurll)e.
Subdivisiol1: 1.01 110.: 1,000 s! , 9. or Is 168,54 •1
i
Ca. ;ddi 500 A. It. or portion 33.92 1
"1 - ,Lt rn:lp /pfreel no.' reunited energy, residential
.,., . . - . Dk:SCl11P'r1b,'i Olz tr'OitIC iwilhubo.c nil.) 67. &t 2
• .
' ,
1 Limited cncrR},aulti- )amyl)' (;7
1 , ' - , di c 1 . . ` -1 1 / rm (..rh abo.r u1 1 1
Services nrrrc*lers Installalintl, niterat andlor relocation
III 300 naps or less 100.70 2
P ItOPE1CIY OWNER ❑ TE.N,A\ f 201 maps to 400 :snips 133 56
Name: 4111 amps to 600 mops 200.34 3
601 maps to 1.000 amps 301.04 2
Adilrt.^:s: Over 1,000 urnps.ur volts 552.26 2
City/State/ZIP: '1'cluporary services nr feeder in1tullutlnn. alteration. and-inr
rclncatinn
Phone: I ) fax: I ) 200 11174 or h 59.36 1
Owner iuslnllntion: This installttlion is being amdc ern reopens that 1 oa•n which IN no NI naps to 400 metre 125.08
inlcniled for sale. lease. rent. or exchange. :recording to ORS 447. •149. 670. and 70). 40) amps to 599 amps 168,54 _
Brooch circuits - nor, slier silo 1. or rt.tension. per pnua
Owner sign iIiir : y __ _ -.- MR:: . __ _. _ _____ -.- A. Fee Cur branch circuits n ulr
0 . APPi,ICAN r - .. ❑ CONTACT PERSON above service or feeder fa, 7,42
each boatch circuit l
Business name: 11, Fee for branch circuits' 1
:Camel mum:: without service. or feeder fie, 1 56.18 aDr l
z
_ first hranrh circuit
Address: I :uclt m111 hrnnclrcircuit 7.42 t 1. 4.. 2
Jlieceltancoits (service or feeder nut 1r eluded) _
Ciry1State/ZI1': Each mmnufactua`4 or modular
67.114 2
dwelling scrvice:autlnr feeder
I'hunc: ( I L 1 = art. :: I 1 Reconnect only 67,84 ' 2
E- mail: Pump or irrigation circle 67.2(4 , 2 _
• CONTRACTOR • ' Sign or outline lighting 67.84
BtiKincsa teaser: (]_ ,.,� Signal.circuitts) or limited -
L e r l (t." jiL \'C. cot iln' panel. alteration, or
Address: C� i 1 al .(Z‘ extension. 1)eacrihr. Page 2 2
City /Stu) 'ZI I': V Y R l J2�'1 - lately uddlthmul in.pceliurr over nItImul tc In uny,ur rim. ubo.t
v 's.` - '.� Per inspection 66.25 _
Plume: (303) ( 0 71- \ Fax: (.503 I -\ q, Investiption per'Iwur 1 1.,116,) 66,75 �!
Ceti i.ie.:'C'k Eleetrical l.ic • 2t'— '01;101 11:. Lie.: LI %1 ' industrial plamperhour 78.18
\ - r.ELECTRIC L PP'.M11'I . FEES •.
Suprv. Electrician signature. require � -` .. y_ 1 ► ° u Subtotal: ' �` ,>,() 1
Print 1111111e: `. r „ , , • 1 I)att : _ Plan rain. (2376ufpermi[ fix):
• Slate surcharge ()2% of per fcc): �T
Anthori ed signature: . TOTAL PERS1LT FEE : 7 t, 23
T7ds pe appllcaliu ri tt, ri of a permit it not o1121nn) sit bin 1 H
Print IMine: I Date: days alter it eras been accrptrd ms alnsplrIe.
• timber of in.pctni ni Ultimo! I' r pcnnn.
1' 11aiLtin ltieom.l :L•LI. lc,nai..rpd,x 1a 44 1 11.o•,t'ONL9l en