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Permit CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2010 -00354 Date Issued: 07/14/2010 T I GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 ;;. Parcel: 2S103BA00141 Jurisdiction: Tigard Site address: 11965 SW LYNN ST Subdivision: LERON HEIGHTS NO. 2 Lot: 31 Project: Marchese Project Description: (2) branch circuits for heat pump and gas furnace. Owner: FEES MARCHESE, MARK Quantity Description Date Amount 11965 SW LYNN ST TIGARD, OR 97223 2 crt Branch Circuits 07/14/2010 $63.60 wo /Purchase Service or PHONE: 503 - 590 -0223 Feeder 1 ea 12% State Surcharge - 07/14/2010 $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 • e R 952- 001 -0100. You ma ob . . . . . . . . . . . . .o r direct questions to OUNC by calling 503.246.6699 or 1.800,332.2344. / Issued By. Permittee Signature: ` l 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. 07/13/2010 10:51 503- 6781r4a; f7� BEAR ELECTRIC PAGE 01/02 1 Electrical �' : r .. ` Permit Application r JUL 13 2010 -- City of Tigard 7 / ,. Pemrith sU� Phone: 503.639.x171 Fax: 13!25 SW Hall Blvd.. regard, OR 97223 tC� t -> ts: 503.598.1960 Y '' - i I a . 1 par Revi Other - do ��r�: � � l'; " Inspection Line: 503.639A175 "1 BUILDING. �!i`�ISl�C�+ l 3alettoady/Ey: r _ � l t_ r v SI See Pawn for • In ternet www.tigord-otgov *Jihad/ARsme& 8enptemetml tarormrafon TYPE OF WORK .. 1 REIVDT,q ❑ New construction gi Addition/alterationhreplacement Masao cheat all do apply onthinit 2 cos app wraicas denied helm* ❑ Dcnsotition ❑ Other: D Service or feeder 400 at e er more D Balding mar three conies. where the available fault omen esu D litarims and tw»yards. CATEGORY OF CONS1RUCETON a reeods 10000 amps m 110 seas ar Cl Floating headings. ►! I- and 2 dwelling �to wooed. orexceeds 14,000 0 Commaeiedmse agrierfirel Y ng ❑ Commercial/industrial 0 building amps forall other iaetalbtiona, buildings. ❑ Multi•family ❑ Master builder ❑ Other: 0 Fire pump. D woe of 7s X VA or JOB SITE 1N1!QRMATtON AND LOCATION separately derived system • ❑Addtionanewinnerleada ❑ "E". °1,2':"14", Job no.: Job site address: 1 t<Ct' S y y ■ � , imp 1 •, t�or aacr ey. A D rot o<mmn emiamtisl write Rancriesal vehicle parks. Ci(y/51aIelZlP: CI '} � J D Reow►epne (=Mica Q Srppy voltage i1>: more than T � A J " ©t[amrdotre fodniarts 600 volts coming Suite/bldg./apt. no.: Project name: 0 service c re r feeder 100 amps or me. Im /a �1 PPS -PEE SCHEDULE Cross sweet/directions to job site: ,... IE.7111 1r >s_lli New residential single - or ar h ftu i y- dwclltgg unit. Jacludes attacked game. Lot no.: 1.000 sq. ft w less 168.54 Tax map /parcel no.: Ea. add, 500 sq. IL or portion 33.92 Limited energy. residential 7100 DESCRIPTION OF WORK (with above sq. Al t� Limited energy, milli- rattily LMAG \\ ae L r k1(C�k c)( a 011 (- ' A Cr k 1. \� re sidential with above .. $, 7100 Services or feeders tnstallaHoa alteration and/or relocation • 4. .. - i 1 'i s . 200 maps or less MI 100.70 © 0 PROPERTY : ' • , 0 TariaNr 201 amps to 400 amps II 133.56 Name: 401 amps to 600 um:- 200•34 MIME 601 amps to t,000 amps 301.114 Address �rl a wvats = 6 M8 City/State/LIP' re mpora ices or feeders installation, alteration. and/or ocation Phase: ( ) Fax: ( ) 200 maps or kss 59.36 I - Owner Installation: This installation is being made on property that 1 own which is not 201 to AOo amps 123.08 2 intended for sale, lease, rem, or exchange, according to ORS 447, 449, 670, and 701. 401 maps to 599 mays 169 2 Branch circuits new, alteration. or ettenslon, • er panel Owner signature: Date: A. Fee for branch circa 1, with 0 APPLICANT I 0 CONTACT PERSON above service or Iboder fee 7.42 2 each btandt circuit R. Fee for branch circuits withow Business name: ► 1 service or feeder fee, first s 5118 710/ 1 2 Contact name: circuit - - Each add, Watch circuit \ 7.42 'I , 42 2 Address' Miscellaneous (service ar Seeder not included) City/State/ZIP: d man �m 67.94 II Phalle: ( ) Fax; : ( ) 67.94 OMB 67 .84 Email: Signor outline fighting CONIRACTOR • Signal circuits) or limited . . e .. , eretmettsi6n. �L> Each addtdonal • , , .. aver atiawaMe in , of the above Address: R. 0 , 0 / ,- Adthtioual itmpectlan(1 hr min) IM 66.25/ hr �- = 6625/ City/State/ZIP: o .�C j ` * n 2 �, Iawestigation (1 hr eel) 7LI W hr f C ` �� �J Industrial plant (t hi olio) I= 78.19/ hr 11=111. 1. Phone: (.5 I� — i 33 Fax: Ili. . f a i a: jpp listed which hr min is . goof hr Mill 1 lectricaal Lie.: • — • 011=1Stiall "y r ii atf, a:,:z;, l t ,l a a 1 Saptrv. Electrician signature, required: �� � 6IMty Plan review (25%of . - fee): — Print name: ie - ') n t\Q ! � i Date: t State surcharge (12% apart* pa fee): t_ �•• TOTAL. PERMIT Fes: i r Authorized s i g n a t u r e : . lids f permit ap pike Soo awhile a perdu le col obtained srlt 1n rno Print tastes days alter 11 has beet aeespted as com bo% Date: r Numberafinspections allowedperPomiL r hAypda CJW#1O(' 4atrf6iST(111aSf00MJWkA 0 -ear i l ei' :c Thic -