Permit ''r
C ITY OF TIGARD ELECTRICAL PERMIT
• COMMUNITY DEVELOPMENT Permit #: ELC2010 00378
Date Issued: 07/23/2010
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S103BB02500
• Jurisdiction: Tigard
Site address: 12115 SW 124TH AVE
Subdivision: BROOKWAY Lot 25
Project: Howson
Project Description: (2) branch circuits for NC.
Owner: FEES
HOWSON, BRIAN C & GRACE A Quantity Description Date Amount
PO BOX 4017
BEAVERTON, OR 97076 2 crt Branch Circuits 07/23/2010 $63.60
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 07/23/2010 $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 OA -001-0100. Yo • • . - r' _• , �_ les or direct questions to OUNC by calling 503.699 or 1.800.332.2344.
Issued By: —� '�" % -
_ Permittee Signature: �� 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.
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.
07/21/2010 15:16 503 - 678 -1108 BEAR ELECTRIC PAGE 01/02
Electrical Permit Apolicatio ®DECEIVED ° ,,
City of Tigard . Received `"a/
1312S SW Halt Blvd., Tigard, OR 97223 J U L 2 1 2 01 Q °ate01 L (��
- Phone 503.639A171 Pax: 503.598,1960 R....,.
03
1 ; ti i ; _ Inspection Line: 5.639.4175
CITY OF TIGARD 1 paaaa
. . - . ' lu m= www.ttb 63 lAv
IMEIHRE
Tea of MDING DIVISION _ " .
0 New construction 11 Addition/altert<tian/replesxmrnt Please ebode al Oar apply ( � Iva= checked below):
13 Demolition [a Other: 4 Servile arPed �
a400sormore sea DBuiZdng aware* sto
Qua the available limb ammo 4 Maim and boatyards.
CATEGORY OR COAsTRUCTION eeczodi 10,000 amps as ISO vote ce D Floating buildings.
1- and 2- family dwelling C3 t omn erciaVtndustrial D Accessory building less to UMW. or =zeds 14,000 D oaaaoeaeiotgesealpiouunrat
Q Multi-family 1:1 Master builder amps far all other iartamtiow. bonanza,
D Other: CI pimp. D tauanatIon 475 KVA or
JOB SITE II!t !ORbIAIION AND LOCATION D fey system. tares sow, c sy µp q ,
❑ Mahn anew motor load et D "A". "E';"1-2",1-3".
Job no.: lob site address: -1 h A - 100HPer occupancy.
A. D Sin or mere a:sidaatiat snits. CI Reas�oaal wbicie reties,
CitylSWtdZIP: - �7�"3 D Hazardombocalio L � 600volts mina mrofadma
Suitelbldgfapt. no.: 1 Project game_ t `+ 1 A d Savior enfeeder 600 amps ar atom
-FEE SCHEDULE
Cross street/directions to job site: •
New residential single- or mul11- fam1)y- dwNiiag BM.. ft.
1fle1ude3 attached garage.
Subdivision: Lot no.: 1 000 sq. IL or teas 16g.S4 4
Fs add') 500 se> it. w peuliaa 33.92 1
2
Tax map/parcel no.: Limited energy. residential 75.00
DRSCRJFIION OF WORE ( ebovedtit 0.)
3 ,. t KNA i L Limited ` q
i - MA C\e 1 JC) t T c) (_irl .1,'■'r tesidea al (with above s IL) 75.0D 2
`
I /� t Services or feeders Installs atteranot: as ki rdemtbn
IcV lc Q C".`te A c. 20D amps or less 100.70 12
13 PROPERTY OWNER 1 0 TENANT 201 amps to 460 amps 13336 2
401 amps to 600 amps 200.34 2
- 601 maps DI 1,000 amps 301.04 2
Address: Over 1.000 antes or v0lls _ 552.26 2
City/State/Z113: Temporary services or Feeders lmslallat1OI, alteration, andfnr
relocation
Phone: ( ) Fax: ( ) -- 200 amps or teas 59.36 1
201 amps to 400 anti* 125.08 _ 2
Owner installation: This installation is being made on property that I own which is not 401 amps to 599 ita — ae amp_ 16834 2
intended for sale, lease, tent, or exchange, according to ORS 447, 449, 670, and 701.
Btamcb tinemw, alteration, or mamba, per mod Owner signature: Date A. Fee for branch circuits w1m .
above service or feeder fee,
Q APPLICAAPI 0 CONTACT' PERSON each brunch circuit 742 2
Business B. Fee for branch circuits without
Contact name:
branch a nits: ken rust , 56.18 51 r i$ 2
- Each WWI brush ciiwit l . 1 7.42 -- 7 , 42. 2 .
' Address: Miscellaneous (service or feeder not included) _
City/Statef7.IP: Each manuthenrrod m modular 67.84 2
dwelling. service andfor model
Phones ( ) l Fax:: ( ) emir 67.84 2
E- R1aiL'
Pump or irrigation circle 67.84 2
5iaptttroufliaeli 67.84 2
C O N T A A c r O R S i g n a l gy
Business name: (l J ' ' \ (�) \ (� ., sal, a dditi o n. or easiaa Pane 2 2
�Q Each eadditional ims peelEoo over allowable In any of the above
Address: c), e r �x . 3 'v _ i t . Additional inspection (1 hr min) 66.25/ hr
City tate21P: 1 X inc i (�A —7 t Iu4umia Irtirmi � 78 .25/hr -E
Ittdwtrial Mil 78.I8/bur =M■
11 ne: M 4 4 Box: a� aA . Inspections for which no fee is 90.001 hr
* apedaeadly listed (SS hr min)
1 Electrical Lic.• _. t.-i— G V Supr y Lic.: ` .. _ summit. rERMrr PEER . _ • . .
Suprv. Electrician signature, required' _ , c _ .� suteo • _
Plan review as%ofpaat 1::
\ =charge (12%ofpermit ke): - 7. l n?
Prim name: � 0� • R ,a . a / :all ILO. 1 * -
TamrExMrr FEE: 11;2_3
Authorized signanne: Ibis permit appneaden expires 1 a permit as na t Walser wain IoW
days after it has beds eta+posd as aoa>olem
Prilltnwue: • Nember inspections allowed per permit..
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