Permit q
CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2010 -00662
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/24/2010
TIGARD . Parcel: 2S114BA15400
Jurisdiction: Tigard
Site address: 16085 SW COPPER CREEK DR
Project: Washington Subdivision: COPPER CREEK NO. 4 Lot: 119
Project Description: (2) branch circuits for heat pump and service outlet.
Contractor: BEAR ELECTRIC Owner: WASHINGTON, KEVIN C &
PO BOX 389 HARTUNG, KATHERINE D
DONALD, OR 97020 16085 SW COPPER CREEK DR
PORTLAND, OR 97224
PHONE: 503 - 678 -1355 PHONE:
FAX: 503 - 678 -1108
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 11/24/2010 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 11/24/2010 $7.63
Type of Use: SF Electrical
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 sets forth in OAR
952- 001 -0010 through Os" 952- 001 -0090. Youmay_pb o ules or direct questions to OUNC by calling 503. 987 or 1.800.332.2344. ,
/ J
Issued By: i_ , ��-, � 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:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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.
NOV- 23- 2010(TUE) 15:57 Bear Electric (FRX)5036781108 P.001 /002
!° ■ CEIVE it
Electrical Permit Application • Wit Oil' ,IC 1: 1' St; O%I
N 2 2 010 '
IL
City Of Tigard gr
: --' 1 3115 SW hull Cilvd.- Tigard. OR 97,',,,'' —
Phone. 503.639.4171 Pax: 5O33t1 OF TIGARD EffliiiINIMIIIIII
-r• rC::A IiS ' inspection Line 503.639.4175 Ilene ltendvrlty: x. H See Pa¢r 2 fir
Intend: www.tiinuilatr BUILDING DIVISION Nutific 1 Mct o : () Supplemental Intemintiun
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".. t JtlI1't$1�1E[wli {rs€Elt,�k{1Yi.
Q New construction ig. Additionfalteratirnlrepincemenl rte echaa 1111 into 1 I: twunrnII I sets proo %r et used! nchnvi:
pscemee ortoshT, 4 ttumrmnrmtr: 1 fluitdingitter throe Oulu
El Demolition ❑ Other. Mat the avaqunle rout'. coml.
❑ tltrinus and Fx uq unls
¢'+4t i4 %:. i , a : „I. )5.j.I';:c ^ P'C 1► '�irada> leant ric �;�41 'FR. �t �ctx.Int amp. allSll Volt, cM ❑ I'kvrdrbt 6uilJlnFa
ICtu Ill;mond. or C11cLcds 141111(1 ❑ Cttmmcr aul•tm: saltriculmntl
1E,1 - and 2- Carnily dwelling 0 Commercial/)ndu.strial 0 Accessory building .t.n,p. llwrn.snn.inxwnxti.m . bolldinNw
0 Multi- family ❑ Master builder ❑ Outer: ❑ fire pump. cl innullulhm nl'7t KVA or
„� s .�� t � Ernergulcy t;yocm. brute set urisely'l nsed -own.
s � My ;w i'::i argt -: �t'T O :O O1 S '4Cpl� �''a +:'is s ' X : " motor Imid or r � i
Tllr 'QAiiOxip' yt�41��1 A ❑ Addilittli ul'n1 m 1.7 .A^,17, "1
Jolt no.: i Job nit° "4`41•"1 :, in Cr`,�` IP , (�" e . __ f illlitlP e i t - A ke uel
, �r'� ` C1 111� Slxc , rmewc rc.IdantiuQunitr. ❑ kcet�rotlunulvchI cle purso.
City/Statc /Z1?: o I ` `e S —A 1:1 I Iellthworc I'acilltky, CI supply vin(,µ litrmore than
- ❑ l tirenlocix lounge((: nun wits nominal.
Suite/bldg/opt. no.: Project name: ❑ so-decor l tidt 1,0(1 mourn. murr.
Cfots ddircctians to job site: 11,.,11 int, R1�g1 1 ' tilii1ipN i Qlii :
t irrc
_ j l l eltx. i rr. l !nl »1 1
Nov residential single- or m u Iti.fa roily dwelling unit,
Includes attached gunge.
Subdivision: I Lot no: Cum eel. it. orlets IhN.34 4
C•.u. utlti'I 500 sq. 11. or pllrtion .13,k2 1
Tax map/parcel no.:
Limited energy, residential 75.00
2 I eretiegg1 g ESCRIE 1101420 1110 • .44 "• a •'' " , t•..q I :in $w v (with above Mg. 11 )
LimIICM entry()', nlu ltt+tamtly
\T1`re, \ csk ‘....‘p 1. 0 P/C syc p1 t, , }t�'C 1 , residential twilhutxwc.y. R_) '13.0(1 3
r � � sorrinw or feeders inniallatlna alters: Ion. andla rclucntiun
a. -� 1d` ,C\+1 \_ , � l? ` 2. amps or lens 1011.70 2
PI:::',' : l,isl „' . fl 1 iMe'.6 1W ff li<sr ; ; Qlagl' ” C3 r 4 itrS 201 umlm 10 400 untps 133.30
401 ilmtni to 600 snips 200,34 7
Name;
- 60l amuse, I,IIUUUmps 3ot.(R _
Acltimm:• r t neut sows or volt. ct7.11, 't
City/State/ZIP; Temporary xer'viccs or renters iostalllrtion. alteration, undlor
rcluration
Phone: (, ) I Fax; t 1 200 Mips or lag 50.30 t
Owner h uhtitution: This installation is being; made on property that I own which is nut 201 " " "' to 40D "n'va 123.(10 2
intended for sale. lease, rent. or. exchange, according to ORS 447. •49.670. and 701. (11 uitips u 599 tra ,pn I ri8.3 _ i .
Branch circuit% — new. ullen, tin o. or extcnxlon. per panel
Ownerstlgnaitire: r Pn IC _ �.µ D r
' ate: ayw A. Fee circuits with 7.42
4) dam. ;`,.1 : 6::: ® W.+, . t t .. ' .,',; iii ' , .I
; r . »�! O. ivaa Arsi t'r�l ahoy xctrl ur c�tiUcr Y ,a
, aeh brunch circuit
it
alliinrts name: B. Fccliir circuits wkhonr 1
'Service or feeder fee (lest 36.1 R Sip. 1 D
CclnttICt Mime: .hlti circuit
.. �l • Each 144'1 timid! c(rculi !< 7 -42 —I. L .
Address: 511sec�1la acaus lservtce or render oat Included)
City/State/ZIP: ,ZIP Each menutbctur or mod u l ar 117.144
dwe llmt, xe','li e lind,nr 1 ,h'r `
Phone: ( I I Fax: : ( 1 Recanncct tit: ly (174(.1 2
t'unip or irrigation circle (RN 2
E � } f p ,,,[g�� vla��y�y� / IY �q 9q C WG$ µ[Vi � E y 5 Sign or outline lighting 67.114 t 1
V✓vv 'I>= 11/rai WbSYWZERafr3Ctir i'tie. {WlA✓�Y � '' b,6NJxj'�Jg i y�a{t',jA Sigma timitl%1 'micro. '
Business name. ra c F `c: . \r' ` puncl.u llcration.orextension. Puuc 2
t i'.ilclr AdII idonnt inspection over nitunuhte in am' or the ahoyc
Address: pr f p 0 y Q 9 1 Additional inspection (t hr "tin l (CV hr
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t^ Industrial plant (I hr min) 74.1 N! hr
153 .L1
Phone : --t $- 1 R _a 1 Fax; ( SCS I �� Z.1 inspections rue which no foe is
r - � � C.l 1 � Tecl(lcatlly litltcrl l'/, hn
Lk--; (J ni !) 9U,UUl hr
CCD L.; " C ( � \ I '_ 1 Cl=rical Li ,' 24- c l Suprv. Lk .; 5 eyg 2, :te9 71nt"�a`",d 'tSC i "twu 1"E'KhrLmN!t;Elai21g >Q` ?<_F t
t t Subtnmlt 1p r (
$uprv. Electrician siLua lt . tequircd: M 0 � � '11001-5 phm rcvicu (25%orpcnnit rccl:
Pr'int narni7\.Lcx \[rte, -v ` .� I rinrt:• I 1"-r2.3"-- i ! //11 Slate ;uiri:turruu(I 274orncrntltrccl: 0
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Authorized sigrutttue: V , \ l ! t p'1'A). PERMIT { GC; �
. 'rhix penult epplkutian esplres If n Iterntlt Is not obtained within inn
doyw atterit I been rireepted as complete.
Print num= — I Date:
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