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Permit 1 o CITY OF TIGARD ELECTRICAL PERMIT 111 COMMUNITY DEVELOPMENT Permit #: ELC2010 -00716 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/28/2010 Parcel: 2S115AA05700 Jurisdiction: Tigard Site address: 10954 SW CHATEAU LN Project: EVERS Subdivision: Lot: 0 Project Description: (2) branch circuits for heat pump and service outlet. Contractor: BEAR ELECTRIC Owner: EVERS SURVIVOR'S TRUST PO BOX 389 BY DEBRA A EVERS TR DONALD, OR 97020 10954 SW CHATEAU LN TIGARD, OR 97224 PHONE: 503 - 678 -1355 PHONE: FAX: 503 -678 -1108 FEES Quantity Description Date Amount 2 crt Branch Circuits wo /Purchase 12/28/2010 $63.60 Specifics: Service or Feeder 1 ea 12% State Surcharge - 12/28/2010 $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 set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You ma • •i a copy of th rules or irect questions to OUNC by calling 503.232.1987 or 1.800.332.2344.. 1 Issued By: Permittee Signature* OWNER INSTALLATION ONLY — 4;a4P----C1 — 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. 0EC- 27- 2010(MON) 10:12 Bear Electric (FRX)5036781108 P.001 /002 Electrical Permit Application 1.( 111..1.1( l S,.,,".' City or Ti and nne lig 13125 SW Hull Blvd - Ti • rd. OR 9 ° ' O4p I)u I)' '7 I p ( - Permit tin.: �(" id-4671 G9 Pitons 503.639.4171 Fax: 503.598.1�(,I� A � Pim Role% Other remit f� hnrlh• r t c:.. a ri Inspection Line: 501639.417S 'co K • ate teadrn wn: E See Page 3 far nl- Interne: www.iigaor.guv \" illeJAletbud: 7D I Supplemental 'lamination ❑ New construction ® Addition /altentioninsl � rime chcck nil dust apply lwtimlljxt aur plan, ,hltentchecked wool; 10 r,',ecor !ceder 418i mpnurmurc C pudding over Once Morn% El Dem0litlOn ❑Other _ ahne thc available Club omen' p Marko. aral bo oyaMi. QjPep 403 (p p a CORM serif, I OJuu worn at 150 volt. or p main bulk/111p. Isv to ground. or coar.dr 14J11111 CI Commercial-um agricultural 1 -and 7. Curnily dwelling in Commercial/industrial ❑ Accessory. building um%lirr all .nharin.wdl.utnn. 1.4.IIJloo , ❑ Multi- family ❑ Muster builder ❑ Other: ❑ pira pump. in Inuedielnn u(7 kVA for tlt�. , ©lirrinat47 a larger scoured!. dotted r. nent RirQ. I QR;iaZOSI A[� itdb.. 0tard • a ' p° ri AdJilwon anew motor load or 0-A-. W: ". "I: "I.1`. Job no.: JoF pile uddruuu. { IuullPurmurc, uµ •, el� • � Q..\ � k..1 ' h, 0 skur murc rnkl.1.1 unl', 0 keeatinlunol ,0114:1s rk.. City/State/LIP: T i � J a c l O e ctl 21 © I Palm rare iwanitiet. 0 Suppt} soilage fur more Than _ f 0Ilwanlow� loot lhmw !Uhl vn11. Miminal. Suileibldg./apt. no.: Project name: 17 novice or (sole Nut Stlps or more. ' 41:11 tdIt ttlrial CrusssirCa /directions to job !die: Ur.rn,ta. I rit 1 u... ,_ taut 1 New residential single. ur multi -fa mlly dwelling unit. Includes uttnchhxl enniec. Subdivision: J Lot no.: IJIINI K1. ti. or lets I05.yd 4 Lu. add'I 5(111 so. 0. or portion 33 - 1 Tux map/parcel no.: Limited cnerg„'. residential Ii.TVGRLP ItROOP1i; v1I.O _ }, '� Iwith above mi. i1.1 75.01 2 Ltmanl energy. nwtrt.tumty l\ M (r • % • . • ' .. � -. residemialiwithuh'wc,W.n.1 75.011 `. `, . Service,' or feeder' Instutlallnn undlar relocation - tpwr.w t ■ t `�st�rt:�; l r i k ' , - k , =00 ampv or low 101,7(1 ', ,r, , ©IfSrkh+Si•iemi ire/. �F , '`i t w �:a ,.. ;),; ob.., I tkw tj .. ; .'1 : T't r, 201 amp: to 400 amps 133.70 • Nnm c: 401 amp, io 600 arum 00.3.1 601 amps to 1,000 turps 301.03 2 ArlFirrms Clrrr I (1110 most or w,U., tS7 7n C11v1Statd %1 h Temporary 'lenient' or feeders Manlius Ion. niteratlun. uud/or ' relocation Phone: ( . I I Far: ( 1 200 amp, or Ica' 1 59.36 I 1 201 worn to 4130 wmp. 125.00 Owner installation: This installation is being made un property that I own which is not intended for sale. lease. real or exchange. according to ORS 447. 449. 670 and 701. 301 amp, to 594 amiss 168.53 Brooch elreltl - new. alteration. orentcnaluo, per panel Owner signature: Date: A. Fce tur hooch circuits with ;e'..:• Ile 7::; t1;,, i3 IMMetls`kC..QMCIIIRl d[YMit'Ii above xrvke OP' Milo lW. 7.12 melt branch &cult [iuttittcr's name: II. Fee lire branch circuits ,/t ou, . Contact name: h /MINA or realer liv. nrv' 56.18 • d1u cirulll Addr�x: �• 4 " Each WW1 brand circub . 1 7 '� . � 2 yl,scclluneon,' (service or feeder out Include l) City /Strte!![P Each naptutitr:rure'darntndular 67.81 - dwelllnp, e.ervice and u.r P _ Plmne 8i:coronet on l I Far ( I y 67,114 2 E -mail: Hump or iniNttiou circle '17.84 2 Sign or uulllnc li 6714 Eft' lCONtCRrAC"I:O Ilk` T/WFAVAtei [ar 'brio .13'k,"C ads Signal cucuit(a; or 110,1,4.1.m.w Business name: ` r ' ,1](13,1(` \ (' I c\c , panel. nllonthlom. ha atoemGm- Page 2 LL TT'' �- 1t. Each additional Inspection over allowable in any of the above Add=s: P1_2 . )( ‘ • Additional inepedthm(1 lir min 1 Mies, hr ! - -Ci tatdJ1P. - - - - - - - - - -_Pnvatisatlnn.tihu'dnl-_. - -8 (hr - _.... . _ y � \ ° [ k11' 0 �� � Industrial nmtu (1 lir 7X mini 78 hr Phone: ( A` ) It = 1 Far: ( d I •--- : - 1 e 1 inspections din' which ne Poe is 90.001 hr npeelttully Weed iv, hr mini _ CCD Lk. 4 j t' Eleetrie.nl Lie.:' . -',Q " • '. Lie.: T I 4.1Fa;7#7104'.8ratiEl.'Y. I:1410,Al3"dCERMLI ;REEIN/UI41M105 Subtotal: Sunni. Electrician signature. required: �_ r��� �r�j.lef� Plan review (25%ul'pennit.r « l: Print norm- l r !-1 , . I f Rule I' kili r' L. _I(3_ suit. vurcharae (I2 ":ufnernillreel: 1, lei Authorized signature: 7' f07AL PERMIT FEE; - 11.21 � This permit upplk;Qwn r' tr a Its permit Is not ob4dnrd within 1811 days after it but been mewed as complete. Print n:m1c: I Date: • tiumhor..l'In.p.o,u.m nl4.n.tv1 Per p.•nit. HillI lightishtin tittle .t'.I'etno.Mryt,htt4a7a0 /1il 11iMuHYIi1t04.3Iyi 'I:Ii