Permit CITY OF TIGARD ELECTRICAL PERMIT
` COMMUNITY DEVELOPMENT Permit #: ELC2011 -00047
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/20/2011
Parcel: 2S114AA00200
Jurisdiction: Tigard
Site address: 16285 SW 85TH AVE 307
Project: Columbia Heating Subdivision: DURHAM HALL BUSINESS PARK Lot: 0
Project Description: (1) branch circuit for 50 - amp receptacle.
Contractor: BEAR ELECTRIC Owner: SHIPMAN, W H LIMITED
PO BOX 389 BY NORRIS & STEVENS INC
DONALD, OR 97020 621 SW MORRISON STE #800
PORTLAND, OR 97205
PHONE: 503 - 678 -1355 PHONE.
FAX: 503 - 678 -1108
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo /Purchase 01/20/2011 $56.18
Specifics:, Service or Feeder
1 ea 12% State Surcharge - 01/20/2011 $6.74
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $62.92
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 obtain a c the rules or direct questions to OUNC by calling 503.232.1987 or 1.800 332.2344.
��� Issued By: � � Permittee Signature: ' 9..grz-e . �-e9A
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.
JR11- 19- 2011(WEB) 16: Bear Electric (FRX)5036 ?81108 P.001 /002
,4 ,:.., .`t;:)
Electrical Permit Application foil OFFICE USE ONLY
City of' and ° r\'\ it"v I ( 11:1 /WI'll I"ermi, --'4. j—
1 1111 Wells: 61 1312 $1Y Mull Blv d,. Tigant OR 97_ ^23 Q� 1 Itm °Ki,i�„ -'.11:
honc: :itl7.( >3 >14171 Fpx: 51)1.591i 4{� • il
Other { Cf IIIL
�� = iT.'I
his talon Linc: 50363
. 94175 Y `t7utCHcltka.(y': •• see I "age2 roe
TIGARD u I. ° " j et ` t titw0lctf.�t,ethoI: Supplemental !memo; www.11 :lni.or.'4v ® pplemental lnrormatina
. r:
q - 'fir .. 0 tl W4lt14 t' A e,r. *' ' ) �' $il u : "PL:AI k ' " tw , ,� ,
- sr t'Iculccbeck all lent apply Ivubmit 2 sets or plartxv,•it
, emil chucked haltnvt:
El Ness construction AJdiuon /altcrution/replacement),
rr:�I1 t;". ❑ Sw.rriee or feeder doll amps or more ❑ Building over three aluric:c
lJ Demolition ❑Other nhcre the available I:tuhcurrent ❑',Marinas and bon) unis.
Etit r' +. .. S.o "1" .....,10,001) mpa ut150 low, ttr ❑ rioloinu buildings.
t:wfr:,., t, :ciOls t .t" 1,
less u, ground, or tmcrd4 I .1,1n111 in Commercial-use u0,riculwral
_ ! - and 24amily dwelling Eil Commercial /industrial ❑ Accessory building amok IhralI other instal Iallam. buildings.
❑.Multi- family ❑Musterbuilder ❑ Other: ❑ Eire pump. ❑ Installation or 75KV'Aur
*
CI Emergency system. larger separately derived system.
'tri v lv� r t �.r m �.. . .' .
M tn �!;... +t.i a J4 Cy>,r?1iNAn
C1 G` ' w;,: n . lx "1.2 "1-3",
'_` c� �''.)�' ❑ Addition of nova mater load of ❑
Job no.: Jab site address; FI "VV 7 ' rS ` 11)IIN ormore. occupancy.
1 t Vl ❑ Six nr more nsiticntittl ❑1teereutionul vehicle arks.
City /Stine /7.l Pr-- , 0 r e
PTO O2 ��� / ^ / ^( � L ..\ ]� /_� 0 t1,tlth.curc t1,ellitiet. ❑ Supply voltage for more Own
o `• "S ! L.tA -1 '� ( A. f / l3 ❑S er ice o r r M nut
S
�� u loca tions.
nide /bldgJapt, m.: 07 Project name: ' CQ E � a rftwJtrbUn iylspsor * N r rarar tea-' -••,. , t / e A It.urnto ,tpF t4ZkF�f r:� "t " � •
Cross ,a lx lime
Cross stroet/dtrec r. , SI)C: tt•.ar - r C,16v.. I ter, 1 Y I C r " v
-- New residential single- or multi - flintily dwelling unit.
Include* attached gortrge. '
Subdivision: I Lot no.: 1,000 $q, f>, ar los 168.54 •1
' t:u.m id' Sot) tit. 0.. or portion 33,92 1
Tits map/parcel no.: _ Limited. energy, residential --
ara 75.101
ritO � Y,' ; 'Mile'SC,};k11'I
,7'f,'i 1Jlr«,'ti�Y. � at.. ,,tA." re.r. :sir.' (with ahnvesq. n.)
ft�+rre "'nnrer. sea .w.t .f
Limited energy, multi- [itmily 75,00
\ *, La `c 1'1-\? SL �f� _ .. .. residential (vvith above sq -11.1
�"� S �� SCMCcs ur feeders inetallntion sun. and /or' relocation
�' .,., rM° 1 o
200 nmizr ur less 100,70 2
h :.A � k t dye .lr m, TE ' a : .' , 1�wy 201 ampslu411U tarps I J).5(i
401 amps to 6011 amps 200.1 +I 2
Nome: „ 601 amps Iu 1,0011 amps 301.14
Address: Over 1,000 limps or sutra 552,26 2
Temporary services ur feeders inistallit(lun.111lerntban, undlur
City /Slate /ZIP: relveolion
Pions: ( ) l Fax: ( ) 200 amps or lest 59,36 1
_ 1111 201 amps to 400 amps 125.11 2
Owner installation: This installation is being made on property that 1 utvn tvhielt is not 2
intended for sale, lease, rent, or excl an e, according to ORS 447, 449. 67 0, and 701. 401 amps to 599 am ) 611.5 4 _ .-
Branch circus tv - new, alteration, or extens per pia nil
Owner sit;llature: late: A, f•Ce Tot. branch circuits with
�u ne " y p ; , ..„ � .�, ubuve sexy lee' or feeder fee. 7. .,
w' . �.�5 r r , 's �r:A wk ti i I • wit 1'IF"1�.. +
, G r �. "t'�i�l Iry r l °+�,'� .�'� �, ' ���Xd''�PR� i. T 1..,. �G)� VdYI , � ?ill "12
-�--w --LL � eac brooch cVrcuh
Ausiness bonze:; • li, (sea for branch circuits trldlot,
- service or ieeder lee, first 1 SG.I A `� 2
ConhiCi name: brunch circuit r
Each odd") brunch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
Cit l SttltrJ7.l b +:
Hach munuli cttmcd or modular � i
J dwelling, service and/or feeder
Phone: I ) r I Fax: : ( )
Reconnect only 67.64 2
Pump or irrigation circle 67.04 2
11,-Mail: or oatlioe
Sign ig! thtt„ 2
pS :,�, :n , ,n, I 1 61.1{+1 �.-
Si
..,'11tiu f *` ^" ;;^r r .CO• '�il!t 1•VI . M air : ' ' 'f ,....n , . ., , r Y -.
V n tare), ci era x ) or limited-energy
glows name: r �'
uncl• alterutlun, or extension. Page 2 _ 2
I �. A 'Each additional inspection over allowable its any of the uhove
Address: 1` e (\-x -{ w ' A C Additional loypoeiion (I lir akin) 6625/ hi _ -
('�� J - - Investigation- (I- brmInI - — - G6,251-hr- -- — .. -.-
-.-
- Ci ty /S tate /Z I1' : 1 ^
industrial plant I I hr min) 78.18(
Phone: J 5
I l pro '5c Fox: ( — [' 1 ‘0 inspections for which nu rue is
�� pp � s cct Beal ly listed ( "A, hr min) 90110, hr
CCd Lie,:'L0et (Cis Electrical Lie.: q~ C i Su,1rv..Lie.: ` ❑�� i „ta R+ w t ,, ' fhl ,r L�I1 � =' . ,
Suprv.
Subtotal: j I j 1
Suprv. Electrician signature required: . 4sa r Plan revi (25% or perm it. I'ox:l:
Print name: ♦ Dote: \ �^ ` Sla te aureba (12% of permit fee): , L4
TOTAL PrRMiTr•Er:: t "�
Atli rizcti 8lgnarllre: Thus permit application expires fin permit is notuhtulned within OW OW J
fi
days after it has been accepted ax complete.
Print name: LDate: I • Nnmbe nr insp,. noel al laved per pwxmlt-
LlIuitdi ,wplPemtital.C•lknnilApp.ch,n UWWUI /lb .H5- If,11c10 br>1JCUM,tVI Ii