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Permit " CITY OF TIGARD ELECTRICAL PERMIT 111 COMMUNITY DEVELOPMENT Permit #: ELC2011 -00111 T [ G A R D, 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/25/2011 Parcel: 1 S 136AD01700 Jurisdiction: Tigard Site address: 6875 SW PINE ST Project: BLUME Subdivision: Lot: 0 Project Description: (2) branch circuits for new mini -split unit and service outlet. Contractor: BEAR ELECTRIC Owner: BLUME, JULIE E & HENDRIK A PO BOX 389 6875 SW PINE ST DONALD, OR 97020 TIGARD, OR 97223 PHONE: 503 - 678 -1355 PHONE: FAX: 503 - 678 -1108 FEES Quantity Description Date Amount 2 crt Branch Circuits wo /Purchase 02/25/2011 $63.60 Specifics: Service or Feeder 1 ea 12% State Surcharge - 02/25/2011 $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 per it is issued subjec o the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be d• e in accordance with ap 'roved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 day ATTENTION: Oregon law —• • - to f•Ilo the rules adopted by the Oregon Utility Notificati• • Center. Those rules are set forth in OAR 95.-001-0010 th •ugh OAR 952 -801 '090. You may, • - copy of the rul= or direct questions to OUNC by callin 43.232.1987 or 1.800.332.2 44. Iss• B : .411 �/. L. Permittee Signet . _ ' 4 •,,!� i� OWNER INSTALLATION ONLY The installation is being made on property I own whi• is not intended for sale, lease or rent. OWNER'S SIGNATURE Date: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC' ( 13/ 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. FEB- 24- 2011 (THU) 15:41 Bear Electric (FAX)5036781108 P.001 /002 Electrical Permit Applicatici , ' FOR OFFICE USEO \1"Y City of Tigard - 2 4 2011 h.tccived m t3alc /n■ 13125 SW lull Blvd- '1'iganl. Ult ■t7223 II Phtu,e: 307.639,4171 i':1x: 50.59K.1960 lini Other Permit; TIGAItO Inspection Line: 503.639.1175 Dot.: Kead.Ily: runt: •el SST Page 2 fir inlcmct: www.tigurd- or.gov Noll '4tcthod Supptemrntel Intornlwlon tn" 1'�:r i TYPE ",QF " I i tit ,. .. r �,. ,.. , V;1 'Y:h.. " r.'"; ,. t � " '� tp d : \VOR)IC1, 1 l�"""1"�iM reel M �"(n.� n '�"'�'�" '`t�► t'�"� �� � �'�l�'.. 'Y�'` i4.,,, t,," : {, ❑ New construction ® Addition/alteration/replacement Please cllts:k till Thal amply 'Winn! 7 Nees ul - plrue wiin:ars eheckex) below): ❑gpsice orI'wtkr4(ul oaths or Mire C7 'Wilding over threestories. ❑Demolition ❑Other: Wien: Ihcin ❑'Vtarina4 end bout) et*. ;,..,. + " n" ,s ,. .00.E(.ORY,,,"„gl" .ONSTI/WcrION: „ r ,+, ;ki ,,, . ` . meals I0,tlixl amps al 150 VulI VI' 0l'I.ulltlg. buildings. less to ground, or o wed% 14.000 ❑ Commcrelel -use agricultural El 1 - and 2- family dwelling Cl Commercial /industrial © Accessory building amps liirell other Installations. buhdintls. ❑ Multi - family ❑ Master builder ❑ Other: ❑ lire pump. ❑ ln.tulludun of 75 KVA or t ,rei 1 . ❑ linxrgrney system. laser separately derived ...mem. s ., :;,'4, ..�e.x f': a tt, 0F,R I TON , . a i }," ' ; " 1 i. tgs sir i • Q J ❑ Addition ul'rww rn.,a,r lord ul' ❑'A ^ ,'I" »I -. • -1 -i" Job no.: I Job site address 1 n$ +� p ` ,�� ❑ h10111•..rmnre- � uetupaltcy. � 1 `-' \ Six or more residential 'mils. Revreutional whiele vuks, City /Stalc{ZlP: { 1 l 1 �""� -iZ � ❑ 1.1.10,..... Willi le.. ❑ Supply ■r llytC fire Ruin; lien 111 - (�- \"'S' ❑Ile rnk limit Inns, ply Muni n:l. Stiitrlbldg,/apt. nu,: %"-) 1 Project n :tine :' , ❑See keorl'wJ:rG(r0ump. c. 1111115111191111111MfiligirEKSCITSMON.4*Plifi2.E :;' Crowe; ttlreelldircclions to job site: t,.. I yl.. I Per, 1 - I nl11 I - New residential single.' or multi - family dwelling unit. Includes nthiched go rage. Subdivision: I Lot no.: 1,000 sq. 0. or less ul x.54 "I'm map/parcel l no.: I:n. add"' 500 sq. 0. or portion 33.92 l.hnh..'d cliergy, n.'mldcnlIul � . I. ".,+.»... ".. a 4,t :9:7 ,,a,tara (with :atmc3tt, 0.1 75.11 . � ey t� / rq q � .. '���„',r�,r:r7tudw ►1W1.Q1' xSt awe El Lim ilea energy, muld-l:miily 76.00 \n"45p \\ 4 Cr∎ -- \Lk- I. ..X-.); '$ S\ residential (with ah.rre ari, reel Services or feeders installation alterathin, rend /or relocation j _j� ryQ,r, e']�5,.. r r g 200 rumps or less 100.70 2 Pt ":'. n "'"` ^Cott; 0 tii'l 0*40 7!' N. `:�-'r ": Y!, N 4 1 . �:.- M .. 201 amps to 400 amps 133.56 2 Name' 401 imps to 600 amps 200.34 (101 amps to 1,000 amps 301,04 2 Address: Over 1,000 maps or volts 552.20 2 City/Slate/ZIP: Temporary services or feeders Installation, a l (era t in u, and /or retool Phone: ( ) I Fax: ( ) 200 amps or Iess — 19 16 1 I 211 amps to 400 amps 125,118 2 Owner instullation: installation is being made on property that I own which is not - - ` intended For sale, lease, rent, or exchange, according to ORS 447, 449, 670. and 701. .101 amps to SOY mops 1611. Branch circulOt — new,ulterrllnn, 1Cution,permod Owner signature:, Date: A. t'eu for Mulch circuits with r ,,. + . «w; d , t above service or feeder fee. uN, ..;�1tl7ttMi Ei pu . s.. " . 3 . ©" : 1 .... " r In t?amrx^ .. a� :aria u..: 10 .-:.. ,,.. ..... 7.J2 ' each hManch circa it ' Business name: 13. Fee Ibrbranch circuits wirlroi• - - - -- - - . service or feeder lee,tirst 1 ' Contact name: brunch circuit 56 .ixJtp.� v t ( 2 . _ . 111311EMMISIIIMMIIIE1 Address: Miscellaneous service or feeder not h clotivtl t:kh manurauurtd or nodular 0 tolw CitylSlute/ZiP: dweillnn. xervlce atvl nr reader Phone: ( ) I Fax: : ( ) Reconnect only E Pump nr Irrigation circle .. .. '!! `�� '� Y L� "k X8'" P%' rrY ' P k{ N • Sitar or outline lighting . .. rf �. 4li ti:::^. wa; ware^• •C lOR',s" ;'Tone ;,n .AFN :....u.... ,..,, wl) Business name: ?)a-) F \Pc c .K[' .l \ , and alteration. or awns ion. Pa e 2 ; Address: M ` T • ,�, CtyfSlutt:jZil' ................_,... .. I'hoho: fl - 1 (. r rase: chi tv1' - 1 hispothitms for which no foe is 90.00i lir • CCI3 l:.ie.: Electrical Lie.: "-' C Sur Lie. :' g \. • �'""""" ' ;i., " 40114114010 ` ?SJ p ,. '�f.,' . r:E►Tlarw�r E Super. Electrician signature. required: \ Sabtotid: tit , „(rC LP �P..� AS Plain review (251's of permit feel: Print nulne:' 1 9 II w • l♦im 1 , 111 Date: 2-2 _ State surcharge (1.2% or permit fee): 1 TOTAL I'tiRMrf I'LL ( Authorized signature: _ -- ' i' his permitnppl. lcatiauexpiresIf tobtainedwtbi,ttrio Print drys ..err ii has Levu aecepird as curs pier. 1 riot mite`: i Date: • Numberorinspvetions allowed per permit. I-'3luiltlingSfr mrrs11 e.i'lu.nit.pp AN a'ant10 440- 4015'1'4 110054, rotiW'eu