Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2011 -00433
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/03/2011
Parcel: 25101 BB01300
Jurisdiction: Tigard
Site address: 11950 SW GARDEN PL 100
Project: Vesta Subdivision: Lot:
Project Description: (1) branch circuit to reconnect rooftop unit.
Contractor: BEAR ELECTRIC Owner: WALTON CWOR PARK BC 8 LLC
PO BOX 389 BY CTMT - WALTON RE TAX
DONALD, OR 97020 4678 WORLD PARKWAY CIR
ST LOUIS, MO 63134
PHONE: 503 - 678 -1355 PHONE:
FAX: 503 -678 -1108
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo /Purchase 08/03/2011 $56.18
Specifics: Service or Feeder
1 ea 12% State Surcharge - 08/03/2011 $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 a ance • 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. ATT TION: Oregon w re• • ou to follow the rules adopted by the Oregon Utility Notificat.. Center. Those rules are set forth in OAR
952 - 001 -00 0 throu OAR 952 -0 1 -%.90. u may obtain a copy of the rules or direct questions to OUNC by calling -. 32.1987 or 1.800.3 2.2344
Issued B . /� a �'�`'' �l Permittee Signature. di*
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.
RUG- 01- 2011(NON) 15:46 Bear Electric (FAX)5036781108 P.001 /002
Electrical Permi APnlicatii`o'n ' FOR OFFICE USE ONLY
City of Tigard fl L u tt ti -, f Vetmil N„.: E�-� di— fi0
■ 13 i 25 SW Hatt t3ivd_ Tieanl. OR 9722 t't:a, ulYtCl■
hone: 503.718 .2439 I•ax: 5033911.1 G 0 2 2011 Dwells: Other lttmle He P...,,24//-A, 3,2
T I GAl'L l)' Inspection Line: 503.6559,1175 De m Read'dl. ; AMH: 0 bee Paget for
Internet: www.liganl- or.gov rrni np Tinb.;:ln Ng% 1 licd:ltelhnl: Supplemental Infarmatlon
w � ,
Get` - �i i „: i A 1 , r > ,� I 4% F..� ., _ - -
'" M � ti�wn. d1 r i �:�� � 4 ,w , Yn V '�i �' +aY 4 Y Y•�t w14� "w xrrr�� -� ' r .
❑ New construction Additton/olterutkkW reptocement V Ir1L'IifiL`i hOCII all that npplytsubmlt j ot'plans whims chockat below':
❑ Sirs lccor I1vd4s400 amps or more ❑ building over ;lime sturk'se
❑ Demolidon ❑ Other: ntsirc the available oiuh current ❑ Marinas and 110c11yultt3.
»tr 1 -� ttnd 2 r"%''. dvvcll ❑ Commercial/industrial O ifil dustrittl ❑Ace y A, , ., "n i`," .;: lom of amps i:m: t 1 4.010 or ❑ Floating buildings. . e u
• • � CeOR1",�OF C. QI�S3721i. D � {'
Il:as m ttnrund, or cseced>< 1dA1111 ❑ Commcrelul•ux a
Accessory budding amps fi,t' all other Installations, buildings.
❑ !Viol tt ! ❑ Muster builder ❑ Other: ❑ flrepump. 0 Installation or 7$ KVAor
� iH ,,a yy 'y „. ar w ” * i , t CI Emergency s} ew Im larger separately derIt system.
,•„ l i fIQO, QN AIrQ! l� ❑ lddilkmofnewnwmr low „f q ° A" .. "1 2
Job no.: Job site address: • so A , « 1011111 or more. twnrpune.
❑ Sl.c nr man rer,identtul units. ❑ IlLvo utional vehicle parks,
❑ I wilt- are i'aeinhics, ID Supply voltage for more than
0 hicvrtrlous locations. (ion volts nominal.
Sllitc/bldg.hipt. no.: MEMININE ❑ Sovlce nr feeder 6011 amps or more.
,'li; .4 wr. .4 . "j∎I; . •3 ,: :V' S • a } ' MAMdMaZW M Y Akio . a I,
Crow street/directions to Job site: t<+IISO •
New residential singly or multi.fnmily dwelling unit.
Includes ultacltcd prime.
Subdivision: Lot no.: 000 $11. 11. or less _ 168.54 4
Tux mariptt eel no,: P.n. add' 500 140. a. ar porliun MI 33.92 .1
Limited energy, raldendal ■ 75.00 2
; '7'4mv '' mt i r4 r t, ' S.. 01`l C1ZN i VI !u , w w ,. fwhh vhnnos • It
Lim lied energy, mulch - family I.
residential with above • . al 2
s
Services or feeders Installation alteration and/or relocation
200 longs or Icsa 111M 100.70 2
4 w Q 4 :0. ‘ t!'"V'''St If ; 1' 1 "44, rw `w t D' ,N." ;,, . "J 7 I',
401 tuners to 600 amps' MI 200.34 2
Name:
601 umps to 100 amps NI 301.04 2
Address: Over 1,000 umps ur volts NM 552.26 2
Tcmponiry services or feeder's installation, alteration, andlor
retoeution
Phone: (, ) 200 amps or lens IIIIMEIMIIM I
201 amps to 400 amps IIMIESE1111111111 2
Owner installation: This installation is being made on property that 1 own which is not
intended for sale, lease, tent, or exchange, according to ORS 4.47.449, 670, and 701.
401 amps to 599 amps 168'54 2
Branch circuits — new allerutinl orextenstion ter oriel
Owner signature: Date' A. Pee for blanch circuits wish
r ,: -a ,•µ- ca l .. ° t _ � « buvcrurvlccfeederl'ce. . - 2
'''w, I "A w eti,ww i,1 n + . -. t rC w V� td � r � w w•Mw � +' " �.���•�`� Vet � w�, 1' t"! , .µ.`" . u
: C1et1 htaltt:h circurruit 7.12
Business name: 11. Fee for branch circuits without
ncry ice nr feeder rye, Ina ®511 i 2
Contact name: branch circuit
Each udd'l branch circuit MIIIIIKE1111111111 2
Address: Miscellaneous service or feeder not Included
c itglStatc /ZI P'
Each ntanu(actut> d or modul . 67.84 2
dweilln • service and/or feeder
EIMMMIIIIIIIIIIIIMIZEIIIMIIIIIIIIIIIIII Rcconncctonly 67.84 2
Puntp or itrigaiinn circle 67.34 2
1 w 1 Sian o outline lighting 67. 84 2
, w,Y.Y � NM 17 Ir : '. Y.
+rwc t..�Y �i' t + wY „' Signalcircultls)ortlmitcd_oncrgy iii
Business name: Z V� net, alteration, or extension. Z
E ach additional ins cction over al/on in any of the above
E ' 11 ** 5 Additional Impaction (I. lir Ittin) 11111 66.25f hr
i =MI I
II
66.25/ hr 132 ,� , Industrial plan) (1 hrloin) Nu 70.15i hr
Phone: 0 1 a1 +^ Pax: ( ►— 1I \ b ' Inspections for which no fee is ill
a 1 r , '30.00/ hr
s cetl7cahv listed (n hr min)
Electrical Lie.: -. MIZEMS i';,,'i"r Y. ,'" k "t M r', *'. 1 11 ''' . 55ttn « �i 7. ",. _a_,i
_ Subtotal :�`
• L am . � P lan reviewt25%ofpermit fee l:
I !. .L , ' ` 1 `� ' State surebaryte (12% of lrermit The): I., �• /
TOTAL PL "RIVIIT MI: �UA_V
Allat4t i7;d signature: This permit application expires if a permit Is not ubtatnni within 1110
Jays aner it Lab barn arxatrted ay a
• ' Numberofinnpvsuonsallcnvedperpermit.
I: ahrihliny \Penuih \tt 07511I0 440451511 1 MKT' 'IkfiW'fii