Permit CITY OF TIGARD ELECTRICAL PERMIT
' : COMMUNITY DEVELOPMENT Permit #: ELC2011 -00454
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/10/2011
Parcel: 2S 110 BA06600
Jurisdiction: Tigard
Site address: 12102 SW WILDWOOD ST
Project: Smith Subdivision: Lot:
Project Description: (2) branch circuits for heat pump and service outlet. 8/11/11, reprinted permit to include panel replacement.
Contractor: BEAR ELECTRIC Owner: SMITH, VISTON & SUSANN
PO BOX 389 12102 SW WILDWOOD ST
DONALD, OR 97020 TIGARD, OR 97224
P
PHONE: 503 - 620 -5416
HONE: 503 - 678 -1355
FAX: 503 - 678 -1108
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 08/10/2011 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 08/10/2011 $7.63
Type of Use: SF Electrical
Class of Work: ALT 52 Electrical Permit 08/11/2011 $51.94
Type of Const: 6 12% State Surcharge - 08/11/2011 $6.23
Electrical
Occupancy Grp:
Total $129.40
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 objaina sop o ect questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued B �i� .. ' / "'—
By: r � Permittee 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.
RU6-11-2011 (THU) 08: 29 Bear Electric
05, —. 1 FC r _. , o il ir, IM (FAX)5036781108 P.001/U0
ElsAric211 'nit A plication I "6 '' FOR OFFICE USE ONLY
711 City of Tigard It..ctl
1 ,I - - MIK= HIEZ
. . 131'25 SW Hall Blvd. Tigard. AUG 1 2011
OR 97223
. Phone: 503.718.2419 tax: 503.5911.1960 CITY OF TiGivrigail chher Petttil4
TIGARD Inspection Line: 503,659,4175 1 !,.. uwe itead*,11): RI See Page 2 for
Nam: www.ditml-or.gov BUILDING DIVISIC'N'''''"n' Eall '
Supplemental Information
4:::74 ..,,...&4,,,I,!„k,i i, ,REitati#54.4,,,,,,,,,c...,4i. , ., , - 4 , : ,. ; ,, 4 ,;,.,,, ,. ;, I ,,,,.
0 New construction ;El Additionialtemtion/replacement mom:chuck all that apply (submit Zsels atriums %Wilms eneekod L. p.
0 Service or feeder 40)) =pear more 1:11luilding Emu thew Ittorio.
0 DemOliliOn 0 Other: where thc available buil eurmnt 0 MI/rinas and boatyards,
'il.,.d t;,r: .*, Varancel5q, cup.lb 'LIMO amp5 u t 150 „it „ 0 n om I ng b wi
_ ..... . , - ,
less in plural, or mcccds 14.000 CI Curnmcmlahutle agricultural
IR 1 and 2 dwelling 0 Commercial/industrial CI Accessory building amps for all „Mer Insiallatimir, bulkily.
....El Mal11-ralrily 0 Master builder El Other: a l'Irc pump. D Insutliallun of 75 KVA iir
M Ecticrgency olcm. larger separately derived system,
12:1*74 C i . 6 - 01 Ufg 4 . 6-01 Xt l' OM I XObld§:atiAlf .,L ,,' .,ities 0 Addlii„n anew moor 1„ad „I" 0"A",
224
Job • no.: job site addles::: ‘ i & A, I II_ _Oil 111100' or more. twcupanc;.
0 Six or men; rmidential units. 12 Reemutional vehicle parks.
City/State/ZIPt c CQ , lb --) o su rr it y solislyc for mom 'hurt
I CI iluninious Watkins. 6011 volts nominal.
Suite/bldgfapt. no.: -"'") Project name: 1:1 Sunice or feeder ((II) amps or nye.
,
y , ,,, .,....-.- ,,, . . ■ , , 0 i tagiSCHED I !Al' '''' .4 Fi..iir , o+ . 1 ),';, - v..
Cross street/directions to job site: .211 MIMI I I" [ Mrr. I 14041 I •
New residential aluglo or multi-family dwelling unit.
Ineitidett altnehed Ibleage.
----,
Subdivision: Lot no.: 1,000 so, IL *ries% 168.54 4
- Ea. :WWI $00 se. ft. or portion 33.92 1
TaN map/pal net.:
Limiled energy, res idential
75,00 2
,''' 4,40, -BOORIMONEMIWO ' •Ni.'';;' "-.. ..':.. t;, tar ,.... (with above ay_ ft)
- .
* Limited energy, mu Iti.fien ily
2\poku) c\ob se,cvs.c,Q___T'A.-x--ty:)10 residential (with above sq. it.) 75.00 , 2
. \iC ervicint or feeders instillatiots, nituru iiOn. nitt) ior relocation .
E L.... k\—r, •
_ __., .11 ".. 200 amps or less 1 100,70 .... r . "‘', 2
= amps lo 400 amps 113,56 2
401 amp 10 600 amps 200,34 n
.,
Name:
601 amps Iti 1,000 amps 301,04 2
Address: Over 1,000 umps or volts 552.26 2
Ci [VS tat e/ZIP: Te services or feeders installation, alteration, atotl/or
reit/adult . _
Phone: I ) I Fax: ( ) 200 amps or less 12 59 5: 3 n : 1
201 amps in 40)1 amps 2
Owner installation: "This installation is being made on property that I own which is not
1 01.54
intended for sale, lease, rent, or exchange. according to ORS 447, -149, (170. and 701 40 amps io 599 amps 1 2
.
Branch circuits - new, al (enotion. ur extension, per pu net
Owner signature: Date: A. I' CR far brunch circuits wig.
• „.., ... , ,. ,
"'"l.'4:A A .A .,...46. -H IL litt y ,, EA A t;.A4177,71 ? 771 ii . u r
7.42 n
-
Business name: 0, ruc for branch circuits ivithout
SitiVICC or feeder fee. first
56.1 a 2
COall1C1 Male: branch circuit
Each add') brand! eireuh 7,42 IT
Addiess: miscast) eous (service or fccs171: not Ii eludet9
City/State/Z1 P: F.SCII tIlillItlrileISIMI or modular
67,84
&titian, service andinr reeder 2
Phtit1: e: : ( ) "."'".. Reconnect only 67.84 2
E mail:
Pump or irrigation circle 67.84 - 2
-
Silo or outline lighting 67.04 2
%Onil..' .' 4, .4" ',;* WO .. . .'llEiNEItallii) 4 . '.4 ;. '; !. 4 . , ,41 + adlialta si circuilNi or iimii,d,„„ersy _..
llusiness name: B r EA.? c.k.- k. c ,, 0.... , _panel. alteration, or estuitkion. Page 2 2
Each eddilionta inspection over allowable in any of the uhove_ _
Address: p. 0. ■c3... ''
- Aciditiouul inspection ( I hr min) 66.25/ hr ,
Involigatimt (I hr min) G6 '"/ he
City/State/ZIP: e._\ %._11(A Cs wogrini ,iiiiit 0 hr min)
78, La/ he
Phone:tau (t,-- --)
„,— VD._ = W.. . Fax: (agi (4.71‘.- X \ C") Inspections fbr which no RIC IS
'''' ' I /' ■ s mcifleallv noed N lir min) 90.00/ hr
CCU Lie.: eel it Electrical Lie.: - a a Suprv. Lie.: ae '-'''"" -=,- ,,, aimaimeit* . ., .1sigezdenzaz
_ ... Subtotal:
Suprv. Electrician signature, rtyquired. I tl: - ,
Plan review (25% of pennit FM:
— „
)
Mat name: 0' 7 6.i Dat; ma, * — — State surcharge (12% of permit. fee):
TOTAL PERMIT FEE:
Authorized signature: This penult sppi leaned ensires it ,, permit Is unto Med within 180
dap after I L h10 11E4.11 isocgpscil Rs clua pi t s,
Print name: I Date: • Number of inspections allowed per !hymn.
i :nsnallaintnKiaah.ar 1 t.;-mosArp Ow 117,01/ i 0 440-111151( I MOO lisliWI ii
CITY OF TIGARD ELECTRICAL PERMIT
- it COMMUNITY DEVELOPMENT Permit #: ELC2011 -00454
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/10/2011
Parcel: 2S110BA06600
Jurisdiction: Tigard
Site address: 12102 SW WILDWOOD ST
Project: Smith Subdivision: Lot:
Project Description: (2) branch circuits for heat pump and service outlet.
Contractor: BEAR ELECTRIC Owner: SMITH, VISTON & SUSANN
PO BOX 389 12102 SW WILDWOOD ST
DONALD, OR 97020 TIGARD, OR 97224
PHONE: 503 - 678 -1355 PHONE: 503-620-5416
FAX: 503 - 678 -1108
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 08/10/2011 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 08/10/2011 $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 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 O: r •52- 001 -0090 You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By/ �= �i —:t_ 11111 Permittee 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.
RUG 09 2011(TUE) 13:58 Bear Electric (FAX)5036781108 P.001 /002
IgECP4fn
Electrical Permit Anulicati n G zi 1 " 1:oli OFFICE (1Sh ()NLv
City of Tigard AUG 0 9 2011 It ms¢ I veg 1 Dwells': '/
Aalliall _
1 31.; Su' Hall Blvd- Tigard. OR 97.:3 ewer Review
: 2 Phone: 503.7182439 Fax: 503.598.•L.4fr0 I)1nr /t.; . 12121
TI GAItD Inspection 1_ine: 503.639.4175 (l I Y OF TIG,A D D.. 81:44ty: la Sc e I'ace2 for
,�pl inienlett w or.gov BUILDING Div' ?yin,, N+x11t.dimohnJ: BM Supplemental information
rh o m a �rii4.iii :,.,.c.. rv'r'a 'ImY.P,F . , t1�"'li e. - r .. 1 ., - '- --'
'� s ;�' „� �^ +'r llo-lmr, OF�'N!ORk,'� : :ilWt :� ; � i " 't ',� _.,; k � aw.+ �' , w'._►�Pt: R1:'�r rx,v , 4 .1, . wil - :
❑ New' construction ® AdditioWniterutiott/replucement P cheek till that apply ltubml r: belt ul'plum tWticmt ehockal bek1i_1:
❑Sm »lceer feeder - niamp%or 011011 41g t I'Cr thncslorkcs.
❑ Demolition ❑ Other: when: the available fah current ❑ Ntarhtas and boatyards,
1",. i, :1 °" t i x,1 ' p "t 6,! +p I t exceeds 10,000 amps at 150 volts or ❑ Flouting building&
r� Sri,,, _r -: ��A1'I L"QKt t� G.OIS f RUC170N� ;r� t tit tl. ,
less to pnand, or eccccds 14.000 ❑ Commercial -use gtrlcultural
54 I - and 2 - family dwelling ❑ Commercialrndustrial ❑ Accessory building amps for all other Installations. buildings.
❑ Multi- lumity 12 Master builder 12 Other: CI Pirc pump. ❑ Installation nr75 KVA or
tp� c ' 1" Vii' Jf1t2 �.. r' O .,"Ar�I�D, °O t] " 1,. (ti *o- r r Y ,1 yasn:r; ❑ Emergency system. larger separately derived s�mem,
t egi 1Aa., ^,' ,a.,xelrer' t ... _._.1��1.a.ls+. ...0tg . ..Sw ..lati —.. 1 d r i , : ,: 1n Addhlunofnew motorloadur ❑ "A" "1.» " ", "t• ,
2 \11y 1 11101(Pnrmore. occupancy.
Job no.: Job site std(lrrsst l • � , . 41111iii ❑ 54 xar man residcnlinl units` ❑ Recreational vehiele ryuks.
City /State/Zl P :_ oo 4111 ❑ I lnitlh�ctin; lucilitie's. ❑ Supply voltage Ii,r mote than
I - q ! _ —G r' ❑ lletinlout loixolont, 600 volts nominal.
Suite/bldg. /apt.no.: I Project name: ❑ Sat kv.or feeder 600 amps ornwe.
^r, m . 'd!'440' . p'a.O ) : ,, M vl y : ! nit. ,.. ?:!., yy
Cross street/directions to job site: u.wrllaauI I err.. I t•.., 1 '1 nrsl 1 -
Nt.'w residential single- or multi - family dwelling unit.
lbetuJcs attached go rage.
Subdivision: R Lot no.: 1,000 9q. R. or less 168.54 4
•
Tax map/pllrcel no, l.a. add') 500 so. II. or portion 33.92 1
I
._ r 4 it lax
N t'i'tt es..,wdtt'':''t yrca� r .._ ".25 Limited shove so n -) 73.00 —
_.
�t r , • Limited ancrgy, multi- C3Cmlly , % I { \ J ` .�r-I� Q ry i1r1�.LJ,` � )-1-13 residential ohmic de tial (with bey- III 75.00
y
Serviced or feeders iuxnillatinn niteratton, and /er rcloeutom
• 1 11111, . ` lb 200 malts or less 100.70 2
"re ....
l- l" 11 ° ` .l i "�tlimat !` 18a ".lwi,li L, r xs ■ Q11 C ±:' ", + " ;. 70 I l la 400 amps 137.56
Name:
4111 amps to 600 temps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: L Over 1.000 amps or soils 552.26 ■
CiCy /S1ltt izir' Temporary services or feeders Installation, alteration, and /or
relocation
Phone ( , ) I Fax: ( ) 200 amps or less .._ , . 59.36 1
20) amryl w 400 amps 125.nx 2
0 installation: this installation is bring made on property that i own which is not • -
intended for sale, lease, rent, or exchange, according to ORS 417, 449, 670, and 701. 401 amps l0 599 maps I(ix 2 -
Branch circuits - new, alteration. or extenxiun, per po net
Owner signature: Date; A, b(t` lire brunch decode 1 1ri0u '
',`r Ic' ;a.. , �"'" t'1w1_ 1ii10 r•a l i "; "II' • r , • x w r i ;w utwvcscrriccur(ucdcr 2
. s . � � Ja an tar wnrgw(" :Mi [}�,i;l(YI, � t
, , w. each hraueh dltult 7.42
Business neon: D. Fee ear brunch circuits without
service or feeder lee, lirst \ 56 ►g 1 1�
Contact name' branch circuit t
Each udd'l launch circuit ` 7.42 7. 4.j7_ 2
Address: Miscellaneous (aerviCe or feeder not Included) _
Each manufactured 1rr tn1:W011lr
CCity/State/ZIP: dwellinmt,servieeandlnr 16714 2
Phone: 1 ) l Fax: : ( ) Reconnect only 67.84 2
Po or Irrigation circle 6714 2
E-mail:
Sian or lxxtilne lighting 67.84 2
r r "' �` " Signal clrcuh(sl ar llnthad- energy
aia ; ,'� . tw, .G �"1"!C? tv a ,rr �11~rte+�aaa riN
J ' O ti .. ' _ c \ 1r\' pane',a ddit ilao. or extension. Pone_ 2_
Business name. A \ r 1
t Each additional inspection over allowable in ;HIV or the obttve
Address: P 0 � aer\ CI Additilmal inspection (1 hr mint 66.25f hr 7
City/Statc/Z11 t-1.-... L k.. } ) t (-‘,A--1(3-4() investigation (I lumin) 6651 hr
ihJUSlriitl plant 11 hr min) 78.181 hr
Phone: M-3:)( y� Fax: ( 1^ 1 !' � Inspections tiais far which no fee Is
90.00/ lir
Sped %ally listed (V, hr min)
CCB Lie.: 20C � Electrical Lie.: Li -0 Supra.-. Lie.: $'4F%r. E ,l. fACi S L P,. _ it at w yr'
Q - � .y f� Subtotal: { n, t n(�
Sups. F.Icctrieitut signature, required: Plan review (25 ')t of permit fret:
Print name: (� Date: —\ { State surcharge (12% ofpennit fee): o 1 o
TOTAL. PERMIT r Eft:
_ Authorized signature:
This perm lt upplicatiolt expires Ira permit is net ubtnkrrd within 180
Buys aver ii. flat (eery accepted as cum plete.
Print name: fDatc: • Numbcrofinspeetions allowed per permit.
l 4 luildi 'emiimip.Ll'•t'irn,ilApp l 07/111/10 44041,11111 IlIl.Sgal Ain F:n