Permit C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00218
1I � DEVELOPMENT SERVICES DATE ISSUED: 4/25/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171
PARCEL: 2 S 109 D D -10500
SITE ADDRESS: 12740 SW DA VINCI LN ZONING: R -7
SUBDIVISION: BELLA VISTA LOT : 035 JURISDICTION: TIG
Project Description: Relocating A/C unit.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL /PANEL:
MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
RIVERSIDE HOMES, INC. BEAR ELECTRIC
1925 NW AMBERGLEN PKWY. #200 P.O. BOX 389
BEAVERTON, OR 97006 DONALD, OR 97020
Phone: 503 - 645 -0986 Contact #: PRI 503 - 678 -1355
FAX 503 -678 -1108
FEES
Description Date Amount Reg #: ELE 24 -107C
[ELPRMT] ELC Permit 4/25/2006 $46.85 LIC 20919
[TAX] 8% State Surcharge 4/25/2006 $3.75 SUP 49025
Total $50.60 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set
forth in OAR 952 -001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699 or
1- 800 - 332 -2344.
Issued By: Permittee Signature: D
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'N: DATE:
LICENSE NO:
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
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.
APr.24. 2006 12:23PM 'BEAR ELECTRIC No.4767 P. 4
• , f pf er-SG !c 1 1--lc) i,--l.ca - C
Electrical CI "nfI APPlAC O FOR OT 1C
C J ( il .v • ONLY City of Tigard ��� �— �U11 •
13125 SW Hall �1vd., Tigard OR 97223 _ Permit No (p J/ /`� �
Phone: 503.639.417) Fax 503 598 ,- L P1anItcview � L'[
Inspection Line: SU3.03.. rt r J _ 2006 I % s
S03.639.4175 L if Date ,. OthaPcrr
Date Resd S ee 1'ae 2 for
Internet: YBy. l g
!f `6 ' \i a n Notified/method Notified/method I / l tr
�� V •o, ,, J SUpp lementaj lt , f p
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. � -.. "Yr ,7, M P, i�^i3�h� `� ! �X. tt; ' �•t �I"!r �I S '+ 1i � �t r ,,rnr ti' f,p gr Y9:,. igi - - +�¢,,y'
N ew '..� r ..l.'"', ,: h L � R {,, .,,� 1d ,„4,,,,... '� " o i � \5 " _ m.,,„.0: ” ”....-'...-..4 n' ' A f�T 1 i� „� ,,. p .,:.':
n 1\ev, construct-ion VY t : /altcrati /icplacerncnt Please check al) that apply:
•
El Demolition ❑ Other: ❑Service over 225 amps, comm'1 ❑
a r, rr K, �; ._ Hazardous location
" `�,,;na• a ..a rr4� 'camr . ,,,,, r,.�, ❑Service over 32 amps
` ^q, . -, }.' :+,,t • 1. , �'4, 73:0' rt- r� . .` ii} e� lti, r!S. ,_ 74W. of 1- and 2 ellings D4 or m ore new reside
and 2- family dwelling ❑ Commercial/industrial ❑ A5a.etsory building ❑System over 600 volts nominal unit in One structure
[� Multi -family ❑ Ivlastcr builder l vtner: nrlutlding over three stories 5e 400 amps
�! cs edeis, 4 rrt or more
p,
M • ti.a°?i A r?V;, M r n u n 4, �� �w rl i� . ' � p' l l;,:e r� 'r^ '..r'nn, ❑Occupant load over 99 persons ❑Manufacnu'ed structures or
Cc. x,13. _,• ' , t1 G ..v P ` ,„, ,f,S n ki P toclures
Ton 12a: ` ., ;,. - �,1e!:? • ', ❑Egress /lighting plan RN/ parr:
Jab cite. address' 2 7 I 0 r ❑Health -care facility ❑Other: _
`� cy p 9 c�'�^ k 5 S ubmit 2 sets of
Gity/State/G1P: plans with 1 th any of the above. .
_ _ The above are not applicable [
Suite/bldg./apt, -- , pp o temporary construction service.
dp - /apt, no_: Pro c ot name, s';:w 1'yi.. a,'a!,�' %c7m ' P 'a` '' �;
hh ..,•i„,.. Qty. Pet- Total .
Cross street/directions to job site; New residential single - or multi-family dwelling unit.
- Includes attached garage.
1,000 sq. ft or less 145,15 !
Subdivision: C 6 / 1- V s , i 4
7 ct I T of no - 3s- 5„ aad'1 506 ill" R or ortion 33,40 l
GCC Tax map /parcel no.: Limited energy, I
� r gy, 75.0 ^ 1
fa l ` ' I f{ 9 e1 1% 5,'" dw, �➢yyt R : - e "� Li m i ted encr nou- residential
6 3 f. . i'n:�,y ,.��.. i1 r�,` 7 , . �, ntia] 75.00 2
. Iilr� 1 1 ; � :. . }
//�� + . .. AIM . ,ie , I, k �. rt Each manufactured
� � red or modular
dweIlin_, service and/or feeder I II 90.90 '
„ ` v i i � � { �G 4 2
�
.� y — ., � Services or feeders insist a on, alteration, relocation
_ Y 1 r >r✓'�1P p / 1 200 1 li lterrttion.
i ui - . ii � , • „„..„.,T ci-/ ,/r -�.c. 01 00 amps Or less 80.30 1 2 .
' I In• ° 11 '' ,n' r , •b'wl ' 1 1 'c i f ' �, i9 t . ;
w. ,. t . r! �t ' , • 'I t � u ' .r�'21E- rj.'.: ,, u J.e ,:" y- i ! � .',_160 - , ,"' 201 {imps to 400 amps 106, 85 1 2 •
S T S s: ' 401 amps to 600 us 160.60 12
- -- 601 amps to 1,000 amps 240.60 1 2
^. ldre" y_ ` Over 1,000 furies or volts 1 I 4 54.65 � 2
:try/State/ZIP: `— " Reconnect only 7 66.85 2
— _ Temporary services or feeders installation, alteration, and /or
'hone: ( ) 1 Fax: ( ) relocation
> tuner installation: This installation i8 being 200 amps or less 66.85 1 }
made on property that I own which is not 201 amps to 400 amps 100.30 2
itended for sale, Iease, rent, or exchange, according to ORS 447, 449, 670 and 701
Wner signature: _ 401 amps to 600 amps I 133,75 2
Dare: $rs is - new alteration
<� S rye ach circuits
f :. it til I� "'c "`�,f ,ds s �. y��M; , or extension, per Panel
ti4 G .,ik,, , ) L ® �-oi1 ...- , " "I „,:-. A. Fee for or branchci
� n ;� B Tcttits with I I
usincSS name:
ScPviac or feeder iec r^, Ch f
branch circuit I 4.65
ntact name: 0 ,7?� �„5 �� without Fie for branch cir feeder fee,
o
i � ” � f" t. service or fee
actress: each branch circuit 46.85 V6, ` - `I 2
- - I _Each add branch circuit I 6.65 12
t-y /State/ZIP: _ —!
Misceflaueous (service or feeder not included)
O ae- ( ) I FaX :: ( )
Primp or irrigation circle J I 53.40 I 7.
sail: Sign or outline lighting 53.40 2
vr?,c+� ,n Signal circ , ( )
P 1.1.§ i?'.ty l P;✓iklrgi riFI 4:01. 6-4 .', TAik7 y, iSllu2 5'h' . ti Ijg'; "7 Y: :1a�j � -:;; ,., lE t "a = • ' L it s e . Or
– '� :: 'k�,c.lif� :::, ,. . � .r` ' I cncr.n 1 . _l, a i j be- on , 1
,SSIi1�;. t P, Or
smear name: ��«.r 2.---_--.1 � - .+ „ , extcp Llescti I Page 2 I 2
C�I� n c. 3ress: �J_ r ov._ Lach additional inspections over allowa bfc in any of the :hove
/� o ` I Per inspection - M I
y /State .ET. a.�et. Rc( ID �I , _ , 2.SU
' S C Ci'� O Z.C ) I-Investi�ation per hour' (1 lu' inln) 6 2,50 I
(523j
7 / ? 1 8x' C ndU Sltial la
S 12l er h0ur
� ., - (5r':�) � f �- � � � P__ P '
Elects c a F.; . t
1 4'i f,' .... > .;T' x• , ` * «,;4 `', , , , , t .
3 Li
2Lti t t 7 i c. S tir c ,.,.. 73.75 .. _ I 1 Jec cian signa r equ i re . .,(2 � // ,__ I
Iv.
S21bictz! 1 4/ 6) • y a ' �
� ' " _� -; �u�c_ _ flan review (2:,% of permit ice)
nam (�.� ` /� (`- _- Stare surcharge 8% of permit fee) 1
-
tnri�ea S1rnaT;,rc.: I TOTAL PFRMMIrT FE) 1 6 I
_ - ...
This UCrmir sDilli�ariOn CXpirex if a f is Apr UO[:,iu.c within', 180
•