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Permit 17.! CITY OF TIGAR® ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2009 -00386 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/29/2009 IiCrARI} Parcel: 2S114BC00100 Jurisdiction: Tigard Site address: 16565 SW GREENLAND DR Subdivision: Lot: 0 Project: Project Description: (2) branch circuits for new A/C or heat pump and service outlet. Owner: FEES DELANY, NICHOLAS & Quantity Description Date Amount 16565 SW GREENLAND DR PORTLAND, OR 97224 2 crt Branch Circuits 07/29/2009 $53.50 wo /Purchase Service or PHONE: Feeder 1 ea 12% State Surcharge - 07/29/2009 $6.42 Electrical Contractor: BEAR ELECTRIC PO BOX 389 DONALD, OR 97020 PHONE: 503 - 678 -1355 FAX: 503 - 678 -1108 Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Total $59.92 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 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. / Issued By: � Permittee Signature: o� /c7 N 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 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. . i JUL- 28- 2009(TUE) 09:13 Bear Electric (FRX)5036781108 P.001 /002 y � F 'r Electrical Permit AA .r a 0 v -- rorr c�r-FICE USE ONLY City of Tigard € II 2 $ 2009 � � off' - _ !0� � . e< rm; t Na /0 ' —% ! ,P6 13125 5W Hall 131vd -, Tigard, 'O R L9 7223 Plan Review N. - Phone 503.639.4171 FQ/+ A Uaecrti . Other Permit: 'TIGAItb Inspectiontittc 503.639, I I17t1 DateReadytt1Y: tw tins Ssv£veV tar Intcmcv www.ti�td.o JILDING DIVIVIN NatifediMtthod: y �� SuppkmenLl tnformallaa TYPE OF WORK PLAN REVIEW ❑ New construction 13, Addition /altcrationfrcplaccmcnt Please check all that apply (submit; sett Wiliam whfena chec .a1 below): 0 Service or feeder 400 amps or more 0 !ladling over that stories. © Demolition ❑ Other: - where the available fauticurrent d yard OMadrasarbots. CATEGORY OF CONSTRUCTION csceedt 10.000 amts at 150 volts or O Floating buildings. Tess o groaa4 Of aeeedt 14,000 I] Commee hi-o se agmeulmnl IZ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for alt ether tmtalt.ations. buildings. ❑ Multi - family ❑ Master builder ❑ Other. 0 Fire pump. O installation of 7$ KVA or 'INFORMATION AND LOCATION ' O Einersency listen,. larger separately derived system. • JOB SITE _ OAddidae ofteewmomr load of O "A". "E"."1-2". - I.3 Job no.: J ob site address c�� C��Ey� 1 (�. tooter or e texi ac tuo .. UI? t�1s O Sins or mope tesidemnl units l.7 Rscsiatio�ul rehkk parted City/State/ZIP: -" `ii, a 6 2t- O tkatttronec raciiitic:t O Supply voltage rot note Man 114 ❑ !bunions locations, 600 volts wooing Suitc/bldg apl.no.: Project name: 0 Service or feeder 600 mum ot more. FEE SCHEDULE Cross streec/direetions to job site: , Iles rtp0,;. I oil.. 1 r.v. — 1__Tw.t New residential single-or multi- family dwelling unit. Includes attached garage. Subdivision: j Lot no_: 1.000 sq fl, or less 145.15 4 Ea. add'I 500 sq. fl, or ponion 33.40 1 Tax map/parecl no Limited enegy, residential DL'S'CRII'TIOI!1.' . • (with above K. IL) 75.00 2 � ,� n r Limited energy, multi-family 75.00 2 zp �.. Y \ (-)\ K E -k .cm? k'r A O' k residential (with above - ttj . . Services or feeders lnstallatlon.altcratlon, and/or relocation S l C Q Q.l D -` r 200 amps or leas 80.30 2 . ❑ PROPERTY' OWNER " . 13 TENANT 201 amps to 400 amps - 106.85 2 Name 401 amps to 600 amps 160,60 2 601 amps to 1.000 amps 240.60 2 Address: Over 1,000 ampu or volts 454.65 2 City/Statc/ZI I': Temporary services or feeders Installation, alteration, and/or _ relocation - _ _ Phonte ( ) I Fax: ( ) 200 amps or less 66.85 1 Owner Installation: This installation is being made on property that t own which is not ?01 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 40t amps to 599 amps 133.7$ 2 Branch cirruits- new, alteration, or cxtension, per pa net Owner signature: _ - Date A. Fee for branch circuits wolf E APPLICANT • 1 . ❑ 'CONTACT PERSON above service or feeder fee, 6.65 2 mach branch circuit Business name B. Fee far branch circuits without service or feeder fee, Contact numa fmbmrtchcitcuit ` 46.85 416rn 2 Address: Each add'I branch circuit , '♦ 6.65 lor (ar 2 Miscellaneous (service or feeder not Included) City/State/ZIP: Each manufactured or modular dwelling and/or feeder 90.90 2 Phones ( _ ) I Fax:: ( ) Reconnect only 66.85 2 E-mail: _ Pumpo rirrigationeit ele 53.40 2 .. ," , CONTRACTOR. Signor outline lighting 53.40 2 Business name: Bear Electric., Inc. Signal circuits) or limited- energy panel, nitaation, or Address: PO Boz 389 extension. L scribe: Page 2 2 City /StatcrLIP: Donald, OR 97020 Each additional Inspection over attar. pisle to en` of !lee above Per Phone: 503 678-1355 I Fax (503) 67 &1108 inves 6250 Phon ( ) ) � lnvatittalionper hour (I hr min) 6250 _ CCB Lie.: 20919 , I Electrical' Lie.; 24 -I07C Suprv. Lic.: 1-1 3ti I S ✓ Industrialplan hour 73.75 ELECTRICAL PERMI r FEES Sunni. Electrician signature, required: Subtotal: 5() — Print name:: � ,�. � l Date; ? ( Plan review (2.5% of permit fee): .is '�\ ‘'+ �` `J��� � ~ `-' Sate oteharge(12%ofpcnnht foe): ( + y^2 Authorized signature: TOTAL PERMIT FEE P et '2 t/ This permit applkatlan expires If IS permit k oar ebtotoed telthto 155 Print name✓, _ I Date: days after It has been accepted vs complete. * Number of inspections allowed per permit. 1.•Duilcraur R,a,3.'ELC- FwnbAppOee 0123 eo 440461311 I I 01 coatWCD •