Permit ,, CITY OF TIGARD ELECTRICAL PERMIT
1 COMMUNITY DEVELOPMENT Permit #: ELC2011 -00716
TEGAR.D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/22/2011
Parcel: 2S102BC08000
Jurisdiction: Tigard
Site address: 12765 SW WATKINS AVE
Project: KRAL Subdivision: 1999 -007 PARTITION PLAT Lot: 1
Project Description: Electrical for bathroom.
Contractor: BEAR ELECTRIC Owner: KRAL, GEORGE L & SARA
PO BOX 389 12765 SW WATKINS AVE
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 12/22/2011 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 12/22/2011 $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 OA; •52- 001 -0090. You m, .... - .. of the or direct questions to OUNC by calling 503.232.1987 or 1 800.332.2344.
Issued By: %� %� �! Permittee Signature: /AL
40
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.
DEC- 22- 2011(THU) 08:20 Bear Electric (FRX)5036781108 P. 001 /002
Electrical Permit '
A EIVED _ FOR OFFICE USE ONLY
City of Tigard Reteivcd IM
Date's t /i ' , _ -•
III a 13125 SW Hull Blvd., Tigard, o� 19f2/ 2 2011 Plan Review
Phone: 503.718 -2439 Fax: 50 o Date/S Other Pwmir.
TIGARD Inspcttion 503- 639,4175 TI Ustelteadyrey "'- RI SccPagultor
Internet www.tigard -or,gov OF ` Slt7N Nonfied/Mcthod: J, Supplement■linfeemattoa
.."3 r< n xM'r .w �+--";,r as . n,. . a r , ;
�q S �� �� 1� C � J 9 ei�l4i ��'1�'` �'i �' tv �1`r✓ w to "�f x�.w�': � di• I. qy M
dk��'S�nnr(�axivvva u"xe �" 1H r .. , . Y"!iM.�:!�,k�n�C"�:�,4q�. -. =... .� "Mfv�.ry '"C,�.1 - �e � d�. :���(
0 New construction t Addition/eltenttion/rcplacemcnt Please check all that apply (submit 2 sets of plans wlitema checked bemw*
❑ SaYiee or ferder400 amps OT mom ❑ Building over three stories.
❑ Demolition CI Other
where the available fault current ❑ Marinas and boatyards.
- und dwelling % 1 " -a
" w =.:r 1' r,, exceeds 10,000 am pt et 150 volts or
:c w r :.. ...._ "n - g054 - t":6 SIRUG Oriff" 11-`t;t tt - "" p Floating buildings,
less to ground, or wweods I4,DOb [] Conunareial -osa atp
❑ Commercial/industrial 0 Accessory b uilding amps Ibr all other Installations, buildings.
Multi family 0 Master builder 0 Other: ❑ fire pump. ❑ Installation of 75 KVA or
Trot f'mereency system. 1 er separately derived tem.
,4' to rw n.y r "gi t a+g Pa+ Y
a•�«t ty 1 � ');n;, +;70 S ORMA1;! ,AND a,�OCAxJ. ?,�. . " , [) Addition of new molar toad of ❑ "A ", "8 ", "1-2 ", "1 -3 ".
t 1001 -IP or man, ooaupenry.
Job no.: Job site address:
14 7 P s $ S k? a.tK a K 5 ❑ Slx or more residential units. 1� Recreational vehicle perks,
City/State/ZIP: ' + 0 Health -care facilities. CI Supply voltage for more than
/ I� '7p_ f 7 z a 3 ❑ Hazardous locations. 600 volts nominal.
W, r l'I r 600 amps or
J Desert nee
street/directions udirections to ob site: Project name: 0 Service or seder more. 6 r x ' ; S D t ti . d / , t
Cron
�� ( i Qb. i a-e. C TonJ I
New residential single- or multi- family dwelling unit
Includes attached garage. _
Subdivision: I Lot no.: 1,000 sq, n- or less 168.54 4
Ea_ add'! 500 sq. ft. or portion 33.92 1
• Tax map/parcel no.:
r .. u�tau«, m residential
- 7s ao z
" , a energy.
�._ . O fit ... s . ., ,nvam`Cwaval r1.1.'y.;.[', " ..il, . . 0
A ,NP A.x�u�.. - ki.R IC :iM 4 � �V, /'. VIA w 1,"' v:' '," "�,i.V: ..' a- :,x.'.', Limited energy, sq. f0„, -
ned energy, multi - !Emily 75,00 2
realdentlal (with above vt . t)
' Setvloesor feeders Inatallation and/or relocation
200 amps or less 100.70 2
i1 ' d
n v?pp -.. r ..- �t t ,a, .. -- -
133.56 2
y :ll r1W Q.� 11 ;'x' . , er u " r „.., _ r wr " " „ 201 amps to 400 Aitlpe
r w � � � a� " , r ' a' ,, r in �i +1�R��^s r i
Name:
401 amps to 600 amps 200.34 ' 2
- -- 601 amps to 1,000 amps 301.04 2
Address: , 1,000 amps or volts 552.26 2
_ Temporary services or feeders Installation, alteration, and/or
City /State/ZIP:
relocation
Phone: ( ) I Fax: ( ) 200 amps or less 59,36 1
201 amps to 400 amps 125,08 2
Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168,54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Brunch circuits- new, alteration crtcnalon panel
Owner signature:, Date: A. Fee for branch circuits with
c:: , R . . ,. - o., tea.^... , "� . "V1 w above service or feeder fee
t w Vi
zrnii APRLr° i 1 C7 CQ�Ong " . Si ' ' each branch circuit 7.42 2
circuit
Business name: B. Fee for branch circuits without
_ _ -_
service or feeder fee, drat ` 56.18 5 G' /$ 2
Contact name: brooch circuit
- Each add'1 branch circuit l 7.42 '7 • t/ 7r. 2
Address: MIseellaneonajaervlce or feeder not Included) .
Each manuf9cturcd or modular
City /State/ZIP: dwelling, service and/or feeder 61.84 2
Phone: ( ) Pax: : (, ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E
sip or outline lighting 67.84 2
L.:';t -,}�' " `'�M : yi ° ''w , " i:'ta;
Gl `', CIO I ar ' m IMPRE. _ ae Signal circuits) or limited- energy
Business name: /3 eel tfle C c{-/, i C 2,,,„... pct, alteration, or extension, 1',tIt 2 2
. gad' additional ins. action over allowable In an . of the above
Address: pp. /ado v._ 3 7 Additional inspection (1 hr min) 66.251 hr
City /State/ZIP: )tin �/ 0 I 7a x a
Investigation (1 hr min) 6625/h
Industrial plaant (1 hr thin) 78.18 / hr
Phone: (Su)) (.7g- -,, 3 SC Fax: (3c+3 ) (.7f. 440)-5 Inspections for which no fee is 90.00/ to
:. ciftcall listed hr min
CCI3 Lic.:201 i Q . Electrical Lic.: 21/-1 Suprv• Lie- - tr ., i'elarill v: ;a, subtotal: t , x t .:
Suprv. Electrician signature, required: ie D ►'� 1.4"'"" ^ Plan review (25% of permit fee): 4r, _
Print name: Zvi ! dt &SST, ( Date: / 2.- al , / / State surcharge (12% of permit fee): / __.../. (o3
Authorized signature: TOTAL PERMIT FEE:
This permit application expires tie parent la not ub nett within 1130 •
.. r dnrs after it has been accepted as complete./ ) 3
Print name: Date: • Number ofinapcetioasallowed
1: 13uudinastraitslDLC- PmmitApp.doc 07/01/10 40-4AI5T(11 /05/COMFWDD