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Permit CITY OF TIGARD ELECTRICAL PERMIT 111111 COMMUNITY DEVELOPMENT Permit #: ELC2012 -00041 T GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/26/2012 Parcel: 2S102BB00816 Jurisdiction: Tigard Site address: 10315 SW BROOKSIDE PL Project: KONARZEWSKI Subdivision: BROOKSIDE PARK Lot: 1 Project Description: (2) branch circuits for heat pump. Contractor: NORMANDIN ELECTRIC Owner: KONARZEWSKI, HILDEGARD 51086 NW CLAPSHAW HILL RD 10315 SW BROOKSIDE PL FOREST GROVE, OR 97116 TIGARD, OR 97223 PHONE: 503 - 357 -5380 PHONE: FAX: 503 - 357 -4878 FEES Quantity Description Date Amount 2 crt Branch Circuits wo /Purchase 01/26/2012 $63.60 Specifics: Service or Feeder 1 ea 12% State Surcharge - 01/26/2012 $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 OAR 952 - 001 -0090. You may obtain a copy oft .ules .r direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: �� C 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. JAN -24 -2012 01:17P FROM:NORMANDIN ELECTRIC 5033574878 TO: 5035981960 P.2'3 08/02/2011 09:18 5035981960 c l Y u I llaWli rw� iiGC Per1111t 1)q�1Caijol� i i r: r 11 I t I I 1 (0,1 City of Tigglyd um i " _ > s r�,: ' r 13129 SW ball Blvd„ Tig OR 97223 1 �'' : ji / rfi L t l e: 503.7132439 Far: 503.591).1 , . t31he Pemds: i i I 1 inspection Una: 501639.4175 4.'" %'1, ', . re RwdyBy T • So Peggy 2 rasa inhered: www,tigai *i g v �, NalinadiMelh� .: kauaW Inner s ton Twig . • • . �` ■ rti:a�ty 1tEYn11w , . , -er ❑ New construction l Addition /attcrail • les V t 0 1'' Mew e; all . t :. „ • (Waft g eels or plan w - r awaked !" oar Q Demolition ❑ Other: . Marko or ruder 400 maps ar mono ©Buildiing war tone stories. 1. \�? ,� �_ where the available taut manna Millings Intl 6oatya *. CATEOOILY OP CONPr* • N ` � mods MOOS ample 150 wife or 0Illenting laittdtngt it i - and 2• tan to a d, ar instal: 14,000 CI taomamrs ore tcizimmt 2-family dwelling ❑ Comtnervlalfln U Aoet eery building ants for sot an l ow. inttkliagA 0 Mutdd_bmiix Q Maur builder ❑ Myr: 0 Fire pump. 0 tauan lien oat75 KVA or SOIL SITE INFORMATION LOCATION CI compiler eyeball. t mem tv derived eys 0A1. /� / [� ,/ i7 Addit[m of new motor load e Q °A ", "b", "1-2°," 13 Fob no.: tab site address: Fl, 3! t .f7�' 1 hS� fI�C. ®sc�o more rerideetifil antra 0 Iteueelienel vehicle parlor City/State/ZIP: / Z.Z4 0 Reslthaarc tkeitit eo, 0 Supply voltage Ott matt the 1344aarduea loatiortr. 600 volts nominal, Suitcibidg.laptno.: Project name: °Service or feeder 600 or mote IIIIMIMIIIIIIIIIIr t llillIllMIMIIII Cross street/directions to job site: 7G1n: s: 11111-`.11111 1131 ' New reaidcatial single• nr maul ikmfly dectitng amt Inebrdeaattached • raga — Subdivision: Mot no_: 1,000 .,. fi otiose MI 16834 11111111113 Tax es �' F.e. ndd't so°s . ft. Or pardon ME 33.92 11111111111110 L •• cnorjpr, r a n - . 75.00 �, n 177t5C31�N1 OF WORK t t Mtn. • 1, III t- G�f.T �l.[,/1y1 J3?�� 1.1 energy, multi- t iry III 75,00 7 risttild with ,bovn •.. MD — Irks oil. . Installatl u. heretic , a , ,, rektestiee 200. • amore IIIII lo0.70 4 0 1 _ 111Y OWNER - 0 TIE on 201 ,' " , •f 1 . , I33.56 — © 401 am • to 600 asps EMI 200.34 El Names ��� fP /0 601empaisL000mnps 301.04 � Address: Over 1,00o amp oroar MI 552•26 111111111© Cityf3tate • Temperer/ services or ltreders Ieaattention, tIlatton, attention, laid /9r re anon Phone: ( ) Fins: ( ) ' 200 „ . or has all 5936 - NNNIIIIII Owner Intuits:Nott: 'Chia installation is being made on property that I ewe which is not tot am to 400 Dam 125 05 � © intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 70 I. 401 cagy to 699 amps IIIII0 Bre circuits- it aileron ..res w .and Owner signature; Date; A. Fee On . .: circa to WA P MI © APPuc+tNI' O comma SON sbovssesvicc or feeder fee, 7.42 each hen circuit i3uslntss name: B. Fearer .: • circuits , .. a vacs er reeder Esc, first Cont earns: branch cite t 5>T t 3 Eloi Addrea6: �» Each 441't tame It circuit r] �,gi j n M dMeea ice or kr •iti net inelnd City/State/ZIP: "` Fit• amnia armada's, 11111 © ..--. --,", dvyelail eervt. ndrortaodor Phone: ( ) — ! Flax :: ( y Reconnect only 67.84 — Pump or Irrigation circle MI 67.84 _Q E -mail: 6'.e4 11111111111© CONTRACTOR Signal carcuitia) orlimitrtdaru7gy i3usitnss name: / r „ el Oattfnti . or • , ion ISM © 1 . ♦ r.. 1 . 7 -Ai0•■ Is , additional le akin .■ pltrtaabie s a . of the chore Address: 1 , :1..r l . _ .�. I Z Attain Ian (1 tar mM) 5/ hr _ _ III �(' , Additional intpeation (1 hr min 663 City/State/ZIP: PLs - Q g71'i p tad, rot • lent p harms 11111111012211 II Phamc �, �: J F ; . y ��',. tt>?prx as whk er n° fm ' 90.00/ hr — cco Lic.: 01C E l :411cal Lt • : S a • - 1n.1 aced atr , fa Supra. Electra., � , required: INEVI m r 7,./5 3 .T MO .t .. .... �... _ • an review ' °ro n * 11 Print a name Date: - tnto swamp (12% of . tuft f64 Ill 1�r a : � Dt� S IIIIIMMil AuthorizedSignature PERMIT FM 5 Tina perm%application mires . a monk .. no obtained wrraia 1110 Print dame: iara after le bras awn aeca$td as eora3la+e. I • Number of topearl= slimed wpm*. onronehopenshouLoPermluenkeee ermine aa.aetbt'(tteetto tJtarn •