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Permit CITY OF TIGARD ELECTRICAL PERMIT • le COMMUNITY DEVELOPMENT Permit #: ELC2012 -00150 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/20/2012 Parcel: 2S103DA04900 Jurisdiction: Tigard Site address: 13365 SW WATKINS AVE Project: MURFINSIMMONS Subdivision: FANTASY HILL Lot: 10 Project Description: Service replacement and (3) circuits for geothermal heating. • 3/30/12: REPRINTED permit to add (2) branch circuits. Contractor: BEAR ELECTRIC Owner: MURFINSIMMONS, MATTHEW T & PO BOX 389 MICAHLE DONALD, OR 97020 13365 SW WATKINS TIGARD, OR 97223 PHONE: 503 - 678 -1355 PHONE: FAX: 503 - 678 -1108 FEES Quantity Description Date Amount 1 ea Services or Feeders - 200 03/20/2012 $100.70 Specifics: amps or less 3 crt Branch Circuits w /Purchase 03/20/2012 $22.26 Type of Use: SF Service or Feeder Class of Work: ALT 1 ea 12% State Surcharge - 03/20/2012 $14.76 Electrical Type of Const: 15 Electrical Permit 04 /03/2012 $14.84 Occupancy Grp: 2 12% State Surcharge - 04/03/2012 $1.78 Electrical Total $154.34 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 of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. / 111, 1 Issued By - ermittee Signature: 7/ 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 503.639.4176 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. CITY OF TIGARD ELECTRICAL PERMIT ffi COMMUNITY DEVELOPMENT Permit 4: ELC2012 00150 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/20/2012 Parcel: 2S103DA04900 Jurisdiction: Tigard Site address: 13365 SW WATKINS AVE Project: MURFINSIMMONS Subdivision: FANTASY HILL Lot: 10 Project Description: Service replacement and (3) circuits for geothermal heating. • Contractor: BEAR ELECTRIC Owner: MURFINSIMMONS, MATTHEW T & PO BOX 389 MICAHLE DONALD, OR 97020 13365 SW WATKINS TIGARD, OR 97223 PHONE: 503 - 678 -1355 PHONE: FAX: 503 - 678 -1108 . FEES Quantity Description Date Amount 1 ea Services or Feeders - 200 03/20/2012 $100.70 Specifics: amps or less 3 crt Branch Circuits w /Purchase 03/20/2012 $22.26 Type of Use: SF Service or Feeder Class of Work: ALT 1 ea 12% State Surcharge - 03/20/2012 $14.76 Electrical Type of Const: Occupancy Grp: Total $137.72 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 ado•ted by the Oregon Utility Notification Center. Those rules are set fotit in OAR 952 - 001 -0010 through OAR 952 -001 -0090. You may o• - • • • he rul =stions to OUNC by calling 503.232.1987 or 1.800.332.2344. ' 11 1. 11. " / .. Issued By: _ — — ` 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. I MAR - 19 2012(M0N) 13:45 Bear Electric (FAX)5036781108 P.001 /002 Electrical Permit Applica : ; P. ECEI 1:012 OII ICE USE ONLY IN City of Tigard 2012 i, ;>'� reran "o: i5 - _. - 7 • 13125 SW Halt Blvd., Tigard. Olt 972�AR 2 0 Man Review Phone: 503.718.2439 Fax: 503.598.1960 Del Other Permit: TIGARD Inspection Line: 503.639 CITY OF TIGAM Date lteadylliy: Internet www.tigard -0cgov a i Non fiedrM 4 M . , IIIMERIMI BUILDING Pt\ii I t L' T Yr.K :oi woRlr :.: - ..... : : , . -. • 'PLAN REVIEW ❑ New construction ® Addition /alteration/replacement Mama cheek ell mar apply (submit a tenor plans w/iteme checked below): ['Demolition ❑0cite/ © Service or feeder 400 amps ormore 0 Building over dose stories. where the available f current 0 Marinas and boatyards. `< accede 10,000 amps at ISO volts nr 0 Floating buildings' . . =• ....:-. . . . . ::" .....'CATEGORY OF ;CONSTRIICTION;: { >:;: Ieuto ground, or =weds 14,000 QCommerelelwseogtlealtarel E 1- and 2- family dwelling ❑ ComrncrciaUndustlial ❑ Accessory building amps Co r an ether installations baildings. ❑ Multi- family ❑ Master builder ❑ Other• Orin pump. 0 Installation of 73 KVA or CI Emergency Hum larger separately derived system. v... _,. JOB ,.St]'&INFORMATION: `AND_�;0403p15 ; :, • i : ° ::. ; :• , O Addition of new motor load of D "A ". "E", " 1.r, •I -3 ", Job no.: I Job site address: 13365 SW Watkins Ave. 100HP of more. oe up° . ., 0 Six or more residential waits. In lea teadottal vehicle parks City/State/ZIP: Tigard. OR. 97223 10 Heatth•aue facilities. 0 Supply voltage for mare than ❑ I lasmdow Iowans. 600 volts nominal. Suite/bldg./upt. no.: Project name: 0 Svelte or leader 600 amps or Mora. r - lv'rc�es'+h �l!,� 1 t )�C8t ' D{11.. x = r T "" Cross street/directions to job site: tlwcrloaea our. v... — I — .tJ New rddentlal single- or multifamliy dwelling unit. Includes attached garage. Subdivision: I Lot no.: 1.000 sq. R. or less 168.54 4 Tax map/parcel no.: Ea. add'/ 500 sq. It or portion 33.92 1 Limited energy, residential 75.00 2 Y ":T..E•_ _ : ,: ". _. _.: - _._.. nFSOurxxoN_or:•w.,oala r= ` rte:, ; :F= ; �: ::,,,- (wren above 04 (1.) Limited cnefuy, multi•ratnily 75.00 2 Service change and geothermal heating equipment. residential with above ... R. Services or feeders Inetatlatlan alteration, and/or relocation ' 200 amps or less 1 ' 100.70 '100.70 2 E. ' ppRO ownER:- 4- =IV. v , ^5.. 201 amps to 400 amps 133.56 2 Name: 401 amps to 600 amps • 200.34 2 601 amps to 1.000 amps 301,04 2 Address: Over 1.000 amps or volts 55'2 26 _ 2 City /Statcrl,TP: Temporary services or feeders Inslallatlon. alteration. and/or H relocation Phone: ( ) l Fax: ( ) 200 carps or less 59.36 1 Owner installation: '/'his installation is being made on property that I own which is not tot amps to 400 temps 1 25,os 2 intended for tittle, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps lo 59 9 amps t 68 54 2 Branch dreults — new. alteration, or extension, per panel Owner signature: Data: A. Fee for branch circuits with " "M ' - ..., i. .. :. ;: rlC '.At �-P,IOtSON ,� above service ar feeder fee. ���PQCA1�ic —.. I ° ° ' each branch circuit 7.42 2 Business name: B. Fee for branch circuits without service or (beder fee, first 56.18 2 Contact name: branch circuit Each odd'l branch circuit 7.42 1. Address: Miscellaneous (service or feeder not indudcd) Cl /Blatt rliP: Each manufactured or modular 67.84 2 tY dwelling, service and/or feeder _ Phone: ( ) Fax :: ( ) Resumed only 67.84 2 Pump or Irigation circle • 67,84 2 E.-mail: Signor outline llAhdn& 67.84 2 ''` -T:: — .. - . _ -_ CON77t tCTORa g=' . _ s. : : se. Signal circuit(s) or limited-energy Business name: Bear Electric Inc. panel, alteration. or extension. Page 2 2 Each additional inspection over all owable in any or the above Address: P.O. Box 389 Additional inspection (1 hr min) • 66.25/ hr C Investigation (1 cumin) 66.25/ hr City/Slate/ZIP: Donald, OR. 97020 Industrial plant (1 hr min) 78.181 hr Phone: ( 503) 678 -1355 Tux: (503) 678-1108 • Inspections fur which no tee Is 9000/ hr - specifically listed (S5 hr min) CCB Lie.: 20919 1 Electrical Lie.: 24-107C S . Lie.: 4881 S i t caa:-PEtl►sir ' `:� ':, Suprv. Electrician signature, required: Subtotal; 122.96 Flan review (25% of permit fee): Print name: Stephen Shepherd Date: 3/19/12 State surcharge (12x% of permit fee): / ( TOTAL PERMIT FEE: 1 / 3 - 71.7.L Aulh0ri2edsignoture: This permit application expires Ito permit Is not al 180 Prim name I Dale T days after It has been accepted as complete. • Number of inspections snowed per permit. elauildiol0PetmitsllLC •PerinhApp.dnc MIA a 440.46157(111nt;/C0M/W69 . 7 MAR- 30- 2012(FRI) 13:35 Bear Electric l) (FRX)5036 ?81108 P.001 /002 E lectrical Permit Application FOR OFFICE USE ONLY City of Tigard \A' ,,k, „k, oa �� % �� Permit No. ELC2012 -00150 • 13125 SW Hanll Blvdvd., Tigard, OR _1! `l Phone: 503.718.2439 Fox: 503.$ % r .Q Other Petroit Inspection 1 . ' TIGARD �K o n tne: 503.639.4175 `� P� lr 11' fill SaPage 3for • Internet: www- tigard -or.gov W ��� `' . EMI Supplemental Wormed= _ .. . ..- .n'1'Y.E OO:�WORi1C5 ... • ... - . 'A . .. . : ::: �.AN�>f5;, *+ ++"•' 4 � i- +; El New conStruction NEl . Addltion/altern ion/rct • - t near check all that apply (mil !sets *Calms whtems checked below): ❑ Demolition Other: V C �ce or feeder 400 amps or more C Building over three stories where the available fault current Q Marinas and boatyards. i-�: •.:.• - ; - ', = emcee:00 amps ... ':f': �•�' ;• • ,N � ° C ./4TEC01taC0Yr�CON51R1�CQO�i, _c � ��� + - ? '. � : " , rte - _ .� at ISO volts or p Floating baildinga. ® 1 -and 2-family dwelling ❑ Commercial/industrial lees to ground. or exceeds 14.000 0 Commtacial_use agricultural (] Accessory b uilding amps for all other installations buildings ❑ Multi- family ❑ Master builder ❑ Other: 0 Fire pump. C] Installation of75 KVA or _ :F.."'=:••:• -. f . . • . -: ' 40-i tIE': NI ORI1'IC/ITJQN L:VD. OC'AtibN. ' _5 ":. - • 0 ��eney system. -A-. separately derived system. ,::�" Q Addition anew motor load of Q A ". `E". "t•2”. "la - . Job no.: I Job site address: V� S4 • T Q I00/1P or mare, oc Q Six or more residential unite occupancy, Recreational vehicle parks - City/State/ZIP (1-R C Ilecllh•care facilIl1 Cl Supply voltage for more than Tt � ( " • O Hazardous locutions 600 volts nominal. Suite/bldgJapt, no.: I Project name: OService or feeder 600 amps or more. site: ' i= ', "a''' i$C "'" ' - Cross street/directions to job sit DescrIptlan I Qrs. I Pee I Total 1 • - New residential mask- or multi - family dwelling nnit. Includes attached garage. Subdivision: Lot no.: 1.000 sq. ti. or less 168.54 4 Tax map/parcel no.: - Ea. add'I 500 sq. ft or portion 33.92 1 Limited energy. residential f -•'T T ± :; t=6A_• . pESCR�'ION'EOM.O100, '' _.' * te%• ': (with above KA) 75.00 2 Limited energy, multi- family ' 2 ~ e . A . r A IlL .t t>,ux ' I '. 7 ,.... T� CA —, % ` A. residentlul.(with above sq. R I ) 75.00 1 2 ` Services or feeders installation, alteration, and/or relocation _ �`� * , • _ 200 amps or less 100.70 2 i.. yQ tJ'._ ,_ �Z �1 `- a?iiT;i A r °_`4 ."4 -'1.c 20 amps 10 400 amps 133.56 2 Name' • 401 amps to 600 amps 200.34 ^ • 2 . 601 amps to 1.000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 Ciry /StatcJLIP• Temporary services or feeders Installation, alteration, and/or 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, lase, rent, or exchange, according to ORS 447, 449, 670, and 701. Owner signature: Date• Branch circuits — new, alteration, or estenttion,per panel • A. Fee for branch circuits with above service or feeder fee. . Q Yc ' = = each !match circuit 7.42 2 Business name: li. Fee for branch circuits without service or feeder fcc, first 56. 1.11 2 Contact name: branch circuit Each add'I branch circuit Alli M� y' 2 Address: Miseeuaseaus (service or fee not included City/State/ZIP: Each manufactured or modular dwelling, service and /or feeder 6724 2 Phone: ( ) Fax: ; ( ) Reconnect only 67.84 2 E -mail: Pump or irrigation circle 67.84 2 Signor outline lighting 67.84 2 aia --^ -*- �/y� � � • _ , Signal circuit(s) or llnrited•emergy Business nume: P. 7S]_ � panel, alteration or extension, Pate 2 2 �••� Each additional inspection aver allowable to any of the abov Address: cD, 4n, Bc Additional inspection (1 hr min) 66,25 / lir City/Sinter/2P: S� (1 Investigation (1 hr.min) 66251 hr '•'t i Industrial plant (1 hr min) 78,18/ lir Phone: (QS) fl% f :,t5 Fax: ( (_ = lrrapeclions for which no fee is 90.00 / hr ' ,, ifitvtl listed 'h hr min) CCB Lic.' oq 1c I 3 Electrical Lie. ;'�� ^t� Suprv. Lic.• b � Suprv. Ele ctricia n signature, required: - • Subtotal: • 1 - ` - Plan review (25% of permit foe): Print name: it s1 1Rp rho t Daic: 5 —.50 —l2 State surcharge (12% of permit fee): 1 . "l - 'L���J r 'L TOTAL PERMIT FEE: _ 1 ` II , l Authorized signature: _ This permit applle aloe empire* ire permit is not obtained within 180 Print Hume: Dale: • days after It bas been accepted as complete. Number of inspections :dluwed per permit. LtnuildingWemmiml2L C- ratnliAap4ue 07/01/10 440-461Sr(I1/OS/COMIWeD