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Permit CITY OF TIGARD ELECTRICAL PERMIT • COMMUNITY DEVELOPMENT Permit #: ELC2012 -00454 T [ GAR0 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/01/2012 Parcel: 25101 DCO3703 Jurisdiction: Tigard Site address: 13500 SW 72ND AVE 250 Project: Beck Group Subdivision: ROLLING HILLS NO.2 Lot: 44 Project Description: (3) branch circuits to reconnect 3 rooftop units Contractor: BEAR ELECTRIC Owner: BECK FAMILY PROPERTIES LLC PO BOX 389 16700 S GERBER RD DONALD, OR 97020 OREGON CITY, OR 97045 PHONE: 503 - 678 -1355 PHONE: FAX: 503 - 678 -1108 FEES Quantity Description Date Amount 3 crt Branch Circuits wo /Purchase 08/01/2012 $71.02 Specifics: Service or Feeder 1 ea 12% State Surcharge - 08/01/2012 $8.52 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $79.54 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 9 -001-0090. You may btain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: Permittee Signature: 0(A � t P o C 1 TI V II. 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 MOW) site at the time of each inspection. RUG 01 - 20120JED) 09:59 Bear Electric (FAX)5036781108 P.002/002 Electrical Permit Application FOR OFFICE USE ONLY City of Tigard Received Date/Bv: i/l I'errr No ELL, _ • I . 00 S 13125 SW Hall Blvd., Tigard, OR 97223 Pan Review Phone: 503.7182439 Fox: 503.598.1960 Date/Et . Other Permit TIGARU Inspection Line: 503.639,4175 ® See l'agc2far Internet: www.tigsrd- or.gov Su TYPE OF WORK -- PLAN REVIEW 0 New construction 7 Addition /alteration/replacement Pleau duck all slur apply (submit 2 sets of planswhtems checked below): 0 Service or feeder 400 amps or more D Building over three stories. El Demolition ■ • cr. where the available fault current 0 Marinas and boatyards, CATEGORY OF CONSTRUCTION =teem 10,000 amps at ISO volts or 0 Hosting buildings. less to ground, or exceeds 14,000 0 Commercial -use agricultural I - and 2- family dwelling 0 Commercial /industrial 0 Accessory building amps for all other installations. buildings. nisi- family ❑ Mauer builder 9 Otlter 0 1 °ire Pump, 0 Installation of 75 KVA or . JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived system. o rte © Addition of my motor load of ❑ `A - . "G", "I-2 ", , "I.3 ", Job no.: Job site address: ' 5 ( � �tr 1 ix o more a r occupancy. VV 0 Six or rrtore residential units. 0 Recreational vehicle parks. Clly /SlnlC/7J P' t 0 Flealth.care facilities. D Supply voltage for more than �� C�riC �Z " 2.Z � -- - -- p l laxardous location,. 600 volts nominal. Suite/bldg. /upt. no.: Project name: 4 C1�C ,./ r "F ' (�. c -- �.J s'` y� 0 Service or feeder 600 amps or more, • .. EE. SCH F! DUII Cross street/directions to job site: f �(.0 I rl ,Q L t pawn 1 47.1 Rae, I Total I • New residential single- or multi- family dwelling unit. Includes attached garage. " _ Subdivision: J Lot no.: I,000 ft. orlesa 168.54 , , 4 Tax map/parcel no.: 1:o. add'I 500 sq. R. or portion 33.92 I - Limited energy, residential - : DESCRIPTION OF WORK ... • • (with above sq. a,) 75.00 2 ` - Limited energy. multi - family 75.00 2 residential (with above sq, fl.) Ie.' the. r • es. Ie'& ~ _ Services or feeders installation• alteration. and/or relocation __ 200 amps or less 100.70 2 ___ +•;_ _ p rieor�f: owrrER ..._. , ... O TTrN•NT .< 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 552.26 2 City/StnttJ /.I (': Temporary services or feeders installs tion, 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 ] own which is not 401 amps to 599 mops 16 8.54 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits– new, alteration, ar extension per panel Owner signature: Date: A. Fee for branch circuits with �,.: n ,., =. - . . -.. .. ..- . .. , - above service or feeder fee. -�; ; �; °APPLICANT' _. — . ..: - f : ` 1 ;CONTACT'. P dtSON:. : - eac branch circuit 7.42 2 Business name: 13. Fee for branch circuits wit/root . service or feeder fee, first i 56.18 _ g Contact name: branch circuit l Each add'I branch circuit Z. , 7.42 14 2 Address: Miscellaneous (service or feeder not included) Ci /Statt:/ZIP: Each manufactured or modular 67.84 2 ty dwelling, service and/or feeder _Reconnect only 67.84 2 Phone: ( ) Fttx:: ( ) Pump or irrigation circle 67.84 2 E - mail' _ Sign or outline lighting 67.84 2 __.. wr , ; , '. _: r:CorialtACTOR — . �•� -_ , - . -_. . .,.� . ..: ._ -_. ..:._ ' � -:. . ��_, ': � � signal lrr r ul e d •etnTty Business na me. � _yam _ _ panel, attenuiun. or extension. Paste 2 2 ( ' � 1 {�� Each additiunal inspection over allowable in any or the above Address: ) c. ' o. ", Q Additional inspection (I hr min) 66.25/ hr City/State/DP: \( .. & (k--1 ��0 invest a p (I ( min) 66s5/ hr I ndustrial lant 1 hr min 78.18/ hr Phone: ( / _- 1 (� - ` �� Fax: (� ) �� ` O $ Inspections for which no fee is 90,001 hr fvLi 4' specifically listed (i4 hr min) 9,p3 Lie.: ? (c Metrical Lie.: • ,• ~‘01 rv.Lic.:.4GR . ; : e' C77c1CAt loTr iPEES - ._: -:: :'_ Subtotal: 1, L• oz. Suprv. Electrician signature, required: - ---i - �- t---.," Plan review (25% of penis fee): / � � � Print name: t �_, a. , _, • R? Date: V ri State surcharge (12 %of permit fee): 9l Authorized signature: TOTAL PERMIT FEE.: i ck . — This permit appGmtian expires If a permit la not obtained within 180 days after It has been accepted as complete. l'rint name: Date: • Number of inspections allowed per permit. L•1Duildineenmits 2t.C.Permi1App.duc 07/01 /10 440-401.5T( I r myC0ns W i ii