Permit r „ CITY OF TIGARD ELECTRICAL PERMIT
31 1 " CO MMUNITY DEVELOPMENT Permit #: ELC2012 -00702
w 1 3125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/12/2012
TIGARD 13125 2S112CD13900
Jurisdiction: Tigard
Site address: 7864 SW ALDER ST
Project: Beard Subdivision: HAMBACH GROVE Lot: 37
Project Description: (2) branch circuits
Contractor: STEIN ELECTRIC Owner: BEARD, GRETA & PHILIP E
17375 S. SUNRISE LANE 7864 ALDER ST
BEAVERCREEK, OR 97004 TIGARD, OR 97224
PHONE: 503 - 784 -5054 PHONE
FAX. 503 - 632 -5096
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 12/12/2012 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 12/12/2012 $7.63
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $71.23
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable law All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days ATTENTION Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR
952- 001 -0010 through OAR • •2 -001- 090. Yo may obtain a copy of the rules or direct questions to OUNC by calling 503 232 1987 or 1 800 332 2344
Issued By: L �l� i1 Permittee Signature: t .'/ �T 7O,‘,/
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each Inspection.
12/12/2012 08:30 6325096 ^ STEIN ELECTRIC PAGE 02
Electrical Permit ApplicaRECEIVED 1 111( 1 It I I tit %1 1
gi
City of Tigard 11,...,, ll .»� it rte. i�� -Q/ iaZ
13125 SW Hell Blvd, Tigard, OR 9 j r3 12 2012
internist: an Review
Phone: 503.718.2439 Fax: 503. g pig Other Permit
inspection Line: 503.639.4175
�/� p Date Rd/Met h o d. 0 See Page 2 for
}� y j tntet: www.tiganl- or.gov 1t, � OF TIVRfUJ Notified/Method. /t�+��y� Soppinueotd Information
r.'F.. :.hr 1�t l`tl'REf .7".�iAtt ,K�- �4� '.�".. ay l' 1 i l l �.• � I �wni�$,..� '� e i :
l aa r.,
❑ New construction 1 • ddition/aheration/rcplacement Please check all that apply (wit ? sets of plans wlitezns checked below):
❑ Service or fader 400 amps or more ❑ Building over three stories,
❑ Demolition ❑ Other
k W Wiy t rw+!r�n+rrnwy,n , id�!�
shwa the available Sault current ❑ Marinas and boatyards
1ii�Z:rh;4 ; w yr ` . �. exceeds 10.000 amps at 150 volts or ❑ Floating buildings
` : , ,t`. '� `. less to ground, or amends 14,000 ❑ Cornmereial -use cultural
P: - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building �
❑ Multi-family =pa � other installations. buildings. D,i 1 1 y 0 Master builder ❑ Other. ❑ Fire pomp ❑ Installation of 75 K VA or
rY It4�' } h IA* ' ° '�`" `; a , i ; Y. O F.magency system. larger separately derived system
a itina.w.+t�wArl� r;t+ sb, 0 Addtnon of new motor load of ❑ "A" "E". "I -2 ", "1 -3 ".
7 Job no.: Job site address: ■ IOOHP W more occupancy.
0 Six or mote residential units ❑ Recreational vehicle panics, i
C[ty/Statc /Zl h: c� f . Q / ❑ Heal�ane facilities. ❑ Supply voltage for more t an
.T' o `f' / ❑ HarmdOus locations. 600 volts nominal,
Suite/bldgJapt. no.: I Project name: 0 Service or feeder 600 am . or more.
Cross street/directions to job site: ` ":' " ~ "=�_° X'�.
ov Pm tom •
New residential single- or multi - family dwelling unit.
Indades attached garage.
Subdivision: Lot no.: 1,000 sq. f. or less 168,54 4
Tax map/parcel no Ea add'I 500 sq. fl. or portion 33.92 I
,y1(l`ttt� Limited energy, residential
tfk d'�' ��f f,.NV� i hl4A�MYi.i. ,Y�1W ii A � 'M
x %ir4t u i�vJ °'.it.i„d ! -.,i' ;Si� (with above sq. R,) 75.00 2
Limited energy. multi•family
residential (with above sq. IL) _ 75.00 2
Services or fieeden iestailation and/or relocation
200 amps or less 100 70 2
"� ?1 i���k�'I` trf "u!RHw" _ �a�x �. ,a , t,.l, t "� F
;rl rl'ilaipitrr .�t��";';,w. _ : 11 . ,0'• ., 201 400 amps to amps 133 Sb 2
Name: -4:741g- 6 401 amps to 600 amps 200.34 2
601 mumps to 1,000 amps 301.04 _ 2
Address: Over 1,000
amps or volts 552.26 2
Clly /StriDC/ZIP. Temporary 'terries!' or feeders Installation, alteration, and/or
r lotatioe
Phone: ( ) I Fax: ( ) 200 amps or less 59.36 1
201 amps to 400 amps 125.08 1 2
Owner iosgibltioo: This installation is being made on property that I own which is not °�1 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Owner signature: y . , Date:
Branch for branch circwtaa with
or extension, r panel
tik :l; "c' +" ? Y > 7 _, . - F .., • above service or feeder fee.
tiC , ry :Y K t Y >j t! • -: each branch circuit 7.42 2
Business name: B. Fee for branch circuits without
service or fader fee, first 56.18 2
Contact name: _ branch circuit
Address: Each adds branch circuit t 7.42 2
Miscellaneous ( servke or feeder not included)
City /State/ZIP: Each manufactured or modular 67,84 2
dwelling, service and/or feeder
Phone: ( ) I Fax: : ( ) " Reconnect only - 67.84 2
Pump np or irrigation circle 67.84 2
w�sy.r et tJ4rs lthy' M Sign or outline lighting 67.84 2
:Fe1 sfM'!3�. 1+? 1 - :=Mrf. Iti�dsfi� ";iyF'., :,:1.5,..',44I Signal emigs) or Itmtltd-energy
Business name: %\ p„ . _ 1 r Page 2
Lath additional inspection over allowable in any o_f the above
Address: \ -?a 5 S . S u.N r t 0 " Additional inspection (1 hr min) 66.25/ hr -
-•
City/State/ZIP: p a t Investigation (1 hr min) 66.25/ hr
� U , - c-t� .� '1 cloL
Industrial plant (1 is min) 78.18 / hr
e ' ( 5 0 3 ) `l 5-6 �{ Fax: (03 ) l y (P 3a 9( Inspections for which rte fee is hr
CCB Lic.: ap s F5' Suprv. L ic. f 1 1 I _ S O . ' i listed i5 hr min 90'00/
• 3-( lectrical tic.: Y - 313 i•` m to ' .r ., �-,._...
S Electrician si n q
uprv• gna qulr ca 10 r )3 Subtotal: r
Platt review (25 % of permit fee):
Print name: S Date: !z..7'O /12 State surcharge (12% of permit fee):
Authorized TOTAL PERMIT FEE: 7/, p°; 3 ✓
fro:
This peek d k b sac permit is not °bodged d as complete. whin 180
Print name: I Date:
• Number of inspections allowed per permit,
1'tnid1 fylrwaadblBl.C- PbmutApp.deo 07/01 /10 44046)ST(1 105/COM/WEB