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Permit • • CITY OF TIGARD - I3• ELECTRICAL PERMIT ;'1 a * COMMUNITY DEVELOPMENT Permit #: ELC2013 -00050 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/22/2013 Parcel: 25111 DD13700 • Jurisdiction: Tigard . Site a ddress: 8722 SW HAMLET ST • Project: Draper Subdivision: MILLMONT PARK Lot: 14 ' Project Description: (2) branch circuits for furnace and NC 1/22/13 REPRINT Add(1) branch circuit service outlet Contractor: BEAR ELECTRIC Owner: DRAPER, YVONNE C & KRISTEN PO BOX 389 8722 SW HAMLET ST DONALD, OR 97020 TIGARD, OR 97224 PHONE: 503 - 678 -1355 PHONE: FAX: 503 - 678 -1108 FEES Quantity Description Date Amount 2 crt Branch Circuits wo /Purchase 01/22/2013 $63.60 Specifics: Service or Feeder 1 ea 12% State Surcharge - 01/22/2013 $7.63 Type of Use: SF Electrical Class of Work: ALT 0 ea 12% State Surcharge - 01/22/2013 $0.89 Electrical Type of Const: 1 crt Branch Circuits w /Purchase 01/22/2013 $7.42 Occupancy Grp: Service or Feeder 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 OAR 9 - 1 -009 . You may o stain a copy y of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. 1 ,( Issued By: �' v( f� Permittee Signature: Okl ( � / or � ()61CA-4 ( '4 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. o CITY OF TIGARD ELECTRICAL PERMIT I'1 COMMUNITY DEVELOPMENT Permit#: ELC2013-00050 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/22/2013 Parcel: 25111 DD13700 Jurisdiction: Tigard Site address: 8722 SW HAMLET ST Project: Draper Subdivision: MILLMONT PARK Lot: 14 Project Description: (2)branch circuits for furnace and NC Contractor: BEAR ELECTRIC Owner: DRAPER,YVONNE C&KRISTEN PO BOX 389 8722 SW HAMLET ST DONALD,OR 97020 TIGARD,OR 97224 PHONE: 503-678-1355 PHONE: FAX: 503-678-1108 FEES Quantity Description Date Amount 2 crt Branch Circuits wo/Purchase 01/22/2013 $63 60 Specifics: Service or Feeder 1 ea 12%State Surcharge- 01/22/2013 $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 5 -001-0090. You ma obtain a copy of the rules or direct questions to OUNC by calling 503 232 1987 or 110800 332 2344 � r ' Issued By: Permittee Signature: o 4t f tide-( (7 old 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 603.639.4175 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. JRN-18-2013(FRI) 09: 30 Bear Electric (FRX)5036781108 P. 002/002 Electrical Permit Application REGEiv : FOR OFFICE USE ONLY li City of Tigard Received l j-. 3 � Permit 1i �''eC c 3— O , • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review ' �� Phone: 503.718.2439 Fax: 503.598.1960 JAN 2 2 20 i DaieBv: Other!Winn: TICAKD inspection Littct 503,639,4175 �'�/(�� a Date Ready/By: ti R1 Sec Page for Internet: www,tigard.or.gov CITY OFTIG11J rNotihed/Method; ( l Supplemental information TYPE OF wOIx.;3tJII alt ('n9 I o1n' rtti'i REVIEW 0 Nov const ruction ddition/alteration/rcplacemcnt Please check all that apply(submit Z sets of plans w/ilems checked below): 0 Service or feeder 400 amps or more ❑Building over three stories. ❑DenolitlOn 0 Other: where the available fault current Cr Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10.000 amps at ISO volts or 0 gloating buildings. less to ground,or exceeds 14,000 ❑Commercial-use agricultural I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building amps for nil other installations. buildings. ❑Multi-family 0 Master builder El Other: 0 Fire pump. O Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived system. Q Addition of new motor load of 0"A",-E","1-2","1-3". I DOHI'or more. occupancy. Job no.: Job she address: �/ -1.2.- �� 0 Six or wore residential wails. t ❑Recreational vehicle parks. City/Stole/ZIP: �‘ �(& 0,(1a..., �7 'Z ❑Health-care facilities. 0 Supply voltage for mom than - t 0 Hazardous locations. 600 volts nominal. Suilc/bldg./apt.no.: Project name: 0 Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: ne.rrlptt.. j Qt,. l rn. I 'rata I - New residential single-or multi-family dwelling unit. Includes attached garage. Subdivision: Lot no,: 1,000 sq,fl.or less 168.54 4 ax map/parcel n0-' Ea.add'I 500 sq fl.or portion 3392 W I Limited energy,residential 75.00 2 DEscrIoN of WORK (with above sq.n.) _ _ - wi' Limited energy,multi-family 75.00 2 V ' C\-Q`e__ residential(with above sq.Il.) _ Services or feeders installation,alteration,and/or relocation 200 amps or less 100.70 2 ❑ PROPERTY OWNER` ..:❑ T'ENAN'T 201 amps to 400 amps 133.56 2 _. 401 amps 10 600 amps 200.34 2 Name: - 601 amps to 1,000 amps 301.04 2 Address: Over 1.000 amps or volts 55226 2 Temporary services or feeders installation alteration,and/or City/State/ZIP: relocation _ _ Phone:( ) Fax:( ) 200 umps or less 59.36 I -201 amps to 400 amps 125.08 2 Owner installation:This installation is being madc 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. Branch circuits-new,alteration,or extension,flee panel Owner signature: Date: A,Fcc for branch circuits with ^ _ _ _. above service or feeder fee. APPIixCANC:r::•._;....;.::':: _ C011M1fAY>rItSON" ::: X42 2 each branch circuit - Business name: B.Fee for branch circuits without service or feeder fee,first 1 56.18 Contact name: branch circuit 56,1S Each add')branch circuit ` 7.42 LL 1.AL 2 Address: _. Mlacellaneuussservice or feeder not included) City/State/ZIP: Each manufactured or modular 67.84 2 dwelling,service and/or feeder Phone:( ) Fax::( ) Reconnect only 67.84 2 Pump or implant eitcle 67.84 2 E-mail: _.. .;;. 67.84 .. :. ;..CONT'RACT'OR ..:`` _ •. Sign or outline lighting' g r "' "'` .• Signal circuits)or limited-energy Business name: \�e f £ 1 e�('v\C "' C . panel.alteration.orcxtensiun , 1'aKe_2 , 2_ 4 I ) _ Each additional inspection over allowable in any of the above Address: V �x U ■ Additional inspection(I hr min) 66.25/hr investigation(1 hr min) 66.25/hr City/State/ZIP:0o \a`6. V - C - a � l Industrial plant(I hr min) 78.18/hr Phone: 078-( S' Fax: 3) c7$ °l l Q Inspections for which no fee is 90.00/hr spe.cr ically listed('h hr min) CCI3 Lic.: 1 t:::\ Electrical Lic.:-Z4-(07 G Suprv,Lie.: 1 � ,` ...;, _ �CTRJcA1.,PERlvnT RFE.y - Suprv.Electrician signature,required: ' - _ ;1 / Subtotal: 0 - 1� As_.„,,.... Plan review(25%of permit fc Print name: o, D r\flu 1 & Date: / 18 [ State surcharge(12%of permit fee): "' ,(Q3j - l� ��` ���"`---'� ` ►v TOTAL PERMIT FEE: t .7 5 Authorized signature: This permit applicatinn expire inn permit is not obtained within 180 duyx utter it hum been accepted as complete. Print name: Date: • Nun.bet nil inspections allowed pct'permit. I'R"Itdanr.U'a nit*IELC-l'mmiiApp Jon 07dt I/In 44o-441511i1/USICUM/WUU JAN 22 2013(TUE) 13:18 Bear Electric (FRX)5036781108 P. 002/002 a,>.a•..g.a mar a vs easel r pplic.4tIOTl FOR OFFICE USE ONLY RECEIVED Reerne,t 0 .._ 3 �( k/ 3 - o oS City of Tigard pel met N. 0 "C7 W 1.1 In S SN I hill Ilhvd l Tara, 1 qt '/7: - - -•- -- --. _........ _.. Y I'1 Rc.lew I'h 511.; 718 2.139 I ax 4 l ; "Ix 1 'Na, lMtkl l eland TIGARD Inspeel41111.ute 503 IOU .1I75 JAN 2 2 2013 hat. Read, N• — - tau' O Sce Pice2 fur Iltlerim ,e,,,,.uprd - !to. Nuufled ,r1° Supplements) Information TYPE OF WO FTIGARD PLAN REVIEW ❑ Nctt construction ddilion /ah r: Plea.. check all dim apply Isuhmu 2.rts nt plans °nems checked hclo,r , �y 1 ❑ St."' ie ti Ix Iced M er J an no nmre ❑ n111hhllp min three .Hew, © Demolition ❑ Other: ,.here the a fault cunent ❑ Alanna. and haaijmds CATEGORY OF CONSTRUCTION e.ceeds 10,0110 amps at 150 ,idle la 0 Floating buildings — lei. In ISrPlnnd. tit txcecds 13.000 © Cmn u teleail. , n , e apt lcuhwal I and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps I'nl all olhrr m hluldtnps. 1Va11111- faunal.• ❑Mailer builder ❑ Other; Foe pump ❑ In.lallalurn nr15 K VA ai ❑ hdnerpr ncy system Impel sepatotely domed s3.Ium JOB SITE INFORMATION AND LOCATION D AJdirinn ,If new MOW heal Ili "A "1: ', 1 •'" "1 Job site address: 7 z . z ., c ,-- /", `,-,� p IINIHP nmrr ,xcuc Joh no.; t- t 1 I` T ❑ Si or nrore residential units 0 Recremionol vehicle parks City /State /ZIP: ❑ I lcahh -care facilities. ❑ Supply voltaic for mnre than O I Inzarddla k,cat tans. Min wilts nominal Suite/1)14,/dpi. no.: Project m nee; ❑ Setvice or !ceder IMO amps or more. •■ FEE SCHEDULE Cross strccUdireet ions to job site: Doc _ 1011 W/uiIM122=1 Tots . New residential single- or multi - family dwelling unit. Includes attached garage. — Subdivision: (.ni no.: 1.000 sq. ft. or less 168 54 V - 4 Tax map /parcel no.: - — Ea. midi 500 sq. ft. or port ion 33.92 1 1 Limtled energy, residential 75.00 2 DESCRIPTION OF WORK (with above sq. (I.) — ., /-M � , Limited energy, uial (with muwish a ab o v e s q . ilk re 75,00 2 sirntia) (bode sq. ti.) , Services or feeders installation alteration, and/or relocation C • .. ' j 4.-e...___64.2±1 200 amps or less 100.70 2 ❑ PROPERTY O � ' ❑ TENANT 201 amps to 400 amps 133,56 2 401 amps to 600 &imps 200.34 Name: 61 l amps to 1,000 amps 301.04 Address; Over 111 amps or volts 552.26 2 Temporary services or feeders iustallation, alteration, ood/or City /Statc/?_IP: relocation Phone: ( ) l Fax: ( ) 11 amps or less 59.36 I 201 amps io 400 amps 125.08 Owner installation: This installation is being made on propeny that I own which is not amps to 599 amps 168.54 2 intended for sale. lease rent, or exchange, according to ORS 447, 449. 670, and 701. 1 Branch circuits— new, alteration, or eaten:don _rpm nel Owner signature: Date: A. Fee for bronch circuits with ❑ APPLICANT I ❑ CONTACT PERSON . above service or feeder fee, each branch circuit 7.42 2 Business name: 13. Fee for branch circuits without + Contact name: branch circuit 7.42 2 Address: Miscellaneous (,service or feeder not included) City /State/ZIP: Each manufactured or modular 67.84 2 dwelling service and/or feeder Phone: ( ) Fax: : ( ) Reconnect only 67.84 2 Pump or irrisatiun circle 67,84 2 E -mail: CONTRACTOR Sinn or outline 1i81uing 67.84 2 r S limit circuit(s) or limiled- energy Business name: 1 G- - ' `G `c ' pan el, alteration, or extension. Pore 2 2 I Each additional ins over allow able in any of the abov /�` e Address: �\ C� Additional itt4pection f l hr min) 66.25/ hr City /Statc/LIP: oo \ , co lnvesti8alion(1hrmin) 66.25/ hr y„aa .� Industrial plant (1 hr rein) 78.18/ hr Phone: 19:7 )r•,rji�j - I Far:: C7g•— `t 0E9 Inspections for which no fee is 90.00/ hr - ' f(/� 1 c specilieally listed (SS In min) CCB Lie.: 2_04 t — Electrical Lic.: _ 1 O7G Suprv. l.ic.: Q�s 1, . . PLECTRICAL PERMIT .FF,ES Suprv. Elecirician signature, required: Subtotal: 1.4Z, �..> • • Plan review (25% o permit fee);..- ' Print numc: 5 t...p, ( (� ft p (\ 5 . , r 1 ,���M Slate surcharge (12'% of permit fee): C( "` - TOTAL PLRMIT FEE: b . 31 Authorized signature: This permit application espirea ir permit Is not obtaiae+l withlo 180 Print name: Date; • dogs after it has been ace • cpted as eumplele. Number of inspections allowed per perch t' utuiWing \Permiutt;t.C- PermiuAppdoe n7mt /10 +a0 +6I ST( In/USICUM/WCD