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Permit q CITY OF TIGARD ELECTRICAL PERMIT • COMMUNITY DEVELOPMENT Permit#: ELC2013-00052 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503 718.2439 Date Issued: 01/22/2013 Parcel: 2S102BC00903 Jurisdiction: Tigard Site address: 12815 SW GRANT AVE Project: Eng Subdivision: NORTH TIGARDVILLE ADDITION Lot: 29 Project Description: (1)200 amps or less and(1)branch circuit for panel change and bath fan Contractor: BEAR ELECTRIC Owner: ENG,TONY&CINDY L PO BOX 389 PO BOX 23086 DONALD, OR 97020 PORTLAND,OR 97231 PHONE: 503-678-1355 PHONE. FAX: 503-678-1108 FEES Quantity Description Date Amount 1 crt Branch Circuits w/Purchase 01/22/2013 $7.42 Specifics: Service or Feeder 1 ea 12%State Surcharge- 01/22/2013 $8.01 Type of Use: SF Electrical Class of Work: ALT 1 ea Temp Services or Feeders- 01/22/2013 $59.36 200 amps or less Type of Const: Occupancy Grp: Total $74 79 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 •• /001--0090/1 You m�ay�,{btaain a-cooppy of the rules or direct questions to OUNC by calling 503.232 1987 or 1.800.332 2344 /� �{ Issued By: �� (if/1�X,1 W't•l[[if Permittee Signature: c/�l A PPO(!L"T10' 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 603.639.4176 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. JAN-18-201 3(FRI) 12: 46 Bear Electric (FAX)5036781108 P. 002/002 •-••.-a,u,a..aa A VI 11.111 tipplica Lion FOR OFFICE USE ONLY City of Tigard R ctil Ntl' .gar 3. I:125 SWW I LII!Risd I IE:mI r 118 I 1ECEIVED+ I'IICka _.... I ?� 3 Plan kr,less ..._. . . I'hinc "Cl',718.2431 1':,a 5113 59A I'Nrtl Roe Ra iwiei I'cnnn lu'peertun Hoe 511361'1-117i JAN 2 2 2013 TIGARD 1)„,,H.0,.11,a -- - --— i� 0 tier rage 2 for llitcrnct uis Ilgairl•or.go Nollla',t5ICIIuil /J Supplrmrntsllnform.don f I-�I '1'YPF, OF U PLAN REVIEW 1 t-,1�1L11 COI1�it'uctinil Addition/ilh A N1/ lttCC140,1 �i'i irraacrhrrk:rll that apply:sulrtnn2-cinnt plans u'ncruxcheek'dbrin%). IZ1 111 0 1 11 1,'rt1 other; 0 Strviee or Ieedei 40C)amps nr wore 0 fu4dmp asp,direr slows 1 w clr dx:n:ulahlr Inull current ❑Marinas sld n,ale:nar.w CATEGORY OF CONSTRUCTION cseccds 10,000 amps at 150 solo.or 0 FI sal n r hmldml!c Ions In l!roond.or c•):emit IJ Mill) 0 Cntmnetcla!-use airmnilural 1-and 2-I;nnily ds cI1ing ❑(umniercial/incluslrial 0 Accessory building > : ops tin all other Inslallannrls Iwildnl�, .1g Multi-I;Inll lv ❑Muster builder ❑(Other: ❑Fns Pulllp. (�InxYd11t1011 or 71 f VA in JOB SITE INFORMATION AND LOCATION __ - 0 Emergency system Impel scpalatelr derived system " ' _ El Addumn anew ninhV load ul Q •f" "t" ,-( ^I 1'• Joh no.: lob site satire,~: I.a, '„1 C r. 1 (1`�yy 1001-IP0 n,0rr nrenprn„. V y W lf� 1 l v 0 til�or more rcxidrnlial slur 0 Rcercanomd,•CI1reIe parks Cil}'/11tlt1'/S I P' �� /'(S� CI-7�i '7 01 Icalth-emu facilities. ©Supply inhere ro,.noic limo 0 I Ia:tardOrs hxnt10111. na0 VIM:,nominal Suite/bldg./apt, no.: Project name: 0 Servier or leedet hOo amps or(lime Cross street/dime,suns to job site FEE SCHEDULE Utferll,rinn 1'«. 1nr.l ]— New residential single-or mulls-family dwelling unit. Includes attached garage. Suhtiivision ' --- Lot no. 1, so IV or less 16x 54 4 Es.add'I 500 2' Tax map/parcel no: - sy tl.or portion 33 9- I Limited Otero,residential 7$On DESCRIPTION OF WORK ,with above sq.11.) 2 t r,,/� a ` -} l.unoed energy,multi-tinnily X11 t L�1 J -�� �` residential with shove RI I).) 15.00 2 Services or feeders Installation,alteration,and/or relocation 200 amps or less 100.70 2 0 PROPERTY OWNER EI TENANT 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/State/ZIP: Temporary services or feeders installation.alteration,and/or relocation Phone:( ) Fax:( ) 200 amps or less 59.36- I Owner instwllation:This installation is being made on property that I own which is not 201 amps 10400 amps 135.08 2 intended for sale- lease,rent.or exchange.according to OILS 447.449.670,and 701. 401 amps to 599 amps 168.54 2 Owner signature: Branch circuits-new,alteration,or extension,per panel Date: Fee for branch circuits wilt 1 © APPLICANT 0 CONTACT PERSON above Service or(ceder fee, 1 1 I 7 12 4-2. 2 each branch circuit Business name; B.Fce for branch circuits ntlin21g service 01 feeder ice,first Contact name: branch circuit SG 18 2 Each add'i branch circus Address: - 7 42 2 TMlaeellaaeuna(service or(ceder not included) Each manufactured or modular - City/State/ZIP: 67.84 2 dwelhne.service and/or feeder Phone:( ) Fax; ;( ) Reconnect only I G7.8.1 2 • E-moil: - Pump or irrigation circic�— 67 tt4 2 CONTRACTOR Sign or outline bglNing ++ 67.84 2 �. 1'- Signal circuits)or limited-crier Business name: y.. • C (.. G4'-`C —panel-alteration,Otextension. Paget 2 Address: r (- -- Each additional inspection over allow,blc in any of the above 4)6. Additional inspection(I hr min) 66 25/hr City/State/ZIP: • /� (-'-,( ,r _Additional n(I hr ruin) 66_25/hr ` � ”` _a'� ` l / �p industrial plant(1 hr min) 78.18/hr Phone:��77ss�t2� 76 Fax: �.G(U U v' ( ) 7 Inspections for which no fee is 90.00/Itt specifically lister)(�hr min) CCl3 Lie.: Z /1G l(A I Electrictd Lic.: 4-1 6�'` Suprv.Lie.: (0 2, ELECTRICAL PERMIT FIiES -7 Suprv.Electrician signature,required:1, ..c-, r / Subtotal: Co(. 1 s Print name: G Plan review 125%of permit fee): - Sate / i+ State st lchargr(12°6 of permit fee): is C I Authorized signal ore: TOTAL PERMIT FEE: -7dw .� 1 - -- •- `I hix permit appllcaGnn rtpires If a permit ix not obtelntJ within 1 all I Print n'at11C: Date: days after it b,..ben ececptcJ ua rnmplcto • ^~ _ • NttmLn nrrnspectiolls allowed per pertnit. I.lDuitdotTirmis\LC l,,,,utAVw doe 07V1/1u •wU.aaslnlmsrcoss:'wtiu