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Permit CITY OF TIGARD ELECTRICAL PERMIT IN 114 s COMMUNITY DEVELOPMENT Permit #: ELC2013 -00196 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/01/2013 Parcel: 2S114BA14900 Jurisdiction: Tigard Site address: 16090 SW COPPER CREEK DR Project: Zuber Subdivision: COPPER CREEK STAGE 4 Lot: 114 Project Description: (1) replace gas furnace and replace (1) A/C Placement of A/C must comply with manufacturer's clearance requirements 4/4/13 REPRINT Adding (1) branch circuit for service outlet Contractor: BEAR ELECTRIC Owner: ZUBER, LINDA P PO BOX 389 16090 SW COPPER CREEK DR DONALD, OR 97020 TIGARD, OR 97224 PHONE: 503 - 678 -1355 PHONE: 503-372-9210 FAX: 503 - 678 -1108 FEES Quantity Description Date Amount 2 crt Branch Circuits wo /Purchase 04/01 /2013 $63.60 Specifics:, Service or Feeder 1 ea 12% State Surcharge - 04/01/2013 $7.63 Type of Use: SF Electrical Class of Work: ALT 0 ea 12% State Surcharge - 04/04/2013 $0.89 Electrical Type of Const: 1 crt Branch Circuits w /Purchase 04/04 /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 •52- 001 -'090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. LA Issued By: ill . � i '.J : , Permittee Signature: 1 L I� r PL ! e 4 f /D 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. APR- 03- 2013(WED) 09:55 Bear E1 tic (FRX)5036 P.001 /003 •:.•••�•s a Es algal f?pplicattwit /� FO OFFI USE ONLY City of Tigard w� �� "`"''' IOafIP I rlo; n, IS•r mil N - "' I 125 X11' I tall Mid 'I it :nd. I Ilt ': 1 — -- — _ ` , R 0 '1,Irr t4 t,ru I 'WWI I'pr ti 1 hors; 5.1: 7aR ��;, Fa, alt x'18 1' A P 3 20 3 11:nc nt TIGARD Interne.' I inc Sni,hi13 - 117 Ilac t(:: le'nc h.., - 0 Ste Page 2 for CIT Y Interne.' wtctt IILaf[I.OI gm r /� �-7- n Ntq,licd tilCllllki Supplemeolst Information TYPE OF ` + IC �' j� � l�I Af PLAN REVIEW 0 New �unsu ucl fun lddilion /;thrral itm /rcphlCClttCnt SI O I'k iw ells. all dot imply l"uhrml 2 sets of plans w items chceLett Mew ) El 1)cmolit iota [) Other ❑ Service ni tecder noes amps Or • ❑ 0uihlinp mt41 three SIMics ,here are atadable fauh current ❑ hlonnas and toorhard. CATEGORY OF CONSTRUCTION evtecJs 10,1)00 amps at 150 volt. or Q Floating buildings. - Dic I - and 2 -1 imil�' dwelling ❑ Commercial/industrial onu nrreial /indu,(rialw ICS!. CO rrMIMI. 01 e.cced. 13.01.41 ❑ ( -use al.•rreultural ❑ Acccsst,ry building noun for all 'ohm mctallnnMtx ❑ Multi - Enmity hl�--•�� � tunildint!s' t_l Master builder ❑ Other: ❑ Fns pump ❑ (n.lallalnwl d 75 kVA nr JOR SITE INFORMATION AND LOCATION ❑ Emergency s■Slc,o largo SCpalalrly darned xvslclu Q Addllinn of new mOrOf load ul ❑ �" "I ?' `I •: ' "1 - , 1uh no.: lob site address M IODIC oecrr • � �W 1 �� r ►,�J�t . 0 S ix or m residential units Q Rccrealional vehicle parks. CitylS1811I1,l lv: (; t e I 012, � a q �� ❑ I le zardou c I "acililirs ❑ Supply voltaic rut 111Arc Ilan ` - •� ` 4 Q Hazardous l,cauom hnn Koh nominal Suite /bldg. /apt. no,: Project name: ❑Service or feeder KM) amps or more Cross street/directions to job site: FEE SCHEDULE Demo t.r I _ I I le 1 e, Tow - New residential single- or multi-family dwelling unit. Includes attached garage. Subdivision: I Lot no.: 1,000 sq ft or mess 165.54 4 Tax map /parcel no.: - Ea add'l 500 sq A or pon 1 — Limited energy, residential 75.00 _ DE,SCRIY7'ION OF WORK I with above sq. IA.) d } ), /� Limited energy. multi-family /LY t ` 0.1 75.00 2 ��� t� 1 resid iit lwithaboscssq Il ) �"" Services or feeders installation and/or relocation F L 7 (� - Q�`� Vt � I t:�C Vl (� Q � 2 amps or less 100.70 ❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 1)3.56 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 voila 552,26 2 City/State/7.1P: — Temporary services or feeders installation, alteration, and/or relocation Phone: ( ) Fax: ( ) 200 amps or less 59.36 I Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449. 670, and 701, 401 amps l0 599 amps 168.54 Owner signature: Branch circuits- new, alteration, ur extension. per panel Dote: A. Fee for branch circuits with ❑ APPLICANT © CONTACT PERSON above service or feeder fey, 7.42 2 each branch circuit 13usincss name: B. Fee for branch circuits wiihonr service or feeder fee, first Contact name: branch circuit 56.18 2 Address: Each add't branch citCuit t 7.4217,4x 2 .— Miscellaneous (service or feeder not included City /State/ZIP: Each manufactured or modular 67./14 2 dwelling, service and/or feeder Phone: ( ) I Fax: : ( ) Reconnect only 67.84 2 E-mail: Pump or irrigation circle 67.84 2 CONTRACTOR W Sign or outline lighting 67,84 ti 2 Signal circuit(s) or limited-energy Business n atio or ex Pa e 2 2 - C. cl, alter tension, inspection over allowable in any of the abov ! Each additional inn _ Address: a -Lx �q C) Ad ` dilianal inspection (1 hr min) tib 25/ hr ULl Cit ylStatcl7 _1P: `�- �d "'_ - " �� Ci �© - Investigiiiion (1 hr min) 66.25/ hr - ' l - Industrial plane (1 hr min) 78.18/ hr Phone: (3 ( � Fa, : (,✓n JJCVJ J . , ) 117 550„5 Inspections for which no fee it 1 l..r - s eifco liste mm 90,00/ hr CCB Lie.: Z t9 Electrical Lic_: 24 _ f0' , Suprv. Lie.: `f 0 01 �^ ELECTR ES ICAL PERMIT T . . Suprv. Electrician signature, required u u Subtotal: '7 C� Plan review 125% of permit fee): T Print na me: s - Dote: ii _ _t- State surcharge (12%ofpcnnit fe e): Authorized signature: ��> TOTAL PERMIT FEE: S. ?) I -0� c [ This permit appicat tin espied if a permit is not oblalow within 150 Print name: C�� pair: days after it has here accepted as complete. - • Number of inspections allowed per prnnit. I.l Dui toicetre.miIsILLC•rcrodlApp 07/51,10 440- 461STlIliuvl'I1.1nvrn I q CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2013 -00196 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/01/2013 Parcel: 2S114BA14900 Jurisdiction: Tigard Site address: 16090 SW COPPER CREEK DR Project: Zuber Subdivision: COPPER CREEK STAGE 4 Lot: 114 Project Description: (1) replace gas furnace and replace (1) NC Placement of NC must comply with manufacturer's clearance requirements Contractor: BEAR ELECTRIC Owner: ZUBER, LINDA P PO BOX 389 16090 SW COPPER CREEK DR DONALD, OR 97020 TIGARD, OR 97224 PHONE: 503 - 678 -1355 PHONE: 503 - 372 -9210 FAX: 503 - 678 -1108 FEES Quantity Description Date Amount 2 crt Branch Circuits wo /Purchase 04/01/2013 $63.60 Specifics: Service or Feeder 1 ea 12% State Surcharge - 04/01/2013 $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 2 001 -00 . 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: 4 t {.l (' C( / Permittee Signature: V/U "" , ?-1 /QLL 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. MRR- 29- 2013(FRI) 07:42 Bear Electric (FAX)5036781108 P.001 /002 ,.:.a....sa seas s vs tlI1L t! ma FOR OFFICE USE OLY Ci of Ti and RE r:c«„, G/ l 1_SSii ILIAIihd Iicor.l lilt 47);: 11 pa `I" I i 13 Cr fermi; NI ffL.Ci 0k) /3 ' 60 ( W Q ��� O Ilan it,: if... I r hhcr l'ennil : tn, ' h , me. 503 718.2434 Fay its '"APR' 1 2013 Il li+ // pecrnm I i ne 5 n34 417' ^ '+ 0 See Past 2 fo TIGARp ban kead.lts " -,. —_ . r Internet .r.y,. ■ ueant•nt.Ern Ndgierf'tenhod Supplemental IntermrAOn TYPE I ' AIL. i A : PLAN REVIEW ❑ Ness eonsiruenun ►i Addillu tt/altefatiunlfcplia:emellt I'Ira.c l,cc all rl apply Icubmu .cal plans .rncmcchceI.rllKh l n, I] Set•ite in feeder -ma amts rn mare O Ba dding met liner Slink,. ❑ I)Cn101111n11 0 Ocher; • - V.IKIV Me a•:ulahlr faun maim ❑ Mamas sewn Mrn■alJs CATEGORY OF CONSTRUCTION cscecds Iu,I810 amps at ISO was or 0 Floating buildings lil Mss to gro ,n exceeds 1 1,(510 ❑ C ntnmrrciatome agrleohtnal I- and 2- 1amily dwell in!! ❑ Contmcrcial /industrial ❑ ACCesSory building: amps Iin an father mslallaiirnis buildings. ❑ Multi - tinnil ❑ Masicr builder ❑ Other. ❑h lee pump ❑ Installation nl'TS kVA 01 JOB SITE INFORMATION AND LOCATION Q l:nlergeney system. larger separately Jet system. ❑ Addition of new minor Mad iii ❑'A' "I:" "I•'" - I• ? ". Joh no.: I .lob site address: 1lsa°lO 51A � C C� _. ItMFFN fat antic occupancy v �}. V1Ct V[ ❑Six to mnrc residential rou 0 Recreational vehicle parks (—fly/Stifle/2W: - TbtaX ` OR C\17214 — ❑licnhh -care I'Mei /nics. ❑ Supple sultnllc for more Man � + ❑ I Waltham locations. 600 wails nominal Suite /bldg;. /apt. no.: Project name: c !ke ' ,,c53,0 C . Service or feeder MIO amps or mote. • "" — � FEE SCIIEDIJLE (:rtes. strecUdireetinns Io job she: w....i I On 1 FR• JTotr I • New residential suck- or multi - family dwelling unit. - Includes attached garage. Subdivision: _ Lot no.: 1,000aq ft or less 168 54 4 fax map/parcel no.: f Ea. add'I 500 sq. ft. or pinion 33.92 _ I Limited energy, residential - 75 00 2 DESCRIPTION OF WORK I with above sq. II.) \ ( r.r I.ifanited energy, Imrlti•l;r u ►_l. ntt3�(u '� Z, T J ricer c $, L I L residemial (with above sq. ft.) 75.00 2 1( / Services or feeders Installation, alteration, and/or relocation - rtat 1 zO t _._l•. (�a 200 amps or less 100.70 2 0 PROPERTY OWN �� © TENANT 201 amps 10400 amps 133.56 2 Name: 401 amps to 600 amps 200,34 2 601 amps In 1,000 amps 301.04 2 Address: Over 1.000 amps or volts _ 552.26 2 City /State /ZIP: Temporary services or feeders iastallatlog alterafloa,and/or relocation Phone; ( ) 200 amps or less r 59.36 1 Owner installation: This installation is being made on properly that I own which is not 201 amps to 400 amps 125.08 z intended for sale, least. rent, or exchange, according to ORS 447, 449, 670, and 701. 401 annps 10 597 amps 168 54 2 Branch circuits- new, alteration, or e: tension, per panel Owner signature: Date: - _ A. Fee far branch circuits with 0 APPLICANT I CONTACT PERSON above service or feeder fee, each branch circuit 7.42 2 Business name: B Fee fur branch circuits wrthour service or feeder fee, first ( 56.18 a5 Contact name: branch Cirenil 2 - Each add'I branch circuit ' 1 7.42 1. J �____.' Address; Miscellaneous (service or feeder not included) City/State/ZIP: Each manufactured or modular dwelh and/or service anor feeder 67.84 2 Phone: ( ) 1 Fax: : ( ) Reconnect only 67.84 2 E -mail: 1 Pump or Imgauon circle 67 2 Sign or milling lighting 67.84 2 CONTRACTOR Signal circuits) or limited-energy Business name: if C� 1i1c ,_panel, alteration, or extension. Page 2 2 ._ C f — - Each additional inspection over allowable in say of the above Address: '?Q Q Additional t 1 l in spection (I hr min ) 66.25/111 Cit /$titl /Z I': 8 • �n, a 1O /1 Investigation (1 hr min) 66.25/ hr - � lV �1J Indusiri;1) plant (1 hr min) 78,18/ hr Phone: (S(,:)3) tJl--lI[ 3) • , 7) 5 F ax ( ) ��$ I t a8 ]nspccticros for awhich d nhr o m fee i 1 LL1l r J ` specificall ti st (h ini 90.00/ hr CCf3 Lie.: 2CR�� Electrical Lic.: 24 _(03 G S Lie_: . R C, - ELECTRICAL PERMIT FEES - Suprv. Electrician sig reyuircd:X W Subtotal: (03 1g � a:' __ _ Plan review (25% of permit fee): _ Print name: C rp, she. D ote; + - 2Cl _ ( 3 State sutcburge (12% of permit fees 7 , (9.5 Authorized signature: W... �i �, � t - TOTAL PERMIT FEE: �� Z', � .i.�r r� " This permit application expires If a permit is not obtained within 180 Print naive: C IQ.�C . �j`� Date: '7 - ZCI 1 days alter it has been accepted as completes r 1 t • Number nC inspect iOnS gnawed per permit r :•p;g rr,milApp,doc UU:Ian 4410-461sTI) /Q5'COM,wsii