Loading...
Permit a CITY OF TIGARD ELECTRICAL PERMIT 1111. �- COMMUNITY DEVELOPMENT Permit #: ELC2013 00215 TEGARO 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/11 /2013 Parcel: 2S111CC07100 Jurisdiction: Tigard Site address: 15885 SW GREENS WAY Project: Rickert Subdivision: SUMMERFIELD NO.2 Lot: 98 Project Description: (2) branch circuits to reconnect A/C /Heat Pump, service outlet Contractor: BEAR ELECTRIC Owner: HICKERT, GREGORY B & JUDITH P PO BOX 389 15885 SW GREENS WAY 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 04/11/2013 $63.60 Specifics: Service or Feeder 1 ea 12% State Surcharge - 04/11/2013 $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 952 -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. , J y t'� �1 A-PPL eA-n o Issued By: Permittee Signature: l' 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. RPR- 09- 2013(TUE) 12: Bear Elect (FRX)5036781108 P. 001/002 AJan.'s -al 1«111 a , CS >,>t>!it pip wild lion R.E EIVE I FOR OFFICE USE ONLY 1 City of Tigard need' „i1 (; In,n N "' A 201 I1atc k 4 � i 1 3 fL � evr 3= DU31 II 13 15 S11' I tall 11114 1 rr :rots i Ili 9 722. 1 Q ph it,,,..„ - -- - " Phone 50; 7111 .l3'1 I , ;n; 7.118 Kuh V Iliac l; mho l'an InspccGan I „IC 511;, hj4 11 jG 0 •1ee1'ap for ; • TIGARD lime kcxlv,7t�� �h,,. Inlenlet h,vev .11card- rn!tits CITYOPTIGA N.u,fhdMCIIII„1 I'1 c9 ISupplementalInformation i -- TYPE OF Wtr g • a PLAID REVIEW ■ 0 Ncscconstruction Addition/ alteration /replacement —T Please clhcL all that apply tsulnnd2 Kir. nl' plans %.'emschreLed Moo ) 0 Demolition Other: ❑ Service or feeder -11X1 mops nr Mode ❑ huddmp in N HMMs nhele IhC :rcmlahlc Ib11l1 cuneal 0 Manna. and boatyards. CATEGORY OF CONSTRUCTION eocccds 10.000 arupw al ISO volts 05 0 Flrrmlrap buildings. kss on pound, or esceeds L 1.1NNI Ci Cmmnelelal -me mpnrutlnral I- and 2•11onily dwelling ❑ comnwrcial /indiNri:Ii ❑ Aeccsutn huildin ' ❑ Multi- fitmily :imps for all n,hel nmlatL,hnns Iwnldinp ❑ Masier builder ❑ Other: Q I , rc pump ❑ In or 7S k VA nr JOB SITE INFORMATION AND LOCATION 0 F.ntnpe„cy scsrem. .132.:a .qcn : deriv ed sysrah _ Q Addition ofrhwmotor toad of Q "L - •1 - »t t lob no.: )oh silo atldr��s: p 11)0111' or more nccupanry. E 50 85 S W Q.•-Ife'Plr�$ \ `w`� © lira M More f es,denhal Imps. Q RCCrtalim Wilkie parks. City /Stale Z IP: /'•t \ QIiz7 ❑ IJeahh.care facilities. 0 Supply vnhap for Mudd 111,1, •/ t Q I lmau dous Icxat 4m. rdld mourn mm Suilc /hldg. /apt. no.: Project name: 0 Service Co feeder gin amen to Hume Cross street /directions to_jah site: FEE SCHEDULE Demi lam i 1 2h. I — Pre. 1 Tn,tl .. _1..., New residential single- or multi_famlly dwelling unit. .� Includes attached garage, tiuhdivision: Lot no 1 sq. 0. or less 168.54 4 Tax malt /ptlrcc) no.: Fo WWI 500 sq fi, vi purl= 33.92 1 - Limited energy, resldentlol 75.00 2 DF,SCRIPTION OF WORK ( with above sq. 01 �� Limited energy. mule lolmly v residential (with above sq fl) 75.00 2 !V'ti Services or feeders installation, alteration and/or relocation 200 amps or less 10070 2 0 PROPERTY OWNER 0 T ENANT 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/Stale/ZIP: Temporary services or teeth', Installation, alteration, and/or relocation Phone: ( ) Fax: ( ) 200 amps or less 59.36 1 Owner installation: This installation is being made on property that I own which is not 201 amps ru400 amps 125.06 2 2 intended for sale. lease. rent, or exchange, according to ORS 447. 449, 670. and 701. au! amps to 599 amps 168.54 Branch cireuite- new, alteration, or extensive, ' rpanel Owner signature: Dolt:: A. Fee for branch circuits with El APPLICANT • l 0 CONTACT PERSON above service or feeder fee, 7.42 2 each branch circuit Business name: 13 Fee for branch circuits without - _ service or feeder fee, first I 66 Contact mime: branch circuit 56.18 ✓ • (8 2 - Address: ""- Each add'I branch circuit I 7.42 ,_ 2 Miscellaneous service or feeder nit included) City/Stine/ZIP: Each manufactured or modular _ dwellin service andlar fodder 67 2 Phone: ( ) Fax: : ( ) Reconnect only 67.84 2 E -” Pump ar irrigation circle 67,84 2 Sign or outline lighting; 67.84 2 CONTRACTOR Signal circwt(s) or limited-energy ` 'and alteration. or extension P ,e 2 2 Business name: � � , 1 e- - , Each additional in eclion over allowable in an oldie above Addre Q Additional inspection (1 hr min) 6615/ hr City/Slate/ZIP: T 1 Investigation (1 hr min ry �.�Omi d d ► G t '102 ) 6fi.25r hr • CI e' Industrial plant (1 hr min) ERIS Phone: 60 a., ( . 1 c' / f �Tg w Fax: � ( 0 inspections for which no fee is spcci f cally listed (;s ltr min) 90.00/ hr CCI3 lie.: z1 « Electrical Lic.: 2i4 -10 ` Suprv. Lie.; 3ff _2S T; 1.ECTRICAL P}:RMJT FEES Suprv. Electrician signature, required: X t ILY Subtotal: , . 6 Plan review (25% of permit fee): 1-. Print name: lit, rextou Dote: L( - CI . - 1 b State surcharge (12% of permit fee): I. Authorized signature: TOTAL PERMIT FEE: 11, This permit appbcadoo aspired if a permit Is out obtained within 180 Print name: C 1 � days after it has been accepted as complete t..0 — . LSt ie Dale: �"L - i e Number of inspections allowed per permit I.1Uuilan,gtrtoolo vtl.C- Pmrmnnppdoe 0701/10 440- 4615T1u roon;uMnvEO Location: Record Type: Inspection Type: Comments: Inspection Date: Record ID: Result: City of Tigard 13125 SW Hal Blvd. Tigard, OR 97223 Tel: 503.718.2439 15885 SW GREENS WAY, TIGARD, OR, 97224 Residential - Electrical 199 Electrical final 04/25/2013 00:00 ELC2013-00215 PASS - No C of O Violation Summary: Inspector Contractor Location: Record Type: Inspection Type: Comments: Inspection Date: Record ID: Result: City of Tigard 13125 SW Hal Blvd. Tigard, OR 97223 Tel: 503.718.2439 15885 SW GREENS WAY, TIGARD, OR, 97224 Residential - Electrical 199 Electrical final 04/25/2013 00:00 ELC2013-00215 PASS - No C of O Violation Summary: Inspector Contractor