Permit CITY OF TIGARD ELECTRICAL PERMIT
n
a COMMUNITY DEVELOPMENT Permit #: ELC2013 -00280
T f CARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/20/2013
Parcel: 1 S 125DD04700
Jurisdiction: Tigard
Site address: 9775 SW VENTURA CT
Project: Ball Subdivision:VASHINGTON SQUARE ESTATES NO.. Lot: 55
Project Description: (1) 200 amps or less and (2) branch circuits for panel change, A/C and general inlet
Contractor: BEAR ELECTRIC Owner: BALL, MIKE
PO BOX 389 9775 SW VENTURA CT
DONALD, OR 97020 TIGARD, OR 97223
PHONE: 503 - 678 -1355 PHONE:
FAX: 503 - 678 -1108
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FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 05/20/2013 $100.70
Specifics: amps or less
2 crt Branch Circuits wo /Purchase 05/20/2013 $63.60
Type of Use: SF Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 05/20/2013 $19.72
Electrical
Type of Const:
Occupancy Grp: •
Total $184.02
Required Items and Reports (Conditions)
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This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable 'law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through 0 952 -001 1090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800,332.2344.
Issued By: e � . I � � ! /_ Permittee Signature: O� �PP�C 7T "T7O$
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.
MAY=L117- 2013(FRI) 07:09 Bear Electric (FAX)50j67.81108 P.. 001 /002
M•...r.• ,..4=, 1 CI xPNIIIICauUJD • - FOR OFFICE USE ONLY • "
City of Tigard ueeei: / O -.% + ,2 E Y E� I)vClll 5196 (3 Irennu NI, I_e sK/I 3" � d '(�-Z
l N 13125 ti u 11:111 Blvd.. 'I'itl nd. l Ill 17 -„
Phut Recq•u
Thane 311.1.718:d34 ha\ Sui ,Vg NMI I)alc lt+ Uthci Pet
TIGARD I hzpeetn m Line: SO,i,(+j9,4175 l areNcad):'lle _ '_ '
Internet: , v , \,..li •aid MAY 2 0 2013 t 17& S see 1• for
1 t Nnulird•Mcthal Supplemrntal Information
TYPE OF WOtTy Q i 1 PLAN REVIEW
❑ New t iistruction (ltlitm /ahcrlili] ]a I'leax all all Mat apply (submit 2 ,,d, rd' plans wmcnls checked beiwc) ❑ snips 1
❑ I)e111llllllOn ❑ Other:
ri Xcn'ice oo feeder Jr1I1 in u+nrc Builder!! nu•r three 'lot its
tome Me t++ndalde I'an11 COMM ❑ Marina ri i s and hrcdy j
• �.�- -�-�( 1- and Z IClnlll\ dwelling CATEGORY OF CONSTRUCTION e' cced. 10,0011 amps at 150 volts or 0 Floatiui huildmps.
" r less In mound. or exceeds I4•flo 1 El C mnmcriial - u x a}nenhural
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! ❑ Commercial/industrial ❑ Accessory building amps I■a all us wsmltntimn build*, Mlild
0 Mnht- family ❑ Master builder ❑ Other: 1.. 11••�•+ 1' 1 Fite p 0 1mi1111111ntt of 75 K en
JOB SITE INFORMATION AND LOCATION 1'•Incr4.tiicy s.,lem Imp upauucy derived stem.
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0 nddiii
�7/•- C1 � �n !_ n nu of ne w motor load ul' "A ",• °I•:" "1 ,..
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_.1Qh 1)O,;— -lob- site- address S \4 I V �r h ot I t t�. - I1101IP nr mole. occupancy
l ✓ V \ V t 1 Y (h/�,,,(/ _ ❑ SIS M more residential i rni, 0 Recreational ...hide parks
City /Stale /Z.IP: Tca /1 cl ,'�r.4: . D tle:Mb -care facilities. ❑ Supply .nllnre for moledon
Suite/I)Itl /a 1. 110 t dJ1L� > tP J 1',I�1r�1.�I //fin ❑I ervic n or ceder orrs. 000 oohsnnnnnal
b p — _ I role name: ` (+� r /M:12(, (] Service or feeder 6011 amps or more.
Cross sln:cUdi reel ions to job site: V f FEE SCHEDULE
Detr rtpuon . 1 Qt Fee. I Tow I •
New residential single or multi family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,00o sq. n, ti less 160.54 a
Tax map/parcel no,: - G,. add'I 500 stn. fl. or portion 33 92 I
Limited energy, residential v 75.00 2 •
DESCRIPTION OF WORK _ (with above sq. n.) �J f1 /1 ���/'� C /J Limited energy. multi-family
_+. _eA- f,� hang j�l 1 ('1 e _ residential (witli above Sit. 11.1 75.00 2
J _Services or feeders Installation, alteration, audio relocation
200 ;Imps or less I 100.70 10_02
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 200,34
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G01 amps to 1,000 amps 301.04 2
Address:
Over 1,00(.1 amps or volts 552.26 2
City/State/ZIP: Temporary services or feeders installation. alteration, and /n
relocation
Phone : ) Fax; ( ) 200 amps or less — 59.36 _ I
Owner installation: This installation is being mall.. on properly that 1 own which is not 201 amps to 400 amps 115.06 2
intended for sole. lease, rent, or exchange, according to ORS 447. 449, 67Q. and 701. 401 amps to 599 amps 168.54 2
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Owner signature Branch circuits- new, al ur extension, per panel
Date: A. Fee for branch circuits with
❑ APPLICANT J ❑ CONTACT PERSON about service or feeder far„ 7 42
each branch circuit
Business name: . B. Fee for bra circuits a it honr I - )
service or feeder fee, first Contact name: branch circuit 56 I I 5 � 2
_- — Each add'l branch circuit I 7.42 1 : z 2
Address:
Miscelinneou service or feeder not Included)
City/State/ZIP: Each manufactured or modulat
dwelling, service ;tad /or feeder 67.84 2
Phone: ( ) Fitt:: ( ) Reconnect only 67.84 2
E-mail: or irrigation circle _ 67.84 2
-- Sign or outline lightin 67.8 2 •
CONTRACTOR
Signal circuit(s) or hmitcd -cnem 5y
. Business name; sear 5i I' /-a , - panel, alteration or extension. Page 2 2 —
^ 2 'i Each udditinnal ins. Minn over allowable in an of the above
. Address: pa_ 31St Additional inspection (1 hi min) 66.25/ hr
Cit /StatcIZlP n investigation (1 hr min) 66.25! hr
Phone: (5 // ,,,, Q' _ �V Industrial plant (I hr min) P _ 71.18/ hr
\ o'1 V ' I 55 F' � • 1' a$• Inspections for which no fee is
spestifield l isted (%: hr min) 90.00/ hr
CCB Lic - :z 11 Electrical Lic -:z4_i Suprv- Lic, : — `' , ( Q 2 S , ELECTRICAL PF.RMIT,bEEti
Suply- Electrician si(platurc, required - _ Subtotal: 1
• Plan review (25% of permit fee):
Print nemc_ 'LVe, e_e Dtmie55- j ii II 3 State . 1 l -
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1 / 1
Authorized signature: v TOTAL PERMIT FEE: (g
This permit sppUc iiion repires If a permit is not obtained within ta0
Print nitrre: Sr/et& Date: Di 1 f . . days after la hue been accepted as complete.
t lLl I • Numbeo or inspections allowed per pcmti!.
I oW; ldinplPern u7/u1nu • 440-4615T( (1)3pWru
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
9775 SW VENTURA CT, TIGARD, OR, 97223
Residential - Electrical
199 Electrical final
05/23/2013 00:00
ELC2013-00280
PASS - No C of O
Violation Summary:
Inspector Contractor