Permit •
n CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2013 00318
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/10/2013
Parcel: 2S1 11 AA08500
Jurisdiction: Tigard
Site address: 8896 SW GREENSPARK LN
Project: ZELL Subdivision: GREENSWARD PARK NO.3 Lot: 69
Project Description: (2) branch circuits for A/C and service outlet.
Contractor: BEAR ELECTRIC Owner: ZELL, JEFFREY S
PO BOX 389 8896 SW GREENSPARK LN
DONALD, OR 97020 TIGARD, OR 97224
•
PHONE: 503 - 678 -1355
PHONE: 503 - 936 -2000
FAX: 503 - 678 -1108
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 06/10/2013 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 06/10/2013 $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 95 - 001 -0090. You may obtain a co. • or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: "AEI. � --.0111111Pv Permittee Signature:
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.
JUN - 06- 2013(THU) 10:11 Bear Electric (FRX)5036781108 P.001 /002
------- ........ - ••••. ^'J,s.as.a FOR OFFICE USE ONLY
City of Tigard I t ern.�fl 6 /G R �J�I� .
w D I}.v e;llet ,b 3 6, : / , I'etiuo Nv �) gc) /3.-- +es'rN►�
II I SW I;t11 Blvd. 'fig &I1R't
t�I�C_
Antic. 511:.71g :439 I:a\ Sll3 Alt' ) Plan nole
!, I'. hn Uate ll l lliWI Pei •
Inspect n.pecttnn Line 503.bt'1.4175 JUN 06 2013 nai cIlaa n I li J71.19. (ntcntel: utw�.li ard�tr. tin See Paget for
p t Mmfk 16kilrod , Cupplemenlal lnformetioo
TYPE OF OFTI ARD PLAN REVIEW
❑ New construction � lkldiliott /u �d� 1M i caNeeh'd all that apply' Isnluto,2s eas plans r.;demschecledbelou1
0
I)CItt01111011 ❑ Service iv feeder 400 amp, nr more 1
0 Other: I ❑ !tinkling ma puce vmi«
,.IKrc INC Ata,lable fault canna 0 Mathias and boatyards.
CATEGORY OF CONSTRUCTION accede 10,un0 amps at 150 tnhs or ❑ Pluming buildings. •
OA I -:aril 2- family litvelthug ❑ Commercial /industrial ❑ Access„n huildinE ' " " " ° 'Awed?. 14.000 ❑ Cnmmncial i.. .ynlcnittnal
❑ Multi family amPF f,a all mho'monaumu buildings
❑ Muster builder Cl Other: 0 File pump. ❑ Inman ion of 75 K VA nr
JOB SITE INFORMATION AND LOCATION El t :rncrgency s.sIcm. Miro w iarately derived system I
❑ Addition of new m"lm heal of ❑ "A' °I:" "1- 2 . - 1.1",
Job nn.: Job site address j n 5 � 1 y v 11/01 or more. occupancy. 71 • �-I( - ❑ Six or Dime residential Innis ❑ Reae:"innnl vehicle parks. •
City /Stater /JP: ■ t� & os .1 , ❑ llmlth.earc faciliiicF. 0 Supply ' for Dune item
±� �/1 ❑ l lazardmy Inrntialn. 00 volts nominal.
Suite/bldg. /apt. no.• `81 Project name: _ ❑ Service or Ieedn OOP amps or more
Cross street/directions lo site: FEE SCHEDULE `
Dried/wk.. 1 417. I pre_ I Towl 1 i
New residential single- or multi - family dwelling unit,
Includes attached garage.
Subdivision:
_ 1.01 no.; 1,000 sq. ft. or less t08.5a 14
'fax mltp /parcel nu.: G,. add'l 500 sq. It or portion 9 3.92 I
Limited energy, residcmial
lD l DESCRIPTION OF WORK (with shove sq. 11.)... 75.00 2
( A • r�(Jl C��"�,1rn" r L•I` ll /t11rw residential (wish above sq. It.)
75.00 2
gas
Services or feeders installation, alteratio and/or relocation
• •
e& A` ' en .s I/_ • 200 amps or tgss 100.70 2
❑ PROPERTY OWNER ❑ TENANT 201 amps Io400 amps $33.56 2
Name: 401 amps to 600 amps 200.34 2
Address:
601 amps to 1,00(1 amps 301.04 2
Over 1,000 amps or volts 552.26 . 2
City /State/ZIP: Temporary services or feeders iostallolioo, alteration, anrUur
relocation
Phone: ( ) 1 Fax; (, ) 200 amps or less 59.36 1
Owner installation: This installation is being mode on property that I own which is not 201 amps to400 amps 126,08 2
intended for sale, lease, rent, or occhlmgc, according to ORS 447, 449, 670. and 701. 401 amps 10 599 amps 168.54 2
Owner signature:
Branch circuits– new, alteration, oor extension, !Janet
Date: A. Fee for branch circuits with
a APPLICANT I j] CONTACT PERSON shove serv or feeder fix, 7.42 2
ea branc circuit
Business name: B. Fee for branch circuits without 11
service or feeder fee, first I t, �l
Contilet name: branch circilil 56.18 �tSR 2
Address: Each odd'I branch circuit 1 7.42
Mlaeellaneoos service or feeder not included)
City /Stale /7,1P: Each manufactured or modular
dwelling, service and/or feeder 67.84 2
Phone: ( ) Fax :: ( ) Reconnect only _ _ 67.84 2
E - mail: - Pump or irrigation circle 67.84 2
' CONTRACTOR Sign or outline lighting 67.84 2
Signal cireuil(s) or limited•cnergy "-
Business name; � panei.altcration, or extension. - Pape 2 - 2 • . —. Each additional inspection over allowable in any of the above
Address: Additional inspection (1 hr min) 66.25/ lu
City /Statel7.1P: I a a , � �1 Investigation (I lir min) 66.25/ h
G Industri I plant (I hr lain) 78.18/ hr IIII
Phone( / •
• / i��l� Fox; IF' /1 , , r !1 f ► ` emi [ions for which run fee is
_ Fr listed 1'h hr min 90.00/ hr
CCB Lie.:��'! q Electrical Lic.2 — ) uprv. Lie. - �$! 3 L' ELECTRICAL PERMIT FEES -"
Sltprv. Electrician signature, required: _ Subtotal: _ t..tL
;- - � Plan review (25% of pennit fee):
Print name:
• . Date: /„ � L� State surcharge 12 °5 of permit fee -
Authori%cd sigrtulllrc: r I � 1tM •
j TOTAL PL1T FEE: L.✓ e,
This permit application expires if a pertain Is not ohtnintd cd I iplii 380
Pill It ntlm U r
— Dare: 441011, days a f t e r has been =rented as C O M
• Number of inspections allowed per permit.
1.IDuitdineUPei mit :TLC -I•cl mitApa.doc nutria 44 4solSTl I ups/COMA/ED