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Permit rt CITY OF TIGARD ELECTRICAL PERMIT 1111 g • - COMMUNITY DEVELOPMENT Permit #: ELC2013 -00335 Date Issued: /2013 06/18 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 6 200 Jurisdiction: Tigard Site address: 12655 SW 111TH PL Project: BARNETT Subdivision: WILDERNESS Lot: 8 Project Description: (2) branch circuits for furnace and heat pump installation. Contractor: BEAR ELECTRIC Owner: BARNETT, CAROL A & CHARLES E JR PO BOX 389 12655 SW 111TH PL DONALD, OR 97020 • TIGARD, OR 97223 PHONE: PHONE: 503 -678 -1355 FAX: 503 - 678 -1108 FEES Quantity Description Date Amount 2 crt Branch Circuits wo /Purchase 06/18/2013 $63.60 Specifics: Service or Feeder 1 ea 12% State Surcharge - 06/18/2013 $7.63 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $71.23 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 2 -001- Yo may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1. / Issued By: Permittee Signature: OA/ 6 '/' / C � 7O " _ OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease or rent. OWNER'S SIGNATURE Date: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC' Date: LICENSE NO. Call 603.639.4176 by 7:00 a.m. for the next available Inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each Inspection. JUN– ld- 2013(FRI) 07:30 B tc Dui (FRX)5036781108 P.001 /002 IC. City of T igard SUN 1 2 013 Itc,�r.r.1 ��, �� / I " mil N:" 3X 0 3 1 }rl�l I ;1_ ��N 1lannnd Il r111 'r -- ... . 1 C I <Ir: 71$ ?Jiy , 1 19a,.„,k.. _ _. . __..�.-'-- " ____ --. _._ I a. •t1: OF TIG ON i �1:rtc 11, 1ll lie, 1 %, ∎44yEC'aoi3 — dot /I • TIGARD f*1'� u I tin ;II* n '1 .I I': B 1 i INGD 11.11.' :rd, II. ..... I., 0 Set Pagel fur • I itivinci ,...p 1 got j7 V 4,glln•.I MC1110I __ Suppltrotntal lntorm.11Un —� - T•• TYPE OF WORK W - PLAN REVIEW • 0 � 1d :emm ermsl rue! inn tli IIuivalt rat ie /r.:pIaCCInl111 -- - - �. -- Pica•:( heel. all ilia, apply lout 2.01< nl plans.. ncms checked behr I --• 0 *wt.u: a, Ice,1c1 lfln amps 01 ring. ❑ Itud.lmt• p.d, duo. dint• Q DI:1110111 ion ❑ 01110. -- -- —` ehdlgihe :l.adahldI:nulleunrm ❑Alalll.l Indll.'lt.nd> CATEGORY OF CONSTRUCTION . •' I> 10,11111) llvlx at ISO ..,ll.,, ❑ I luaunr huildmg. • "'- - ". l.ys In rrnoml. m c.ccc its 11.11110 ❑ l',gniowl -mc l ucuhu.8l e • ,111.1 foiniIv dwelling Q ('OItullerei:11 /indits1h l ❑ Accessrlr% huihliii ;nnp> I... all mho msrallauums hudtlmr. ❑ Multi - 11111111% ❑ Master huilder tt--�� Other: 0 i '' pump �. O. I ❑ lu.lallalnn.nllS �VA m JOB SITE INFORMATION AND LOCATION ❑ 1.imdq'dnev `.`real hlrFel sellllmel■ deu.dd <.<lern / ,y�� 0 Addition of ism is held Of 0 'A" "I' •• "I.7' "I • �" lob no.: Job site address:I 2.L 5 I I I -tin 1 p) iimin,.,, ionic mclipaacc ^� raj (. II \' /tilall' // I1': / ❑ ire\ m mire resrdcntiat oohs ❑ PtYtta .Yhrrlr t ``�� I 2- _ ❑ 1101111.cm! larditw,, ❑ suppl ro)laec Ibt mote Than • ❑ I laraulnees Inaanwn hnn..dr> mlurrrral Suite /bldg. /apt. no.: Project mane:.- ❑ Service ni feeder h amps as mole FEE SCHEDULE Cross street/directions Io jnh site: -- Der[r4 Ibu �- I QR.1 Free 1 Tw,• 1 l New residential single- Or multi- family dwelling unit. _ Includes attached garage. Subdivision: 1..ot no.: 1,000 ft of less IhK $4 Tax map /prlrccl no.: la add"' 500 sq 11. ul portion 33'97 Limited energy, residential 75.00 2 DESCRIPTION Olt WORK (withabove t A . 1 a . 'I. a ii 1 b- ) \S _ _ a 0 t tQ t , Limned e, ill hfvrns . II.) 75 00 2 \ 1 DC1 rrsldemisl nergy wide ahOve 5+ Services or feeders installation alteration, andlor relocation 200 amps or less 100.70 2 ❑ PRO ERTY OWNER [j TENANT 201 amps Co 400 amps 133 56 7 Name: 40) amps to 600 attics 200 34 2 601 amps to 1,000 amps - 301.04 NM El Address: Over 1.000 amps or volts 552.26 — City /Stale /ZIP: Temporary services or feeder installation, alteration, and/or relocation Phone: ( ) Fax: ( ) 200 amps Of less 59.36 1 ' M Owner installation: This installation is being made on properly that 1 own which is not T 201 amps to 400 strips 125. 2 intended for sale. lease, rent_ or exchange, according to ORS 447, 449. 670. and 701. 4 01 amps 10 599 amps 168.54 wimp Branch circuits - new alteration, or ealenaiuo , er 'noel Owner Signature: Date: A. Fee for branch circuits with ❑APPLICANT ` Q CONTACT PERSON above service or feeder fee, ■ 7 42 i — each branch circuit Business name: 1). fee for branch circuits without, IQ Contact name' service or feeder fee, fetal 56.1 B LSr 0 I branch circuit Each add'I branch circuit ` MI`IZZ© Address: Miscellaneous service or feeder not included — City/State/ZIP: E Each manufactured or modular ■ 67.81 MEN dwellin :. service and/or feeder Phone: ( ) Fax: : ( ) Reconnect only 1 67. © Pump or irril;ution circle 67 g4 E -mail: -g Sign or outline lighting 67.84 CONTRACTOR _ Signal circuits) co lilnile4•enrrgy Business name 54 I M anel, alteration or extension. � © "a r Lf k1.i Each additional Ina teflon over allowable In an of the above Address: ilia 6 ex SCGj' Additional inspection (1 hr min) 66.251 hr City/Stale/ZIP: � C� o � �0� Investigation ll hr min) 66.25 / hr 1 Industrial plan! (I hr min) 78.16/ hr P- one: • te ti �j Fax: y� • I • Inspections for which no fee Is ■ � 0... 90,00 / hr 1 CCB Lic.: ? � 2L/_ C )n ) z / specifically listed r4 hi Tin � � I E lectrical l est.: '( I I � Suprv. Lic.: v ELECTRICAL TE'Rl►'Tlti' FEES e Suprv. Electrician signature, I :X, ' / / Subtotal: ! �` ez Plan review (25 °.0 of permit fee): Print name: b ayed g enii ) 1 Dsite: , j S surcharge (12% of permit fee): gr a - , Authorized signature: /7 � TOTAL PERMIT FEE: 7I f _ This permit opplicatioo caplrev if o permit is not obtalaeu within 180 1'r irrt n e am do d/,e L 'y l Date:0)1(11 J' 3 • i d ? ci n it has been accepted us cgmplert. C �(�ld� T I Number Of i nsprur o ns allowed pe per W I: Qiaildinop es..0151LLC- 1...,,,i,App,d 07101110 4 40 - 4CISIr11 /0)ICOh11w[D .