Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2013 -00347
T 1G ARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/25/2013
Parcel: 2S112BD06700
Jurisdiction: Tigard
Site address: 14750 SW 80TH AVE
Project: Robinson Subdivision: BRITTANY MEADOWS Lot: 3
Project Description: (2) branch circuits for NC.
Contractor: BEAR ELECTRIC Owner: ROBINSON, TIMOTHY D & CORTNEY T
PO BOX 389 14750 SW 80TH AVE
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 06/25/2013 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 06/25/2013 $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 9 - 001 -0090. 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: Permittee Signature: ON `� C " / /'G /e 7 0 .
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 603.639.4175 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- 2d- 2013(MON) 08:53 Bear Electric (FAX)5036781108 P 001 /002
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TYPE of TYO TTIIG -- - - _ -
L _ . �l t. IJ�fc PLAN REVIEW
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CATEGORY OF CONSTRUCTION ..adttl 10.01111 amp% al l\II udr,.11 0 H.un !huh*,
IV O. to Nrrsnntl Cd N 111111 i) (] t' nau u(r.ial u..• ts. uhmal
I• i ila2' amiI.. shtcllinl. ❑ Ctatinu•rCialhnduuridI ❑ Acces utr\ hotldiltE nap ltn.dlmho uwlauatuom hudtnp`
❑ Muhl. lanti l\_ ❑ Mailer huildtr 0 Other' 0 nC pump ❑ In.Idll.tu..0 Iii 7C t VA no
JOB SITE INFORMATION AND LOCATION a mnpcn.v x\si n boo ep.n•nCl% druvnl +l .Iem
❑ Million ofoe..11)1,1.11 kid DI ❑ ••A "I ' -1.;' •1 1'
,li h no ' 11101 f1' or more nccuIan% 1'
Jt7h sac athlra,��4 Q �� I
3.i )] 1 CH nmlr resrdrnlral some ❑ ItecrNnnmal lrintl.• parl.x
C /Slalcl %II 1 I ❑11c:ddt.ealc ixdii ci 1:I suppl.. Ii
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f CI I Ia /altlnux hnallnnx soft soh nominal SUtte /bltlg, /apt. no.' Proleel name: X618 �, i a AT ❑ SrrvrtC Ili feeder 600 amps D1 mmC
FEE SCHEDULE
Cribs itrccifeli rein tons Ii) 10h Site: ' Dru.iption II orr. II Fre. 1 Thiel I •
New residential single- or multifamily dwelling unit.
!Deludes attached garage.
Subdivision: Lot no: 1,110U sq Ii or less 108 54 4
—
-- "`-- F.3 add', 500 sq fl, 1)l puma', 33 92 1
l'a� m p /punt l no :
Limited energy, tesidenlwl 75 DO 2
DESCRIPTION OF WORK !with above sq. it )
AND /1 ; L energy. multi - family 2
-Pe; / J HP C,i, _ residential (with above s9 ft) 7 00
Servieea or feeders installation, alteration, and/or relocat
200 amps or less 100 70 2
U PROPERTY OWNER I Q TENANT 201 amps to 400 amps 133 56 2
Name: °` T
40 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 /S;ntc /ZIP: - Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) 1 Fax: ( ) 700 amps or Tess 59.36 1
Owner installation: This installation is being made on properly that I own which is riot 201 amps 10400 amps 1 Otl - 7
intended for sale. tease_ rent- or mange. according to ORS 447. 449. 670. and 701. 401 amps to 599 amps 168, >4 2
Branch circuits- new. alteration, or extension per anel
Owner signature: Date: ' p- �
1 P ee for b ranc h c with
El APPLICANT 0 CO NTAC T PERSON above service or feeder fee,
rr each branch circuit 7 42 2
Business name: � . :� J Iva ,. . B Fee for branch circuits without � �j I Y service or !ceder fee, firs! yh 1a 1..,LJ • 2
Contact naive: branch circuit -� _
�•�
Each add'I branch circuit ,1 7 42 I � 2
Address: BEAR ELECTRIC. INC
PO Miscellaneous (servlce or feeder not included) e.
City /State /ZIP: 20886 BUTT5vILLE AD rIE Each manufactured or modular 67 84 2
ONALD OR .70 r dwelling, service and /or feeder
Phone: ( ) p 20216 Fax: : ( ) Recoluteci only of R4 2
T -m il: a 1101 t/• A - B , e , I � I . C — - Pump or irrigation circle 67.84 2
- ' " ' • �. S igh or outline lighting 67.84 2
CONTRACTOR r -• -•-- -¢
5 rgn.d cucwt(s) or limited-energy
Business name: a ' fr , ptuul, aheration. or extension Palle 2 2
`• l Each additional inspection over allowable in any of the above
Address; .P0 ... 315 -1 7 Additional inspection (I hi min) �_' 66.25/ hr
City!$lale/Z -f <IJ�J� InVesugahun 6625/hr
Phi_ ne: F vf-v _ Industnal plant (I hi min) 78.18) hr
44/ ( • 13 Fax: 66 0 7 f 1 O8, Inspections for which no fee is
�7 A specifically listed (h hr min) 90.001 hr
CC>3 Lie.- `ar Electrical I,ic.p �( • � Suprv. Lic. - -- W ELECTRICAL PERMIT FIEFS � .
Suprv. Electrician signature, required. __ Subtotal:
Plan review (25% Of permit fee): /)_
Print nnmq:a{ t^ ) , Si ` �•" lv i I Datci r ,4 State surcharge (12 %• of permit fee): _ � �
Aulhorizcd signature: TOTAL PERMIT FEE; 1
This premii application empires if a permit Is our obt within 180
Print name. V _ 1 1 2. 1� / n(r I days after It bus hens accepted as coutpleIL
(J atC:1..�Q�e F • Number of inspections allowed per penmt
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