Permit CITY OF TIGARD ELECTRICAL PERMIT
1 1 1 1- I: COMMUNITY DEVELOPMENT Permit #: ELC2013 -00455
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/01/2013
Parcel: 2S104DB06400
Jurisdiction: Tigard
Site address: 13252 SW MAPLECREST CT
Project: Windwood Homes Subdivision: MAPLECREST Lot: 11
Project Description: (2) branch circuits for NC and service outlet.
Contractor: BEAR ELECTRIC Owner: WINDWOOD CONSTRUCTION INC
PO BOX 389 12655 SW N DAKOTA
DONALD, OR 97020 PORTLAND, OR 97223
PHONE: 503 - 678 -1355 PHONE: •
FAX: 503 - 678 -1108
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 08/01/2013 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 08/01/2013 $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 -0 90. Y u 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: e� '/ 73 C I%7l! /■
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 503.639.4176 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.
JUL- 31- 2013(WED) 07:52 Bear Electric (FAX)5036781108 P. 001 /002
• .• - - - -- - - --- - ..... ...i.r.a.« %IV I • I ' FICE USE ONLY
City of Tigard Ilcrc j. . / �/f
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TIGARD S nIl Information
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Information
1 ' OFGAIiU -- , •
. OF • I I a - - -••--- sa s s. 1 PLAN RF,V1EW --- • I O% CoilSlrul•littll tltht11111/ :I1k : � t. � - ctnetll
0 1 'kaa•:Ike / all Ihara pldy lsuhrml ! KY!. 01 plaits.. nenl
El ❑ h:r,r:: mi..-:d. 4110 amp. .n mar: ❑ It,uitiow,•ace'Iii ,
Demolition ❑ l)Iher. t.hcic Ili lisadahle 1sill ennenl
-- �_ 0 M1launJ, 01 Ivlatt.u.1,
CATEGORY OF CONsrRucrioN • • I 10.11110 amen. at I s0 volt, du ❑ I Inmior 1unl.hnp.
-
Mss Io wound. ,a eaceed> 14.0011 CI nmM
l apl,cnlwul
I- :11111 24:111111y dwelling ! ❑ Commercial/industrial ❑ ACCeti ?Ur \' hllmilli! amp lu, all.uhci tnmallainnt MuMm0.
0 1Vlhhi- I:Illil lv 0 master build. r ❑ Oilier: 0 site pump ❑ Irntalla of V. A OI
JOh SITE INFORMATION AND LOCATION ❑1'mel lenevtt<rcln Im }tl sepalm,Ivrl,tnvd.vslem �
❑ Million of new imam 1110./ all ❑ - A" "P: "l -' "I
Joh tin,; ) 32 c k nr li nn eccupanh
Joh rile addrLtii; 25
V 111011P ❑ Recreanonal vehicle pSILS.
,/� .rr /n� ❑ tilt m Inure reRHlenlnl amt's
C Iry /Stale / %IP:11 h g _ (�'i 0 I 10111h-ewe I•ocdiHes 0 Supply w,bapc 1'01 ma IC Mao
J 1 _ ` �r D I It., ,Inns Inollunl h011 sills innmral
Suite /bldg. /apt. no.: Project name: ❑ Service in ieedet 6110 amps 01 Marc -
FEE SCHEDULE
cross sarccUdi Nei ions lo,joh silt: • uercelpl I Qr7. I Pm. I Total I •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: 1 -al no.: 1,000 s4 ft ul less 1611.5• 4
- ^ Ea add'1 $0014 ft. w purtinn 33 92 1
Tax map /part cl no.: _ Limited energy. residential 2
DESCRIPTION OF WORK ( with above sq. ft.) 75.00
�I A Limited energy, multi- family
_I V 3- 14 T) SW rr4.+ 011+{0— • residential 'with above sq. h.) 75.00 2
Services or feeders Installation, alteration, a/or nd relocation
200 amps or less 100.70 2
I PROPERTY OWNER 0 TENANT 201 amps to 400 amps 133,56 2
Name: 401 amps to 600 amp 200.34 -
601 amps to 1,000 amps 301.04
AcltlresS; Over 1,000 amps or volts 552.26
City/State/ZIP: Temporary services or feeders installation, alteratlou, a nd/or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not 401 amps 10 599 a mps 168.54 • 2
intended for sale, lease, rent, or exchange_ according to ORS 447. 449. 670. and 701. ---
Brands circuits new, alteration, or extensiuo, per panel
Owner signature: Date: A. Fee for branch circuits with
0 APPLICANT 1 0 CONTACT PERSON above service or feeder fee, 7 42 2
each branch circuit
Business name: B. Fee for branch circuits wirhoui , a nit
� BE*R EL --iWC service or feeder fee, first 56.18 ✓ z
Contact Hum ' e:\ C� PO BOX 300 branch circuit 142
— 20V86 -BU EV1LLC RD Ni... Each odd'I branch circuit I 7.42 2
Address: DONALD, OA 07020
CH IP �nutg Miscellaneous (service or feeder not included)
�
City /$tale/Z1 }': Each manufactured or modula
dwelling. service and /or feeder • • 67.84 - 2
Phone: ( ) Fax: : ( ) _ Reconnect only 67.84 2
1� Pump m iniyalion CireIr 67,84 2
E -mail: e .� i7 tin Jrtalsi a • Cer Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s) or limited - energy
/Business name: - t , - panel. alteration, or extension. _ Pape 2 2
}.L�J` Each additional inspection over allowable in any of the abuve
Address: 0. _3 Additional inspection (1 hi min) 66.251 hr
City /State/LIP: Thi• �U2/'1 Investigation (1 hr min) 66.25r hr
s LJ� J �V lndusuial plant (1 to min) 7a.► In
Phone: (bg ��$ � 5 Fa; :60 I dl is". l i Q$ Inspections for which no fan is 90,00/ hr
✓ Q specifically listcdJA hr Irvin) _
CCB Lic 0q1t7 Electrical Li _; fl C Su - 1,iCx tom' / ,s )t LECI'It1CAL PERMIT .FEES lX . IJ •
Suprv. Electrician signature, required: . •
Subtotal:
•tiw ∎ !•∎ Plan review (25% of permit fee): ^ — �
Print name:)( 41 - p ; IS State surcharge (12% of permit fee): TM
Authorized signature :. .� TOTAL PERMIT FEE:
� j 1 _ 3j f _ _ This permit application expire% if a permit is not obtain within 280
- 1 , days after it has been accepted as complete.
]trial ItarrlC
• V r / 5 `- Q / b Dote: 1-1 �- • Numbs of inspcniora allowed per permit.
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