Permit CITY OF TIGARD ELECTRICAL PERMIT
11111111 COMMUNITY DEVELOPMENT Permit#: ELC2013-00489
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/19/2013
Parcel: 2S102BB02800
Jurisdiction: Tigard
Site address: 10140 SW MOLLY CT
Project: Harrington Subdivision: MOORE'S MEADOW Lot: 9
Project Description: (2)branch circuits for A/C,service outlet and breaker change out.
Contractor: BEAR ELECTRIC Owner: HARRINGTON, DAMIAN&JENNIFER
PO BOX 389 10140 SW MOLLY CT
DONALD, OR 97020 TIGARD, OR 97223
PHONE: 503-678-1355
PHONE: 503-784-8035
FAX: 503-678-1108
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo/Purchase 08/19/2013 $63.60
Specifics: Service or Feeder
1 ea 12%State Surcharge- 08/19/2013 $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 throw h O 9 - 1-009 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: t'� /97‘),(--
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.
RUG-13-2013(TUE) 14: 51 Bear Electric (FRX)5036781108 P. 001/002
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TIGARD 1I16 1 3 'rij. �21 Set Page3fo,
_ . - Inlclnii .1 a 1■U4atrt•111 pm A l'•- e3 z013 1 I N.411.....1 NIelln%1 SuppItmenld Inrorm•0on
ttL „ TYPE cn TIGARD 1 -- PLAN REVIEW
10No, eolimrue,ion ddili�ilr.ihPl4tltllrt/REi2nermoN - — I'L': eelv1.all n,ntapply liahm rr7.elcnipIam..don..lit.0, lll>.•4n.1
l IJILUfIYlI U1V jj.Jl`I ❑al.he.W 1. .Iii•711n 91180 IN male ❑RmI.hnr Inc.ll,,'.lion-•
❑ I)Cllltllitilm ❑I)th.•r. �� _�` ..Itele like a.:utahlc halt.unenl ❑Maim,r,and la.ah.u,l.
CATEGORY OF CONSTRUCTION ' •••1,10.111111 amp.,Al I'I0 IAN in ❑I'hMmr hnikhntc
1•;lull -I:IIIUI\'dwelling k'.s in Frnlln.i.iv c.voc,l!1-t t iln ❑Cmuntoccil•u.c air.p•nha.al
❑CnIt1111erci;ll/industrial 0 Accessory httildittF amps MI all nrhet m•tallau.pn MuWlnp
u •Multifamily ❑Master builder ❑Other: 0hie pump ❑I talL�tm at 15 1:VA m
JOB SITE INFORMATION AND LOCATION
171'1„errcltev?lSIe1n Inr�cI ti11A1 Meld de111Cd a14e1n
❑&Gluttonofneu'n„mnloa•ldl ❑"A "! "I•:' •{.�'.
Joh no.: Joh site address:t 0190 S + lams.%ionic occupannu
s Sts m ionic residential Anus CI Aenealmnal vehicle park!,
City/State/ZIP: -11 (Ifc` 0Rd ai�7 2 ones.....:,,edil,c.
i Vii IIAA 1�+ -1 (�J ❑Snpph 1.dlAS•e fm mare than
❑'Inman.*klcalions boo lnlb nmun.al
Suite/bldg./apt, no,: Project nittne: CC Service of Icedcr wimps pf mote
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FEE SCHEDULE
Cross strlrt/directions in job site: Oe,enp,tel, (fin, ( v... i TOW 1
New residential single-or multi-family dwelling unit.
��. Includes attached garage,
Subdivision: Lot nn,: 1,000 so Ii.or less IbM 54 4
- Es.add'1500'•q.fl.on portion 1392 I
Tax map/prlredi nu.: '
LIIIIIred energy,residential 75.00 2
DESCRIPTION OF WORK !with above so RI
Limited energy.muln•fomlly� 75 00
/ idential f with above sq.31.1
1 BUJ � i _ � �!� �i�er�_ • .�'Al i ��tt � . ..
Services or feeders installation,alteration.and/or relocation
200 amps or less 100.70 2
El PROPERTY OWNER I ❑ TENAN'i' .. 201 amps to 400 amps 133.56 2
Name: '' 401 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 I 2
City/Statel7_1P: Temporary services or feeders inatnlluliod.alteration,and/or
_ relocation
Phone:( ) Fax:( ) 200 amps or Tess 59.16 1
Owner installation;This installation is being made on property that 1 own which is not 201 amps to 400 amps 125 08 2
intended for sale, lease.rent.or exchange.according to ORS 447.449.670:and 701. 401 amps to 599 amps 168.54 2
Branch circuit„-near alteration,or extension per panel
Owner signature: Dale: A.Fee for branch circuits with r
0 APPLICANT Q CONTACT PERSON above service or feeder fee.
each branch circuit 7'42 2
Business name: B.Fee for branch circuits without 1 c6
service or feeder fee,first 56.18 gp 2
Contact name: BEAR ELECTRIC,INC.. branch circuit
Address: 2021115 BUT TEVII.LE RD NE Each add'1 branch circuit ( 7.42 '" 2
DONALD.OR 67029 Each
(service or[ceder not included)
City/State/ZIP: CB 0 20918 Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Phone:( ) Fax; ;( ) Reconnect only '67.84 2
- ^Pump or imgalion circle 67.84 2
E-mail: /r be i 0, f/' L'„ • .4111
Sign or outline lighting 67.84 2
CONTRACTOR Signal circuits)or limned-energy
Business name;�pntr - r ^^ _panel,alteration,or extension. Page 2 2
l ='^t' `--)�` Each additional inspection over allowable In any or the above
Address: .plc) 'B 39t�
Additional inspection(I hr min) 6615/hr J
City/$tate/Z11': baSd 0�-(11
Investigation(I hr mitt) 66.251 hr
JJ
Industrial plant(1 hr min) 78.18/hr
Phone: � `.13 -a rev;:503 U2-'�'•I 11.1c inspection;for which no fee is •—
I 1 6 specifically listed(h hr min) 90 001 hr
CCI3 Lic,&,(1171 _l,^ Electrical Lic.: :012,1 Supry ),ic.:x yN,r 1 S _ ELECTRICAL YE1iM]T,FEE,S tee'
Su rv,Electrician signature, ' Subtotal; �-
p >;rlaturc.required:,) Plan review(25%.of permit fee): -�
Print Haines-)( Jam`"' Date: by 115 State surchar a(12%of
E permit fee):
Authorized signature:r TOTAL PERMIT PE : "'•'+'
This permit application expire it a permit is nct�tala it l
Print name: days after It bas been accepted as compin6
��bow Ante: $�,){ l • Nimbi,of inspections allowed per permit. Ke/
1:1I1wteinexe,rminstt_c_F.,,,aevv•iv 07/01110 • 44a461STt 11/05IC0Mtwl:p
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