Permit Support Document CITY OF TIGARD ELECTRICAL PERMIT
:"> COMMUNITY DEVELOPMENT Permit#: ELC2019 00808
Date Issued: 11/13/2019
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 • f parcel: 2S101 BD00300
Jurisdiction: Tigard
Site address: 8015 SW HUNZIKER RD
Project: Fred Shearer&Sons Subdivision: None Lot: None
Project Description: Bathroom Can Lights. 12/5/2019: REPRINT permit to add (7)branch circuits for a total of(9)branch circuits.
Contractor: BEAR ELECTRIC Owner: 8015 HUNZIKER LLC
PO BOX 389 8015 SW HUNZIKER RD
DONALD, OR 97020 TIGARD, OR 97223
PHONE: 503-678-1355 PHONE:
FAX: 503-678-1108
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo/Purchase 11/13/2019 $63.60
Specifics: Service or Feeder
1 ea 12%State Surcharge- 11/13/2019 $7.63
Type of Use: COM Electrical
Class of Work: ALT 7 crt Branch Circuits w/Purchase 12/06/2019 $51.94
Service or Feeder
Type of Const: 0 ea 12%State Surcharge- 12/06/2019 $6.23
Occupancy Grp: Electrical
Total $129.40
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 952-001-0090. You may obtain e rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: 'r '�—�� A. -__. Permittee Signature:
v Oar'
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.
Electrical Permit Application.-4 pcliCr, FOR OFFICE USE ONLY
L.A.,/Len II4 1,_
City of Tigard Date/By: /zfr Z"erlcirE‘e..20/9-00d'OP
te/By:
111 q 13125 SW Hall Blvd.,Tigard,OR 97223 an Review
: 11 Phone: 503.718.2439 Fax: 503.598.1960D EC 4 2019 Pl
Date/By: Related Permit 4:
Inspection Line: 503.639.4175 i s.FTV i,. r 1r.,;,,,,0,-.1 Ready Date/By: Jurist Filf See Page 2 for
I!GARD
Internet: www,tigard-or.gov ... s''',.' ."*. ! '„I,'''1-11'4•' Notified/Method: Supplemental information
Alk - --- — --- ' '
,-, ,,,t,,, I,,, .,, ,„„,,,,, , :.,,i,,,, .,, ,,rihi ,,,,,,,, ,.,-, „,,,-,,,,,:,,,,, ,,,,,,,,,p,,, PLAN''Rgygyv
El New construction Addition/alteration/replacement Pleage check all that apply(submit 2 sets of plans wlitems checked):
D Service or feeder 400 amps or more ID Building over three stories.
Ej Demolition 0 Other: where the availabk fault current 0 Marinas and boatyards.
CATE94?Alt OF MNSTRUCTIOIS*wat, li exceeds 10,000 amps at 150 volts or El Floating buildings.0 I-and 2-family dwelling 101 Commercial/industrial 0 Accessory building less to ground,or exceeds 14.000 0 Commercial-use agricultural
amps for all other installations. buildings.
ID Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
:2;.:11Allik-Viir " 1,$.1,-- ::0;14.8****04; -:n',' ON'::''''''-±-7;1:!' ,,, 0 Emergency system. larger separately derived
Addition of new motor load of system.
Job#: Job site address: E. 0 I 5" 5t,t) /4.14 0 z.,/ k e/v- o
100111'or more,
City/State/ZIP: -II 6A IZ_ID Ole10/-7(:),.. ..- 0 Six or more residential units.
0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bidglapt.#: I Project name: 0 Hazardous locations. 0 Supply voltage for more than
0 Service or feeder 00 amps or more. 600 volts"embed.
Cross street/directions to job site:
ilikt14'-1.' ! ",, FEE SCHEDULE
Description I Qty. I Each L 'rota! I .
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
Tax map/parcel#:
1.000 sq.ft.or less 168.54 4
Ea.add'l 500 sq.ft.or portion 33.92 I
101fti-A0 ,„Pl.-if:Mt Fjalina,M,'„ 11 it llit),FAOW i 1.;'''.i 0:421P ,.',,,'"ZAAAJO Limited energy,residential
/1"111 ' (with above sq.IL)
/19-00 7 t ft c t./als iv ,et.siisily i (ex_. # . ,„ Limited energy,multi-family 75.00
75.00 2
2
residential(with above sq.ft.)
,-, Renewable Energy 0 See Page 2
Li PROPERTY OWNER El TENANT
Services or feeders installation,alteration,and/or relocation
Name: 200 amps or less 100.70 2
Address: 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:
601 amps to 1,000 amps 30E04 2
Phone:( ) Fax:( ) Over 1,000 amps or volts 552.26 2
Email: Temporary services or feeders installation,alteration,and/or
relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 I_
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
D AP,PLICANT 0:C0,1.7'f„', E,OON' ' 3 '''2 AB.rFaeneel for
rocr branch
ircuits new,c-ircuits w alteration,ith or extension,per panel
Business name: above service or feeder fee,
7,42 2
each branch circuit
Contact name: B.Fee for branch circuits without
Address: service or feeder fee,first
56.18 2
branch circuit
C i ty/State/ZIP: Each add'l branch circuit 7 7.42 57,ii. , 2
1 Miscellaneous(service or feeder not included)
Phone:( ) 1 Fax: :( ) Each manufactured or modular
67.84 2
dwelling,service and/or feeder
Email:
2
Reconnect only 67.84
. ,
CONTRACTORi Pump or irrigation circle 67.84 2
Business name: Let,-p,e g../ e€41t-r-; c //I(' Sign or outline lighting 67.84 2
/ Signal circuit(s)or limited-energy
Address: 2 0 ig ev 3 g 0 See Page 2
panel,alteration,or extension. See Page 2
City/State/ZIP: poisjiltii op• 6)-70.2_0 Each additional inspection over allowable in any of the above
U/ ' _ Additional inspection(I hr min) 66.25/hr
Phone:(5233 6-7g -1 3.5-5 Fax:(S03 )to-7 g ---i log Investigation(I hr min) 90.00/hr
Industrial plant(1 hr min) 78.18/hrEmail: Perwi I st‘' Q...„.• beo,trek.e.z-tr 1'c..-, . eovv, . Inspections for which no Ice is
90.00/hr
CCB Lie.: 2,0 q I cit Electrical Lie.: 2...q ..(0-7 c Suprv. Lic.:... -79.5.- -5 specificaily listed 0/:hr mai)
titg-,::ii:'VI,,':: ELECTRICAL PERNIT1' 10,'",;,„.. .
Suprv.Electrician signature,required: . r..4...... A ,'
Subtotal: _5/, 971
D te: ,02,pi—vtetif 0 Plan Review Required(25%of permit fee):
Print name:
State surcharge(12%of permit fee): 6. .2.3
Authorized signature: :- ' ,, .. TOTAL PERMIT FEE: ...s-d-, /7
This permit application expires if a permit is not obtained within In
Print name: On ' I Date:/.2/ ' i , days after it has been accepted as complete.
* Number of inspections allowed per permit.
I Altai klingWerntastELC_PertnitApp_ELR_ER Etloc Rev(WI 7/2015 440-4615T(I 1/05/CONEWEB