Permit Support Document (2) 71 ,, CITY OF TIGARD ELECTRICAL PERMIT
■ ' ` COMMUNITY DEVELOPMENT °° ' Permit#: ELC2019-00808
T!CARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Z O Date Issued: 11/13/2019
re-
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.
5/15/2020: REPRINT permit to add(1)200 amp service and(1)branch circuit for a total of(10)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
1 ea Services or Feeders-200 05/15/2020 $100.70
amps or less
1 crt Branch Circuits w/Purchase 05/15/2020 $7.42
Service or Feeder
0 ea 12%State Surcharge- 05/15/2020 $12.98
Electrical
Total $250.50
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 52-001-0 0. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
7
Issued By: - Permittee Signature: 0 /51.77/"L`iCf�'-Tlc'r✓
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.
RECENED
N....rvcd 0/-� L?_�/V or
- c►ty,./Tigard MAY -4 Zo2a.Pat_ray vet�y 1v a P.Imiln�Cj G'
tr 13125 s1C 11.111 Blvd. ftg:uti UN 97223 flail Re nc
Phalle 5u371N 2439 fn.: 5t13.59N.19ht) Tt .-. ,,., 1>+a-ray NelalcJ Pclnal a.
Inspection Lure. 501.6394175 CI I .Jr ' \;9A1�13 anal DekB Aso y ��y� El See rate 1 kr
1I<.ANn i g BUILD]NG DIVISIO Hira1'\Inh.0 'Y ze 470
Inlrn)m. wtvsv 11•ntal-m. era , Suppkmanlal Inlnrrtuuoa
TYPE OF WORK _ c
�5��� iFe't1_11.- PLAN REVIEW.
0 New I.onstructnln ❑Adds son altclanoun cplacen IcuI 19.a.4 CI..,i all that app;y I submit a.,1,,n plaits r Ctn. rip.,St.1,
O Set rnc,,lcerkr 4111 am,.to mote ❑nwWinp ave+It!'CC,.,nit,
❑Ikmolilim) nfhhrl - N'hnc OwJ.adJdr lank concert Q Slanni.and bualy.ud
CATEGORY OF CONSTRUCTION cu..J,to teat ansps a1 ISt,volu err 0 Elnaling buddmgs.
❑ I-and 2.l:undy dwelling l anunct atd/mdusutid ❑Accessory building le.to g+owai el CS,.[NI,lapin 0 Cummm..nI-tt.c agncuhwai
.Ir1y..lot III other alcralialons building.
❑ Multi-family htlsterbuddel ❑Oiher: ❑I'ue pump Qlntallmxm of 150 KVA or
4(]8 SITE INFORMATION AND LOCATION Q link ipncy ysic in tassel v./lamely derived
Job job hole addl'CSS: 8 1� �A 0 Addition at new molar load of .ys¢m
Ii V•AhL1 IC.tyL P-L), ttalMl'in more ❑`A E..,"I.2".'9.3".
City.State ZIP 'j{6 Aft fl OS,.01 11101.reaiJrnllal inns .1.a,114111cy
0 nealth.am li,dike. 0 Re,reation.l vehnlc park..
Suite bldglapt.4. Project name: 0 F1eunlau.Jocallon. 0 Supply vamp.COI lucre ttsu,
- 0 Sat.tee.v lerdel tan,Jmps nl lrore ed1O v..h,nnevnal
Cross street/directions to juh site. -' - -----
_ FEE SCIiEUULE
earn ninon it t.. rath 'rout 1 -
S ew residential single-or mold-family dwelling unit.
Subdivision: lot 0: Includes attached garage.
Tax map/parcel#:
I3NN1 sq It.or Inn 1614.54 4
L a add'I 500 sq.It.an portion 33.92 1
DESCRIPTION OF WORK Untied energy.residential 7500
r I twilit sq.It.i�- -
Q Q e,r T- D/'4 r1 di,__.- . Lined energy,multi-family 15.00
OPT f1191 IT # ELCZO1g -00?Og restdenteal Omni aboVe sq.'RA
0-PROPERTY OWNER Itenewublc Energy ❑ See Page 2
TENANT Services or feeders installation,alteration,and/or relocation
Name; 200 mops al less 1 100.70 2
Address: -� 201 amps iv 400 amps 133.56 2
401 amps to 600 amps 200.34_ 2
City/State2TP:
601 amps to I NO snips 301.04 2
Phone:( ) I Tax:1 1 Over I.tgM)amps or volts 552.26 2
' Temporary services or feeders installation,alteration,and/or
Email: relocation
Owner installation:This installation is being made on property that I own which is not 200 amps m less 59.36 I
intended for sale,lease,rent,or exchange,according to ORS 447,449,670.and 701. 2m amps to 400 amps 125 US 2
Owner signature:„ Date: 401 amps to 599 amps 168.54 2
['ranch circuits-new,alteration,or ealension,per panel
1 0 APPL2CANT ❑COTTACT PERSON A Fee tea blanch circuits wall
Business nano: above service or feeder tee, , 7.42 n
each hunch circuit
Contact name: 0.Fee tin branch cucuiu wifhoul
service or'ceder fee,first 56.18 -'
Address: branch circuit
Each alkl'I branch circuit "42 2
City/State/ZIP: Miscellaneous'service or feeder not included)it
el,j Phone:( ) Fax: ( ) Fach manufactured ar mmklar 67.a4
dwelling,service and or feeder
ty Email; Reconnect only 67.84 2
_.. . '-Gonfr .ACCOR/t . - Pump or irrigation circle 67.84 -
Business name: ��, e/�) i11�/1 'hit t Sign or aulllne lighting 67.84 2
sy"3 3� Sanel.aiteriion of limtledtncrgy 0 See Page 2 2
Address: d //�y j� pand,alteration,or extension
City/StateJZtP: Co M LD /0n-/9 / 07-0 Each additional inspection over allowable In any of the above
Additional impectom ll hr nun) 60351 hr
Phone.1$03)(Ole- 13,.jc FaX ( 'I Investigation tl hr min) 90.1aV hr
P7 I duvotal plant 11 hr min) a l a/hr
• email e'rnY1iT.S@L� ,C. 0DYY� -
Ilape.0uns for which no lee is Iqy tat/hr
CCR Lie.: 40(.( rq l leetrtcal Lie.:24i-/6 7 Suprv.laic.: .prnlicaly h.t_d I 'hr min) - .
/ �� EL ECIRiCAI.PFRhitT FEES
Suprv.Electrician signature,require M"7Y,, suhr.,lal 14 Y_
Print name: Stephen R S phe Date:,j,. t f_7�� CI Plan Bevies•Requited 125•..otpem+il for (] `,
Slate surdwrgc I I2°.of permit feel.
i___- Authorized signature: TOTAL PERMIT FEE a
tG Ta{s perldl appanHeo aspire,a a permh i,nil alll ainrd..Doll.1,0
Print name:A/iO,/) ( j4I Ale."1. Lf da)s.lrar b►u.been urcrplcd as.'vmPl''/ry/
��r1 ' - Numbs"al ln.peetw'u Wlownl let net /C' r (�)
t�nodau1Pm, .'aLc bnostAyy Elit LRE A..Rev tO•17::uiv Jaw61!TIIi.05 CoSt-WED
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