Permit `RJR CITY OF TIGARD ELECTRICAL PERMIT
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g 3 , COMMUNITY DEVELOPMENT Permit #: ELC201000355
Date Issued: 07/14/2010
T I CARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S104BC07200
Jurisdiction: Tigard
Site address: 12650 SW BAILEY TER
Subdivision: BAILEY WOODS Lot: 8
Project: Fazal
Project Description: (2) branch circuits for A/C and service outlet.
Owner: FEES
FAZAL, ZUBAIR Quantity Description Date Amount
12650 SW BAILEY TER
TIGARD, OR 97223 2 crt Branch Circuits 07/14/2010 $63.60
wo /Purchase Service or
PHONE: 503 -715 -6595 Feeder
1 ea 12% State Surcharge - 07/14/2010 $7.63
Electrical
Contractor:
BEAR ELECTRIC
PO BOX 389
DONALD, OR 97020
PHONE: 503 - 678 -1355
FAX: 503 - 678 -1108
Type of Use: SF
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 952- 001 -0100. You may o•es or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
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Issued By: �� �! Permittee Signature:
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 an inspection that business day.
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.
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07/13/2010 13:55 503- 678 -11 8 °, BEAR ELECTRIC 01/02
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Electrical Permit Application aj LL. 1 i i, , I . t , .1
3 2010 T
City of Tigard a .7,-„, � ': EL-Co 10
Osten ' 13125 SW Heil Blvd., Tigard, OR 97229 ---t r s.
Phone: 503.639.4171 Fax: 503.598.196oL e c k ' ° - - - , ,
, , Lime: 503.639.4195 BUILDING l +
i(i� i t Inspection i � VIL�'B�t... �Ekll�l�3 d11a1eRexl ,-, ®SeeAaQe2tor
` � - ^ : Internet w*Vw.dgord•or.goV Notified/Method_ / Se coral Inforraution
TYPE OR WORIC NAN! 1tBEW
0 New construction gAdditioa/altemat n/replaccmem Masse elm& all that apply inibmit E mu of plans veneers chocked below):
O Service or feeder 400 amps err more 0 Belding over Ihwo caries.
❑ Demolition ❑ Other: where the available mull comae Mariam sad boatyards.
CATEGORY OF CONSTRUCT C ION - oxcecds lo.000 amps et 150 votes ar D Floating budding' s.
km to sieved. er awed, 14,000 D Cemmmrthl-ose agricultural
I.1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other iwra1bdcnr, kmildmgs.
❑ Multi - family C:1 Master builder ❑ Other: O Fire pump. 0 1asm:hmaa of 75 xVA or
JOB SITE INFORMATION AND LOCATION 0 icy syswem. separately derived system.
0 Addition of rem moms haul of O A "E"."t,2 , "14 ",
MOW or maim occoportcy.
Job no.: I Job site address 12. '� FDNA >� \\ 0 s two raktocinl ones. Or " o sal vebiek paals.
y Z \ ('� �-, �� I]Iteatih oes facifdks Q supply voltage 1. more tree
Cil IP: "r' r �- D aslocmioar 600wlnaa 1.
Suite/bldg./apt. no.: Project name: OServico ar sootier 600 amps err ream
1111E SCHEDULE
Cross strert/dirvclions to job site: omtnaoa 1 _era. 1 V. 1 tow 1 •
-- ivetr seaidential single-0r maid- fatxly- dwelling nail—
includes attached prag
Subdivision: Lot no.: 1,000 sq. R or l 16 8.54 T 4
Ea. add'1500 s0. R. or portion 33.92 1
Tax map/parcel no.: Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above RAJ
A l e °t �, limited energy, multi- family 75.00 2
t
{ C� '\ \\ r)e /`‘‘ - C -- \CI' 1 c` i S .. 9 ' - V l C' Q residential (with above R. R.)
S ervices or feeders installed° alteration:, and/or relocation
_ ♦ r 200 amps or less 100.70 2 '
IR. Q PROPERTY OWNER 0 Timm 201 amts tnlOD amm 133.56 2
- 401 amps to 600 amps 241).34 2
Name: 601 apps 1o1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
Temporary services or feeders Installation, alteration. audio
City/State/ZIP: relocation
200 amps or km 59.36 1
( Fax: ( ) 201 maps to 400 seeps 125,0 2
Owner installation: This installation is being made on propcfY that 1 own which is flat 401 amps to 599 amp, 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670. and 701. ' Branch *culls - new, alteration, or extension. per panel
Owner signature: - Date: A. Fee par brawls circuits with
❑ APPLICANT 1 c 1 cur r/► el' PERSON above settee or feeder fee, 7 -42 2
e
each blench circuit
B. Fee far branch ai mutt Wit heed
Business name: service or feeder the, shat ' S6.1 B 2
Contact name: branch circuit `
Eac arkil I Iamb cirmdt 1 7.42 2
Address: MlseeUaaema (service or feeder not included)
Each mmmfam red or modular 67.84 2
City/State/ZIP; dwelling, service and/or feeder
Reconnect only _ 67.84 2
Phone: ( ) Fax: : ( ) Pump or irrigation elude 6724 _2
E-mail: Sigoor outline tiandn 67.84 2
CONTRACTOR Signal circait(p) or limitedkenew
p anel nitele or c>aatsien. Pone 2 2
BusincsS name: m ot _ m tin % Each additional lac leetioa over allowable in any of the above
_ w • pdtfititmal irt5peclion (i hr min) 66.231 hr
1nvpGV 1 broth) mnt) 6625/ hr
City/Stale/ZIP: CY , 1 () 0 , g'-AC 2411 Industrial plant (I nr min) 7g.18/ br
rl tartans for which no Re is 90.00/ tar
- Phone: ( 1 j F ax: ( ) aa � �'" l _ . sped fiealh listed (K>�le;o
t`'1 El • •
CC8 L >iIIJ I CljRICA]e naval—was. _.__:
Lk.; Electrical Lie : � Supt'. Li 6� t _ Subrotak Cp: I. rn
Suety. Elcclsician signatuf>r required i �t �. Plan cavil err QS9fo of tit fa): i
Print name: " . f'11 .11 1 1 .2 nay: `) State surcharge (12°.6of permit feed 7.. in iii TOTAL PERM' FEE: — 1i ., '7 a
Authorized signature: 'tats permit spotted= alp IP no A permit is n obleiced within 180
des alter 11 bas been accepted es complete.
Print name: Date: • Itmaber of inspections allowed per panel.
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