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Permit p CITY OF TIGARD ELECTRICAL PERMIT • 1 I o COMMUNITY DEVELOPMENT Permit fl: ELC2010 00633 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/09/2010 Parcel: 2S111AB00201 Jurisdiction: Tigard Site address: 9033 SW MOUNTAIN VIEW LN Project: Madison Subdivision: Lot: 0 Project Description: (1) branch circuit to reconnect heat pump. Contractor: BEAR ELECTRIC Owner: MADISON, JEFFREY ALLAN & PO BOX 389 MADISON, SUSAN MICHELLE DONALD, OR 97020 9033 SW MOUNTAIN VIEW LN TIGARD, OR 97224 PHONE: 503 - 678 -1355 PHONE: FAX: 503 - 678 -1108 FEES Quantity Description Date Amount 1 crt Branch Circuits wo /Purchase 11/09/2010 $56.18 Specifics: Service or Feeder 1 ea 12% State Surcharge - 11/09/2010 $6.74 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $62.92 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 a co. - • = les or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. 1PP r 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 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. NOV- 05- 2010(FRI) 12:31 Bear Electric (FAX)5036781108 RECE Electrical Permit Application NOV 5 20 Fr1IC "F1: t: t ;h t1.l.) City of Tigard CITY o' A. n i.. • Moue: SW Mall BMd. Tigard. OR am 503.634.1171 Pax: 5o3s DIVISIO �- z' 7 • t; A r , ll Inspection Line 303.639.4175 Iliac Itchlr•(II%: eaaliieElli �Q Inferno: www.tiganl.tw.ptm %adticdntrquid: M, ."..1' MTL7ig I d�`TW 0346 0��yrg��,',��� 1tKi+y,t3aR/bryrcW -e, 1,W r1 10P4�15- t.iman . r �.y u . r 1 T O D V 0 ,1 � r(�� + lit: - +..•'•� 144�.i'�,'�te:. 1 1.:. 11 Ml�.li. JT: l%LW�=ill�� :.YM.`..�'�i G�fMf� : .1� I �1'�I�'.il�F'lR.;�I�r• ri1j ❑ Ncw construction Igl,Additiunlalterationireplac mcal glarec check : SRN% apply iwhmn1 'es tiplarn ❑ Demolition ❑ Other: Disoetcc Dlhuldmyu.cr u,tcc >tllrw'. ..here the at•ailabc Bali moron 0 MIwlihn and Mebane. ■ >r erftECOiiilt tiC iftaGCldO t4MIlscene. cum.' lu,tirn autp+ . al i'Ii toll, m' 0 I'h.ulna handing:. 1m, el ground. ur mania. 14.111111 0 Commas:LI -nee ligneultura' (A. - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amp. tb..a other in.WliWltet. builJ1ny.. D Multi- family ❑ Mosier builder 0 Other: 0 lire rum. 0In:autltuhm of 7$ KV.S or giOt ligaiO { O .O I!tlifr t ire ti'��t l? If w ti 0 l ncwn hvper' Joked q,tm QA d IblhM ul'rkewmltnr b1:1.1n1' 0 "A ". "I'C'I•- 1 ] - Joh an.: I Job :dtc tlddn -ta , - lnnllit. ur ire. tl.xuran.o. t� .71/ �I l 1��J.lilr(� �.� Sin Of Rk R hY1thYULl1 unite. 0 Rl ciccah,nul .ahletc IaA « City/Snitch,' itdZI P: 7 \ c ( _ q -' L''2- -A O l lmllh•oirc Melnik, 13 Numb. anpaAe litemutc own I 0IWanks,' IaWIMM0. 6111 volt•nlmimd. Suitc/bldgJapt. no.: Project mume: 0 soviet ur Iixd. Mm amps'''. meet. /t'Lu1 �Srx�l Cross stntisUdintions to job site: Il.,rttiar..a ___I tm1`- I We. 1 tan 1 ■ , ;slew rail dent laltingle-or multFrumllydwelllag unit. tnelwleu Winched mirage. Subdivision: 1 Lot no„ I.utnl mi. n. or lea - I (l1 4 4 i'ax map/parcel no.: 0 WO San so 0. or portion _ 33.92 1 Limilial energy. residential 7501 2 a• ' , f. 1 altaND ONkiEnWO i.I eo..gag ::; :" j st∎ Olt (wide ahtwe sq. 11.1 l.tm Ocatmcrgy. multi. lamlly 75.1111 2 Ca v,Yxe_c_k_ /C �� s x.\-1,c), residential iwith allow r4l,It,l Service* ur feelers Imlmllutitn..altcr.lhm, and/or mina thou 200 amps or lens 100.70 2 alegiatid © iiRRORERVioWklll l.1,:eat! ;.,40-; ;. • 4: I.7 , moi y P 201 amps to 400 amps 133.36 Name: 40 amps in 6110 amps 200.34 601 amps to 1,000 amps 101.04 2 Arlalr"ne elver I.11111n ante ow with s 5 S Tii 7 City/State/ZIP Temporary xer vices ur feederr'mMannikin. alteration. nad/nr rel,cailnn Phone: ( I I Fux: ( I 204 1IIps urInls 59.3 I 201 amps to 4ell amps 1 25.04 2 Owner iaxtntiptioq: This irxttnllatilan i} Ming m:1dC un property that 1 own which is noI 401 unttn w 544 asap. I rig.Sd z intended for sale. Rase, tent. oroichalve. atxonJing to ORS 447. - 1 and 701. mlaturc' b ale Branch circuits - nen, alteration. ur euleminn, per panel Ostler vi B e A. Iec far Munch challis with It .. t rr+ rot 1. .••.- :1"" ncrvlc to i 444r ll' . e r ... ' ;imnlI �CQIRA wEEIn Ilvk;3 c 7.d- : eac hratu:h ct ra,li Business name: 11. Fee Ibr hrmch Clrculls wi!/h.n7 Q service ur feeder rn, 11rr1 1 Sh.1 i cj1Q4� D 2 Contact name h 1 ' i Each odd'l bn n h cheek 7.42 2 Address: 1 Mixeeilaucuns (servlee ur l'Neder nut Included) I:adi manuthctur.d or modular City/Stoic/ZIP: _ dwellilgq,,crvieeandnrrieeder r+7.IN Rcconnecttmly 07.84 2 Pump ur irrimwtism Girds 617.84 2 G- (nail: Signoruullinclighting 07.11.1 ^_ >1 :i7 iisti l .. } IIMIMt irrcONTJr'ALZTOi $:° ` h�:litl4 ti C !�"•3 . ,IY!' vefrigm ,y :1;K.j u sisig.,' cuuuillel u I' exl w1 wwrs Businesname: _ • Busin3 ne: B ear 7- \P c c-, r• . •t- % morel. alimalNm. nrclnitm. I Pr : - �r 11 rrrr ` I ' 1 Eueb addatm of ltll invecrlug nucr nlluwu Me in any tllc Alive Address: 1t Q �V q / Additional inspection (1 hrmiui rl025(lir City/State/ZIP: r r►c�c ` Jcii ("I ^ Imcnlipttial 11 hr mint tNi.1. II r `\ 11 Industrial plant (1 Ircmini 78.18/ lir INtanc: ( 53 ) w1 - \ Fax: 5C 101 % - I ‘C)$ tnylealtms fur w11ids nor fee Ir (l (I(l(hr epee' nom IA hr mint CCI3 Lin:.: tt • Ele atriwl Lie.: .. lb Su L k.: y e =.11INS1i .<IKPa7°�t 1.`E ' t =i .,, :: i . _ 1 • e:ercrcrirlxi►tm<a�vss ,l;t Suprv. Electrician signature. required: Submtul : 10. v / , ---_. ' 1 Plunrcvku.(2 hurPer Prim. nstne lee r p� t ( 1 11 � I hate• `1r3 Suite surdlutu (I - urpannll reel: 1 ^ ^ i TOTAL PaltMIT ret: GZ Authot4 signature: •this pemmult aplakauarn oldies Ito per it Is not obtained Aphis 180 Print name: I Data: Ilan athr it her heen acc ptel An complete. % ntmtwr..t'In.peet ions atb...e.i p.Y permit. tlllulldingh•cmtii J I, :.I/. oApp4.1c a7NI /Ill • III - /.I 11•11MA 1JW111