Permit E LECTRICAL PERMIT
1-1 a CITY OF TIGARD
2 ' COMMUNITY DEVELOPMENT Permit #: ELC2010 -00720
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/30/2010
Parcel: 2S115AA05000
Jurisdiction: Tigard
Site address: 10903 SW CHATEAU LN
Project: Loeb Subdivision: Lot: 0
Project Description: (3) branch circuits for heat pump, service outlet & furnace.
Contractor: BEAR ELECTRIC Owner: LOEB, RENAE L
PO BOX 389 10903 SW CHATEAU LN
DONALD, OR 97020 TIGARD, OR 97224
PHONE: 503 - 678 -1355
PHONE: 503 - 515 -4050
FAX: 503 - 678 -1108
FEES
Quantity Description Date Amount
3 crt Branch Circuits wo /Purchase 12/30/2010 $71.02
Specifics: Service or Feeder
1 ea 12% State Surcharge - 12/30/2010 $8.52
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $79.54
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. ATTENTIO • w requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 ough OAR 952 -0 9 . may obtain a copy of the rules or direct questions to OUNC by calling X95252.1987 or 1.800.332.2 44.
f /
Issued 444 041 Perm ittee Signa u � • %_ _, - lt�2�
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' aa Date:
LICENSE NO. yps�l
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.
DEC- 29- 201001ED) 14:24 Bear Electric (FRX)5036781108 P. 001 /002
Electrical Permit AWplicatioIREC F J i.liil. Flt t:i si:l`I,V.
u = air „,
City of Tigard i 7 /. '// Penn' Nn4 _ , • _ OU? ,r
I Isl 131= 5S��HalllilvtLT{g+ni OR Y7223 DEC ,2 9 2010 - 711+areemlc
mn= 503.639.4171 Fat: 503St111,I%II
Inane Linn Line 5113.639,1175 Date ltcl Jun.: E Sr See 2 ear
T t c. , ,, t,
Inlcmel' www.tigtlrtl -urbnw CITY OF TIGARD N'Mlliedl\lethod: Suppknitmal lamination
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'. , .", `r,A.,:pr,'s.1e.,•"'' gtgrwteig s e, IA ?t V rgit"✓'g; : tcf,M e.%4" ' �41tjii ` l JfR XIVS'.IIiiitiii1'�.:... '1 ..
❑ New construction 1I Addition/alteration/replacement rl�.cn�rt Wllnru+ml: aanmit: x� ,nrr,lon.wn +.,n ,ct+�w«Inel,>t:
p Service or tender .1s11, ammo? min D Molding over once stones.
❑ Demolition C] Othem when:the available !huh eunvn ❑ Ntarines and Marvunls.
. ..— • ir+w C'• li ,, 6 tcwudsla.anl uI19uvon% Floating bul l.lh7 ,L
. '0.' - ' , ...". ;r;s,: ;IISt!."; t*' :'r. mitt OR1�iOii CON.k' .1rRO4titittl i'1i�.i.1y avtgat� �' vi Ice4 u gnuutd..r NJltro ❑ C,mmneteWl.ur uuricullurul
j81 I - and 7,- family dwelling ❑ Commcrcialfindtrtlrinl ❑ Accessory building ..rp kw all nlhvrinwgll,rl.,n. b,u,une..
❑ Multi- family ❑ Master builder ❑ Other. D Firepun,r. 0iq+ui0ationa75 K! A o.r
. , T ❑ Lmenamey iysio s, farm separately derbcd wwem.
v u. ;; "
� , ,t10. 1�ow ON . OR•{'voNArg+ 'm1R'A"•a' A: ".r9!Y;t 0.,dJ tionnrnov motorMala 0'A ". Ir. - 1.2'. -,l`.
Jell nay: Jab oho uJdrana: M
Imp IP ur more. uut�miin4:.
la
iir6 �A. J ! r[ l it , Q . ,r more re9idcntiulmils. D Iteerl.uloratiwiIclepants.
t ill Cit /StatelLlle:' r (-� • Q I kahh -care IueilIlic". ❑ yupp1Y vl li mnrc than
y t, V D l ltvanlialS Ilona. t,tltl vull+rnonlmd.
Suite/bldg./apt. no.: Project name' O Service or roister M H I umpn or more.
B ItO I.IEI r 4ktPEDIE l emit xV€aZIV,
Cross street/directions to job site: INerigd„n ( fJI . I 1•..• I 'I$ud I "
New realit nttal single - or multi - fatally dwelling unit.
Includes attached uiirug .
_
Subdivision: .......-1 Lot no.: 1,01111 sq. u. or lass I uit.J4 a
Eu. mld'I 500 sq. It. or pinion 33.12 I
Tax maplparcel nu,: Limited energy. residential
, t r s•. fr r i i t u:i1"d:.t Qtr. 'with nhllvc , A -I 75,011 y
-�. # � *a > �t: <�t!;' . t . :i �p6 :3CRI�lON�OIr'.l�t�O7!ilrr;n�c .� '�� � 'ut
■ �Lom ma t vitr{po,muttIdmmly 75.III
1 . .. Ilv \' . �, jR ` � resident loll twit!, abswey. Ili
y Scrvirm ur feeders lnstIlution Microfilm, amUur rclocntlon
-4 l y ` OA. i 4 i% .. l C I IL 14! y 200 umin or !eke 1011.70 2
, ? 1 0, ,,,,, L 1i O L .�.r .m.. `' "6 ,' -, ' +. ,: t i.: ® 111 iz i 1 . a 201 umas to dtlll untnr 1 33.36 '
ID I amps to IWO maps 200.14 2
Nam1,. 601 amps to 1.000an+ps 301.04
/Wilms:se. MITI I nrul,anr..ww CC'' 7
Temporary ncrv'iewl or feeder,' InslnUatlon. alteration. unapt.
City/State/ %1 P: minim don
Phone: ( ) I Ftlr' t l 2110 amps or less 59.36 I
201 ungn iv •100 rape 1 23.00
Owner instal:dims: This installation is being made on proper that I own which is not
intended for stilt- Icesc. rent. or exchange. uuennling to ORS 447.449.670. and 70 I. III I amen to 599 mope 1611.3. 2
Branch circuits. -new. alteration. or ctternlun, per panel
Owner signature: Dale: A. Fcc for brunch circuits adth
nA e'. tr ,r Yr'' t!' :1 ur r^l�tit' `• u 7: ? ,'ix ilk., aw*vha an 114.1.1.1 Ice, 2
t Q ' l�rs rti�sxs d� ";d�4rri� ®K�Q A e 3o1!t �ii;rcA; each hnmclt circuit 7.3
U. P6.,0 use hunch circuits wlalulll
Business mime: p
ncr.lec air rooter l . e,pr,l 1 gar 1 s4,lx p 2
Contact nutty:: hand' circuit
Each add') brunch circuil . I 7,42J1L,9l.j 1 2
Address: Miscellaneous L41cryicc or rceder not Idcltldal)
City /Swtc/7.IP: hachmanulhcturcd r;7. &1 2
dwetlhsq, service and realer
Phone: ( I 1 Floe : ( l Reconnect only t67.s.1 2
Ihmtp or irrigation circle 67.L1 2
E-mail: Slanurunilloelighting 67.I1-1 -
rdEgar MPr COMTIZA I,M ,113 ,'.t .? P aM�%!�. R :e°',N: Filson! oar:il l:0 or limited unurt{
BusinmIss namc. ` I ���1 . pa alienation. urns inn. Iwgc 2 ,
ttt>- �--uuu Each ch od dkInald Inspection over allowable In any al the above
• Address: a COI Additional inspection t I hr mint 66,25a hr
CitY/Slaki /-I l'' III y llli,i IM MO p _Invt tirwtium.11. hr.minl aa�gr hr — __.,,. -.—
Industrial plural" lir mini 711.1ni Iv
pQ /V - (i ' Phone (S (CM- k ,a Fax: 61. n g ( 651, ln*panlune I'ur which no lie is 911.1111( ! Icr
specifically Hoed 114 hr mint
CCD Liu:.: 204 ICI ' Electrical Lie.: -2 Li- icria:luprv, L e g (7., i's'aa t' 'nij ! i d t
75 Gi 3" , I�" a7y�L" EGCiciCiAti' aihplil► 2L7' .SI►•l�P��iib3.;Zisr:' > . ;;;.
Suprv. Electrician siunuture. required: Subtotal: 1.(Y2
r C!♦ t. J . � Plan miles. (25%oruermil 1'o:):
Print nam,r ► -D Nu. Mlle, 29.1 IC Ni mlrchnlvc f 12!w of oafish h ft:el: ,
— ' u I TOTAL PERMIT I E1 : 7 r._.1
Authorized i ThIs permit npplkatlnn tapir/II 1141 penult It, out ablaut. sllhin 11111
de }s after It hat been accepted an complete.
Print I Dale: r A: unbar ,.I'imvvlkm.ullu.ord ply purr*.
1111ulldi,raermiI9 I.C•l c,niIArp.,un 117.111/ III 1l164u0 I I t 1 41St 1 LW W+:l1