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Permit
• CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2011 -00273 1 3125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/25/2011 TIGARD Parcel: 1S134CD09200 Jurisdiction: Tigard Site address: 11645 SW TIGARD DR Project: Torres Subdivision: BURLWOOD NO.4 Lot: 26 Project Description: (2) branch circuits for A/C and gas furnace. Contractor: BEAR ELECTRIC Owner: TORRES, NANCY PO BOX 389 11645 SW TIGARD DR 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 05/25/2011 $63.60 Specifics: Service or Feeder 1 ea 12% State Surcharge - 05/25/2011 $7.63 Type of Use: SF Electrical 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 1: � ' Issued By: Permittee Signature 00 You may obtain a copy of the rules or direct calling 503.232.1987 �1.800.332.2344. / � O ej 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. � 1489 -23 -201 1 (MON) 09; 55 Ber mil, c r.�,c V 0 (FRX)5036781 108 P. 001/002 E lectrical Permit ApnIicationMAY 2 3 2011 FOR QF•;h ici: USE ONJ.1' City of Tigtird �. 1' y ; - rr,,,Jll.n.: ��C zo // —Ow d?73 i _ ■ 131_3 SW Hall Blvd., Tigard. OR 9727 ° y 4 �' �t '` ® Plan tteviu E' 11 11 Phone: 503.718.2439 Fax: 503giZ.1'96Ui9VG DIVISION omen, other fermis /fEC,,2 / / , , _._ , TtGARD inspection Line: 503.630.4175 t me kcay,3y: N 8 See Paget fbr Internet: www.tigiir1 ur.guv 14c/tilled/Method; Supplementallntbrmatlon ∎,',e,.Y,ir ''t . l �.°° 4 0 -' r'', .„ 40001.-6 �'k ir. �4 .4 ,, ''`4 r ,Y yt ". '.�: le ?''''' m:,,iA "'' ..'` ° " ;; ; ' 4. dr.l, ., , :. r i :.),,, s 1 ,,i . w tNY. �1.. ■ rr r:v YF"'.: ' Y, ''{ r . Y a �n �' ✓ � r I�. mk� Y '"'N .. ��T•n � • ❑ Ncw construction M Addition/alteration/replacement Picnsechoek all !hut uppb (solaria ? qty urpwna wrlcrose below): CI Strvicc or feeder 400 umps or mare Q Budding over three stork's. ❑Demolition ❑Other: where the (mailable fault current ❑Marinas ant boatyards, «l4 irs fir ",*-14.". ',,7,%,..;'," tti,n .it, e. . kT i� R1, .or,.in,, '' a, .,, ,, :i: ^ • , rr �. w r :,� cxecctla10.011namrant fSI) Liar Cf fiwtingbulldinga ��' ' ' " '' t ,,. Iea+ In proand, or ttceede 14,UIlU ❑ Cummc -use agrlculturui 1R1 1- and 2- family dwelling ❑ Commercin /industrial ❑ Accessory building amps for all other Installations. buildings. ❑ Multi family ❑ Master builder ❑ Other: tire pump. tern ❑ Inwttlladnn af75 KVA or .yy�r�9 '" In mer sya larger sepanuel) derived system. ,'„ , ,"' Y , ; a r t �r ri r i, 4� V,0 � +Ir(i4�iY�+.r� ,g 1Q $ a. I ;. • ry ..; vJ 11 C cr4 « " w f,. « 2 " U i� ,��7 a�p+,��i.)51t;1� i ❑ Addition a minor lutxl of ❑ A . 1.. t. . "L1 , Job the ild(1fC&8' , _` ,G —(^ IPi' +x more. oecupnnc:. Job no.: 1\l��y =) �+V \ \' 1�� \ ]fir • ❑ tilx nl1 nr m «i rc�iJcntl,d unllc ❑ itcwculinnui , chicle 'Avk,. A ❑ 11mt1di.rnc [hell ❑ Suppl wuttaga for Mum hut City /State /Z1P t l+ � 1� © ttarlttkoua Iocntluns. 600 volts notnbltll. Suite/bldg./apt. no,: l'roject name: ❑ ` Icc feeder 101) amps or /NM, 8 ; . . :^'rr. +.,r , .^..,1ll',, . 'CM 4:41",'„..',:+0 "FIr��Y.��. . (� 7:::��Yr:� ^J .�,.. „.,,r. ' �:r�_.,,ux::, rl� �r� H AfM r .,,':•,:� '�.��.....•.r. rr Cross si :et/direction:s to job site: ierar:liit'!w+ i - ur.• l ►.- I I.,el I • New residential single- or multi -family dwelling unit. Includes attached us rage. Subdivision: I Lot no.: 1,000 sq. n, or loss 168.54 4 Ea. add'l 500 sq. ft. or portiat 33.92 1 Tax map/parcel no Limited energy, r _ f t iJ mtlul '' r ' yam l lw „ ? ,46, 4 li a' (will' above sq. R-) 73.08 2 n '\ .. 1 Lhniled energy, multl•lhmlly \\ l - r 1 `� K , r . r'i 0S �" 1 c , y residential (with above sq, 11.1 75.00 2 Services or facdcra inst:rllnlion nitc rutton, rinc io rclneade n % Er` 4 11Inft Is! Is! S a/1 1l M 1 200 amps orlees 100.70 2 dd ':;" l r�l1.zif '„•." t.- ., ' "rWL L,.21L0l, ,';, .'. r, ', :,.s CSI,,,,- I"!0i1, 201Ump61U 41;0 tunas 1.33.3 2 Name: — e �A-E- � , # /Ne 401 amp lu clew u: 200.34 2 6U I amps Iv UAW u tnps 301.04 1 Address: �, "111 -- Over 1,000 amps or Oils 552.26 2 Temporary scrvlcvs or feeder+ installation, alteration, andtur City/State/ZIP: relocation Phone: ( ) I Fax' ( ) 200 amps or less S9.,16 1 201 amps to 400 amps IMIIINREEIIIIIIIIIIII 2 Owner Inlituilutlon: this installation. is being mode on property that I own which is not intended for sale, lease, rent, or exchange. according to ORS 447, 40. 670, and 701. 401 maps to 599 amps 1 68.5.1 2 Branch circuits - new, allenilion. or extenalon, per panel Owner signature: l)ialG: A. Fee for branch circuila with iM #; rl r �. r' g7 "�:" ^)I e I ° .tan 4 � ;r4l " VI : �,r'r Vu r, A� +k: c A f!i .... s Airs t r '•� above serwh>;C nr feesk rots II, � 1 1 1 I t �, �« t,.,..., «.....,,.,�,. � .�, � y�tw� ...... r:.:..:ui.... , 7.42 2 each branch circuit Business name: I3, Feu for branch circuits wllhour ___ ncrvl<c or feeder fee, drat 1 56.18 a, 2 Contact name: branch circuit Each add'l branch circuit 7,42 I '1 • '12. 2 Address: Miscellaneous (service or feed n ot Included Cit. 3 ' /StatelZlly: Each manufactured or modular 67.(41 2 dweilingLervicc and/or feeder Reconnect only , 67 -84 2 Phone: ( ) I ",ix:: {. ) — - Pump or irrigation circle 67.84 rill! 2 � ; :s. ' "• alww 1:°174."1".:. sign or outline lighting 67.84 2 f l w r 1 ' y ,• , 'a 1w i ' -', y^ l ' t' '(,>:' '1M r :' "U;]I0 wvr '{ '"•^'+' r � ' h,^ ,1a " P a T Signal ea or Iiniir'ed•energy panel. illtcralion, or extension. IPaite 2 2 Business name: f1 r =10,'` 1� P ‘'h11 Laeii udditiuuul luspectlop over allowable la unv of the above Address: p, Cr:), J Additional luspot:tlon (1 hr min) 66.25/ hr _ investigation (1 hr min) 66,251 hr .. - Cie /SWtr•/Zil7- t --, - 0\1- ... ............. _ ...... _ . t.- 4 > `l 1 , �� ■ industrial p lant (1 lir m in) 76.I31 hr Phone: (t k . . . 6 " 1 t ,7--_ Fax: ( ` ( 5 - 3 1 ' ( J lnspcc(iuns for tw1ih h no fee is 90.011; hr �],,-� j ry '1 t_ A Qc(7� s Meetly listed 'i lir mini -) j(j,/ Lie.: r\C\ \C Electrical Lie.: �C Suprv. 'c.: L4 (S 1 ' - r , a , . w. i sl I'S: „mm"" w Subtoull: (�` r Suprv. Electrician signature, required: C _ -yi.. x e....-r Plan Plan review (25311 of permit recl: Print min � � n. ii. , . l •'b.k) i 'tit.: 2 \ \ State .,,char ( 12% or permit fee): J . ` .i . TOTAL PERMIT FEE: , ,2 Authorized sign:ilurt.. Thla permit upptleatlun etplece era permit 15 not obtained within Ind days after It liu. been utreplrJ us cuntpielr. Nat name: I Dtile. • Nt iml>L r fir inwpueliuns unwed per permit. 1 U t ndual ent iMRi 1L- IA1,pi {p) +) doe. i17:r11llil 4.IIF4h11 AL 0:11)