Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2011 -00469
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/19/2011
Parcel: 2S101AB00100
Jurisdiction: Tigard
Site address: 12023 SW 70TH AVE
Project: Red Rock Center, Phase II Subdivision: Lot: 0
Project Description: Temporary service for new construction.
Contractor: BEAR ELECTRIC Owner: FRY, DOUGLAS
PO BOX 389 23077 SW NEWLAND RD
DONALD, OR 97020 WILSONVILLE, OR 97070
PHONE: 503 - 678 -1355 PHONE:
FAX: 503 - 678 -1108
FEES
Quantity Description Date Amount
1 ea Temp Services or Feeders - 08/19/2011 $59.36
Specifics: 200 amps or less
1 ea 12% State Surcharge - 08/19/2011 $7.12
Type of Use: COM Electrical
Class of Work: OTR
Type of Const:
Occupancy Grp:
Total $66.48
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. ATTENTI• • . Oreg• law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-001f rough OAR 9' %11 -6094 You may obtain a copy of the rules or direct questions to OUNC by callin . 32.1987 or 1.800.332.2 .4.
d ,
Issued - /l l
Permittee Signatur • p�i���-' �
•
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.
•
RUG- 19- 2011 (FRI) 09:36 Bear Electric (FAX)5036781108 P.001 /002
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Electrical Permit Applica k C a r � $ . , volt orrl( l: i sr, c�Nl.1
City of Tigard i i � ' 0 " t. t l.0 't°e°'�°� �j ./f �/
`� - b Datdnv. b �� Permit No.: £ -vQ 7 ,
, y 13125 SW Halt Blvd., Tigard, OR 972 i I r y ( 2 O 1 1
Phone_ 503.718,2439 Fax: 503,598,0 6t)U Y it Oher Permit
TI c A R 13 Inspection Line: 503.639.4175 pare Ready /lsy: Arre:
D R
lnterneInternet www,tigard- or.gov CITY OF TIGA IP� Supplemen tal Notified/method: . Page l far
af Information
I, , a , ^ }�W!,r i� r r� �. �W 1 @� 'IG 1 1 .... ... 8'„ 1 Y, \
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,� .S 3 vr�,l�t� l�r, ..awn )i�,lan iil tit d? II,�' �� �C' � tt4l tl; rV 1, tr`)s' „u1 �7i, •,{ : elat t,. }, 1� 1 n 1 t � a �::
„�r)}r{/'� +'�h i�r,tr t( �� id,9�,r,. " •
:1 New construction ❑Addition/ulteration /replacement Plaaaeehock ill that apply (submitj, plane w /items checked below):
❑ Service or feeder 400 amps or mom ❑ Building over three stories.
0 Demolition ❑ Odior. where the available fault currant
^ 6 0 Marinas and boatyards. .
' w. "k� i : " l ' ' � ,� „ r , wu � , nau " 4 °I2 ill;d rf�?$Ip�;FR'a't'�,ld�, �r:1. °V; f;1 nm
exceeds 10,000 psat 150 volts or ❑ mowing buildings.
a ,« � 1 � 4WtC,9 �
less to ground, or mrceeda 14,000 ❑ Colmttercial•nae agriceihteal
1- and 2-family dwelling 1,. Commercial/industrial ial ❑ Accessory building amps for all other inatallatloos. buildings,
❑ Multi - family ❑ Master builder ❑ Other' ❑ Fire pump. ❑ Installation or KVA or
”" . „ r . , � � • v�t4t �II cysts+ l a er aratcl derived
1 " . " '} .F1d94kW�M rr 1 b "t,u lr sari l ,.riFiu�'6�f.Y }'Yll�uu4:n:}' A t e[I IXri. Rt r Y system. +IS z '' ❑ Addition al'new motor load of ❑ °A * , `�+ ^ , "1 -Z' "h't " ,
Job no.: Job site address: i',013 SU ' 11# t 00HPor more. °eminency,
❑ Six or mare residential units. ❑ Recreational vehicle parks.
4,V ❑ Health-care fiicilitiez 0 Supply voltage for mom then ❑Haxnrdouslocabons 600vo11s nominal.
Suite/bldg./apt. no.: Project nuttle:'b .r. - 't tY ❑ Service or rower 600 amps or more
Cross street/directions to job site: "i� s o' ) ...`1' `1,i1=1,), :.1` r : ei 1 N @ ;r1 g.1.' EEN: �t• llA Pit, !rd
menpaaa on. _... F. T.
New residential single or Multi-family dwelling unit,
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft, or less 168.54 4
Ea. add'l 500 sq. ft, or portion 33.92 I
Tux map /parcel no.
00INtN(l N !NENdNIi�iIN N , 4 ' ,, NZ" " ,l ,1" Jt " 1t . ' itACi l . gS�I , �t N ,}t�er, , , tM1 , c ��, l ! , , �ll; ,1 , ``Oh d abo above td
}�� f) 75.00 2
�w,3i;ila u,s, ,s,as ar wl i Limited energy, mulli•famlly
MI-- t f ':'' residential [with above sq. R) 75.00 2
Services f instalhitlon, a relocation
S�c�t �J { X 200 amps or or less eeders alteration, and /or reloc
100,70 2
i ?lilliu�i ir, t i ; a ' ,h ai,d!mnbi, rL'br a°eSSl �t"T' 7 l r I irP;! djj jt��i,.,i 1 �:1rj »t4l� , .t r i (iai x {CIE I t a ,, ¢r+ttln , 8111135 to 400 am
�t � ! 1 � � 13 �� 0a � �' � �lU' { t �t�! � t t'� S� ( .t ;w 1 t ,'�{wf'fl! 11111 H l' "ll }, �a� 201
- Da 13336 2
Name: 401 amps to 600 amps 200,34 2
601 amps to 1,000 amps _ 301,04 2
Over 1.000 amps or volts 552.26 y
City /Slate/7l ?: Temporary services or feeders'istadlation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 mops ar less 1. 59.361 S R ,3() 1
201 amps In 400 12$.00 2
Owner installation: This installation is being made on property that 1 own which is not
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Branch elreuib alteratims or extension, cr panel
Owner signature: `` �� Date: A. Fee fbr branch circuits wail rEMEN► C EI n,.s # ' DE +I Q3i l ( E ;iilt�>fii i li 16Zl' iri `a l`P i mll >lr , tr p i, 7 about "rvic or testier fee' 7.4_
1u a)�iflfw �dd>rilltki'N�, it i each branch circuit 2 2
Businetis flume: . 13, Fee for branch circuits without
service or feeder fcc, first
Contact name: brunch circuit 56,18
Each ndd'I branch circuit 7.42 2
Miscellane (ser vice or feeder not. included)
City /State/Z1P Each manufactured or modula 67.84 2
_dwelling, service and /or feeder
Reconnect only 67.84 2
E - mail:
Pump or irrigation circle 67.84 2
l '' r , � 1 l� i' C G I;i' ii; Ii il4iC h Wd, : . 4 l ,:veto , I` 1 E ;<Eal iiEI >~;wl. i3 °" na i'5 Sign
ircnit(s) Or limited- ener
lighting
gry 67,84 z
Qusiness, name: 6.eA,,Q_ • r� • panel alteration or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: 1 O c : 9 Additional inspection (1 hrmin) 66.25/ hr
City /StFl1c/I.IP:p pl� b Investigation (1 lit min) 66.25/ hr
industrial plant (I hr mitt) 78,18/ lir
Phone: ( 4 ) (p g- 1 Fax: (5b ) G ' (Lot Inspections for which do lee is
" s •emffcalt listed '' /zh rmm)
90.00/ hr
- Sup Lic,: I f 09( d n,tr ,rilti,llprrTlc+ll! ,; a t ar4,.. il'r: rAi]:t lit r ;(��, tlfe tg iiiiiii s •ecif l�e ar Sri
Subtotal:
Suprv. Electrician signature, required: � � _` C I Plan review (25% of permit fee); -7
7• 1-7
Print name: Date: 8. 1 c3 _ / i State surcharge (1 of permit fee):
TOTAL PERMIT FEE: p
Authorized signature: - ry G
This permit apphcatou expire, ire permit is not obtained within ISO
Cliell
Date: I - (�
8 days after It hes been accepted as complete.
• Number of ,YMVyI'/
inspections allowed per pcnuit .
Ia Uwldiasll'emtitsoLLC•PrnniApp. 07101114l .441- 4615T(I /COMAviiu