Permit CITY OF TIGARD ELECTRICAL PERMIT
• COMMUNITY DEVELOPMENT Permit #: ELC2011 -00499
TIGARD. 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/09/2011
• Parcel: 2S103AD01900
Jurisdiction: Tigard
Site address: 10935 SW PATHFINDER WAY
Project: Wessel Subdivision: PATHFINDER Lot: 10
Project Description: (2) branch circuits for heat pump and service outlet
Contractor: BEAR ELECTRIC Owner: WESSEL, ROBIN &
PO BOX 389 10935 SW PATHFINDER WAY
DONALD, OR 97020 TIGARD, OR 97223
PHONE: 503 - 678 -1355 PHONE: 503 - 330 -1616
FAX: 503 - 678 -1108
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 09/09/2011 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 09/09/2011 $7.63
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $71.23
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 9 001 l : i I. You ay obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
SEP-09-2011 (FRI ) ]a:49 B e a r E I eTtlr I c7,111 g 7 f i,i1 (FRX)5036781108 P. 001/002
11EL$L-1 V ti
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard SEP 9 2011 R „ mil iiriffirfa
D Pennit No. i0 V •
N 13125 SW Hall 131vd., Tigard, OR 97223
• i Phone: 503.718.2439 Fax: 503.598,196cITY OT
F IGARD 0 11...,
, Other Permit;
TIGARD Inspection Line: 503.639.4175 BUI1 DING DiViSION Daie Ready/By; S3 See Page 2 Par
interne: www.tigard Notified/Method: IlliM Supplemental Information
, ";k 7 i4i:"..,?liKeY,44 : 04 i 61 14,4.*,,c5R,.;i....a,&,i;tC. „ •:•;. .'".".'!... 4 1 1 grAtiltaggiettPro ', 1 :
0 New construction lal Addition/alteration/replacement Please c h e ck all that apply (submit Beta Or plans w/itcms checked below):
0 Service or feeder 400 amps or more 0 DuildIng over three stories.
0 Demolition I: Other: where die available fault current 0 Marinas and boatyards.
, t , j 47 :i ,:.,:: „ r4, :',,,,, i .:, A.:„AV:cittNiac41340:0Rygpagoti• iht,itgrior,"vil ;^, :I , . ,:. exceeds 10,000 amps at 150 volts or 0 Floating buildings .
less to ground, or exceeds 14,000 000MMeretal-use agricultural
sr 1— and Itturtily dwelling 0 Commercial/industrial [] Accessory building amps for all other installations. buildings.
0 Multi 0 Master builder 0 Other 0 Fire pump. 0 installation of 75 KVA or
. 0 Emergency system. larger separately derived system.
, '■ . :::,.t" ' `.",'".. ;;;' g" ' ' ,4'.1 '''''' ' ' ;4. ' k ''.. ' ''' : ''' 0 Addition anew motor load of 0"A", "E", -1-r.-1.:1-.
Job no.: Job site address: lea .... ,, A ..,,, % 100HP or mom. occupancy.
Ilk as (13,° rti Six or more residential units. 0 Recreational vehicle parks.
IDHealih-care facilities 0 Supply voltage for more - than
CitY/SUlierZi .. • lot 1 \ 4M11 LVEUZIIIIIIII 0 Hazardous locations. 600 volts nominal.
Suite/bldg./apt. no.: Project name: _ci Service or feeder 600 amps or more.
- Z ); , ; .,SCIBIDUL ; 1,0
Cross street/directions to job site: DescrIptiou I Qty. .1___Fee. I Toed ( •
New residential single- or multi-family dwelling unit.
lucludo attached garage.
Subdivision: Lot no.: 1.000 sq. ft or less 168.54 4
5, tidal 500 sq. ft or portion 33.92 1
Tax map/parcel no.: Limited energy, residential 75.00 2
ir NW ,., . ,-%:.! , s tgat ur r i ti rt ecni p y 4 , ' d ' (with above sq. R.)
Limited energy, multi-family 75.00 2
ihn. . • ad , it !,, , le . la b ,,,, , residential (with above sq. 11.) _..
• Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
_
vtf.,4; tigititVIONWit4I.;IT' i.`. I4i ,. .!:=17, 7 7tli OF I; . 4 a. ,, :, , 0)9 201 am to 400 amps 133,56 2
401 amps to 600 amps
601 amps to 1,000 amps 301.04 200.34
2
2
Address: over 1,000 uMps or volts 552.26 2
Temporary services or feeders ustallation, alteration, and(or
City/State/ZIP: relocation
Phone: ( ) EEMIIIMIIIIIII 200 amps or less 59,36 1
201 amps 10 400 amps 125.08 2
Owner installation: This installation is being made on property that I 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 circuits - new, alteration, or extension erpanci
Owner signature: Date: A. Fee for branch circuits with
..,'': A ' : jh - „h... J ' co - ; ...,.. • , c' . eac branch circuit 7,42 2
Business name: B, Fee for branch circuits wit hour
service or feeder fee, first \ 56.18 .0ag 2
Contact name: branch circuit
Each addi branch circuit 1 7.42 ""). 142_ 2
Address: Miscellaneous (service or feeder not included)
Each manufactured or modular
IL
City/State/ZIP: dwelling, service and/or feeder 67.84
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
Pump or ir circle 67,84 2
Sign or outline lighting - 1 67.84 2
d-energy
_panel, alteration, Or ox1C11Si011. Page 2_, 2
r i tbrAlk IMIIIIIM_ ....i. Each additional inspection over allowable in any of the abov
112M 1111,0111111MtIMMIKI Additional inspection (I hr min) 66.25/ hr
- ---.., t.uk, -.11 ii i Investigation (1 lir min) 6625/ hr
City/State/ZIP: lik- ii 10, . . Industrial plant (1 br min) 78.18/ kr
Phone: 4 ; 0 • ti M ME I ti 51 I al 'CFA M Inspections for which no fee is
s.ceificall listed th hr min 90.00/ hr
EMS 40/112=2:1EM Suprv. Lie.: OIL i::, .1 ' • : .Eii!of, GI ' ' °A= : . i ops :A : : .
Suprv. Electrician signature, required: -41611111. k■ Plan review (25% of perm t e a r): .' 'p
Dale: 1111" a - State surcharge (12% of permit fecy 1
. ..LOS--
Authorized signature -
TOTAL PERMIT FEE: — II, - 2 _ 5
: This permit application expires ifs Is not obtained within
days after It has been accepted as complete.
Print name: Date: • Number of Inspections allowed per permit.
lAkkailliglPorit8181.C-PcnnitApp.doc 07/01/10 440-4615T(11/05/CONUO/P.14