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Permit CITY OF TIGARD ELECTRICAL PERMIT 2 • COMMUNITY DEVELOPMENT Permit #: ELC2012 -00118 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/28/2012 Parcel: 2S110BC10800 Jurisdiction: Tigard Site address: 12033 SW STRINGER LN Project: TSE Subdivision: BULL MOUNTAIN VIEW ESTATES Lot: 6 Project Description: (2) branch circuits for gas furnace and A/C. Contractor: BEAR ELECTRIC Owner: TSE, TOMMY PO BOX 389 TSAI, CHUNG -CHI DONALD, OR 97020 PO BOX 91324 PORTLAND, OR 97229 PHONE: 503 - 678 -1355 PHONE: FAX: 503 - 678 -1108 FEES Quantity Description Date Amount 2 crt Branch Circuits wo /Purchase 02/28/2012 $63.60 Specifics: Service or Feeder 1 ea 12% State Surcharge - 02/28/2012 $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 O • : 952- 001 -0090. You m- • • ..• , cop es 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. FEB- 24- 2012(FRI) 16 28 RECEIVEID (FRX)5036781108 P.001 /002 Electrical Permit Application FOR OFFICE USE ONLY City otTigard rtB 2 4 2012 . , - IN . 13125 SW Hall Blvd, Tigard, Plan Review ���r� NO'� /°2 - Q/ Phone: 503.7182439 Fax 5 .B F TIGA�ID Oat :. Other n ntr /E 02042 e/ / j • TIGARD Inspection s UILDING DIVISION No„ , et : • Internet . . . . ';.j. ..TXPEi.Ot ORIC •.. ......_- e... •. ,y:3•.. t: :]p1t.AT` t. .r� .. •• :.11•; +: 0 New construction ® Addition/alteration/replacement Meese et auk au War apply (submit jtets of plans wlit ma checked below): El Demolition ❑ Other: where ▪ Service or feeder400 amps or more 0 Building over three stories. where the available thult current ❑ Marina and boatyards. :i ' ; „r . • , CAT,SGOR.Y•°'OF-CONS1 tUCDONV � ::- :. :- exceeds ID 000 amps at ISO volts or p ?lea ums buildings. " an to ground, or exceeds 14,000 CI Conmteeeld.usa agricultural ® 1- and 2- family dwelling ❑ Cornmcrcial/mdustrial ❑ Accessory building amps for all other inawnanoas. buildings. ❑ Multi- family 0 Master builder 0 Other: CI Fire pimp. to hnWWlon of 73 KVA or . ,. .. ; C. r'JOBI 1 EO M.FR11 i4tiii:Pfi 1 Iii TOtuitic , ``' :, ' f ' * - - - - 12 Fusser ° um m larger E". -i r. derived system. �' '� OAddldon oraew maker load or 0 "A ", "E ". "1.2 ". "13 ". lob no.: Job site address: 12033 SW Stringer Ln. 100HP accupenb. O Sie or more residential units. ❑ Beeratdianal vehicle parka City /State/Z1P: Tigard, OR. 97224 ❑ Health-care lhcilities. 0 Supply voltage lbr more than 0 Hazardous location.. 600 volts nominal. Suite/bldg./apt. no.: Project name: in Service or feeder 600 amps en mad Cross street/directions to job site: ry j o . ,, . i p, Te I • New residential singla or rnultFLmily dwelling unit. Includes attached garage. Subdivision: l Lot no.: 1.000 sq. fl. ar less 168.54 4 T8X ma Ea. add'l 500 sq. S or portion 33.92 1 Plparcel no.: Limi1N energy, resldealial r '". ,._ . .2 . 2-MB SC :019;.0T i7t,�gs ; =.•Yt. : x...'? : _ _ (with dam sq. I I 75.00 2 _ Limited energy. muiti-fmnily 7100 2 NC circuit and a gas furnace circuit. residential (with above an, _fl.) Service Of feeders InstaUation.alteratinn, and/or relocation 200 amps or less 100.70 2 °.1; (.3 1tp1OpS" 1"i to 0 :.!:=_ 201 amps to 400 amps 13356 2 • Milne: 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 55226 . 2 City /State2TP: Temporary services or trims Installation, alteration, and/or relocation Phone: ( ) l Fax: ( ) 200 amps or less 59.36 1 1 Owner installation: This installation is being made on property that I own which is not 201 amp to 400 am 125.08 2 intended for sale, lease. rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 16x54 2 Branch dreads- new, alteration, or extension, Ler panel Owner signature: Date A. Fee for branch circuits with .j: - w �. ah e bnu rvi or fee, 7.42 2 ... -- . ©n:i*'�� r ,l7 each hraaaeh ce eireuit feeder Business name: B. Fee for branch circuits without service or feeder fa, first 1 5618 56.18 2 Contact name: branch circuit Each add'( branch circuit 1 7.42 7.42 2 Address: Miscellaneous (service or feeder not Included) Each manufactured or modular City/State/ZIP: dwelling, servic andhx feeder 67.84 2 e_ Phone: ( ) Far; : ( ) Reconnect only 69.x4 2 Pump or irrigation circle 67.84 2 E-mail: _ Sign or outline lighting 67.84 2 W . - F FT Y '`: =•-'l Signal circuits) or limited- energy .. G, aheratia or extension. Page 2 2 Business name: Bear Electric, Inc. Each additional Inspection over allowable in any of the above Address: P.O. Box 389 nddllivntd Inspection (1 hr min) 66.25/ hr Investigation (1 hr min) 66.25/11r City/State/ZIP: Donald, OR. 97020 Industrial plant (1 Ian min) 7818/ hr Phone: ( 503) 678 -1355 1 Fork: ( 503 )fi 1108 Inspections for which no fee is 90.00/ hr C B Lie.: 20 9 j El Lir : 24 - 107C S u rv Li 48818 t • m all liamd , /B Subtotal: 63.60 Suprv. Elec . i u re, required: plan review 5 °.6 of it feu a gem+ ) Print name: Stephen Shepherd I Dale: 2 • State surcharge (I2%ofpermit fee): 7.63 TOTAL PERMIT FEE: 71.23 t Authorized signature: This permit application apices Ira permit is not obtained within 180 • Print came l Date: days after a be been aeeepied as compinle. " Number of inspections allowed per permit. t: tewaunBtpemuutFi .C- PalnYtApp.d°e u7roI/10 44u•461ST(II/OS/COM/WM