Permit CITY OF TIGARD ELECTRICAL PERMIT
Is • COMMUNITY DEVELOPMENT Permit #: ELC2009 -00502
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/24/2009
Parcel: 2S104CC00800
Jurisdiction: Tigard
Site address: 14275 SW MISTLETOE DR
Subdivision: Lot: 0
Project: Nass
Project Description: Add /alter (2) branch circuits to reconnect a/c or heat pump and service outlet.
Owner: FEES
NASS, KERT Q Quantity Description Date Amount
14275 SW MISTLETOE DR
TIGARD, OR 97223 2 crt Branch Circuits 09/24/2009 $53.50
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 09/24/2009 $6.42
Electrical
Contractor:
BEAR ELECTRIC
PO BOX 389
DONALD, OR 97020
PHONE: 503 - 678 -1355
FAX: 503 - 678 -1108
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $59.92
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 s R 952- 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
� I
Issued By: �� I_ . >i i 1' )♦ Permittee Signature: Q_,
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 an Inspection that business day.
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.
_, 5EP_- 2.3- 2009(WED) 13:37 Bear Electric (FAX)5036781108 P.001/002
Electrical Permit A licati CEIVED FOR acrid: USL ONLY
City of Tigard Eill.111111111M remit ltd: E l Q2•0q'- 4 053 a
rlm SW Hall Blvd, Tigard. Ott Mae EP 2 3 2009 P6ae R..l.. .
ae 503.639A171 Pax: 503.591.1960 Odell* MOM rn Q`
T I` An n . .0! CI OF TIG '� a+ of r.�: r,.
IrrlderKt „ PLAN =VIEW
0 New eoostrucdan faAditil :atlaher>ttionhtptacauent nogg dr* aauw+ opr +dl.w ilia aeons wwm. dwelled Inter*
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Qswa a A.der KO Sept er now • Mullane over Woe navies.
o Danolitian 0 Othe mow dm ardlabIe WUclung 13 Marinas awl board..
=m ow OP o 17ON .lm& 10X0 amps id 150 valuer 0 Flambe WW Wrings.
a - hat to roes. or etude 14.000 OCemmseidwle.p;cvbnol
al. 10C12 dueling ❑ Commeevatrmdusulal 0 Memory building art mrall oder lawasnias baiWrap.
0Multi- family (] Mader builder ❑Other. CI RR poop. 0 lastdisnoo of75KVAor
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Job no.: I 3641c lnddt» 1 0 r 1 5 SWY1:S�1E`1nP_ '. O now asikth t amt D Reelatio
ob i •pie
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Clty!$tatalP, I O Ileddocere faciIhin. O 50.ontry •slap tar mere tine
C)ILaterlotrImam KO voila .,nisei
Suite/bldg./apt. sto.: Project mama O Serra or feeder MO aware mew
• awrrlwlr FEE SCHEDULE w.. - -) Tub. t
Cross stroet/directious to job sitc Now ruldeodal single- or mwrddaad(y dwelling malt.
laded= numbed wraps.
SubdlvWan: 1 Lot no.: , 1.000 m fl.°rim 145.15 4
••. Ea. rain SOD IL or • 33.40 1 I
Tats map/pared no.: United emu, raldaaial 75.00 2
Limited energy, mahldlraily 75.00 I 1 2
9 1 e c C " N T V C 1 P C A/c_ nr \POI , I >) r - $ tsideeial O a t h abo.eeq a•)
Senates or feeders Inetall$UoNaltervtlan, andlprpleeat
• t P '' - V MCP r x�P'c', " 200,tapsortoe, L 00.20 2
-.0 llEOrl myna • . I' • 0 Titian 201 Imp 10400 amps I 106.85 2
N a m e, 401 moths 4 0 6 0 0 amm 160.60 2
601 lags to 1.000 amps 240,60 2
Addre� Over 1.000 mem or volts ` 454.65 I 2
CIty/SteteIZlP: Temporary smiles or faders 1nstatlotioo. alteentloo. miler
relocation
Phone ( ) J Fag ( ) ' 200 gaps orleo 66 I 1
Owner IastalI,t am This installation is bang made on property that 1 own weeds Is not 201.0101 to 4001aga t 100.30 2
intended far sale, lease, rent, or atelsanCa according to ORS 447.449. 670. and 701.
401 1tapetos99 135.75 _ _
Broach circuits.. new. niterallsa.ay eaendeu. oer panel
Chimer signs:Roc Dat
• e A. Fee foe Amen circuits s
. .0 APJl13CAttr . _ • 1 0 coxrACr Pop= above service or feeder fee. 6.65 .
each bond climb 8ulinest none: B. Fos: far bands ciaults t
Contact naps" Ana widow
tmm t fee. 46•55 yip. 2
Adair= ads Mal bloichcircuit % 6451 VI, 1a
- Ml tdlaneeas t eraser or leader not Iaetndedl
Each mitred or modular 90,90
awning, scrlcc .dlor fog •
rlmnc ( ) I Fad:: ( ) Reconnect ordy . , 66.85 - 2
E maib NTRAC hum or irrigation 53.40 2
. g JOR ' Sign aradlacUlatdng 53.40 2
&minas names Sear Elea*, Inc. ene rml tannin at a limbed.
or
e'tsrBy Pte. attention. or
Addrac PO 801389 amnion. Drainer~ • Paget 2
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Cityi widZIP: Demald, OR 97020 - Cob«tdIt1.rl looPool so over 1._ al w .lr.r..r,h..r�r.. Inspec 62.50 I - 1
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CCB Lie,: 209 r I t>" 7 MP 7 • 17ar.CTRICAL mum= P
Suprv. Electrician signature. required: :d: . kl ..3, 7;1 Subtwa
Print fro n 1/ J 4 $ •e ( om Q 2 R s is a maderr S12SUO saint reek 10 . 1 .42,
Authorized signorare: T PERMIT FEE �jq q2
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Print nos= Oaten days sky u ha lre• aeeephd u rnmplete.
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