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Permit CITY OF TIGARD ELECTRICAL PERMIT 2 COMMUNITY DEVELOPMENT Permit #: ELC2012 -00148 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/16/2012 Parcel: 25111 DC04500 Jurisdiction: Tigard Site address: 9440 SW SUMMERFIELD DR Project: KREMIDAS Subdivision: SUMMERFIELD NO.7 Lot: 360 Project Description: Panel change and (1) branch circuit for gas furnace. Contractor: BEAR ELECTRIC Owner: KREMIDAS, LETITIA & TOM PO BOX 389 12297 SW CHANDLER DR DONALD, OR 97020 TIGARD, OR 97224 PHONE: 503 - 678 -1355 PHONE: FAX: 503 - 678 -1108 FEES Quantity Description Date Amount 1 ea Services or Feeders - 200 03/16/2012 $100.70 Specifics: amps or less 1 crt Branch Circuits w /Purchase 03/16/2012 $7.42 Type of Use: SF Service or Feeder Class of Work: ALT 1 ea 12% State Surcharge - 03/16/2012 $12.97 Electrical Type of Const: Occupancy Grp: Total $121.09 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 952 - 001 -0090. You may 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. • MRR 14: 03 Bear Electric (FAX)50367B1108 P. 001 /002 Electrical Permit Application] ECEIVE il FOR OFFICE, USE ONLY City of Tigard MAR r r 1 2012 13125 SW Hall Rival., Tigard, OR 97223 Pimm Review Phone: 503.7182439 Fax: 503.598.1 ,- TIGR D D aldB : OtherPamlr. T I G A I' D Inspection Line: 503.639.4175 Date Reedy/dr RI Se Pap 2 fbr Internet: www.tigard - or.gov B DIVISIO . NoifiedlMrrhod: V['- sapptemeataneformadon ........... _ TYPE OF :.WORK.............. .'7..-......- .. - TUN :REVIEW ❑ New constriction ® Addition/alteration/replacement Meese mimeck an sum apply (submit 1 sal orphan momma checked below): [] Demolition ❑Other. 0 Suvlee Or feeder amen or [Dore O BuiWhtg ova three siodes. where die available [ cwrem D Marinas and boatyards n:L; ; : ;.; - : CATECOREY.OF CONSTRUCTION 511 _ - _ exceeds 10.000 amps at 130 volts or D Floating tmildings. ® I and 2- family dwelling ❑ CommerciaU ❑ Accesso ry building g less to arownd, or exceeds 14,aoo 0 Cammcrcl l.me agm{euhund g amps for all oiber intralhirionL buildings. ❑ Multi- Gamily ❑ Mager builder 0 Other. 0 Fire pump, 0 Iuuiledon of73 KVA or - ,F ;.' 1- 7 -'' 0B•SL LDI.FORIIATIONt(11NI:a0C�'�CI.i `, . D gm` fnewm laser 1 `1-3 ". -2t'.de-ivedeyatem. — '•' "" �" • - D Aotdldom anew moans load of 0 - A ". - E'.'1 Job no.: r I Job she address: 9440 SW Summerfield Dr. 1tmHP or mole. occupancy. D Six or more maldential units. 0 Recreational vehicle yaks. City /State/ZIP: Tigard, OR. 97224 13 Health-care imailides. 0 Supply voltage fix more than - 0 oes Huard locations. 600 volts nominal. Suite/bldgJapt. no.: 1 Project name: CI Service or feeder 600 SOWS or mole. • Cross street/directions to job site: 5W x ,, . •• . , Total 7.]: , tin'. J - New residential single. or multi-famfy dwelling atilt Includes attached garage, Subdivision: I Lot no,: 1,000 sq. ft. or less 1 168.54 I 1 Ea. add'I 500 sq. R or portion 33.92 I Tax map/parcel no.: Limited energy. residential 7610 2 �c ; = ;. - _ DES 1`i0N OP W ORIC L7.1 ' " .' ,' - '"'.. ' ' (with above sq, It) Limited energy, multi- family 75.00 2 Panel change and gas furnace. residential (with above sq. ft.) - Services or feeders Irotallationotterat1on, and/or relocation 200 am or less 1 10 0.70 1 100.70 1 s4 -I;1 . O I'E[YI;Y?owF4 x-;:r , : ©, ... .. a 201 antra to 400 amps 13336 2 401 amps to 600 am 20034 2 Name: .. 601 amps to 1,000 arms 301.04 2 . Address: Over 1,000 amps or volts I 55226 2 City/S[atrILu Temporary services or feeders Imrtallattoa, alteration, and/or relocation _ Phone: ( ) I Fax ( ) 200 amps or less 59.36 1 Owner Installation: This installation is being made on property that l own which is not 201 amps to 400 amps 125.08 2 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, per pond Owner signature: , Date: a Fee for branch circuits with ' ;. above service or tbeder tax. 1 7 .42 S 0Ati ICJII!1I%-Vt ;AiiZ I ;A ' � CQU1t' ,ii;R 5 : .•: raieh branc e U cal r 7.4Z 2 Business name: It Fee for branch circuits without service or feeder fee. that 56.18 2 Contact name: _branch circuit Each add'l branch circuit I I 7.42 I 12 Address: Miscellaneous (service or feeder not Included) City /$tatrlLIP: Each manufactured or modular 67.84 2 dwdlln% servlee and/or feeder Phonc: ( ) I Fax: : ( ) Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 E -mail: Sign CH' outline lighting 67,84 • 2 g¢ : : - = - • — i CON O R - r ' = ra _ ' • , W " 4 :'t 1 S gnal eircwt(s) or limited- energy Business name: Boar Electric, Inc. panel,alteratlon , ormnrteaslmt. Papc2 _ 2 .. .. Each additional Inspection over allowable In any of the above Address: P.O. Box 389 Additional inspection (1 hr min) 66.25/ hr Investigation (I hr min) 66.23/ lo City/State!LIP: Donald. OR. 97020 lnduan'wl phmt(ihrmin) 78.1/1/ hr Phone: ( 503) 678 -1355 I Fax: ( 503) 678 -1108 " Ii spections for which no fee is specifically listed (h hr min) 90' hr CCB Lie.: 20919 I Electrical Lic.: 24 - 107'C tSuprv. Lie.: c" i i IgerRI(t; Tt. s ; Suprv. Elccu•ician siputure, required: r Stand: 108.12 _ Plan review (25 ".6 of permit fee): Print name: ot:il,Csie ^ � . lei ►ate: /15/2012 State b te suorge (12;b of permit fee): 12.97 TOTAL PERMIT FEE: 121.09 Authorized signature: This perm]/ oration cokes ire permit IS nor Oblelded Wilde 150 Print name: 1 Date: daysatteritbu sbemeeceptedsecamplete. Number of inspections allowed per perutim. clnuildinelPenmislm.C- PemeiAp .dvc mroino 440.4615111lm3,corarwea •