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Permit CITY OF TIGARD ELECTRICAL PERMIT 2 COMMUNITY DEVELOPMENT Permit a: ELC2012 -00217 T [ G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/17/2012 Parcel: 2S103DB10600 Jurisdiction: Tigard Site address: 13225 SW GENESIS LP Project: LUKEY Subdivision: GENESIS NO.3 Lot: 69 Project Description: (4) branch circuits for mechanical work. Contractor: BEAR ELECTRIC Owner: LUKEY, GLENN W & KATHERINE R PO BOX 389 13225 SW GENESIS LP DONALD, OR 97020 TIGARD, OR 97223 PHONE: 503 - 678 -1355 PHONE: FAX: 503 - 678 -1108 FEES Quantity Description Date Amount 4 al Branch Circuits wo /Purchase 04 /17/2012 $78.44 Specifics: Service or Feeder 1 ea 12% State Surcharge - 04/17/2012 $9.41 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $87.85 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: /AO 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. RPR- 12- 2012(THU) 12:35 Bear Electric (FRX)5036781108 P. 001 /002 Electrical Permit Applicatiog FOR OFFICE USE ONLY City of Tigard , APR 12 2012 of k l ® � — M. : 13125 SW Hall Blvd., Tigard, OR 97 Man Review Other remit: Phone: 5033182439 Fax: 503.39 i la Se Page 2 for I O F TIGA D ate Rea dy/Br TIGARD lM Inspection Line: inc: 5 03.639.4,d173 �� Internet: www.tigard•or,gov BUILDING DIVISION Nodreddhad: R suppummi -0°° ?[53dE 01t:;WORK:.': . . •• - • - • PLr1 7d;.RENJEfiV,.,:1:1.:':.:i •e.:r:r�iC. • -.. ❑ New construction ® Addition/alteration/replacement ]'feu china an u,n, =ply (submit I Sets orphan Wawa checked below): 0 Service or 1leder 400 amps or more 0 Building over three s s, torie ❑ Demolition El Other: where the available Gault current 0 Marinas end boatyards. R = �::: ` : GT&GORY'OF.= 'CONSIRUCAOI!T - ;;••=::. :- ' '' - :: exceeds 10,000 amps at 110 volts or 0 Doming buildings, lea to ground. or exceeds 14,000 0 Commercial•use agricottumf IT 1 and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building amps far ell outer installation,, buildings, ❑ Multi - family ❑ Master builder 0 Other. ❑ Piro pump. 0 iratallmfoa of75 KVA or _ _ ::.. • 0 Emergency system. larger separately derived system - .. -:,_ JOb SCYE7NFl1RMA1'lON AND6LOCA710N ;: 0 Addition of new motor toad of 0 'A ". "E~. "1- 2". "1-3 ". Job no.: ` Job site address: 13225 SW Gonesis Lp. 100HP or more, occupancy. I ❑ Six or more residential units. 0 Reereedrend vehicle perks. City /State/ZIP: Tigard, OR. 97223 ❑Healtlresre facilities. ❑ Supply voltage for more than ❑ Hazardous locations. GAO volts nominal. Suitc/bldgJapL no.: l Project name: ❑ Service or feeder 600 amps or meta. Cross street/directions to job site: , nw wt a ow. I se.. J Pia. 1 TLM i • New residential Angle- or muttl- family dwelling unit. Indadca attached prage. Subdivision: f Lot no.: 1.000 sq. it or lees 169.54 4 En. add•I 500 sq. n or portion 33.92 I Tax map /parcel no.: _cz-•,:.•;. ,r. : , : rte.. -;..: '.."DES OIV OIMWO1 k'r'°=.. L"."'.v�,5:f.c .. _.. Ln( wlho ho vve s q.f 75.00 Y • t -..= � ... - = - = - Unified enerty. multi-family Hook up A/C, service outlet, gas furnace, and electronic air cleaner. residential (with above so. n) 75'00 2 Services or feeders installation alteration, and/or relocation 200 romps or less 100.70 2 - " 1z p :< 201 amps 10 400 amps 133.56 2 ..'':�' -�I oe �2l�tl '' fir• >�as�..- "v� =. �i= �•r��= �..: Name: 401 amps to 600 amps 200.34 2 601 amps to 1.000 amps 301.04 2 Address: Over 1.000 amps or volts 552.26 2 Ciry /State ,,, Temporary services or feeders installation. alteration. and/or _relocation Phone: ( ) Fax: ( ) 200 amps or less 59,36 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125,09 2 intended for sale. lease, rent, or exchange. according to ORS 447, 449. and 701. 401 amps to 599 arms 16854 2 Branch circuits — new, alteration, or extenston, tier panel Owner signature: . _ Date: _ A. Fee for branch Circuits wfih - °'' , ' . 11 'r; ' ©I . 1 P$R50DC: ' ,b_? above ervice or feeder ire, 7 as ❑F u Is o ' CO Ci A2 2 each branch ci rcuit Business name: B, Fec for brunch circuits wirhmu service or feeder fee. fiat 1 56.19 56.18 2 Contact name: branch circuit Each add'I branch circuit 3 7.42 22.26 2 Address: Miscellaneous (service or feeler not included , Each mime factored or modular 67.84 2 Ciry /State/Z1P: dwelling, service and/or feeder Phone: ( ) Fax: : ( ) Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 E-mail: Signor outline lighting 67.84 2 ''= .x' eAgl : : ;l CO) CEORiI»•2 '�: _ T :T:: '1, t Sigtnal Clreull(s) or limitedencvgy Bu;tiness name; Bear Electric, Inc. land, atterlrtion, or extension. ( Page 2 2 Each additional Inspection over allowable to any of the abov Address: P.O. Box 389 Additional inspection(( hr min) 6625/ hr Investigation (I hr min) 66.25/ hr Ciry /State/Z1P: Donald. OR. 97020 Industrial plant (1 hr min) 78.18/ hr Phone: (503) 678 -1355 I Fax: (503) 678 -1108 Inspections liar which no fee is 90.00/ hr spccifeally listed (! hr mitt) CCB Lie.: 20919 Electrical Lie.: 24 I Suprv. Lie.: 4881 S : W?` W' a dC glithaTIOUSW4.7 s sir'] Suprv. Electrician signature, required: —1 subtotal: 78.44 _. _ _. Plan review (25% of permit fee): Print name: Stephen Shophord . l Date: 4/12/12 State surcharge (12% of permit fee): 9.41 Authorized signature: TOTAL PERMIT FEE; 87,85 - This permit impanel= spire if a permit In oat obtained within I80 days Olen It has been accepted as complete. Print name: 1 Dale: • Number of inspections allowed par peroun. . LWuildingWarmiya LC- PerniLApp.doe 0mmn /no 44o460T(f /COMawa!a