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Permit 1111- „ CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permtt #: ELC2012 -00449 T1GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/30/2012 Parcel: 2S112BD07000 Jurisdiction: Tigard Site address: 14709 SW 79TH AVE Project: Brittany Meadows, Lot 6 Subdivision: BRITTANY MEADOWS Lot: 6 Project Description: (1) branch circuit for optional plan with bathroom Contractor: RK ELECTRIC INC Owner: PACIFIC EVERGREEN HOMES 24495 NW OAK DR 7410 SW OLESON RD STE 133 HILLSBORO, OR 97124 PORTLAND, OR 97223 PHONE: 503 - 640 -1344 PHONE: 503 - 664 - 6423 FAX: 503 - 356 -0513 FEES Quantity Description Date Amount 1 crt Branch Circuits wo /Purchase 07/30/2012 $56.18 Specifics: Service or Feeder 1 ea 12% State Surcharge - 07/30/2012 $6.74 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $62.92 Required items and Reports (Conditions) • This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through OAR 952 -001 -0 90. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: Cl Permittee Signature: Q// / / /C OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease or rent. OWNER'S SIGNATURE / Date: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC' Date: LICENSE NO. Call 603.639.4176 by 7:00 a.m. for the next available inspection date. This permit card shall be kept in a conspicuous place on the Job site until completion of the project. Approved plans are required on the Job site at the time of each Inspection. Jul 31 2012 9:22RM HP LRSERJET FAX 5033560513 p.2 07/31/2012 10 :05 5835981960 CITY OF TIGARD PAGE 01/01 Etectr rmit Anolicati s `�elaaartt����'" ! j� � � � I ,, ,i.: , •n I I. I 1 •.I ; CAI \ �l r d A, 1 3W Sfa11 Tiapld,OA 97223/UL a 2 ��� ' .v => ' .iSI t _ b y Pnvllt No, ., ,_, r.�� k Photos 503.7112439 Fitt: 103.59$.1960 P Rama OrtiirpemriR 1n/paetion Lint: 561 694.4173 R '' r l . , 5 .y r: yy s Me www.Npnrd•or.g,ov _ 11p. ,� � 4,t . -; ' au - :v kn !dr H Pas t etmW „ ' N OW COG or • • . '% I r, tt 4,.,r. ® • �`k17�! t • d construction ® Additionteheradnokeplacetocnt J Memo risk tl1 MO apply Wane I tau or , e -.7r'-' r_,... ): O amotteop p Oth J 31 201 08 ., knee 400emptat 0 tl,didlna over throoeoortts. whee the amIltblo Ault cumin 0 Merenea sad bahqirk unoogit or mvotv (lrrd a rr • anodr 1o,030 mine p 90 vottt m O t beitel a d , Wile priunll, or owwod. 14,000 0 Otermn:td•uw la 1• and 2 dwelling Q Commerclalrodust,<ial � "� aFtwtaaat a Multi-fienli ° Vt' i IIS O O F � fit eon uptowns. b �ttd � D Master builder • . >> �• _ v puma O Ieandledon of 71 KVA or r10g .S1'f7f,, ' ,. - lfiDbi AM '1tn�Oi • D lnddlliml of mot nioralned t a°tdy de,;rwlpaum. Or 0''A•` °E'. "1.1°,•1.1 ". lob no Job sire Wren: i ■ ' 7140 , I001fP ar Ann, ammo. - •� - •. • G Bit it MVO rIl iel tune. 0 Reaauonai %V icty pafte. City/State/ZIP: 1 1 ,,1 Olt.- 9 2 . 7 . 1 1 a theddmIte emilkiu, © ®nroh whip rbr more thin Otlmrdoor tocisamt. 600 vow eaaua, SuitalbldSJapl. no,: Project rune: O rne:fi &WS OSorvieo feeder aDnenerormoro. Crass etroedldirectlon6 to Job aitc `' ' . FZ ICIIED[1L7;' . New reaidenIIal steels. or multalmlly dwealalp unit. Inelnden attoehed Sta nikWaion: 6 OCCM1411 ,P7 ,1wt tot no.: & i.000 rq, A. or toe U t6a,s4 ME Tax m •� MOT no„ 4, WI 500 M. A. Of • • Mon 3192 La • • ahwrgy, rettdtntl © ' D . I Or von: tbabive... , 73.00 — 1 s7�1CS1� t�fa $Art' !� limbo! I "� "' >y n. 76.00 2 Scrotum ar Orden - inn Alterattagjtnd/or relocated 200 a � or Ma 100.70 2 + aeon owns w mA1rT 201 amps to 400 map 193,56 � Name: 401 mot to CO amps 200.34 eaCSIMmaggeelf 641 • • • to 1,000 ampu 301,04 Address: 7 0!!C7 .51.4, t�C 1 5coo./ I2-0 5 "" 1 paw 4000 asps Orvoha = CttylStete»tl': P, i en. ef 7 Z2 T l o cati a* r car or ro eleta lax • ' eon, allele , • .,1 •, reloation Phone: ( - • , 1 _ ('0/.112- Fent: ( ) 200 o e or lap MN 59.16 _ El Owner lnafallatlont ibis Installation is being made on properly that 1 own which In not 701 amps 10 4011 amps 125A$ _ intended fbr sale, lease, rent, or anchovy, according to ORS 447, 449, 670, and 701. 401 waste 99 mops 166 .11 ; rand clreu ,, . new elaeratlmt •. : -n , nalon OWrror alQnatute: putt:: A. tae Ru btaeah tau et why El • , • :IS ' *II'PI.9t.ANT . ' :' I. . 0.' comma. pilaw • • ebovean a ttriar e' Re. -:, bfeocbcirc satinet's Mac: pig Chi. £ l p �, �i ) I_.. _ . , 110 for brooch *ante to w&Ao it K . LA r++ f�f,F tankage hadar ka Are 4 r r branch of S6.l$ Contact mew Ac, ht2 V Each slit' wench nettle 7,4T Sw °� '"� l /33 Whin Nu (stn rvlea Inertia � Add1e: lqi City/State/MP: 1 L„AN'p 4 '? -Z 3 Eoc mow Anna or madalar 67.54 — wellh, terrine mdkr Rider M II OM: (503) ._ . G Z•3 F :: ( ) Reco n ett only IN 67.114 E] E-mail: _ % /I .. Jiff!, - i' Pump or Irrigation CIt5 01,64 El o ,. �� a Si • n at twtl1ne11ghtfng 67,x4 manna . Si ii• eittu (tllr limit • •energy ( Business Home: R K 1 y C , t • L pmr1. &tcmtia, orcetaneioe. � © Address: ..t'7 S s t et. ntthscans, ,:.;1. ,.n • . al.. able In n. . the above Additional imncbtion(I hr min) 66.25/ hr C'ity/State/Z,1P: 1,1..‘ 116 L,oro U R c .y l • lavaltlaeaoa 1 hr min) 661!1 hr rM - 1 Industrial plant (1 to N M MIIII VONbr MIME Mom 6 (73 - ( o L4o . - , (3 44 1 s aw + DS . +J' lMp00hers for whlrh no ... It C 00.00/ hr II CB Litt Of L i -2 7 5` E(eeMcnt Lie.: — 3 7S a Sorry. Lis: 1 2 -6"" -r- • , 9uprv, Electrician signature, required; 0.7 I F, . !print nonce 1Z 0 h L. 4 1-2- Slaty surcharge (12% of permit Am); Authorised signature; owl leg tot .` TOTAL MOW FEE; Thb permit dpllanae u aspire iifaaomlitG.ytofi aid I.5'. Print namc Ron . I. 4i' 1- Dec: 31 • Nolnbtrnrtn �nn wcn bees steeped n so estoprala n.wna aomonnnl.e.r.r.i„ph. owl hp 4411 .4015T(itr0tM.0MARyp , •