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Permit f n CITY OF TIGARD ELECTRICAL PERMIT C; COMMUNITY DEVELOPMENT I Permit #: ELC2012 -00586 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 /O /p Date Issued: 10/08/2012 /2 Parcel: 2S104CD10800 Jurisdiction: Tigard Site address: 13908 SW HILLSHIRE DR Project: Greenough Subdivision: HILLSHIRE ESTATES NO 2 Lot: 149 Project Description: 2 branch circuits for (1) furnace and (1) A/C installation. 10/10/12, reprinted to add (1) additional branch circuit for freezer plug. Contractor: BEAR ELECTRIC Owner: GREENOUGH, TODDE PO BOX 389 13908 SW HILLSHIRE DR DONALD, OR 97020 PORTLAND, OR 97223 PHONE: 503 -678 -1355 PHONE: 503-807-5196 FAX: 503 - 678 -1108 FEES Quantity Description Date Amount 2 crt Branch Circuits wo /Purchase 10/08/2012 $63 60 Specifics: Service or Feeder 1 ea 12% State Surcharge - 10/08/2012 $7.63 Type of Use: SF Electrical Class of Work: ALT 1 crt Branch Circuits w /Purchase 10/10/2012 $7 42 Service or Feeder Type of Const: 0 ea 12% State Surcharge - 10/10/2012 $0 89 Occupancy Grp: Electrical Total $79 54 Required Items and Reports (Conditions) This permit is I • ■ subjec ; the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable law All work will be done in . •rdance with appro ed 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 ATT: TION, Oregon law r- :•ire• you to follow the rules adopted by the Oregon 4 4• • - • enter, Those rules are set forth in OAR 952- 001 -00 0 thro !h OAR 952 -00 • i :0 • may obtain a copy of the rules or direct questions OUNC by calling :F 87 or 1 800 332.23. Issued B : P ermitter '•nature: 'w- r f 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. OCT 07:53 Bear Electric (FRX)5036781108 P.002/002 Electrical Permit Application FOR OFFICE USE ONLY City of Tigard Datc/B : l0 /D C ,_. /, —00 Dme/Bv: III /' Permit No Phone: 503.718 13125 SW Flail Dlv Tigard Received Review .24 39 Fa x: R E C E I VED Date/13v. Other Permit: T 1 C, AKD Inspection Line: 503.639.4175 Date Keady/13y: km CA Sec Page 2 for Internet: www.ligard- or.gov OCT 1 U 2012 Notified/Method: Supplemental information TYPE / i PLAN REVIEW ❑ New construction Li Addi I �• / I. ;t I Please check all that apply (submit a seta of plans whims checked below): (1 i h . ,. ❑ Service of fccdn 400 amps or mote ❑ Building over three stories ❑ Demolition ❑ Other: where the available fault current ❑ Mann= and boatyards. CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 volts or ID Floating buildings lass m ground, or exceeds 14.000 ❑ Cmnmercral•use agricultural ❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations buildings. ❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump ❑ Installation of7S KVA or JOB SITE INFORMATION AND LOCATION ❑ Cmergeney system larger separately derived system. O MdiIon of new motor loud ol' l] "A ", E", r. - 1.7 - , Job no.: Job site address: IoOHP or more. occupancy, 0 Six or more residential unlit. ❑ Recreational vehicle parka. City /Slate/Z)P: 0 Fleallh•eare facilities. ❑ Supply voltage for stare than 11 Hazardous locations. 600 volts nominal. Suite/bldgJapt. no.: Project name: © Service or feeder 600 auras or more, Cross street/directions to job site: neeraptioa SCHED I Qty wee. 1 Teel I - New residential single- or multi -family dwelling unit. Includes attached garage. Subdivision: Lot no.: l.OD11sq, 0, or less 168.54 4 En. add'( 500 sq ft, or portion 33.92 I Tax map /parcel no.: Limited energy, residential 75.00 2 - DESCRIPTION OF 'WORK- . -.; • - - (with above aq ft), • - r L imited e nergy, m ulti•fann l y 75 00 2 • / Ik t, ed. e l! = residential (with above sq. ft.) Services or feeders ivatalladon, altcration, and/or relocation at , s to _ / -+ m i r 200 amps or less I 100.70 2 ❑ PROPERri OWNER - - - - ._. '❑ TENAN•'I' –z: _ 201 amps to 400 amps 133.56 2 Name: 401 amps to 600 umps 200.34 2 601 amps to 1,000 amps 301,04 2 Address: Over 1.000 amps ar volts 552.26 2 City/State/ZIP: Temporary services or feeders installation, alteration, and/or refutation Phone: ( ) Fax: ( ) 200 amps or less 5936 1 1 Owner installation: This installation is being muds on property that I own which is not 201 amps to 400 limps 125 2 intended for sale, lease, rent, or exchange, according to ORS 447. 449. 670, and 701. 401 amps to 599 amps 168.54 2 Owner signature: Date: Branch circuits – new, alteration, or extension, per panel ! A, Fee for branch circuits wish above service or feeder fee, - _ m : APPLI AN :- .. -. - { - - ' ❑ :CONZACr PERSON;= - each branch circuit 7.42 2 Business name: B Fee for branch circuits without service or feeder fee, first 56.18 2 Contact name: branch citcuit Each add'(baaneh circuit J, L 7,42 -1 •'k7. 2 Address: Miscellaneous (service or feeder not included) Each manufactured or modular City /State/21P: dwelling service an■i /or fend 67.84 2 Phonc: ( ) Fax: : ( ) Reconnect only 67.114 2 Pump or irrigation circle 67.84 2 E -mail: - _ Sign or outline lighting 67,84 2 - – _ . —'"' - - _CONTRACTOR _ :`.:' • _ - = Signal circuit(s) or limitcd- energy a pan el, alteration, or extension. Pa tL c 2 2 Business name: � Q Q Ges_r___Cilr's Each additional inspection over allowable in any of the above Address: 363 Additional inspection (I hr min) 66.25/ hr Clly /StaIdZIP: Sv1f7 /; investigation (I h r nun) 66.251 hr C v"l Industrial plant (I hr min) _ 78.18/ hr Phone: Lt 1 � l Fax: Ds 67'0 c�V � Inspections for which tin fee is 90.00 / hr V specif tally listcdj', hr min, CCB tic.: 7 c (� i Gt Electrical Lie.: ;� 5+ Ell,/ Suprv• Lic, 8 l c : _. _ E1:EC1RIt AI aI+RFS -�. `., :7: .1,- 1. — Subtotal: `7 , 4 Z..... Suprv. Electrician signature, required. Plan review (25 % of permit fee): Print narne:,---ls r� (� �` UJ,t a rm Dale: / w j1o/t... State surcharge orge (12% of permit fee): / TOTAL FERMI'!• FEE: Authorized signature: 1 This permit application expires it a permit Is not obtained within Print name: Date: • days after it has been accepted as complete. s t Number of mspectlons allowed per permit. I lauildtns TermitsiLLC•PermmApp.dec 07/01/10 aulsGIaTIIlleSICiuM/WNv q CITY OF TIGARD ELECTRICAL PERMIT 8 • COMMUNITY DEVELOPMENT Permit #: ELC2012 -00586 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/08/2012 Parcel: 2S104CD10800 Jurisdiction: Tigard Site address: 13908 SW HILLSHIRE DR Project: Greenough Subdivision: HILLSHIRE ESTATES NO.2 Lot: 149 Project Description: (1) furnace and (1) NC installation NC must maintain 5' side yard setback and approved rear yard setback Contractor: BEAR ELECTRIC Owner: GREENOUGH, TODDE PO BOX 389 13908 SW HILLSHIRE DR DONALD, OR 97020 PORTLAND, OR 97223 PHONE: 503 - 678 -1355 PHONE' 503 - 807 -5196 FAX: 503 - 678 -1108 FEES Quantity Description Date Amount 2 crt Branch Circuits wo /Purchase 10/08/2012 $63 60 Specifics: Service or Feeder 1 ea 12% State Surcharge - 10/08/2012 $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 OAR 952 - 001 -00 0 You may obtain a copy of the rules or direct questions to OUNC by calling 503 232 19 or 1 800 332 2344 Issued By: Permittee Signature: 0A1 A Pr/L /eA' 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 503.639.4176 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. OCT- 04- 2012(THU) 13:54 Be E CAE® (FAX)5036781108 P. 002/002 Electrical Permit Appltcat FOR OFFICE USE ONLY City of Tigard OCT 0 4 2012 Received !A Permit No . , 1111 I3125 SW Hull Blvd., Tigard, OR 9722 Plan Renew ® PL 01�a - �/ C Phone: 503,718.2439 Fax: 5 0 3 . 5 9 1 ? OF T t?n fl OilierPermtt: �� • - —GAS& TIGARD Inspection Line: 503.639.4175 /� DstcRudylBy: hue. See Page 2for Internet: www,tigard or.gov BUILDING v, v' Notifed/Mnhaf: I 0 Supplemental Information • TYPE OF WORK PLAN REVIEW ❑ New construction Addition /alteration/replacement Please chock all that apply (submit Z sets of plans w /items checked below) O Service or feeder 400 amps ormore 0 Building over :Mee works. ❑ Demolition ❑Other. w die available fault current 0 Marinas and boatyards CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. 1 and 2 dwelling less to ground, or exceeds 14,000 O Camtne eial -rase agneuIuunal y g 0 Commercial /industrial ❑ Accessory building amps fix all (titter installations, build 0 Master builder [) Other. ❑Fire pump- Olnstallationof75KVAor JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived system. O Addtttonof hew motorbad 0 "A ". "l:", "1.2 ", "1.3 ", • Job no.: Job site address.' \z q o 8 S 14, ��yA r address.' W p r0 occupancy. Six or more residential units. 0 Recreational vehicle parks. City /State/ZIP: ' 7�' ' � Q�Q Si ' L '� 7 0 Hwlth-care facilities. O Supply voltage for urns than V \ `� 1 D l laxa S rdoua locations 600 volts nominal. Suite/bldgJapt. no.: I Project name: , O Service or feeder 600 amps or mote. FEE SCHEDULE. Cross street/directions to job site: Dead atba T otv. 1 pee. I Taw 1 • New rcaidendal single- or multi - family dwelling unit Includes attached garage. Subdivision: Lot no.: 1,000 sq. fL or less 168.54 4 Ea. ndd'I 500 sq. IL or portion 33 92 1 Tax map /parcel no.: Limited energy, residential 75.00 2 _ - - DESCRIPTION OF WORK (with above sq. IL) Limited energy, multifamily 75.00 2 G 1 . ' 1 0 ( ". — residential (with above sq ft.) Services or feeder insta Wtion and/or relocation 200 amps or less 100,70 2 - - ❑ PRO_PE RTY_ OWNER 1 ❑ TzNANT 201 amps to 400 amps 13156 2 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 City/State/Zit,: Temporary services or feeders installation, alteration, and/or relocation Phone: ( ) J Fax: ( ) 200 amps or less 5936 l Owner installation: This installation is being made on property that I 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 Owner signature: Branch circuits - new, alteration, or extension, r panel sit _ Date: A. Fee for branch circuits with - . ti - i. . ' : = D A 1 T L I C A N T , ` . _ .. • I • . - 0 CONTACT PERSON _ above service or feeder fee, 7 42 2 each branch circuit Business name: U. Fee for brunch circuits without Q service or feeder fee. first , 56.18 -1 S Contact name: branch circuit Address: Each midi branch circuit % 7.42 —1-4-1—. 2 Miscellaneous (service or feeder not included) _ _ Each manufactured or unodula City/State/ZIP: dwelling, service and/or feeder 67 2 Phone: ( ) Fax: : ( ) Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 E -mail: — _ _ CONTRACTOR _ - _ Sign or outline lighting 67,84 2 . Signal circuit(s) or limitcd-cncrgy Business name: t e r 1 �; C ,n A panel, alteration, or extension. Page 2 2 �.l s� t 9 1/L� Each additional inspection over allowable in any of the above Address: 1 Additional inspection (I hr min) 66.25/ hr City/State/ZIP: r. r � S i �� � Invcstigalion (I hr min) Industrial plant (1 hr min) �ti 78.18/ hr ,181 6625/ hr hr 1 `_'�� Phone: ( ' 6 � GJ ., 47 z , l� � ff"] Fax / : 1 1 Inspections for which no fee is " I S l O t� spfically listed t h hr min) 90.00 / CCB Lic.: � tq Electrical Lic.4.j074, Suprv. Lie.: C 7 _ ; . . -- : -,-,-7 ..... „ 'TLECTRICAI: 'ERNII - * KK ='_ , -,, . ry Suprv. Electrician signature, required: Subtotal: _ Plan review (25% of permit fcc): (p� Print name: Date: �! S t ate surcharge (12% of permit fee): -- 14 ,, a . / TOTAL PERMIT FEE: AuUtori■cd signature. S This permit application expire if a permit is not obtained within 1la .e.� e8 t K A ta. Date: • days otter a has been p accepted as campkte Prins name: D[z • Number of inspections allowed e- perunt. I. 11lwtm no■t+pnta,\CLC- ramitApp.doc 07/01/10 44a-16t 5 O1/17,n:OMIWL•a