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Permit n CITY OF TIGARD ELECTRICAL PERMIT 114 S COMMUNITY DEVELOPMENT Permit #: ELC2013 -00101 T i G Ask D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/13/2013 Parcel: 2S104AB12300 Jurisdiction: Tigard Site address: 13150 SW BENISH ST Project: Anderson Subdivision: MORNING HILL NO.6 Lot: 152 Project Description: (2) branch circuits for new A/C Contractor: BEAR ELECTRIC Owner: ANDERSON, VICKY PO BOX 389 13150 SW BENISH DONALD, OR 97020 TIGARD, OR 97223 PHONE: 503 - 678 -1355 PHONE: FAX: 503 - 678 -1108 FEES Quantity Description Date Amount 2 crt Branch Circuits wo /Purchase 02/13/2013 $63.60 Specifics: Service or Feeder 1 ea 12% State Surcharge - 02/13/2013 $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 2- 001 -0090. You ma 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: DIJ i4 PPS 1 Cf9 -7 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. FEB- 12- 2013(TUE) 13:01 Bear Electric (FRX)5036781108 P. 001 /002 11:411%. ataI .1 vi i s n ' t ti L1 ut:74 IU11 FOR OFFICE USE ONLY City Tigard 1t "r "'''' 1 I (3 ^� /, `J of Tiard 6 ,RECEIVED Primo 1'nrmrN,. tJ'•t� ����V/ 0 / I tale 91 . 1 31'2 5 ,' 1l I tall 111.,) . I r':u,1 I lIt ,t7 -. • _ -- • II -- Mon It:, a•u Phone `tl 1,71lt.d'1 3'1 fits 511,1 398 I'7hl I Ulm l'cnm• I talc is TIGARD !I pl.el ram 1 MC 5113 1r.19 417 F 2 2013 U,ue 111. 11 :i )nr,> 0 t'Pp,e tar — ; Illternm %tV. ! trd o lI-ur.Em N,'ulied•hleth,rd 1 C p Supplemental Information rwE or w PLAN RrvIEW New construction Addilinn.ah t t N P letl>e check alt Mar apply litrhmrl 2 wls of plan> ,. Items cheeLed helot.) ❑ u.cr lee nr feeder 400 mom or More ❑ lluddml' n%Cp dote >toues ❑ Dcnmtilion ❑ Other: uhciclln available Taub coast. 0 htantu > :rid 1au1111145. - CATEGORY OF CONSTRUCTION exceeds 10,000 also a1 1 Si) wits w ❑ F hunne hvr6hnpi. ICSi to (;rormd. or c >eeedi 1.1.15111 ❑ l•immcl ink rue alnunhural Tik I. lull 2- Iamily' dwelling ❑ ('ummcrciaVindustrial ❑ Accessory building amen kw all other mstallaunns hruldr, or, ❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire puny CI of 75 KVA m I _ JOB SITE iNFORMATiON AND LOCATION O gmepeney system bred sc�rlr . 2 . taCrltYd S)14011 i ❑ Addition of new motor kW of • `_ 1001-War more. occupancy. Job no.: Job site address: v7 514 1511 bt' 1::1S11 _ M tins more 1e41dmtial units. ❑ Rceicanim al vehicle parks. C'it)' /Stlltc /'LIP: Tl "-A 09, 9 2 , � a licahh -care facilities. ©Supply tnllafe fur mine Man ❑ I larardolls locat ions. 1 volts nn Suite /bldg. /apt. no.: Pruiect name_ J tie 1 1 1ht ❑ Service no feeler non amps Of more -- ' °�C FEE SCHEDULE Cross slrecUdirect to job site: netertptlan I Qtr. I pct. I TW,l I - New residential single- or mold- family dwelling unit. Includes attached garage. Subdivision: Lot no.; 1,000 sq. It. or less 168.54 4 Fa. add'I 500 sq. f1. or portion 33 92 I Tax Wrap /parcel no.: Limited energy, residential 75.00 2 . DESCRIYi'ION OF WORK (with above sq. ft.) // Limited cncro, mule - family 75.00 2 _ � C W Klemm 1 , .t1 _1. � A rc l d ef i ers above sq. ft.) �+ Services es o f ee d ers nstallation, alien lun relocation 200 amps or less 100 70 2 Q PROPERTY OWNER j ❑ TENANT 201 amps 10400 amps 133.56 2 401 amps to 600 amps 200-34 2 Name: . 601 snips to 1,000 amps 301 04 2 Address: Over 1,000 amps or volts 552.26 2 U. Temporary services or feeders i nstallation, alteration, and/o City/State/7-1P: relocation Phone: ( ) I Fax: ( ) 200 amps or less $9.36 t 201 amps In 400 amps _ I2$.08 2 Owner installation: This installation is being made on property that I own which is not , jai amp to 599 a m ps 168.54 2 intended for sale.. lease. rent, or exchange, according to ORS 447. 449, 670, and 701. Branch circuits -new, alteration, or extension, per panel Owner si gnature: D ote: - A. Fee for branch circuits with " APPLICANT 1 0 CONTACT PERSON above service or feeder tee, . 7.42 2 each branch circuit Business name: ft. Fee for branch Circuits willow 1 'I .� - • service or feeder fee, first 1 �'• 13 2 Contact name: branch circuit 56.18 �t Each add'I branch circuit ( 7 42 1,41. 2 Address: ' Miscellaneous (service or feeder not included City/State/ZIP: Each lhanufocturcd or modular 67 2 dwcllin� service and/or feeder _ Phone: ( Fax: : ( ) Reconnect only 67.84 - 2 Pump or irrigation circle 67.84 2 E - mail: Sign or outline lighting 67.84 2 a.uts EXACTOR ._ Signal cireutt(s) or limitcd.errerty Business name: + te. LC T..-DP,... panel. alteration, or extension. Pale 2 2 f Each additional iosEeenon over atlowa_hlc (n any of the above Address: TO •sus/ 3a� Additional inspection (1 In min) 66.25/ hr Investigation (I hr min) 66.251 hr City /SlaIdGIP: ���•+L� Cl/0 • Industrial plant (I hi min) 76.18/ hr Phone: (5 0 5 , via i Fax: ( a) - 3) (,.'7 (log Inspections for which no fee is - — - specifically listed ('h hr min) 90 / hr CCB Lie.: 2 Electrical Lic -:2 -10.1C-. Suprv- Lic.: 31 ( ELECTRICAI;'PERMIT ins • . Suprv. Electrician signature, required: X / _ _ Subtotal: 1933.90 I� ` Plan review (25% of fee): Print nilme t n '� Date; 2 _ ,� 1^� 1 Slate surcharge (12% of permit fee); [ - � TOTAL PERMIT FEE: I,-, 7.. Authorized signature: _ This permii upplication expirm if o prrmit is not olriaincd within 180 Print name; Date: days after it has been accepted as complete • Number of inspections allowed per permit. lAutu■lainr \PermirrthI.c -per mil Appear 07101/10 440-46151'r 11/05,COmANFO