Permit ;, -. CITY OF TIGARD ELECTRICAL PERMIT
Ii
:! . :' C COMMUNITY DEVELOPMENT Permit #: ELC2010 -00166
13125 S W Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 04/14/2010
TIGARD 9 Parcel: 25101 BC01800
Jurisdiction: Tigard
Site address: 12490 SW KNOLL DR
Subdivision: TIGARDIA TERRACE Lot: 5
Project: Beaudoin
Project Description: (1) branch circuit for furnace
Owner: FEES
BEAUDOIN, MICHAEL Quantity Description Date Amount
12490 SW KNOLL DR
TIGARD, OR 97223 1 crt Branch Circuits 04/14/2010 $56.18
wo /Purchase Service or
PHONE: 503 - 620 -4586 Feeder
1 ea 12% State Surcharge - 04/14/2010 $6.74
Electrical
Contractor:
HEBERLE ELECTRIC
29012 SW EGGER RD.
HILLSBORO, OR 97123
PHONE: 503 - 628 -2095
FAX: 503 - 628 -3076
Type of Use: SF
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 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: Permittee Signature: C /'✓ 6j / OL / criz
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 an inspection that business day.
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.
•
04/12/2010 15:20 5036283076 HEBERLE ELECTRIC INC PAGE 01 - � ^ • ` .a 4 i ` ., x • 14 1;(')R (tl "Itl I SI:: ) :N ti_.� ., .i et w
Electrical Permit ApRlication _ - - v Alit it>ot • tea, to t .
_ City REC� ILF-7' m_ �, )? itNa.� .a. /i —L9 /6OIG
�� d�i of Tigard i ,I � Z� /0 �� .
r , 13 125 9W tin)1 Blvd., Tigard, OR 97223 pion • ;ow either Permit:
k !I Phone: 503.639.4171 'Fax: 503.598.1.960 Datd13 • Alrtia: • � . 1•nAc 2 -
t? �t n . onyA3y: for
t # Inspection 503.639.4175 APR 1 2 1 Rd Sr iementalInlbrrmation
3iii `r Werner: www.tigard "or,gov • lied/Method: rep
ITFE OF wow _ ..
0 New construction Jg�Addition/alncralion /r please cheek annuli apply (snbrttit Rers of plans w cha ke4 below):
❑ Service or feeder 400 amps or Moro ❑ &Wing over throe steno.
p Demolition 0 Other: - � wham the available fault current ❑ Marinas And boatyards.
^' CATEGORY 'OF : ctpr peri N exceeds 10.000 amps nt 150 volts or El Floating buildings.
toss to ground, or meads 14,000 ❑ Commorcinl -use ogriouhnml
And 2- family dwelling 0 Commercial /industrial ❑ Accessory building " amps for all other installations. buildings,
0 Multifamily ❑ Master builder ❑ Other: � �� 0 Piro pump. ❑ Installation of 75 KVAor
_ —_ ❑ Emergency Promo. Wiser scparntcly derived irritant.
VOB. $I1 E t ())!t'111A�1''TON ANT) .LLICAT)CIC)l!1 ❑ /kldition of new motor load or 0 A • "l
- — ( L 4 � � i / � �! .,.•
10011P tn
P or i Recreational Job no.: TJ s it e address; , � perks.
residential Q ❑ Six or mere residential unite, ❑ Recrcarianal vehialo Pa
City /Slate /ZIP: '� 1 'Z�,' Li Haahh.cnrc facilities. ❑ Supply voltage for more than
.._. ❑ Elnznrdrnra taentiouu. 600 volts nominal.
Suite/bldg. /Apt. no,: Project name: r p n • re, or
ervtoo or feeder n
Cross gfiCCt/dirCCti9118 to job site: t -1---- An.cn lion L.Q1I,,,J, -- Pea, -
° -- - --°---- New residential single- or multi- family dwelling unit.
includes attached ,,v taste.
Subdivision: — -� - ��„ ^ __ _ 1 Lot no.: " Y 1,000 sq. ft. or loss w " 168.54 4
- So udtl'I 500 sq, ft. or portion - 33,92 1
no': Limited energy, residential
M - -- _. _ . Q 67.84 2 ll Tax lnAp /patti a DESC. `RRWTXKl1V' Of WORT _ jwith Above a . ft,)
_�.. � t { -- __,C,. invited energy, multi - family .67.84 1 •
residential Willi shove S,. ft. •
Serviecs - nr focdrra Installation, operation and /or rolocatlo
ut...
200 amps ar less 100.70 -M � Is
T�' .owliE � TENAN'T' 201 amps to 400 amps —,J 133.56 -- Ill
Name: t �-1�4 401 am to 600 nsn s 200,34
TfTL' t ", 4 a� _ I P
' ss: � - � �_ ....-- _ -_._�— 601 am s to 1.000 amps I. 301.04
Address: - ..
e - Over amps nr volts 552,26
City /State /ZIP: Temporary services or feeders tnstaihninn, Alteration, And/or
_ 4 relocation _
Phone, ( ) - Fare: ( ) 200 amps or less 59,36 ' 1
Owner installation: This installation is being made on property that 1 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
/ranch circuits -- new alteration or extension cr and
Owner sifirtAtllro: - _,__ Date: A. r''c for branch circuits with
0 .A;k?I'I�1CAN)C CONTACT .PERSON M � shov service or feeder fee. 7 " }2 ■
" each branch circuit
- Business name; f "^ �- R Fee for branch circuits
� � - wldmat servioo or feeder fee,
56.18 ,p VY • Contact name- / ,,'�rp ' first branch circuit •
Address: f ~ 1 ` �N T A- T sell ndd'1 branch circuit 7.47. 2
" - 1 - - • ---- Mltcollaneoua (service or feeder not included)
city /State/7_TP: Each manufactured or modular
.._. _ • ,---' i
Phone: m ", -.
( ) Fax' ' ( ) dwelling, service and/or fccdar 67' 2
___ _
Reconnect only - 67,84 2
E - mail ; ~ Purnp or irrigation circle 67.84 .2
O[}Ni'RAICTOR:. 7 " - -...,_
-, Sign or outline 1iglttin " 2
--- 67.84
Business name: HEBERLE ELECTRIC, INC - Signal eitnuit(a) or limited-
—'""- _ ,. ._.,,..- „,"., energy panel, alteration, or
Address: 29012 SW EGGER RI) extension. Describe: Page 2 2
..
City /State /ZIP: HiLLSBORO OR 97123 Each additional Inapeetion over allowable In any of the above
" Per inspection 66.25
Phone; (503) 628-2095 Fax: (503) 678 17tS investiga[itm er hour ([ hr min) 66.25
CCBLic,: )52342 V Electrical = -l60C Suprv,Lic,: 3Q53 -S Industrial plant 78.18
Suprv. Electrician signature, required: ♦ ' ' FEES, . name: JEFFREY .. �/
= - at e: �- T _ Pb ( Subtotal; -.
Pr I. O
.. 1 7. 5 %s of p ermit fee ): —.
Print T Y C. HEBER r'� , awes st,r r
- -- rgc (2% ot'parmt fee) - 7
T•Auth(>tizod signature: TOTAL PER'MI1T FEE: r .
Print. name JEFFREY L. HEBERL t ii Date: pits permit appllcntion expires If a permit Is not ni - mord within ISO /
,.. dnya after It h bum accented bu accented as entnpinte, ✓
Number of inspactione wad par permit, '7 Z
r a sh didine∎PermItrAELC- ParmliApp,dnn 10/01/09 MSO tlflv )M/R'F.n