Permit CITY TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00393
DEVELOPMENT SERVICES DATE ISSUED: 6/8/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 103CD - 07000
SITE ADDRESS: 13930 SW 118TH CT ZONING: R - 4.5
SUBDIVISION: CREEKSIDE PARK LOT : 001 JURISDICTION: TIG
Project Description: AC & GFI plug.
•
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL /PANEL:
MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
KAMBERGER, ANNE C HEBERLE ELECTRIC
13930 SW 118TH COURT 7456 SW BASELINE RD #414
TIGARD, OR 97223 HILLSBORO, OR 97123
Phone: 503 - 684 -2725 Phone: 503 - 628 -2095
FEES Reg #: SUP 3053S
tion Date Amount EL 14
Description ELE 34 - 160C
[ELPRMT] ELC Permit 6/8/2005 $46.85
[TAX] 8% State Surcharge 6/8/2005 $3.75 REQUIRED ITEMS AND REPORTS
Total $50.60
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws.
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 than 180 days. ATTENTION: Oregon law requires you to follow 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 copies of these rules or direct questions to OUNC at
503 - 246 -6699 or 1- 344.
Issued By: At_ �. /��_ / 1 L Permittee Signature: 09,-1 G2ft? C' 7.0 /Y■
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'N: 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.
1 06/08/2005 10:16 5036283076 HEBERLE ELECTRIC INC PAGE 01
1'1:)11 t)F1'I('1'. i:5t: C)VL1'
Electrical P L j, . 'a t , i 11 • ca t- ion Received ry g Electrical l
p er • _, I_. 1 , . i_,.. . f i)ntcli3y: V / /o) D . Permit No.: i. � , • �j - Ot?73 Z
„ Tigard Planning Aprr�v Sign —
City of 7 ig _ nate/I;y: Permit No.:
1 3125 SW Halt Mvd. JUN 8 2005 Plan Review Other
Tigard, Oregon 97223 bate: Permit No.: --
Phone: 503 -639 -4171 CFY 'YS(3� ,9 9 Post- Review • Land use
� < " .. !.► 1" t ry bate /D Case No.: _
Internet: www.ei.tig i' S �] - . } c +�i Contact Luria.: See Page 2 for ^ •
24 -hour inspection R .t. / 'ff.. - yis � Name /Method: ''r Supplemental information.
_ __ TYPE OF WORK PLAN REVIEW (Please check 01 Di at apply) w _
ii N _ c w _ construction Demolition . ❑ Service over 225 amps. I lenith -cnrc facilit
igj commercial E l Ila'aldous location
replacement t Other:
- p , ['service aver 320 annps raldndt 0. El Building over 10,MX) square. feel,
- - CATEGORY OF CONSTRUCTION 1 & 2 family dwellings four or mote residential units in
y Q System over btlfl volts n ominal one structure
1. I & 2 [ an�ily dwcl Commerc
0 Building over three clin Q Feeders. 400 amps nr mote
• Accessory Building . _ 0 Multi- family ,3333 _- „� U Occupant load over 99 persons ❑ Manufactured structures or itV park
Master Builder , D Other: ' ❑ Egress/lighting plan 0 Other: _- ..__......_..--.--..--
- - JOB SITE INFORMATION and LOCH ON Suhmir _ sets of plans with any of the above. ,
. - - •• - .,... - - - -- — — T he above are not ap licable to temporary construction sgry ice.
Job site add, ePs. W _ �t _ Ci'r- FEE° SCIi>[:13Ul
- .
SLlite il: _.. .. 1 .;CI 3 r7 lild '. /A 1.11" Number of inspections er ['Inuit n allowed
...33.3.3 . .. .._ ..- �' - - -. �? ___..__....��...,,_._.. ---- -- � c• (co4 loin r
I'rojcc.t Name: UDescription Vty 1
_ ._--- 33.. -- - , ._ . ..__. -._. -� ` - _�.._,.�.w New residential - single or multi - family per t
• Cross street/Directions to job Site: dwelling unit. Includes attached garage. •
CD '''' Service In or des
IOW sy, rt. or less _ - _ - _ i as.15 , 4
Each additional 5(0 sq ouortion Meicof _ , _ 13A0 - - I
.: • Subdlvtsittrl: mnC
ld,I cr�yareit,_, •-..... ,...,_.
�, l.�oi. 11: 3. ............,....,..,.. ,_ ... :75-Q0 .,.......
--- ..- .....- -... - • • - -- -- - - - - - - - -- - Limilea Energy,, IMO residential 75 Iii
,t
Tax map /parcel //: Fitch manufactured home or modular dwelling
DES RII''1'ION OF WORK _service "' feeder 90 ,
Servksi or (ceders - lnsUllaiMn,
—_ ^'- _. ,..... , ..... alterarina or relocation:
2110 tram o,' Ieeg , . _� --- - _ . _.. 80.30 _ _ 2
--.-- - - - ,.._. -- 201 amps to 400 amps 106.85 2
401 amps to 600 amps _ - _ 160.60 2
PROPERT - NER TENANT 601 aims to 1000 argFs 3 ___ - __ _ ..1 )40.60 _._ .�2
° "" ^' ^ Over 1000 amps or volts 454.65 2
Nainc Reconnect only 66,86 2
_... ......,......_.. . ._._ ._ .33.3..3._.._. -,...
Address: , services or feeders - installation,
. - — — alicratian, or relocation:
C i t y� S tae /Zi 1: r � 200 amps orlt s _ - -- 66.85 t
Phone ( 'l'ax: _ zoi.amps I. don. r�+c _ ----- - -. - -- - -- 140.30 l
401 to 600 one 133.75
0 APPLICANT CONTACT PERSON
! �-± ,.._,..._. _ -..�
.. .. Branch circuits - new_ alteration, or '
Name: extension per panel:
Address: - - - -- A. Fee for branch circuits with Purchase of
__.........._ service or feeder lee, eaclr branch circuit
C /Slalc /ZI ): 13. Fec for branch circuits witbol it.nuir 1447,6-57-.
�
t Manch circuit pf
i
-� _.. .....:.. ... ..... ..... I _
!at 46.85 _ _2
Phone: lax: � ..._ .. ,,.. -- - ... - -- _ ire.
_ -----•--- -- _ ^y V - Each additional branch circuit 6.65 2
E -mail: ;
Misc.(Service or feeder not included):
• CONTRACTOR Each pumpar in�i atiuncircic T..,......... -.-., .... 53,40 ._.�.,_� 2
^ ^ °,•, , -•�,•� ' ' " Each sign or outline li IItiR 53,40 2
Job No: Signal elrcuit(s) or a Iimiled energy panel,
- -- -- .3......3.....3.3...... - - ... -- -- - - - --
Busmess Name: alteration or cRlcnsion
iga .. EIS > ,g, c P�Ill1 ` t4 ....._,...�,a
Address: 7466 8W B NE I)cac riptio n;
C:it /State/Zi • l•-acI) additional Inspection over_1bc allowable In Any of the � above: -_ -_
y _. - - -__ _ _,_^ _-_._...., Per inspection per Mtn (min. 1 hour) 62.50
Iitonc: E• z ; . -- Fax: &, S'G1.. Invc - 7de , _ litigation : :.... .-- -•- -----_..._
f'C13 Lie. _
I O ' C.,_. ou,e,: _ --
is (SZ 3�! Lie. It: -3 � ....,...I_�... ' Electrical Permit Fees* —
Supervising electrician lilikk Subtotal Si na S ___ __ _
ure re t u Plan Review . _ t.�
.,. . �. -_ - •� 1 ired — - - _ .... -�' - -- — t (z5 "/o of I'crmit f �ec S
Print Name;..? "�' • i I ie. • ft . j " -j- °� State Surc (8% of Permit Fc)
- 3333 TOTAL, PERMIT FEE $
Authorized .. .. . .__.._ - --
¢ Notice: This permit application expires If a permit in na1 a r within
Signature, -`! _ -__ • _ . Oate( / t Ro days after tl has been accepted as complete.
• gee dotogy set by TA- County Rnitdi I Seance: hoard.
tile:. arnc) ... �
i:\L)sta \pcnnit . \.` titApp.duc 01/03 _
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005 -00393
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/8 /2005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7/12/2005 TIME: 7:06AM PAGE: 75
SITE ADDRESS: 13930 SW 118TH CT CLASS OF WORK:
SUBDIVISION: CREEKSIDE PARK LOT #: 001 TYPE OF USE:
PROJECT NAME: KAMBERGER
DESCRIPTION: AC & GFI plug.
OWNER: KAMBERGER, ANNE C, PHONE #: 503 -684 -2725
CONTRACTOR: HEBERLE ELECTRIC PHONE #: 503- 628 =2095
Inspection Request Scheduled For: Date: 7/12/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 011185 -01 503. 830-0719 N
Corrections /Comments /Instructions:
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P - S C: 1Z c .' 7 '--'-- i o S
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4-/c, p, IcCo S AvAAP Fus-
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I) PAS PARTIAL APPROVAL ❑ CANCEL ACCESS
I01ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED yiNO
Inspector: D - 6 Z ° "Phone #: (503) 718 -