Loading...
Permit C ITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2003 -00520 � �� �� DEVELOPMENT II Tigard. 97223 (503) 639 -4171 DATE ISSUED: 8/19/03 PARCEL: 2S103CD -07100 SITE ADDRESS: 13890 SW 118TH CT SUBDIVISION: CREEKSIDE PARK ZONING: R-4.5 BLOCK: LOT : 002 JURISDICTION: TIG Project Description: A/C and GFCI outlet 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: 1 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: GROVER, JERRY AND JUDY M HEBERLE ELECTRIC 13890 SW 118TH CT 19680 SW NEUGEBAUER RD TIGARD, OR 97223 HILLSBORO, OR 97123 Phone: 503 - 684 - 1809 Phone: 503 - 628 - 2095 Reg #: SUP 3053S LIC 152342 FEES ELE 34 -160C Description Date Amount Required Inspections [ELPRMT] ELC Permit 8/19/03 $53.50 [TAX] 8% State Tax 8/19/03 $4.28 Elect'I Final Total $57.78 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 -001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699 or 1- 800 - 332 -2344. Issued By: Permit Signature: iii %, 22 OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: DATE: LICENSE NO: Call 639 -4175 by 7:00pm for an inspection the next business day .08/1012003 16:16 5036283076 HEBERLE ELECTRIC PAGE 01 Q E! ec tx • i c a 1 P ermit Ap plication . Mit 01:11(11_18E tiNLV Date/ 131cctticnl � Q Datc/By: Permit No. :?i -a-,P3 -o�Soj • • - City of Tigard Planning Approval Sign Permit No.: 13125 SW Hall Blvd. AUb I B 20113 Plan Review Other Tigard, Oregon 97223 Date/13y: _ . _ " . Permit No.: • • - Plfone: 503-639-4171 Pa Post - Review Lend Use • 1�Q$ "l sri' 11,i1\ Date/13_ Case No.: Internet: www.ci.tigard.o DIVISION a +,` IA 11 • Contact lurk., i ® See Page 2 for 24 -hour inspection Reque ' . -� -4175 Name /Method: I S_�u .piemental Information. __ _ : , ; .TYI'iGClx",woRc,r ' ;,�lr,..... �'.�,,,�����::�,r.._�,:,. ,, T,.. a,. �,. 1' r> AK1 zEYl1JW .. r1e�s+1;'l:lieckAllt.ltatiii• ;1" , ...:..:a °:.::� JJ New construction f Demolition ■ Service over 225 amps- N ilcahh -care facility - -- commercial 0 i- iazardous location Addition/alteration/re lacemcnt Other: I ❑ Service over 320 amps- rating of CI Building over 10,000 square fact. ,•,t ~ ' ;:•••.:,''''', ',CCATIGORY OF'CONSTItUCTIONt ' ' 5 ,;!1', "`r ' + ;;!':i 1 & 2 family dwellings four or more residential units in ' 1 & 2- Falnily dwelling 0 Commercial/Industrial ❑ System over 600 voile nominal one structure ❑ Building over three stories ❑ Feeders, 400 amps or more Accessory Building ❑ Multi - Family ❑ Occupant load over 99 persons 1111 Manufactured structures or RV park Master Builder ❑ Other: ❑ Egress/lighting plan U Other;_, r � y; .,�� , .�+, submit_ sct5 of plans with 0117 of the shove. ' ' JOB SITE IN litid:IjOCATIO • ;i u:, ., } l Job siteaddress: ��Q - Ski -Y JAB `4'� G'� The above are not n likable to tern 'mar consl l Suite 11: Bld ./A t. #: lion service. 4 - �1'i'Z Number of ins tedious ' euerntit allowed Project Name: beseri ition am FreOm) moot - Cross street/Directions to job site: New residential -single Or multi-family per - �. Is -- Z dwelling unit. Includes attached garage. Service included: 1000 a.. il. or less 145.15 • Each additional 500 sq. ft., or portion thereof 33.40 in Limited energy, residential E ... 75.00 © Subdivision: Lot >'t: Limited energy, non residential IMI 75.00 In 'I aX inap parcel #: finch rnnnurtnchued home or modular dwelling r , , 7:... i 7o,.r, (! i 4r 'ial i service and /or Services or feeders - Installation, feeder 90.90 "' `' "' ; " `' , e � C � .. f.. "� `; ‘2 12....... alteration or relocation: 200 am T : or Icss 80.30 . - 201 am,ato 400am.. 106.85 401 amps to 600 amps 1 160.60 • ,., . , � °•� r: e , n ' r t:r : 5 . l q� 4 6 01 stn 'to 1 000 am 240.60 i l�xo >><rrx o nlux:: '. TEN � ;� . , i tt,i , p 48x65 C � p � .C ,� � � ()vcr 1000 arms or volts Name: �,1 nom • Reconnect onl 66.85 Address: Temporary services or feeders - Installation, alteration, or relocatlon? City /State /7ipp: . • • 200 tuts or less 66 -85 Phone: / C' _ k,� J -. FaX: 201 to amps 600 400 amo 100.30 t® „ , 401 to 600 am s 133.75 0 /A0/APPLICANT , : y ::. ' `''. •;':`` 1 , .: ■ :G.ON,'1''4hd..,.'iI ItSCjl Branch circuits - new, alteration, or Name: extension per panel: A. pee for branch circuits with purchase of Address: service or feeder fee each branch circuit 6,65 (Mitt' /Sftlte /�.il): - 13. Pee for branch circuits without purchase of service or feeder fee brat branch circuit 46.85 WS / P11o11C: 1 Fax: Each additional branch circuit • 6.05 ll )L -mail: MIsc.(Servicc or feeder not included): Y q , ' "'I,G? 0:` , pf . t! :. 4,11 . 4 , . .., i4• Each . or irri • , lion circle 53.40 2 ; :A:: ::i'4" it.�th Y .. CONTE.A.C's V �i�uili '�• ,, c ' , Poch s or out li ghting . 53.40 2 Job No: Signal circuits) or a limited energy panel, Business Name: scri HEBERLE ELECTRIC, INC. D e oryoreictcnsioa Pa, e2 2 Ik�criplion: Address: 19680 SW NEUGEBAUER RD. _ ; - � Cit /State /Zi.1 ) HILLSBORO,OR 971 Inch additionalIns ectionovertheallowablehian of the above: Per inspection per hour (min. 1 floor) Phone: 503-628— 2 0 9 5 Fax; 503 . —628-3076 _ lnvestigntion fee: Mm other: CC13 tic. # :15 2 3 4 2 Lie. #: 3 4 —16 0 C 1 ;i ;;:' ''' ,i: ,E Otf c 1 '.0 :Ii. lt I'eirs. r.':1 ,., ,., � . i, Supervising electrician Subtotal $ .4• 5'V signature required: Plan Review 25% of Permit Fee S 1'rinL Name: Jeffrey L. 1 Lie. # : 3053 —S State Surchar (.8 P om Bii. S ..5 — 7 FIEBERLE TOTAL Atithoriz ( ' J Not ice:: Thls permit applicati c:r If a permit is not obtained within Signature: .f' . Date: _ O '0� 180 days after Kills been accepted as complete. ter- _ *Pee methodology set.by 'I'd- County Building industry Service Board. ease print name) I • i:16." r. t milt Po . u cPermitApp.doc 01/03 • . CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received 2 Date Requested O � AM PM BUP Location /3 VW) Suite 3- OO so( Contact Person Ph ( ) PLM F Contractor Ph ( ) < 0 - 3g SWR BUILDING Tenant/Owner EL 3- ©D 5 Footing o lg`f 1 g0 Q Foundation Access: ELC Ftg Drain ELR Crawl Drain • Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing t, V-' ,14 `- b� ) Fire wall (� Fire Sprinkler l� l G Fire Alarm Susp'd Ceiling Other: C bti L , �, I `r ► C ._ � \4J Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final �3_4 S PART FAIL ), ) v , 1IIIECHANA eam ,e__, Rough -In Gas Line Sm. a Dampers T FAIL ECTRI7 S ce ou h- UG/Slab � j Low Voltage fyI V Fir larm I , 'Final PASS PART IL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SITE ❑ Please call for reinsp: ction RE: ❑ Unable to inspect - no access Fire Supply Line ADA _ Q • Approach/Sidewalk Date Inspe • r t _ Fad Other: Final DO NOT REMOVE this inspection record from the o site. PASS PART FAIL