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Permit
CITY OF TIGARD ELECTRICAL PERMIT 111 1- COMMUNITY DEVELOPMENT Permit #: ELC2009 -00209 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/11/2009 Parcel: 2S111CC04700 Jurisdiction: Tigard Site address: 15970 SW CENTURY OAK CIR Subdivision: Lot: 0 Project: Butler Project Description: Install/ alter (5) branch circuits for garage door outlet, light switches, and microwave. Owner: FEES HARROLD, ROSEMARY A DORAN TRUST Quantity Description Date Amount 15440 S LEN RD OREGON CITY, OR 97045 5 crt Branch Circuits 05/11/2009 $73.45 wo /Purchase Service or PHONE: Feeder 1 ea 12% State Surcharge - 05/11/2009 $8.81 Contractor: Electrical 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 $82.26 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 - 0000100. You may obtain \ a copy of the rules or direct questions to OUNC by calling 6.6699 or 1.800.332.2344. I Issued By: � .I�Q Isl Permittee Signature: 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. a ' 05/06/2009 09:41 5036283076 HEBERLE ELECTRIC INC PAGE 01 a E Iec_ .t�'1CaI M'er' 1�Dp�lcatltl>i RI ` von. (ii i.1( t t' t'. t�M1 t-� w ° t City of Tigard Received a S , (Q • 4 - -.4 1'erntitNo,; C l C-ZOOR - Q 6 9 DmeB : _. f q 13125 SW Hall Blvd., Tittprd, OR 97223 MAY 0 6 2009 Plan Review Other Permit: Phone: 503.639.4171 Fax: 503.598.1960 Data/13v; Inspection line: 503.639,4175 Dp 1lnad 9cc Page Z for i :' i �' CI TY OF TIGARD Notitied/Mo . supplemental Information Internet. www tigard- or.gov t o '' r''''' ! r(rn u,„ F ' n 4t I , ,s" 1 � > h ; 1 1" „'ip, ;,∎: " q• , i p t � e , vn a r�"'A' ,,71'7'.' ' " r , i ) f 1l 1 �� a e X1',4 1 v1 ,' ' , 7 }' { ; I S'� • < 1'1 • ' , e: v 41 , E t .;' r 'ffi 1 a ,, r I" a vl •., 4'', +1•,,.. a n�' u ID New eonatruction L, Addition /alteration /replacement Please check alt that apply (submit +oqt of plans w /itattra ahookcd below); ©sarviao or feeder 400 amps or more I Building over three stories. IDernolition ❑ Other: where rho svaiteble fault currant ❑ Marine Red boatyards. 1v „' q :,I % +^ „ t, 1 N p r7 fi fl li' ',' ' ;ji exceeds 10,000 amps ntl50 volts or l�Floating buildings. 1, 1'1 '.. ,1 "Jrf 1 :ri ' '� %' +F '' ' ; I! I rUf M a: M I' M CAI Mi1C , , F I .: , t +v , } q,; • loss to ground, or oxceedv 14,000 ❑ Cnmmeraiel - use aRricotttsrel P 1 - and 2-family dwelling ❑ Commercial /industrial ❑ Accessory building amps far all other installations. buildings. © Multi - family D Master builder © Other: 0 Fire pump. 0 Inatallation of 75 KVA or aoxm w ynavNw r ,>Hmra;y�' , o, , n °r 1 ,' r ,,,' ; .., ; �. . © Emergency system- larger separately derived system. „u', 1 1 i' Ir M ii ; i l li ,. 'i "x , sl tl r. ti; 4 '�, l e t I a 7%t's e...lt aii ( ; #1,j'iG : f , ', r ,v�ysl�a��ro��aecin,�' 8s�t .�mt , 12 Addition of new motor load of ©• •'F• "1 "1-3", Job no.: Job site address: ( -7p Cf- t { CIP 10013P or more. ❑ Recreational vehicle parks. ❑ Six or more rosidantial units, , City /State/ZIP: ""C'�,�D q -7 _ -� ❑ 14aaIt -taro facilities. 0 Supply voltage for more than 0 Hazardous location,, 600 volts nominal. Suite/bldg. /apt no.: I Project name: ( i 0 Service o j r fender 600 snips or non. .,, Cross street /directions to job site: - -j + j ---"1j`7 D.,,,,.. qt Iras, 'rani New residential single- or multl -family dwelling *snit. Includes attached garage+. Subdivision: Lot no.; 1,000 sq, ft, or less 145,13 Mil - - Ea. add'l S00 sq. f. or portion 33,40 Taxruap /parcc) no,; 1, entice a /iJ :, nl,,.y „c '' l ',h i i ii 4 p'C,i y i ^icl'.'fr'ji �T�{ �!(., . kl '17(:.., p; �:� �;, r ,. �,., lmittld energy, residential 75,00 { ,I xyn , nV I : 11 p ,itiii f17d1 qd 0, 01 t: d ;. y t7 ill' I` ( withahWe 4 f1. gli �� . �� ZA c r 1 Limited ent ial with above a. , ft %/" ((ems residential weh above s r , ft, 75.00 NM 2 �, C a ' 1- 1g �, . „ Services or feeders Installation, alteratirm and/or roloentlnn r t w� t� 1•t.* , ;ZOO Amps or less 80,30 2 i 7 ''►,�„ a a , ^, ,, 1 u �y I i�. , ' r 1 , -•i li l irl I p ' 201 a I m to 400 ' r " " ?;h'. ... >� : : ' ;, , • ' �'o.L,,, �� ,� ps amps 106.85 2 Name: \M , , . } ki (2� L" ___ 401 Felipe to 600 amps 160.60 2 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454,65 2 City /State/ZIP: Temporary services nr feeders trurtnilatlon, alteration, ead/opr relliteatten Phone: ( ) bps ''_ 4 ti E i Fax: ( ) .._ 200 amps or less 66.85 1 T Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to OILS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2 Owner signature: p ate; Branch dreatts -ne alter or extension, per panel n A. Pee for branch circuits with . N i 1 `'`'�,'` ,f' n S 1�, 1 dh, rl ,��. y 9 ae , �'l fa4,�` r,.,. . � �• r +l,{ �- +R 1 ,,1� d •'t t 0 1, ,,IVs . .«,.1 ^.ni „ice ,t a ' " Au W 1 � w.:,;�,l .', r `, above service or fonder f e, 1 e arm 1�1�af ,'• ! each branch circuit G.65 2 Business name: ' B, Foe for branch circuits tvl /hnl LSe ' ice or faad4r fcc, 46.85 ''f 4, n 2 • Contact name: first branch circuit Address., ' to. = Each odd'] branch circuit /!li 6.65 mann 1 . e Ml,ceilanootts (service or feeder pat included City/State/ZIP: � PN tn Each ltnufhotured or modular Mg0.90 dwollil service and/or feeder �� Phone: ( ) . _ . .. Fax:: ( ) Reconnect only 66 - 85 -I E - hail: Pump or irrigation circle 53.40 2 '� 'r'�lii °'i'�i;l',Ir hh,, '`' ?'s`�'•ai ;"fakC'r! ,:P1, "; I,tl' f� , ',r. '�s`•'i',. : ✓. „. •:•Ir""""' ,,, l.'; + •••Y . ', t ;' i�I:6A4 i. , i .,,��1 } 6 °: `''; I S} .lei ` ` n1 , ,r.� _ � •, �� ',i'`,':r�a,),llT9;�1) „ r, 1!.,, ,!;"Yra""dl.��� e1!;iii:i;i a;O:ddihT ;irm nl'i ti ..., Si or outline lighting 53.40 2 Business name: f'leberle Electric, Inc. Signal cirouit(s) or limited- energy panel, alteration, or Address: Heb rle I cxtcnsitxt. Describe: Page 2 2 Ciry /State/ZIP: ; t r j Qt ' - f '. 1 Each additional ins coiner over allowable In an of the above - Phone: ( ) H]Il } �iiQ /� f� ro, OR 97 c' , (- ) Per inspection 62,50 T.eVestigation per hour (1 hrmin) 62,50 �� CCB Lie.: I,,''67:64 Electrical Lic.: - gLi _ 1 j 0 r . Lic. ; 105 - Industrial planet ypyer hour 73.75 -- . - Snprv. Electrician signature, p1K + , ri ,a r; ?''i�;.'S:4' 1 1 M Fib` �...: l9 1 :t." 1i, 0 , i;'I required: .9 % ; . ' e f 4 d l:' �,. ,{ i -rat. Subtotal ,. Print name ;..e : !M.. _cr-liffl Date: --,4_, _, _, Plan review (25% otpennit fee): State ourelnrge ( 12 5 4 o f permit foe); I Author'ind Signature: - • • TOTAL PERMIT FF-,F: 1'i Print name: Date: nib, permit application ,spires if a permit is not obtained within left day,, after ft hes been accepted as complete. I:lDnildieg\parrnItattlI.iS Pmmftl pp doe 01/29 • , -,,, * Number of inspections allowed er permit, Z C /+ /'� _ � T2 1 , c e't"� I I L j a- � 4 •