Permit A CITY OF TIGARQ � ELECTRICAL PERMIT
PERMIT #: ELC2005 -00348
DEVELOPMENT SERVICES DATE ISSUED: 5/23/2005
I - ' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S133DB-11000
SITE ADDRESS: 13380 SW SUMMERWOOD DR ZONING: R -25
SUBDIVISION: SCHOLLS FERRY ROAD TOWNHOMES' LOT : 036 JURISDICTION: TIG
Project Description: 2 branch ciruits. AC and GFCI.
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:
HANUSKA, JUDITH M HEBERLE ELECTRIC
13380 SW SUMMERWOOD DR 7456 SW BASELINE RD #414
TIGARD, OR 97223 HILLSBORO, OR 97123
Phone: 503 - 590 -6223 Phone: 503 - 628 -2095
FEES Reg #: SUP 3053S
tion Date Amount EL 34-160C
Description ELE 34 -160C
[ELPRMT] ELC Permit 5/23/2005 $53.50
[TAX] 8% State Surcharge 5/23/2005 $4.28 REQUIRED ITEMS AND REPORTS
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 -:•s '- 332 -2344.
Issued By: Air _ ii _ � Permittee Signature: e)/1_
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.
ri 05/08/2005 20:58 5036283076 HEBERLE ELECTRIC INC PAGE 01
a FOR OFFICE USE ()NIA'
Electrical Permit 4 # # f i 'cm .
— ...e _ .r. - Received , ,, Electrical I ,
- - - - -
9----.4, ! D Dale/13. ,-, „ at .41 Permit No.: _! _•,.__„ - OC.1 3 qs/
Planning A rove! Sign
City of l'igard
Date/fly: Permit No.:
3 125 SW Hall Blvd. MAY 3 204 Plan Review Other —_-.-______.
Tigard. Oregon 97223 Dot t : Permit No.: _
Phone: 503-639-4171 Fax: 503-50019m TI ,,,;„,,,.0.,,v, Post-Review Land Use
Date/By: Case No.:
intenict: www.ei.tigard.or.us BUILDING D I, :IL' :AI' Contact !Ng o See Page 2 for --
24-hour Inspection Request. 503-639-4175 -.'"-- --" Name/Melhod: • - Su !mental Information.
TYPE OF WORK . ..
, PLAN REVIEW (PlensLcheck all that apply)
New constniction
i I bemolition
Addition/altcration/re laccmcnt • (1 tiler: ....... Service 225 amps-
commercial Lilleallh-care fcility
a
El Hazardous 'creation
1:1 Service over 320 amps-rating if 0 liuiltling over 10,(100 square feet.
CATEGORY OF CONSTRUCT ON I & 2 family dwellings four or mitre residential units in
...
l& 2-Family dwelling J • Commerial/Industrial Cl %Vein ilVer 600 volts nominal one struellitre
Er Building Over three stories 0 Feeder& 4 00 siliPS or more
• Accessory Buildin , il Multi-Fahlily 0 Occupant load over 99 persist's 0 Manufactured Structures (yr RV park
., .
• Master Builder Other: 0 Egress/lighting plan 0 Other ..._.. ...._
JOB SITE INFORMATION mod LOCATION! Submit _ sets or plans with any of t above.
s above arc not a likable to tem to construction service.
Job sae Iddr . ecs (3,
.._.._.... _.1.....-;.... . 7 A€C 0 . 1 51e.;._eS44it•tetinfIMIV__ 7.,. - FEE* SCHEDULE
Slide II: IiIti -. A2Aptii: Number of inspections per penult allowed
___,
Project._ Name: _14 41,44., Description Qty ' ' Fee Oa.) Tout n
NA. residential-single or ruuld-fandly per
Cross strcet/IIireetions to job site:
Servi Included:
loathed garage.
1000 ft or less 145,15 4 .
Each additional 500 aq A. or )101 lila cor 33.40 I
--------- - ' • ' '-- — - • - "" -- ----- - ' -- 7 - _,;" --- Limited enclgy. residential 75.00
Stibdivi51011: 1-01 ii: _,___.
._._. Limited via . rtgylt resiskntial 75.110 .•
_. _
Tax map/parcel it: • Fitch manufactured home or modular dwelling
DESC rrioN OF WORK . ' service and/or feeder
• Services or feeders - installation,
r ha. VnIll- alteration or relocation:
,
— --
A ilki 200 amps or less 80,30 2
_________ _
201 1alT 4 Ani g 106,85 2
—_...._ _. ..- —
401 amps to 600 amps 60.60 2
K:0 __Y OWNER IN TENANT . • 601 art______ s trp_1_000 am 1 240,60 2
Name 4,7 ...3%,.‘v• t-nir . „ w , Over 1000 anteir volts
. Reconnect only 454.65 2
66.85 2 - _ ......_,..... -. -
Address: Temporary services or feeders - installation,
— alteration, or relocation;
City/State/Zip:
200 am or less _ 46.85 l
•
Phone: 41,0.747.,g3, I7ax: 201 amps to 400 mnpe„„ 100.30 - 2
• _ 401111 600 am 3 133.75
__I:LtipPLICANT " •0" PERSO r letults - new. alteration, or . .
Name: PLEASE FAX HE : u extension r panel:
Address: - TO 503-628-307$ A. Fee O tt ch circuits with purchase of
s . feeder fee, each branch circuit 6.65 7
CiiViSiale./Zip: .... I of 'Valid Cif CO; without cam or
.........
service or feeder fcc, ust bench circuit
-
Plionc: rizax: _ .,,, Each additional brancEcircuit ----- -.-- - - 6.65 /III '1 2
•
E-mail: ir Misc,(Serviee or feeder not included):
• • CONTRACTOR • - • - . . _ Ra_stp ump a irrigation circle 53.40 2
' ' Eaeluiltsor outline %tins_ 5140 7
Job No:
Si eircukto or a limited covey panel,
7450
_Alteration or extension .„ _ l'Age 2 2 - Business Name : '
_tiElitt BASE .E.7.. P.n .. _,...... Description:
Address: LIN
., •
C'ity/StaTei 411"3°R"tirrt23- — Each additional Inspection over the allowable litany of the above:
— -
I boor) _ 62..50_
1110 11C: ' 4f 2 tg• Z123 Fax 4:) Z.F.- - S 4 ?7 6. tow:51406ml fee:
....____ , ..
CCB Lie. th (5 ,_ I-ic- ll: aq - 1 4p 0 --
Electrical Permit Fees* .
.§ui7Cr;ising cleciricilTit • ---- ---
subTotar 5
Plan Review (25% of Permit Fes" -:$-... -•-- --
..-7.40._
Print Name:JE % 'Lei Lie. #: - 3n 5" _ state Surcharge (8% of Permit I $ ,*
„,_____.
IOTA I, PERMIT FEE . - iir.." ;1 7,* 7
Authorized
NoTi perrnit applic.lion es Iresii a permit rs' not obtained whit u
Signature: '', -.Alf' ." -- • 1701e. ..6 Z.3" 5 ."..--
....____ • ._. • _ -- 180 days after It has heen accepted s emnpletc. a.- air -7 .-1 g
•
• Fee methodology set by Tel-Conroy uthling industry Service Road.
' ..!.e.__
( 5P"..42- f(9.
._ .. ..
—ear---
411 ..- - Pie . arm)
i:Wsts \P 1 ermit ; -.1 \ 7 . atAppc .
loc 01/03 ..
.
CITY OF TIGARD v'(t.GS_cwZ-
BUILDING DIVISION ` PERMIT #: ELC20000348
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5r23J2005
Phone: (503) 639 -4171 ��'I1'
Inspection Requests (24 Hrs.): (503) 639 -4175 �'I I..
INSPECTION WORKSHEET FOR DATE: 9,22,7005 TIME: 7:12AM PAGE: 67
SITE ADDRESS: CLASS OF WORK:
13380 SW SUMMERWOOD DR
SUBDIVISION: LOT #• : TYPE OF USE:
PROJECT NAME: SCHOLLS FERRY ROAD TOWNHOMES 036
DESCRIPTION: HANUSKA
2 branch ciruits. AC and GFCI.
OWNER: HANUSKA, JUDITH M PHONE #: 503 - 590 -6223
CONTRACTOR: HEBERLE ELECTRIC PHONE #: 503.628-2095
Inspection Request Scheduled For: Date: 9/ 22/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Mess- •e
199 Electrical final 016347 -01 503 - 830 -0719 N
Corrections /Comments /Instructions: .
v
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ C FO ,; TION ADDITIONAL FEE ASSESSED
Inspector: Date: 7 )-'le_5 Phone #: (503) 7180 ).%