Permit CITY OF TIGARD ELECTRICAL PERMIT
11 • COMMUNITY DEVELOPMENT Permit #: ELC2012 -00564
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/27/2012
Parcel: 1 S133AD08100
Jurisdiction: Tigard
Site address: 12850 SW CHICORY CT
Project: Beyer Subdivision: AMART SUMMER LAKE Lot: 125
Project Description: (2) branch circuits to replace defective FPE service panel and GFU to existing plugs in kitchen and garage and (1)
200 amps or less
Contractor: HEBERLE ELECTRIC Owner: BEYER, JULIE
29012 SW EGGER RD. 12850 SW CHICORY CT
HILLSBORO, OR 97123 TIGARD, OR 97223
PHONE: 503 - 628 -2095 PHONE: 503 442 -6395
FAX: 503 - 628 -3076
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 09/27/2012 $100.70
Specifics: amps or less
1 ea 12% State Surcharge - 09/27/2012 $13.86
Type of Use: SF Electrical
Class of Work: ALT 2 crt Branch Circuits w /Purchase 09/27/2012 $14.84
Service or Feeder
Type of Const:
Occupancy Grp:
Total $129.40
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 9 2 01 -0090. You Att may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987
' I ~" 00 � 19877 or 1.800.332.2344.
�)
Issued By: . Permittee Signature: o&.( 4 )ud
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.
C0 503.639.4175 by 7:00 a.m. for the next available inspection date.
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.
09/26/2012 20:25 5036283076 ��," BERLE ELECTRIC INC PAGE 01
''''''Z''''''Z'' �
ti Metrical Permit Applicati0 halt nf1 Ir'f; Ilvl; ()NIX
City of Tigard``" F l Permi No,;
oat q t3.7 � l�- S. 6" -- ...; 101 -[S6
13125 SW Hall Blvd., Tigard, OR 97223 n Plen Review
` R ' r.'honc: 503.718.2439 Fox: 503.598.1960 C1 ! pply f Ur - } } 17breBV; Ocher Permit:
l' I f. •h i+ t i Inspection Line: 503.639,4) 75 3UILotf /; r p��s • � Read tv�; 21 , e ' See Page 2 for
Internet: www,tigard•or.gov L� \' l i_ otfied/Mcthod: ' [ C I �D Supplemcecel Information
z ,7, �j��}`7,'�� ,ry }�',•,,� �,.�`"_7T ��jyn � •rvrrr r A m�5n,!f,�pq�;�
1r+ .`' =T ..I
... y::.�6.r. a. i � vP t l Qc f•*K::t l�l }HtS.ri'W a::,n�ti, �:tl1'A7k"A.'�L:;Y1'Y.6t+ Pl I C4rir.:, �.FY7174£3"l��IE'.) "1 �. �E.�c r. t. 1`1',,.t•.
Please cheek n that t whims 6 ..
Q New construction To • ddition /alteration /replacement apply 3 sots of below):
D Service or feeder 400
❑ Demolition 0 Other: amps or more ID Building over three stones.
i _ r; where the nvailabte fault current ❑ Meriraro end boatyards.
4�9r . . : Y1�k ri ,4n'�t, E . ,-.... - :_.., p. Sn volts or ❑ F10atingE
..' y '�'� 1 �,,};.r• c •`.' •,:,.• ��.��" ''' exceeds 10,OOpam amps I niJdingc,
G�`" ��' leas to ground, or eaceeds 14.000 ❑ Commenter-wee agricultural
and 2- family dwelling 1:1 Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
Multi - family ❑ Master builder 0 Other: ❑ Fire pump. D Installation of 75 KVA or
^ ° a w At� r; r�; °, �. . El Emergency system. hut= aratel derived em,
e r •'hti ` . °4 ?. ; . s�x:.+ r> `• , ❑Addition of new motor load of ❑ "F" "I.2" "I -]'
A 4st, , W/ c4•tcK.raA -" '40.4.„ Ix or Of
o te resi mote, Recreation.
Job no.. Job site address: (Z
e �l � Cl - Six or more units. ❑ Recreational vehicle parka.
lrlty /State/ZiP: --ti _. , g .T. � ( T' CI
facilities, ❑ Supply voltage for more than
❑ Heentetous locations. 600 volts nominal.
Suite/bldg. /apt. no.; Project name: (icj.r GR. ❑ Service or feeder 600 amps or more.
• Cross street/directions �. `'•.a= .+"�zs.c ...,
ens to job site; � y.: ,ton w: n b, , :: 1.2 4,. '4.
ton .0. No. 7. •
V.--S C. C.C.S ...... . r New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.' 1,000 aq. ft, or less 168.54 4
Tax map /parcel no.: En. add'I 500 sq. ft, or portion 33.92 1
ME ,j- ,- __ • Limited energy. residential
! ,.t' irlv�CO:" L . I '+:'uri s " ti ti ^ ' '�! '�- c With above s ) 75,00 2
;7 GQ - _ I� c p/ /� Li m i t multi - family.
75.00 2
♦�✓d V - (�'nr L � G f 6 1..Xy� rear•ett4 (with above SO. lt.)
"� ti-vi Services or ceders installed. alteradon nd /or relocation
eTT7 ^"u caafrt e4 i-vi. eiv 1' X00.70
�s --„s Z C7�•t � .. , or l ess � E.ar c'� - F,a -.. ", n "hti;" ewer' �(rN r .: ; ' , t'' ,' ''' • '7 201 amps to 400 amp % - 133, 56 lam
Name: i �� 401 amps to 600 amps In 200.34 ��
zj 601 amps to 3,000 amps 301,04 el
Address; — Over 1,000 amps or volts 552.26 2
City /State/ZIP: Temporary services or feeders installation. alteration, and /or
1'/' relocation
Phone: ( ) ^ `4 —/ ' t ' 'rFall: ( ) 200 amps or less 59.36 I
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 intended for sale, lease, rent, or exchange, according to ORS 447.449, 670, and 701. 401 amps to 599 amps 16854 [ 22
Owner signature: Da Branch circuits - new, alteration, or extenslo,, r panel
1:1 ^ - "1,%..
, -• tier� , ;.carry a s '' � A. Fee for branch circuits with
';- 9:�rtrrc -' "' +;� y
i , ; ' ., r ••S:K�.
x g.' s Date:
above service or feeder fee, 7.42 2
Business oriole: each branch circuit
c B. Fee for branch circuits without ✓
Contact name; , '� 0. service or feeder fa, first
branch circuit 56.18 • 2
Address: Ga� �Q Each add'I branch circuit Z_ 7.42 14, Tit
14 ^` Miscellaneous service or feeder not Included _ City/State /ATP: �1�1 Each manufactured or modular
dwelling, service and/or feeder 67.84 2
Phone:( ) _ Fax: ;(
Reconnect only II 67.84
E -mail:
Purhp or Irrigation circle
67.84 '
+ .:yYr,Rm:',< .: , , ':ia ° .. 1..e , , Li3� 67.84 si or outline lighting
RUSinesy name: Heberle Electric, A1nC s ig nalc ir cu it (s)orlimited•energy I
---` Ranc1, Alteration, or extension. Page Z 1111111
Address: 29012 SW Egger Rd Each additional inspection over allowable in an of the above
. Additional inspection (1 hr min) 66.25/ hr
City/State/ZIP: Hillsboro /OR/97123 investigation (1 hr min)
66.25/ h►
Phone: (503) 628 -2095 Industrial plant (I hr min) 78.18/ hr
` q t Fax; (503) 628 -3076 Inspections for whie q p fe is
CCB Lie.: 152342 '1 `x I Electrical Lie.; 34 -160C Suprv, Li c.. 30535 �,
, �rr �itica listed 6hrmin 9 0.00 hi'
p il
Suprv. Electrician signature, r + " ? ...� a!� ;_ 1' iii. y�;�irrr�� 1,C 7.,
8 required: A .t�'3 -
�.I►'���� Subtotal;
Print name: Jeffrey L. Heberle 11111111 — Plan review (25% of • mil fee): 1
State surcharge (1 2°6 of permit fee): V3.,
Authorized signature TOTAL, PERMIT FEE: itg
> rint name: This permlt appUwtioa es p l ra 11 a permlt not obtained within ISO
-
Date: 4 days after it Tres been accepted as complete.
Per li iFJ , C • P enrtitnpp,eee 07AIIF0 Number of inspectio allowed per 1 �q ' 4-to
uwn4n r permit. —. 1
440.46 r 5rt r n /05 /COMAV .