Permit CITY OF TIGARD ELECTRICAL PERMIT
1 , 1
PERMIT #: ELC2009 -00083
COMMUNITY DEVELOPMENT DATE ISSUED: 2/26/2009
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 110 B A - 06200
SITE ADDRESS: 14230 SW VISTA VIEW CT ZONING: R -
SUBDIVISION: SHADOW HILLS NO. 2 LOT : 045 JURISDICTION: TIG
PROJECT: SWANSON
Project Description: Install (2) branch circuits.
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:
LOWELL SWANSON HEBERLE ELECTRIC
14230 SW VISTA VIEW CT 29012 SW EGGER RD.
TIGARD, OR 97223 HILLSBORO, OR 97123
Phone: 503 - 684 -3445 Contact #: PRI 503 - 628 -2095
FAX 503 - 628 -3076
FEES
Description Date Amount Reg #: ELE 34 -160C
[ELPRMT] ELC Permit 2/26/2009 $53.50 LIC 152342
[TAX] 12% State Surchar 2/26/2009 $6.42 SUP 3053S
Total $59.92 REQUIRED ITEMS AND REPORTS
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: Q. 6\a` n _ Q Permittee Signature: 1 Q II `
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.
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• a 0241°/2009 14: 45 50362 : E irm,j3 HEBERLE ELECTRIC INC PAGE 01
Electrical Permit Application ��ED I t ilt i i t , It, I" ()\ I .ti
City of Tigard FE B 2 6 2 0 09 ed hemltNo, . s - pp • �
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13125 SW Hall Blvd., Ti aid, 0R 9 ! '4.
t3 •. 4 ®F TIGARD Review Other Permit.
Phone: 503.639.4171 Fax: 503.i � �� Dam/D
� ; , ;. Inspection Line: 503.639.4175 • I 'N�' DIVre /Me thod: keit ® �are a mint totnrmeNon 2 for
Internet: www.tigtud- or•gov
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❑ New construction WE Addition /aheration/r'eplacernent Please cheek all that apply (submit j sea of plans w /seams checked belotrt)
0 Service or feeder 400 amps or more CI Building over three smites,
❑ Demolition ❑ Ot her: where the avellable fault tuners 0 Marinas and hoetyarda.
• * ' r y l g0 .' .'' • . exceeds 10.000 amps at 150 vas or ❑ Floating buildings.
l ..hi,-,,,;":".1'
I dwelling Commercial/industrial Accessory building kiss to ground. or exceeds 14,000 ❑ ge ldings l•use seriwlturel
Vi.. and 2 fbmi l) ng ❑ ❑ ry g amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: D Fire pump El Installation of 75 KKVA nr
, � y 1 '' A -, D Emergency system. larger separately derived system.
„ . iti `f - ' D Addtuen of now motor load of D "A• . P , "1.2" "I,3"
t 4 , Cf - , t r 1m4P m more. -7_ -- occupancy. no.: Job site address: s / W v 11 vi
Psis or more rcsidontiel units, 0 Recreational vehicle Dinka,
City /State /ZIP: ' "7 2 L c- c-- n Health -taro facilities. ❑ Supply voltage for mere than
❑ 1heardnes locations. 600 volts normnal.
Suite /bldg. /apt. no.: Project name: <j Sr) D Service or fiteder 610 snipe or more
Cross street/directions to job site: — �/ � e
(o �"-- 4�—'4� „eea.itN,wn �. �•� "rat *
New residential single- or multi - family dwelling unit.
includes attached sera e.
Subdivision: Lot no.: 1,000 sq. t. or Toss 145.15 4
- - Ea. Ea. add'1500 sq. ft. or portion 33.40 1
Tax map/parcel no.:
Limited energy, residential
with ove
k, �' , `'' • ' ='J o
' IV; l(*�ti' IK ., .' ' ; r' ; -' ' � , • ( ab ae. . 75.00 2
_ _ (� � �� � - i , c l � , residential d— L imited energy, (with a b ov tnily 75.00 2
V • t � 0�� tlal (th a eq. A J _
--- 117 , - 3 C b t' (J r 1 c cr E _ - a4 -e� ,A� Services or feeders instaAatloa and/or relocation
1 200 amps or less g0.96 2 _
9E' ... "�0 it it , +lf 11'1'1', 201 amps to 400 amps 106.8 2
Name: 6f,-(7 1 � IQ E ' J, -s t 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City /State /ZIP: Temporary services or feeders installation, alteration, and /or
-e' relocation
Phone: ( ) i -- if .[Fax; ( ) 200 amps or less 66.85 1
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 ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Owner signature: Date:
Branch circuits - new alteration, or extcualon der panel
A. Fee for branch circuits with
1' *4'API <;N'I',',.r'' : . ' . c, ACT',p above service or feeder fee, 6,65 2
each branch circuit
Business name: - J ' �16 B. Fee for branch circuits „�'"
Co tact name: - ' S0 s ` ,� •
_ apor service or feeder fee, ` first branch circuit 46 85 1 , i c � 2
Address: 1 _ ' Each add'! branch circuit 1 6.65 J (o• e ' 2 —
!�� Miscellaneous (service or feeder not included)
City/Star e a T P. Each manufactured or modular
dwelling, service and /or feeder 90.90 2
Phone: ( ) I Fax:: ( ) Reconnect only 66.85 2
E -mail:
_ Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
Business name: Neberla )Electric, Inc. - Signal circuit(s) or limited-
energy panel, alteration, or
Address: 29012 SW Egger Rd extension. Describe: Page 2 2
City/State/ZIP; Hillsboro, OR 97123 Each additional inspection over allowable in an of the above
Phone: (503) 628 -2091 Per inspection 62.50
( ) Fax: (503) 628 -307 Investigation per hour CI hr min) _ 62.50
CCB Lic.: 152342 Electrical Lie.: 34 -160C Suprv. Lic:: 3053 -S industrial plant per hour 73.75
Suprv. Electrician signature, require. ` 1Blli t ,,
Subtotal: f "
Print name: Jeffrey L. Heberle A Da .. 2, ' Jb 'Q Plan review (25% of permit fee): --- Stare surcharge (12�yof permit fee): (0 j, q
Authorized signature: TOTAL PERMIT FEB: 'g , 9 7
Print name: Date: This permit application cxpiree If a permit is not obtained within 180
days after It has been eftep6ed as complete. p
f. VinildingtPemtin6 $_PuarrdtApp,epe tai ° Number of inspections allowed per permit 7 �'
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