Permit CITY OF TIGARD
ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2010 -00287
Date Issued: 06/15/2010
TEGARD, 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 1S133CD16700
rt
Jurisdiction: Tigard
Site address: 13845 SW ASHBURY LN
Subdivision: PEBBLECREEK NO. 3 Lot: 57
Project: Hudson
Project Description: (2) branch circuits for bathroom remodel.
Owner: FEES
HUDSON, MARTIN L & H SUE Quantity Description Date Amount
13845 SW ASHBURY LN
TIGARD, OR 97223 2 crt Branch Circuits 06/15/2010 $63.60
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 06/15/2010 $7.63
Electrical
Contractor:
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 $71.23
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- 001 -0100. You may obtain a co les or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: ��� y — Permittee Signature: 40'
t■119.
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.
CaII 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.
06/11/2010 09:09 5036283076 HEBERLE ELECTRIC INC PAGE 01
T 1_A- L r� L— J
El lcct 'ca Permit Aeplication I, (,nz ‚‚ I.: l !,, I (.). ■
City of Tigard ', `...; D R :i vat l • ID _ P
{ I) n1o/ H i Pe rmitMo.: (,,�''�1r)�.tkpi 7
1 ,1 n 13125 SW Hall Blvd., Tigard, OR 972 3 ° '' ' - pi R aviow - - 1 zcs
' PI: • Phone: 503.639.4171 • Fax 503.598.1960 Date/By; Other ?omit P u ' to� �l� —001e:1'1
r i 1 :: A R11 Inspection Line: 503.639.4175 JUN 1 1 2010 Date Rcndy - ` Intl: RI Sot Page 2 far
Internet: www.tigard-cr.gov Netifiu/Mcthod; - StrpplementalInfArmatlom
❑ New construction Addition/elicit LlC{i aPflike s G! ry - , :' ° , Please cheek all that apply (submit 2 sets of plans w /stems checked below).
❑ DCmOIi lio ❑ Other: 0 Service or feeder 400 amps or more 0 Building over three sttxlas.
- _ where the available fault current El Marines and bontynrds.
:'.' p ;?J)II' ►' 1� C'M " I i . exceeds I0,000 amps et 150 volts or ❑ Floating buildings.
' less to sound, or exceeds 14,000 ❑ Commercial -use agrieulturai
and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building rumps for rill Miter inatnllationa, buildings.
0 Multi - family ❑ Master Wilde: ❑ Other: ❑ tiro pump, 0 installation of 7S 1t VA or
""^ -�"" Em ergent system larger sapnretu y rivr 5 m
�iCF14 �1i1 lilStrj i' AND ;At:'A'T1!lkil D y .,. I r. I do d. .
( / _�_...-• - --_ t ��� yyy , _ 0 Addition of new motor load of ❑ ••A« •% "1.2", "1 -3"
ttj /Job 110.: Job site address: e - 3 •� q s( 1 f i DCi I 100 11p or mom, occupancy.
Q tr 1 1 , /1�v ` V`--1 [a S i x or oleos res miie. 0 Recreations! vehicle parks.
City /$talc /7iP: ❑ Honith -ogre faeilitios. ❑ Supply voltage for mono than
- -- - -- — -- _ �� 0 lecationx 000 volts nominal.
Suite/bldg./apt. no Project name: 0 S011iCe or feeder 600 steps or more.
w i. , .
�p� 19>L1 F'.
Cross street /directions to job site: Atr 5 J A '� Description , r oc. - ..7.-. —Ter9
New residential single- or nmltl- family dwelling unit.
_ includes attached garage.
Suhdivisioll: jLot no.: 1 .000 sq. It or loss _ 168.54_ 4
Ea. add'l 500 sq. it or portion NE 33.92
` Tax map /parcel no.: Limited energy, residential ■
%iEl l M*
tot G'1p (with ahova , l{,) . `
67.84
.....".," t •_ ,... _ , " - Limited energy, multi- family
' ' � _ _ residentia](witlr above sq. 8 1111 .. 67.84
Services or feeders installado alterntlot, and/or rclacadmi
C! amps or less
. .)46:trailtgrY ' : El '1'ltl+#A1VT`: . - . 201 amps to 400 amps NM 133.56 •
Name. ( - ( � 14 t & c 401 amps to 600 amps 200.34
601 turps to 1,000 amps 301.04
Address; Over 1,000 amps or voila MEM - 2
City /State/ZIP: temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) 5 9' —C • -1-t Fax: ( ) 200 amps or lean —,.... _ 59.36 t
Owner installation: This installation is being made on property 'hat I own which is not 20i cry to 400 amps _ 125.08 lEll
intended for sale, (ease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.5a 2
Owner signature: Datc: . Itranch eircuit,s - new, alteration, ar extension, per panes
— ^' - Foe for branch oiro
-- A. ttits with
z1 it ''
► ®I ` too, 1> EI tS t3l�I above service or feeder fee,
each brnnoh circuit 7.42 2
Business ttarrtC ,y B. Fee for branch circuits "ter c "'
Contact name: ■ )0; ,.� wirkn r service or feeder foe l ! b
��. ctc
r, onrcuit 56.1$ ,h. 2
Address: ,.v . A Q‘ Each add'1 branch circuit 7.42 - 7. 't
Z.,..2
City/State/ZIP: � -'' Miscellaneous (service or Gamier not included)
�
Each manufactured or m fe odular 67.84 2
Phone: ( ) Fax:: ( ) dwelling, service and /or feeder
E -mail: - Reconnect orily 67.84 2
Pump or irrigation circle 67.84 - 2
"C.i AC'I'OR Sign or outline lighting 67.84 2
r. usiness name: NEBERLE ELECTRIC, INC Signal airetrit(s) or limited -
energy panel, alteration, or
Address: 29012 SW EGGER RI) extension. Describe: Page 2 2
City /State /ZIP: HILLSRORO OR 97123 - Each additional ins . Ikon over allowable In an of the above
Phone; (503) 628-2095 _ ~ �� Fax: (503) 628 -3076 Per inspectio 66.25
Investigation per hour (I hr min) 66.25
CC13 Lic,: .1- 22 33 4 6 Eke ri ai Lic 34 -1 ✓$ C Suprv. Lic.: 3053 -S Industrial plant per hour _ 78 18
Suprv, Eloctribtan si a are, d: t r 10 it U �.. p -
Prim name: JEFFREY L. HEBERLE �.sti -- subtotal:
-- Data / w `( _L, Plan review (25 "!n of permit fee):
Authorized signature;
fc� state surcharge (12% ofparmir fr.G ty
TOTAL. PERMIT FEE: t "Z
Print name: JEFFREY 1 ,., HEBERLE ' Date: I( This permit application expire„ if r po1911lt is not ohtnined atthhtn 1 RO
days after it ins hero accepted no ntrrplctr,
r. tr,lnunmre ,, +a or c- Pm,naiy,t ,,tic tear oo ' Alumhnr of innpoctinea niiowed per permit. --- L. Z
440.46151711M<,cOMttvnn //
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