Loading...
Permit CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2011 -00422 1 3125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/28/2011 ?IGARD Parcel: 25111 DA08100 Jurisdiction: Tigard Site address: 8912 SW GRAVENSTEIN LN Project: Axberg Subdivision: Lot: Project Description: (2) branch circuits for NC and GFCI outlet Contractor: HEBERLE ELECTRIC Owner: AXBERG, BROOKE K 29012 SW EGGER RD. 8912 SW GRAVENSTEIN LN HILLSBORO, OR 97123 TIGARD, OR 97224 PHONE: 503 - 628 -2095 PHONE: 503-997-1613 FAX: 503 - 628 -3076 FEES Quantity Description Date Amount 2 crt Branch Circuits wo /Purchase 07/28/2011 $63.60 Specifics: Service or Feeder 1 ea 12% State Surcharge - 07/28/2011 $7.63 Type of Use: SF Electrical 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 -0090 You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: _ .■/ - Permittee Signature: 6N /7",G/69-7 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. • Call 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. 07/27/2011 08:58 5036283076 HEBERLE ELECTRIC INC PAGE 01 Electrical Permit Apullca r`"; 1 _ CE� Intl: < t i r If l 1 , t;t •\, ,; City of Tigard 'I 0 13125 SW Hall Blvd, Tigard, OR 9�r, ry ' . ► o Pmmittdo.:�L `(J��' ©a l�� • / 2011 AntedB Other Permt+ 1 1 i , i , lrtspcationf Lino: 503,639,4175 (1 � / /'�a•3 -SA -. ' Phone: 503.639.417] - Fax: 503.5• • , .02 mist; gatdnor.gov N ara lodtud ho �� C OF TIGARD N",isalotbaa; ItiarmAw,n ' 1 . ,g, � 1 ,:a n.' ,'•;,.;;:: ' ❑ New construction Ili Addition/alteratia�/� "N "�Y new. cheek all that apply (-submit g seta of plena unitorna checked Wow); Other: fault more ng„ . . .:, available Sonic,' or feeder Q »uldi o r throe stories. 0 Demolition , ,y�y((yy.,, , y�y,y whom e ❑Marta boatyard ( :. . } '.: ' �' ,_�; . ;i�;r! 't;= ':�� aficeedaTQ,000 amps at150 volts or 0 Floating buildings, � ! 1- and 2-family dwelling 0 ] Commercial/industrial [] Accessory building amp f�+ all other installations. © b me ietwae agriattthual Multi-family ❑ Master builder 1. � r ._ _ 1 re pump. C] lnstallntion of 75 KVA or I�V�aeV "? Other: tFrCr" D A jj l r. ^ °i 9' ' 1 :1','`;i�. '.ii,,. , : , ©, stem lgor .aar"toly derived a; stom I� AciditiE es Of MysW moto r taeld of 0 nr "A» ^E' op -1.2" „ 1,3 Job no.: Job site address; .514 j ,4 . ODFip or poop occupancy, " l ' i'V 1 D S or more residential units, © Recreational vehicle parka. City/State/ZIP: izn /�. " .1 —y OHMtth,aumfl.oilitien, �r L- �'1,� ❑ &molt' voltage for more than .. ." 0 He rvieo or to cto rona. 500 volts nom;nal. Suite/bldg. /apt. no.: Project name; �� -- ❑ 9ervlco or feeder 600 amp or more. Cross street /directions to job site: .4t- /_ ' ,1b1, Now residential single. or multi -family dwelling unit Includes attached `a . Subdivision: Lot no.: 1,000 s.. it or loss 168,54 NM ax r rtap /parcel no.. ER add'l 500 s.,12. of . e 'on MINECiliiIMIIIIIN ;';':.�.: - Limited ;, a . B o f -r :m 1 residential with ai ov 67.84 ME � a a ft . y.,__ a L"" µ r Limited energy, multi-family 84 i tote, w,o or � w . , :;; irratalllt n and/or relocation residential with above 8 Services r feeders Hatt alteration i w' .., ; a 200 imps or less 100,70 Neture: '� ' +' . ., , ,"- 201 atn.m to 400 am,: IMIMMIMI �'t,, 401 am.a to 600 amps 200.94 Address: 601 stn a to 1.000 amps ii. MI EMU 8 City/State/ZIP: Over 1,000 amps or volts IIIIIESSEI EN Temporary services or leaders Installation, alteration, otedtor Phone: ( ) relocation r (3 -7 M Fax= ( ) 200 amps or leas .111 5 Owneer installation: This installation is being property that I o wn w hi c h as not 201 a •: to 400 am . s MEM MI made on 2.5 0 8 intended for solo, loam, rent, or ckohango, accordin I25,8 min g to aR5 447, 449, 670, and 7p 701. 401 amps to 599 amps IIII 168.54 Owner signature: 7777::::-..,71705 Date: Stan circuits - new site , r Cate ii ;'';e7 T " � 9 ,,, n , 7 . ., , for branch airoutta with I artol .. ,, u�, A. Fee e set = - . N J1.„ , , ;q : .,, : ; ' . 8ttsinegs name: „ shove sartria or facder f r each branch circuit Contact name: .4 ,A • B. Pea for branch aicauite 1. 1 wfth+aa( service or Meader fee 111111113111 Address: _ - • ` ,,,,.).2. cm Gnat bm i ;E'oireuit Each add'l trench circuit f 7,42 M1sccHanooaa service, or feeder not included Phone: ( ) -.4411--- dwe matltr service or modular miazi E II - mail: Fax; : ( ) dwellin , sntvioe and/or feeder Reconnect onl �� Pump or irrigation circle NININIMMuillEi Business name: IIEBE,RLE ELE sign l ircu or limited Address: 29012 SW EGGER RD energy pupal, alteration or /Sts e/ZIP': extension. Describe; Page 2 Ci tar IIII.I.584iCt0 OR 97123 Each additional his • action over allowable to • of the abov P . (f13) 628 -2095 Fax: (503) 6 ; .176 Per inspection Lie.; 152342 Electrical Lie.: 34 -160 C Stn lnveInvestigation .r hour (1 lupin) prv Lic,: 66,2 CB i Saprv. Electrician signature, r tared: 3 - Industrial plant per hour Print name: JEFFREY L. H)~I3ERI,4a ,. . .' ,;, 'E n' "il¢, ! . .. ' ^';; • Date: Subtotal: �"�r, r,. r >r i ill � � - � Plan review (25 % of patxnit fee.): !* signature; State surcharge (12% of permit fee): rink norm: E�' L. TiE ' TOTAL PERMIT pOrn, t le not FEE: nncu Date: This permit Application axiom u w t'er+ewt obtained within "�N" f62. �am+ttttpp.dno MIA* days after it t8R IP 440.461 2 ° Nnmbor of ina tinny allowed t a permit. d se. complete. �1 y g e-e T 6 7:::, _ l 0:F -2-- 440-961 p Per permit. (�, L