Permit r CITY OF TIGARD ELECTRICAL PERMIT
PERMIT ISSUED /3/200 7 -00198
COMMUNITY DEVELOPMENT
DATE ISSUED: 4/3/2007
TI GARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S114BA -13100
SITE ADDRESS: 16495 SW COPPER CREEK DR ZONING: R -7
SUBDIVISION: COPPER CREEK STAGE 3 LOT : 096 JURISDICTION: TIG
PROJECT: FRYKMAN
Project Description: (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:
JENNIFER FRYKMAN HEBERLE ELECTRIC
16495 SW COPPER CREEK DR 18645 SW FARMINGTON #326
TIGARD, OR 97224 ALOHA, OR 97007
Phone: 503 - 747 -3001 Contact #: PRI 503 - 628 -2095
FAX 503 - 628 -3076
FEES
Description Date Amount Reg #: ELE 34 - 160C
[ELPRMT] ELC Permit 4/3/2007 $53.50 LIC 152342
[TAX] 8% State Surcharge 4/3/2007 $4.28 SUP 30535
Total $57.78 REQUIRED ITEMS AND REPORTS
This Permit is is ued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws
All work be done i .ccordance with approved plans This permit will expire if work is not started within 180 days of issuance, or if work is
susp ded for more than ;0 d- • . • ENTION. Oregon law requires you to follow rules adopted • • - Oregon Utility Notification Center
Tho e rules are set forth in I • R 95■ 001 -0010 through •AR 952 -001 -0100. You may obtai • - of these rules or direct •uestions to OUNC at
503 246 6699 or 1.800.332 ;44.
Issu d By: ` .4 . L Permittee S i . . �s _ �J ��� i l�
_ 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:
• NTRACTOR INST LLATION ONLY
SIGNATURE OF SUPR. ELEC'N: ..e � 1 � r 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.
04: 07:58s� a HEBERLE ELECTRIC INC PAGE 01
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Electrical Prmit Application ,
n ry y
c, 'R �� C��1 ]t)tt<)Irl I(1 I,�1 O�I1
City ofTiigard �' Remvc,t / Ql A ..
DmdB Os A- V Permit No. G!�aeo ,e6/76
13125 SW I tall 131vd , Tigard, OR 97223 t Man Review/
Phone: 503 639,4 171 Fax: 5(13,598 - 196041 y or i - Date /B Other Permit,
Inspection IJnc: 503 639,41 75 q� �'1��Tr .,:. (( Dmc Rc,dylkty; hid, �t RI Sec Pace 2 for •
�internet: www ci.tipard.ar.tls WRIT t ! er �� - NotifiedUMcthod / (,p, Supplemental Information
TYPE OF WORK PLAN 'REVIEW
❑ New construction igt Addition /alteration /replacement Please check all that apply:
O Service over 225 amps, comm'I ❑Hazardous location
El f)emnlilion ❑ Other:
CATEGORY OF CONSTRUCTION ❑Service over 320 amps - rating 013uildng over 10,000 sq, t)„
of I- and 2- tamily dwellings 4 or mare new residential
1- and 2- family dwelling ❑ Commercial /industrial El Accessory building ❑System over 600 volts nominal units in one structure
❑ Rut ►ding over three stori ['Feeders. 400 amps or more
❑ Multi - family ❑ Master builder ❑ Other;
❑occupant load over 99 persons ❑Manufactured structures or
JOB SiTE INFORMATION AND LOCATION ❑Egress/lighting plan RV park
•
lob no.: Job site address: 1 `� W r �� p � . � ❑Health -care facility Dottier: -
11 Ct' - Y:P.-
Submit ,, sets of plans with any of the above
City/State/ZIP: — 11, 44-247 Q - The above are not applicable to temporary Construction service.
Suite/bldg. /apt- no.: I Project name: ' l� Kt,,v/ � " - FEE" SCHEDULE
/ 1 r. t � f neucrirrlinn I QM 1 F. Total
Cross street/directions to, job site: p '/ � � / New residential single or multi family dwelling unit.
I Includes attached garage.
1.000 sq - R or less 145,15 4
Suhdivision: Lot no.: Ea. ndd'I 500 sq iI. or portion 33.40 I
Tax map /parcel no,; I.4ltitcd energy. residential 75.00 2
Limited energy. non- residential 75,00 2
DESCRIPTION OF WORK kach manufactured or modular
_ C dwelling, acrvice and/or feeder 90.90 2
i Services or feeders installation, alteration, and /or relocation
200 amps or lass _ 80,30
___________
S ' ROTY OWNER ❑TENANT 201 amps to 400 amp 106.85 0,60 2
2
Aiiiiiraaniit, �� c 401 amps to 600 amps 16
Name: 1 GL�L. 1 . L 'Fe.-1"14e,
01 amps (0 1,000 amps 240,60 2
Address! over 1,000 amps of volts 454.65 2
City /State/ZIP: Reconnect only 66,85 1 2
L Temporary services or feeders installation. alteration, and /or
Phone; ( ) `14 7 ` 3 I I Fax: ( ) 200 a relocation
200 amps or less on l
Owner installation: This installation is being made property that 1 oven which is not -- W -
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670. and 701. ?01 amps to 400 sumps 10030 2
401 amps to 600 amps 133,75 2
Owner signature: _ __ _ Dat e: Branch rirenits - new, a iteration, or ex tension, per panel
R CI APPI,ICAN 0 CONTACT PERSON A Fee for branch circuits wrrh
Rugincss name; service or feeder fee, each
`' Cr�p branch circuit 6.65 2
Contact name: ." ---- �P��O'+6 y l3, Fee for branch circuits
without service or feeder fee, 46.85 t J 2
Address: W10\3 each branch circuit `
tatd! I Each add'! branch circuit '"T 5
—
City /S
„ Miscellaneous {service or feeder not included)
Phone; ( ) l:ax :: ( — Pump or irrigation steels 53,40 2
I: -mail:
" Sign or outline lighting 53 40 2
Signal circuit(s) or limited •
CONTRACTOR energy panel. alteration. or
Business name: extension Descri
H e b erle Electric,cmc.Habm Elects c ,
Page 2 2
old. #326
Address; HEBERLE - AIOha, 007 ,a a dditional Inspection over allowable in any of the above
Pcr inspec 62,50 -
City /Statue /ZI
USEIQRO. OR IErt _ Investigation per hour (1 hr min) 62.50
Phone, (5 sp ¶t5 Fuk: ('i3) 4.147 - Z 6 Industrial plant per hour 73,75
°~+ 1 ELECTRICAL PERMIT FEES*
t t 4 Z Electrical I.1c-; Sitpr i,ic - _
CCI3 (,ic.: �5
" � S Subtotal 5 -0
Suprv, Fleet tan signature, required: "I'mw
Plan review (25 "/a of permit Ice}
!iv : a -�y- -�
Print name; Stale s urcharge ( 8% of permit fee) 4, n
A thorinci signAture: - TO l ' AI., PERMIT FEE 7
" Thlc permit application expires if it permit Is not obtained within 180
Number Print name: � I Date: • Fec menio after it has been reeepltvt as ((mottle
dnI / sat by Tn- County Buildups I n du stry Service hoard
1811,1,1,, •' lx r of inalxcsions per r allowed.
- µ \Ycrmm \1.1,(• .rcrmunt,pd ,a 12/s 44rt -nh tsT IIIlIt Se.
W_ _.....5--7,
t 1K OM/W113 4 -
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•
CITY OF TIGARD
BUILDING DIVISION
PERMIT #: ELC2007-00198
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/3/2007
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 W —"
INSPECTION WORKSHEET FOR DATE: 4/612007 TIME: 7:04AM PAGE: 6
SITE ADDRESS: 16495 SW COPPER CREEK DR CLASS OF WORK:
SUBDIVISION: COPPER CREEK STAGE 3 LOT. #: 096 TYPE OF USE:
PROJECT NAME: FRYKMAN
DESCRIPTION: (2) branch circuits.
OWNER: FRYKMAN, JENNIFER PHONE #: 603-747-3001
CONTRACTOR: HEBERLE ELECTRIC PHONE #: 603-628-2095
Inspection Request Scheduled For: Date: 416/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 046130-01 503-961-2736
Corrections/Comments/Instructions:
71/
•
PASS fl PARTIAL APPROVAL LI CANCEL NO ACCESS
FAIL 0 CALL FOR INSPECTION 7 ADDITIONAL FEES ASSESSED
•
Inspector: Date: / A 401 Phone #: (503) 718- 1-1411‘.