Permit C ITY - OF TI GARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00087
1111 DEVELOPMENT SERVICES DATE ISSUED: 2/14/2005
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S136AD -04600
SITE ADDRESS: 06707 SW PINE ST
ZONING: R -4.5
SUBDIVISION:
BLOCK: LOT : JURISDICTION: TIG
Project Description: Installation of (5) branch circuits for kitchen remodel.
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: 4 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:
BILL & JAN HETTICK WEBER ELECTRIC INC
6707 SW PINE PO BOX 231154
PORTLAND, OR 97223 TIGARD, OR 97281
Phone: 503- 452 -1129 Phone: 503 - 620 -1906
FEES Reg #: LIC 44087
Description Date Amount SUP 4028S
ELE 34 -44-44
2c
[ELPRMT] ELC Permit 2/14/2005 $73.45
[TAX] 8% State Surcharge 2/14/2005 $5.88 REQUIRED ITEMS AND REPORTS
Total $79.33
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 - • 5; - 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -66•:9 or 1 -800 -332 -2 • .
Issue • ! . ��� i Permit Signature:
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: - /s %�J� _,r /j'/� DATE: /Yas----
LICENSE NO: xtieNg. S
Call 639 -4175 by 7:00pm for an inspection the next business day
Electrical Permit Aisplication FOR OFFICE USE ONLY
Oty of Tigard . Received
, _ffiigropm Permit No.: fl.,,e_ g ii7
13125 SW Hall Blvd., Tigard, OR 97223 Date/B :
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Adi. ■
1 '-- q-iglie,-. Date/By: Other Permit:
Inspection Line: 503.639.4175 All 6 ' II Date Ready/By: Iuris: 121 See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: _ Supplemental Information
,? wi
......... . .., , 5 „.. ,._. : ' 1..,..-7,: . t" - :.i:.,,,tir,24-..eT,4:".t.O.Fif,t,,ta-M;?.0„.. ■( . u.k.i14 1, 11, t4:- ., -....7.; : 1'2. • ,
0 New construction ffAddition/alteration/replacement Please check all that apply:
OService over 225 amps, comm'l ['Hazardous location
0 Demolition 0 Other:
- .- ' .. : ' '' ' .
OService over 320 amps - rating 0Buildng over 10,000 sq. ft.,
CATEGORY CONSTRUTION.
'''' ' ' ' '' ' t' I '' '' ''''' -.‘ li
,, ,,- 0' •-• -'''''' : • '. ",', ' i ''• ' • C , ,i''*:`44. d? --e ,Y of 1 - and 2-family dwellings 4 or more new residential
.... .:. ,4.±vt!^ : '.t°`1 :
and 2 dwelling 0 Commercial/industrial 0 Accessory building (=System over 600 volts nominal units in one structure
['Building over three stories ['Feeders, 400 amps or more
, ,,. 0 Multi 0 Master builder 0 Other:
' Occupant load over 99 persons ['Manufactured structures or
,_,
--...,..,
, ,.."."...,;` ..... ,..,
[ , ,` .,...;; .: ...._,..4'.. ' .,.. ..,; ,.,'" •i-- " ' ' '' , •:,.. t'
El
' ''.':...,....■':':', '.'"'. '',-. ;' ''':'. t1 ?! 5° ... 1 f` ' ' '' nrt . )13-1 Y1 A ! , PPt.,41`3P -.';,, -'-i h` -1, I:Egress/lighting plan RV park
0Health-care facility ['Other:
Job no.: . Job site address: 6 707 s p,s„.,_ 57 of plans with any of the above.
City/State/ZIP: Ti 4'
5 Ar d3R . 9 722 3 The above are not applicable to temporary construction service.
' : - `' , Vel> .
t NT. •:-. ''' : .'
Suite/bldg./apt. no.: Project name: .,Y
Description I Qty. I Fee. I Total I **
Cross street/directions to job site: New residential single- or multi-family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 • 1
Limited energy, residential 75.00 2
Tax map/parcel no.: .
- Limited energy, non-residential 75.00 • 2
DA :z1. Each manufactured or modular
- dwelling, service and/or feeder 90.90 2
C C I4TS - te. -.1- c.......... v-e-"-•-.S...k. Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
: -: te4),I2.0i0iitir:` Eg,: •• "..; 1-'-., -_-- 201 amps to 400 amps 106.85 2
_.-, , ,, . . . . . _ , .: _., , ' •• ' - ' : - - - • • - - ''''' -'-'-'''' - 401 amps to 600 amps 160.60 2
Name: 14 f ---- l I I. ft GLAA..... • 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
.- relocation
Phone: (,Z3) ci5-2._ / / 2 Fax: ( ) 200 amps or less 66.85 I
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 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
5 '4-t:i.:: ,.',1 .:i'': I El b:SitiyAti..:EEitii*'"' -:'''' ' ''': k Fee for branch circuits with
service or feeder fee, each
6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee, 1 4685 Ai ,7
each branch circuit . '10 ta 4
Address:
Each add'I branch circuit 11 6.65 24)t3" 2
City/State/ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) Fax: : ( ) .
Sign or outline lighting 53.40 2
E Signal circuit(s) or limited-
'-7-I,t1-..,;;;.te_:",,I.-,,. ,, y, :...,-:. -,..e-Osi ., -,,,,,,,...,-..„,.,,,,;•- energy panel, alteration, or
extension. Describe: Page 2 2
Business name: 1.442_6e r F _ LQ,Jr „.„,.. I: c....
Each additional inspection over allowable in any of the above
Address: 1R 23/ i 5 Per inspection 62.50 .
City/State/ZIP: ---- 9 ?
0 - c _i_ 0(2., Let - 1154
5 ,.... 0" Investigation per hour (1 hr min) 62.50
CV-3 ) ,_ o 0
Co (- - / ?C• 6 Fax: ( 5 6 2.0 -. co? 1 9 Industrial plant per hour 73.75
Phone:
CCB Lic.: .1q Electrical Lic.: 3e1 _el 12 r Suprv. Lic.: 4o a ,S : Subtotal 73 4
..---
Suprv. Electrician signature, required:777‘v ../..: / /\ Plan review (25% of permit fee)
A-ee
State surcharge (8% of permit fee) c g 8'
Print name: n'l iJe6-e r Date: 2 - 1 4 _ 5 -
TOTAL PERMIT FEE -70 3
i f .
Authorized signature: This permit application expires if a permit is not obtained within 180 _
days after it has been accepted as complete
Print name: Date: • Fee methodology set by Tri-County Building Industry Service Board
** Number of inspections per permit allowed.
iABuilding\Permits\ELC-PermitApp.doc 12/03 4404615T(10/02/COM/WEB
Electrical Permit Application - City.of Tigard •
Page 2 - Supplemental Information; - -
LIMITED ENERGY PERMIT FEES:
SEE wa sioat
Fee for all residential systems combined $75.00
Check Type of Work Involved:
O Audio and Stereo Systems*
El Burglar Alarm
O Garage Door Opener*
El •
Heating, Ventilation and Air Conditioning
System*
• 0 Vacuum Systems*
O Other:
,:z421
Fee for each commercial system $75.00 •
(SEE OAR 918-260-260)
Check Type of Work Involved:
0 Audio and Stereo Systems
0 Boiler Controls
Clock Systems •
O Data Telecommunication Installation
• 0 Fire Alarm Installation
• HVAC •
El Instrumentation ,•
El Intercom and Paging Systems
0 Landscape Irrigation Control* •
O Medical
O Nurse Calls
O Outdoor Landscape Lighting*
O Protective Signaling
Ei Other •
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
i:\BuiIdingPermiu\ELC-PermitApp.doc 04/03
CITY OF
BUILDING PERMIT #: ELC2005 -00087
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/14/2005
Phone: (503) 639- 4171
Inspection Requests (24 Hrs.): (503) 639 -4175 -_ -� °__ I
INSPECTION WORKSHEET FOR DATE: 3/18/2005 TIME: 7:24AM PAGE: 22
SITE ADDRESS: 06707 SW PINE ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: HETTICK
DESCRIPTION: Installation of (5) branch circuits for kitchen remodel.
OWNER: HETTICK, BILL & JAN PHONE #: 5034511129
CONTRACTOR: WEBER ELECTRIC INC PHONE #: 503-620-1906
Inspection Request Scheduled For: Date: 3/18/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 002209 -02 503-784 -1043 N
Corrections /Comments /Instructions:
C /
PASS ❑ PARTIAL . PPROV . ❑ CANCEL ❑ NO ACCESS
FAIL ❑ C / : - " " TION ❑ ADDITION . FEE ASSESSED
Inspector: / L// Date: ir 0 Phone #: (503) 718 - -)--4