Permit CITY. OF TIGARD._ _x. ELECTRICAL PERMIT
PERMIT #: CAL P RMIT 3
i A DEVELOPMENT SERVICES DATE ISSUED: 7/5/2005
. II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S111 AD -15200
SITE ADDRESS: 09059 SW REILING ST ZONING: R -4.5
SUBDIVISION: MALLARD LAKES LOT : 018 JURISDICTION: TIG
Project Description: (8) 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: 7 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:
BURR, NORMAN S /KATHLEEN E HEBERLE ELECTRIC
9059 SW REILING 7456 SW BASELINE RD #414
TIGARD, OR 97224 HILLSBORO, OR 97123
Phone: 503 - 620 -4528 Phone: 503 - 628 -2095
FEES Reg #: SUP 3053S
LIC 152342
Description Date Amount ELE 34 -160C
[ELPRMT] ELC Permit 7/5/2005 $93.40
[TAX] 8% State Surcharge 7/5/2005 $7.47 REQUIRED ITEMS AND REPORTS
Total $100.87
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
suspend r more than .;0 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
l
rules set forth in OAR 95' of I . • through OAR 952 - 001 -0100. You may obtain copies of th- . ' -s or direct questions t•• • UNb at
503 46 -6699 ckr 1- 800 -33 4. • /
Iss d By: � Permittee Signa =•■ •' ' , , f o x.. 4. _
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 INST • LATIO ONLY
SIGNATURE OF SUPR. ELEC'N: _ "'" ke %%� v ` r------ DATE: d S A.
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.
r Electric al Permit Application P.' Received FOR UFl l('1: t' k : ONLY'
Ekctricat - n ,�
.t RECEIVED Dald13 : 2 5 o s Permit No.: '-►
Cit of Tigard Planning Approve Sign .
13125 SW Hall Blvd. DatdBY: Permit No"
U L 0 r 200 Plan Review
trl other No.:
Tigard, Oregon 97223 �,�,•
Phone: 503 -639 -4171 lax: 150 25f • l3a Post- Review • land Use
'`, '` W t' tdpy ('use Nu,:
Internet: www.ci.tigard.or.u43UILDING DIVIQ A. x • 1 11 Conta " ,. _t See Page 2for
24 - hour I uspctaiun Request: 503- 639 -4175 - - Name/Method: Su Icmental information. •
-
_ TYPE OF WORK se PLAN REVIEW (plea check all that a I
.! New construction Demolition • Service over 225 annms- Q I lealth -care facility
----
commercial 0 Hazardous location
Addition /alteration/replacement Other: o Serike Over 320 amps - rating of (] tluildin over 10,000 s leet.
CATEGORY OF CONSTRUCTION � - I & 2 family dwellings low nr more residential units in
I & 2- Family dwellim Commercial/Industrial ❑ System over 600 voila nominal are structure
Accessory Building OMultl- Family ❑ �
Building over three atones ❑ Manufactured Feeders. 4 amps Of more
❑ Occupant load over 99 persons ❑ ManuLtclurcd structures or RV park
Master Builder ID Other: ❑Egresstlighlingplan 0(nher:_
JOB SITE INFORMATION ad LOCATION • Submit • ,,,, sets orphan with any of the above.
Q . . ` 'The above are n ot _ a , . licabk to temp . rar construction service.
Job site address' `f MfV FEE- scuGnU1.,C
Suite #: 1 1314 /A 1t,ii: Nu
- ...... _........ e n it all
.b t -_ -- utL t• of iusprcllu s per pernt owed
Projec Name: Description y Fe. (.a.) Tu
t � - _ -' — "� Spy
residentlaMMgk or multi - fondly per
Cross street/Directions to job site: dwelling atilt. includes attached garage.
4p5— l 00 O q fI or Included:
s .
1 ery ce n or less 145.15 4
loch additioal 500 sq. B. or portion thereof 33.40 I
S111/1 VIS1011: Lot #:
-- Limited energy, residential 75.00
�. �_... . _ _... ' Limited energy, non residential 75,00 •
Tax snap /pare:ci ll: Fnch manufactured home or modular dwelling - - - - -
DESCRIP ION O ' WORK service and/or feeder 90.90 .
/ Services or feeders - lastaaattob,
A....0 a' C� alteration or relocation:
200 amps or less 90.30 2
. —. -------- 201 am . to 400 am , - - 106.85 2
401 am - to 600 am - . ......_._. _ •-- 160.60 2
RO R1'Y OWNS • TENANT .. 601 amps iu 1000 amps -- — 240.60 ` 2
W
Over IO snips or volts 454.65 2
Nam r l � -0,l -I! A.La _ Reconnect only ,_..._...... — _ 66.95 2
Addr ' 'I'emperary services or feeders - Installation, •
-•' - -- - —"' - alteration, or relocation:
CI S //Sttat ' e/Zi ' . 200 am. or less - - - - -- 66.85 1
Phone - T .- ate -
hone-: f5 l a 201 amps to 400 amps .. — 100.30 1
❑ APPLICANT 1 . ! CONTACT PERSON ' 401 n h Mumps 133.75
--- Drench circuits - Dew, alteration, or
Name: eateustun per panel:
Address: A Fee for branch circuits with purchase of ' I-
-- .,_,_. service ur feeder fee• each branch circuit 6.65 y
City /State/Zip: I). Fee for branch circui ter haseor .._ /', '
- � - service ur fader ice, final branch circuit i' 46,95 API ' 2
Ilion-: Fax: Each additional branch circuit 7� 6.65 2
l:. -Mali: Miac.(Service or feeder our included); � —
. CONTRACTOR . Each pump or irrigation circle 51. 40 2
Job No: Each sip or outline li(uing - -- 53.40 2
�. -- Siva, circuits) or a limited energy panel,
Business Name: ' LE . PM #414 alteration, or extension - ratio: 2 2
. -- .. - -. -- 7458 W BASEUNE RD '_._, r.. _. Description:
Address:
I ly /Stale/ 7 t: —H ¢' OR 97123 Each additional Inspection over the allowable In any of the above: . —
• - -_ Q ., I 3_44_- -y ,, Per inspection ner hutnanin. 1 hour) 62.sU
Phone: G•.6 • Zo Fax: 6 .g. � t, J // c' "7 0 � hrvesti iWt fcc; — -- ........ - -
Cat Lic. #: 1 SZ 3Y Lic. #: Od
Electrical Peewit Fees* -
Supervising electrician I\ Subtotal $ ,
signature re uired: V _ Plan Review (25% of Permit Pell S
Print NameJF- "_ • Ili _ Lie. #: , 5 S State Surcharge (8% of permit fee) S --- _ 4 7 _
Authori ____ _ .TOTAL PERM1•l' FEE -�p(7, 7
Si thori Notice: 'this permit applicatiau expires if a permit is not obtained width;
6 - ._ Date: ISO days after It has been accepted as complete.
' Fee mmaribodoit>gyr let by Tel-Comity nodding industry Service hoard. \.,__ ( A - , •
(P , . , inc)
iVstsTennit , ••.: \ : titApp.duc 01/03 _ fli• 7 .—)
•
Z0 39Vd 9NI 9Ii'119313 31Z13S3H 9L06839E0S 017:0i 9002 /S0 /L0
CITY OF TIGARD , y� l�� _P g,7
BUILDING DIVISION PERMIT #: ELC2006-00e173 1
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/512005
Phone: (503) 639- 4171
Inspection Requests (24 Hrs.): (503) 639 -4175 . ' �jll I
INSPECTION WORKSHEET FOR DATE: 9/7/2005 TIME: 7 :08AM PAGE: 4
SITE ADDRESS: 09059 SW REILING ST CLASS OF WORK:
SUBDIVISION: MALLARD LAKES LOT #: 018 TYPE OF USE:
PROJECT NAME: BURR
DESCRIPTION: ,g'� branch circuits for kitchen remodel.
3
OWNER: BURR, NORMAN S/KATHLEEN E, PHONE #: 503. 620 -4528
CONTRACTOR: HEBERLE ELECTRIC PHONE #: 503-62 &2095
Inspection Request Scheduled For: Date: 9/7/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 015079-01 503-888 -9953 N
Corrections/Comments/Instructions:
,,x:c_ i,
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: f'--? S Phone #: (503) 718-