Permit CITY OF TIGARD
A.tv ELECTRICAL PERMIT
PERMIT #: ELC2000 -00628
1 SSUED: 11/13/00
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S134BD -06800
SITE ADDRESS: 11725 SW SPRINGWOOD DR
SUBDIVISION: ENGLEWOOD NO.2 ZONING: R -4.5
BLOCK: LOT : 156 JURISDICTION: TIG
Project Description: Installation of (1) 200 amp or less feeder only. Homeowner will do rest of electrical work under the
master permit, MST2000-0021 7.
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: 1 W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 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:
MCCORMICK, ANTHONY D + HEBERLE ELECTRIC
SHERILYN M 19680 SW NEUGEBAUER RD
11725 SW SPRINGWOOD DR HILLSBORO, OR 97123
TIGARD, OR 97223
Phone: Phone: 503 - 628 -2095
Reg #: SUP 3053S
LIC 42841
ELE 34-160C
FEES Required Inspections
Type By Date Amount Receipt Elect'l Service
PRMT CTR 11/13/00 $80.30 2720000000( Elect'l Final
PLCK CTR 11/13/00 $6.42 2720000000(
Total $86.72 EXPIRED
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. Q
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 0
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987. '� ;
1
PERMITTEE'S SIGNATURE ISSUED :Y: �. r ; ` „ JA E_
OWNER INSTALLATION ONLY e
The installation is being made on property I own which is not intended for sale, lease, or rent. O
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
0
SIGNATURE OF SUPR. ELEC'N: ._)d 0 0 . 74-- DATE:
LICENSE NO: 5 _ 55
Call 639 -4175 by 7:00pm for an inspection the next business day 410
BUP - Building Permit ELC - Electrical Permit
Inspection Description Date Passed By 1 Inspection Description Date Passed By
Footing /Setback Underground cover
Foundation walls Wall cover
Footing drain Ceiling cover
Waterproof bsmt walls Electrical rough -in
Slab Electrical service
Crawl drain Electrical final
Underfloor insulation
Post/beam structural
Shear walls /anchors ELR - Restricted Energy Permit
Roof nailing I Inspection Description Date Passed By
Firewall Low voltage
Tilt -up panel Electrical final
Masonry/Reinforcement
Framing
MFG - Structure set -up MEC - Mechanical Permit
Insulation
� Inspection Description Date Passed By
Drywall nailing
Post/beam mechanical
Suspended ceiling Gas line
Engineered soils Mechanical rough -in
Welding Lab Final Fire damper
Concrete Lab Final Duct work
Bolting Lab Final Smoke detector
Fireproofing Lab Final Mechanical final
Structural observation
Final inspection
PLM - Plumbing Permit
Inspection Description Date Passed By
BUP - Fire Protection System Permit Plumbing underslab
Inspection Description Date Passed By Crawl drain
Sprinkler underfloor /slab Post/beam plumbing
Sprinkler rough -in Plumbing top -out
Sprinkler final RP /backflow preventer
Fire alarm final Rain drain
Storm drain
Water service
SIT - Site Permit Sanitary sewer
Inspection Description Date Passed By Culvert/catch basin
Footings Pump /fill septic tank
Foundation walls Plumbing final
Sprinkler supply lines
Sprinkler underfloor /slab
Catch basin/Manhole SWR - Sewer Permit
Engineered soils d Inspection Description Date Passed By
Engineering acceptance Sanitary sewer
Final inspection Final inspection
•
INSPECTION RECORD - BUP, PLM, SWR ELC, ELR, MEC, SIT PERMITS
•
Q ( G ( l ELECTRICAL PERMIT
�- CITY OF TIGARD '`
PERMIT #: ELC2000 -00628
v, DEVELOPMENT SERVICES DATE ISSUED: 11/13/00
13125 SW Hall Blvd., Ticiard, OR 97223 (503) 639 -4171 PARCEL: IS134BD -06800
SITE ADDRESS: 11725 SW SPRINGWOOD DR
SUBDIVISION: ENGLEWOOD NO.2 ZONING: R -4.5
BLOCK: LOT : 156 JURISDICTION: TIG •
Project Description: Installation of (1) 200 amp or less feeder only. Homeowner will do rest of electrical work under the
master permit, MST2000- 00217.
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 HMI SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 1 W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/0 SRVC OR FDR: PER HOUR:
401 .- 600 amp: EA ADD'L BRNCH CIRC: 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:
MCCORMICK, ANTHONY D + HEBERLE ELECTRIC
SHERILYN M 19680 SW NEUGEBAUER RD
11725 SW SPRINGWOOD DR HILLSBORO, OR 97123
TIGARD, OR 97223
Phone: Phone: 503 - 628 -2095
Reg #: SUP 3053S
LIC 42841
ELE 34 -160C
FEES Required Inspections
Type By Date Amount Receipt
Elect'l Service
PRMT CTR 11/13/00 $80.30 2720000000( Elect'l Final
PLCK CTR 11/13/00 $6.42 2720000000(
Total $86,72
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 set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATURE ISSUED :Y: ;
e..
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: ._d Op i (_as -/t� DATE:
LICENSE NO: o0553
Call 639 -4175 by 7:00pm for an inspection the next business day
. . . . ... .. ..,. . . •. , 1 . �, L ,If�,,.0 .0 -'J-
r
CCIY OF TIGARD Plan Check U ri
13125 SW HALL BLVD. Electriq rm[t Application Recd By
Date Recd /0 . 4 "��
TIGARD OR 97223 OCT 2 6 2000
Oats to P.E. -------
Phone (503) 639 -4171, x304 Date to DST
Inspection (503) 639 -4175 COMMUNITFIrrittifaype Pemtit# e9004- 0Cfon
Fax (503) 598 - 1960 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee .Schedule Below:'
Name of Development _ -_ , . Number of Inspections r permit allowed
Name (or name - o of business) _ Service included: Items Cost Sum
7
Address 1 i r Z UJ S dQI y f j WO ff _ 4a. Re,ldential • per unit
City/State/Zip . 17/ 11-z 1000 sq. ft. or less b 5 117.75 _ 4 r
ty p • % Each additional 500 sq. ft. or
portion thereof I $ 28.25 1 f
Commercial ❑ Residential, Limited Energy • $ 60.00 I
Each Menufd Homo or Melt at
2a. Contractor installation only: Dwelling Servl r Fe c $ 72.75 a
(Prior to permit issuance, applicants must provide contractor license 4b. Services r Feeders ' r a r 3 f� gO
information for COT data base). Installation, aft cation d /
Electrical Contractor EBERt E LECTR
EIC _ 200 amps or :ass - 5 /WS - .e 2
201 amps to 400 amps _ S 85.50 2
Addiess 19680 -S (Il._Nallglebauer Road 401 amps to 600 amps $ 128.50 2
i\ City st�dm 97123.9446 601 amps to 1000 amps $ 192.50 2
i
Phone No. __ Z r
- o q Over 1000 amps or volts S 363.75 • 2
G'e Job No. Reconnect only _ _ $ 53.50 __ 2
Elec. Cont. Lice. No. Ti- /&0 (.... Exp.Date /O I - . YY .4c.Temporary Services orFeeders
OR State GCB Reg. No. kZfY / Exp.Date "7 - C) --CO instalatton, alteration, or relocation
2 00 amps or less . $ 53.50 2
COT Business lax or M - • N 0 1"U - ! - 2.-_Exp.Date "[- (- 4� „, to 400 amps $ 80.25 2
4 01 amps to • r" , s-
__ $ 107.00 T _ 2
Signature of Supr. S ec' _� - over 600 amps to 1000 vows,
see "b" above.
\` License No. "...o"'" _ ' E .Date tO - t - Q 4d. Branch Circuits
Phone No. Z� ,• *3) S .-- New, alteration or extension per panel
a) The fee for branch circuits •
2b. For . ner Installations. with purchase of service pr
feeder foe.
Print Owner - Name C C. VA i CPC._ Each branch circuit $ 5.35 2
Address b) The fee for branch circuits
without purchase of service
City Ste Zip • or feeder fee. •
Phone No. First branch circuit 5 37.50
• Each additional branch circuit $ 5.35
The installation Is being made on property I own which Is not 4e. Miscellaneous
intended for sale, lease or rent. (Service or feeder not included) .
Each pump or irrigation circle ^ __ $ 42.75
Owner's Signature Each sign or outline lighting $ 42.75 •
Signal dreult(s) or a limited energy
panel, alteration or extension $ 50.00
3. Plan Review section (if required):* Min0r Labels (10) $ 107.00 __-_
Please check appropriate item and enter fee In section 5B. 41. Each additional Inspection over •
_ 4 or more residential unts in one structure the allowable in any of the above
amps or more Per Inspection S 60.00
Service and feeder 225 am
p Per hour 5 50.00
System over 600 volts nominal In Plant $ 59.00 _
__ Classified area or structure containing special occupancy as
' describes in N.E.C. Chapter 5 5 F ees: I
5a. Enter total of above fees r�j0 ' ° $ / 1 y �
,
* Submit 2 sets of plans with application where any of the above apply. J J • OA Surd -a:ge (.05 X total tees) / y o2- $
Not required for temporary construction services. . JL' Subtotal tp r $
5b. Enter 25% of Ilne 5a for
NOTICE Plan Review if rewired (Sec. 3) /
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal 0 ' $
IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account fl V AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ • 6 q
r
l:rdstslforms‘eiccvic.Juc , / f O co ( 2222- ad - C.'47.) - 't' ! r. .. - 69 , 3q
61.1E -,`( le 1'2153 dt,_e__.-
11/09/2000 21:58 5036283076 HEBERLE PAGE 01
HEBERLE ELECTRIC Residential - Commercial
19680 SW Neugebauer Road
Hillsboro, OR 97123 -9446
503628 -2095
503 -628 -3076 FAX
FAX COVER SHEET
i
Please confirm receipt:
Yes no
DATE: a( c 9 1
TO: 32, 6t, L FAX:
FROM:.
Re: r Y \ t CJ J
(■1-.= ---Ile a-- -CC/6 --( 9 ,/ (_____0
04,tit- - '
101,,Xlie.-- ----js2w.-4 b - r 7 C - ( PUA ‘'3 ( (2°°Pi
Number of pages including cover sheet:
Receipt #: 27200000000000001248
Date: 11/13/2000
T I D E M A R K
COMPUTER SYSTEMS. INC.
Line Items: •
Case No Tran Code Description Revenue Account No. Amount Due
ELC2000 -00628 [ELPLCK] ELC Pln Rev 220 - 0000 - 433040 $6.42
ELC2000 -00628 [ELPRMT] ELC Permit 220- 0000 - 431510 $80.30
Payments:
Method Payer Bank No Acct Check No Confirm No. Amount Paid
Check HEBERLE ELECTRIC 0 9996 • $69.39
Check HEBERLE ELECTRIC 0 10032 $17.33
TOTAL AMOUNT PAID: $86.72
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