Permit . CITY OF TIGARD ELECTRICAL PERMIT
II c _= COMMUNITY DEVELOPMENT Permit #: ELC2010 00102
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/03/2010
Parcel: 2S 102 BCO2004
Jurisdiction: Tigard
Site address: 10680 SW FONNER ST
Subdivision: Lot: 0
Project: Carmichael
Project Description: Provide grounding to SFR after replacement of water service piping interrupted existing ground.
Owner: FEES
CARMICHAEL, LINDA & JOSEPH Quantity Description Date Amount
10680 SW FONNER ST
TIGARD, OR 97223 1 ea Reconnect Only 03/03/2010 $67.84
PHONE: 503-670-7004 1 ea 12% State Surcharge - 03/03/2010 $8.14
Electrical
Contractor:
FRAHLER ELECTRIC CO
11860 SW GREENBURG RD
TIGARD, OR 97223
PHONE: 503 - 639 -4627
FAX: 503 - 639 -4673
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $75.98
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-D01-0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: l ;�Al Jt ,D Permittee 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:
t i CONTRACTOR INSTALLATION ONLY
J' ✓ �
SIGNATURE OF SUPR. ELEC' /I I ,p 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.
Electrical Permit Application .
OFFICE USE ONLI'
• City of Tigard : iew 13125 SW Ha ll B d ., Tigard, 0�� 3.. 1NNN D DateB PermtNo.:� a/ . 111 �.// �. /
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit: 9'rn 2e)10 0
Inspection Line: 503.639.4175 MAR 0 2 2010 Date Read /B lures:
TiGARD Ready /By: ® SeePage2for
Internet: www.tigard Notified/Method ' C- Supplemental Information
ar '" i j a., TYE,O 0:t I '' 4' u ..,,. r? -r. % r , " P AN `Itt —* iW ,L s '; a' ;_;
❑New COnStruCti n ®Additiori�ll atiii e � r 'r, Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three. stories.
0 Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
S ` -CAGO O ,coNS-L'R '. t v i j , z ? , , :. exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
TE ` 1r = ` } f t " less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
4J 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi family ❑ Master builder ❑ Other: . ❑ Fite pump. ❑ Installation of 75 KVA or
' JQ$ `SAC ` NF 0N;I TdON.` . 1 ❑ Emergency system. larger
G s r s " .. . '',' it Q v D A ON "'�tt ' .'. g �o Y g separately derived system.
.•... ,. ,. , ...� ..�_... _ ❑Addition of new motor load of ❑ "A ", "E ", "I.2 ", "1 -3 ",
Job no.: J ob site address: 100HP or more. occupancy.
673 56 10680 SW FONNER •S IRE ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: TIGARD, OR 97223 ❑ Health - care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg./apt. no.: Project name: ❑ Service o r feeder 600 amps or more
J CARMICHAII RESIDENCE i > p
E ( .ft
Cross street/directions to job site: Description l Qty. 1 Fee. 1 - Total 1 *
. New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: 1 Lot no.: 1,000 sq. ft. or less 168.54 4
Tax map /parcel no.: ,���y Ea. add'I 500 sq. ft. or portion 33.92 1 •
�: a ' t - re'.:S' t • A.,. - a ,. Y .J O° N ?OI WORItT , t . -, F *' 'u' '-P,: Limited (with above sq ft.)
Sidentlal 67.84 2
Limited energy, multi - family 67.84 2
PROVIDE ADDITIONAL GROUNDING TO REPLACE WATER residential (with above sq. 11.)
Services or feeders installation, alteration, and /or relocation
PIPE GROUND 200 amps or less 100.70 2
f a 4' , TY DW$IER rr._T s Q, ,.0 YMA` T€I' ", a : ' a 201 amps to 400 amps 133.56 2 _
Name: 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) • I Fax: ( ) 200 amps or less 59.36 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. - 401 amps to 599 amps 168.54 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
A. Fee for branch circuits with
i'a l t l L,T�AiV?I •' , r , q OO11T j above service or feeder fee,
each branch circuit 7'42 2
Business name: B. Fee for branch circuits
without service or feeder fee,
Contact name: 56.18
first branch circuit
Address: Each add'I branch circuit 7.42 2
Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular 67.84 2
Phone: ( dwelling, service and /or feeder
Fax: ( ) Reconnect only 1 67.84 67.84 2
E - mail: Pump or irrigation circle 67.84 2
<{,b ". r {rr d ?, y, sCONTRito.T .0 - t' t f < r aE' Sign or outline lighting 67.84 2
_. . , . ., .� ._ � . � Ate, _... �._...._, ;. �_� �Y . � . _- .:�.5,ar � ; . _ . ° .. ,..� � P� g
Signal circuit(s) or limited -
Business name: FRAHf ,ER FiFCTRTC COMPANY energy panel, alteration, or
Address: 11860 SW GREENBURG ROAD extension. Describe: Page 2 2
City/State /ZIP: TIGARD, OR 97223 Each additional inspection over allowable in any of the above
Phone: ( ) F ax: ( • ) Per inspection 66.25
503 639 -462 503 639 -4673 Investigation per hour (1 hr min) 66.25
CCB Lic.: 37410 Electrical Lic.: 34 -13C Suprv. Lic.: 1816S Industrial plant per hour 78.18
/ ��C t/ � 1 � , ` :, :i `:-. F i F;C'•11 C'AL ' F4RIVIb total 67.84 ' al i 'ES ' '
Suprv. Electrician signature, ri d: Subtotal: _
Plan review (25% of permit fee):
Print name: R. W. F RAHLER Date: 02/25/10 20
State surcharge (12% /o of permit fee): 8.14
Authorized signature: TOTAL PERMIT FEE: 79. 9g
Print name: Date: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Number of inspections allowed per permit.
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