Permit , CITY O F TIGARD ELECTRICAL PERMIT
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PERMIT #: ELC2008 00285
COMMUNITY DEVELOPMENT DATE ISSUED: 5/20/2008
'TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 25111 BD -01801
SITE ADDRESS: 14850 SW 100TH AVE ZONING: R -3.5
SUBDIVISION: ALDERBROOK FARM LOT : 005 JURISDICTION: TIG
PROJECT: ODELL
Project Description: Installing (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:
ROBERT & CHARLOTTE ODELL FRAHLER ELECTRIC CO
14850 SW 100TH 11860 SW GREENBURG RD
TIGARD, OR 97224 TIGARD, OR 97223
Phone: Contact #: FAX 503 - 639 - 4673
PRI 503 - 639 -4627
FEES
Description Date Amount Reg #: ELE 34 -13C
[ELPRMT] ELC Permit 5/20/2008 $73.45 LIC 37410
[TAX] 12% State Surchar 5/20/2008 $8.81 SUP 51 l OS
Total $82.26 REQUIRED ITEMS AND REPORTS
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 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued B Perm ittee Signature: � t/
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: 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
c01 FOR OFFICE I ISE ONLY
c , City of Tigard c0 Received
Datc 5-, 677 Permit No.:
-- iFe
II - • 13125 SW Hall Blvd., Tigard, OR 97) Plan Review
: lIl • Phone: 503.639.4171 Fax: 503.598. t! '
x\ "t Date/By: Other Permit:
TIGAI:D
Inspection Line: 503.639.4175 . Date Ready/By: luxis: 65 See Page 2 for
V11 \ ' -
Internet: www.tigard-or.gov , 4 4 ,ed/Method: TM_ Cb Supplemental Information
, . .
, . • TYPE OF "WORK AN k.) .. , Print name:
El New construction El Addition/alteration/kit**
, -+L , . .
• ' • . , PLAN REVIEW
El Demolition 0 Other:
Please check all that apply (submit 2 sets of plans w/items checked below)
CATEGORY OF 'CONSTRUCTION ' ' , '. - . I Service or feeder 400 amps or more 0 Building over three stories.
. , .
El 1- and 2-family dwelling 0 Commercial/industrial 0 Accessory building where the available fault current 0 Marinas and boatyards.
exceeds 10,000 amps at 150 volts or 13 Floating buildings.
0 Multi-family 0 Master builder 0 Other: less to ground, or exceeds 14,000 0 Commercial-use agricultural
. . . JOB SITE DTFORMATION. AND LOCATION amps for all other installations. buildings.
0 Fire pump. 0 Installaticm of 75 KVA or
Job no.: 65773 Job site address: 14850 SW 100 AVENUE 0 Emergency system. larger separately derived system.
CI Addition of new motor load of 0 "A", "E", "1-2", "1-3",
City/State/Z1P: TIGARD, OR 97224 100HP or more occupancy.
0 Six or more residential units. 0 Recreational vehicle parks.
Suite/bldg./apt no.: Project name: ROBERT ODELL RESIDENCE 0 Health-care facilities. 0 Supply voltage for more than
ID Hazardous locations. 600 volts nominal.
Cross street/directions to job site:
ID Service or feeder 600 amps or more.
Detenption i Q19. I Fee. I Total i •
Subdiv)sion: Lot no.: New residential single- or multi-family dwelling unit.
Includes attached garage.
Tax map/parcel no.:
• 1,000 sq. ft. or less 145.15 4
,
..;.,•,. „ , :.;,;;:., .'.. :: - , ",_ ',.•,, : DESCRIPT1ON, OF WORK .., ' ' - .- ' ...--.. - - '' - ...": - '''. •";:"' ' '-' Ea. addl 500 sq. ft. or portion 33.40 1
KITCHEN REMODEL Limited energy, residential
75.00 2
(with above sq. ft.)
Limited energy, multi-family
75.00 2
residential (with above sq. ft.)
0.PROPERTY'. - ,: - ' : ' :- ' ' :1 - ' 0 TENANT ' ' .- ' ,:- ,..: ..' Services or feeders installation, alteration, and/or relocation
Name: 4eor_Ar-- v- atiqu-ii- ()IR q 200 amps or less
201 amps to 400 amps , 80.30
106.85 2
2
Address: 401 amps to 600 amps 160.60 2
City/State./ZIP: 601 amps to 1,000 amps 240.60 .., 2
Over 1,000 amps or volts 454.65 2
Phone: ( ) Fax: ( ) Temporary services or feeders installation, alteration, and/or
relocation
Owner installation: This installation is being made on property that I own which is not
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 200 amps or less 66.85 1
201 amps to 400 amps 100.30 2
Owner signature: Date:
401 araps to 599 amps 133.75 2
A1TLICANT _ - ' - ' ,' •' . - - -.- ' la - ,CONTAC'T.:PERSON ' ' . . .:' Branch circuits - new, alteration, or extension, per panel
A. Fee for branch circuits with
Business name:
above service or feeder fee,
6.65 2
Contact name: each branch circuit
B. Fee for branch circuits
Address: without service or feeder fee, 1
46.85 46.85
2
first branch circuit
City/State/ZIP: Each add'l branch circuit I 4 6.65 26.60 I 2
Miscellaneous (service or feeder not included)
Phone: ( ) Fax: : ( )
Each manufactured or modular
9090 2
E-mail: dwelling, service and/or feeder
• ',- •!::-.-: :..--.' - , : ' . , - .- - . . CONTRACTOR • ' ' : ' =. Reconnect onlY 66.85 2
Pump or irrigation circle 53.40 2
Business name: FRAHLER ELECTRIC COMPANY
Sign or outline lighting 53.40 2
Address: 11860 SW GREENBURG ROAD Signal circuit(s) or limited-
energy panel, alteration, or
City/State/ZIP: TIGARD, OR 97223 extension. Describe: Page 2 2
Phone: (503) 639 Fax (503) 639 • Each additional inspection over allowable in any of the above
CCB Lic.: 37410 Electrical Lic.: 34-13C Suprv. Lic.: 5110S Per inspection 62.50
Investigation per hour (1 hr min) 62.50
Suprv. Electrician signature, required: 4t (''' 4
4,
Date: MAY15, 2008 Industrial plant per hour 73.75
• • ELECTRICAL PERMIT FEES
Print name: ADAM ETHERINGTON Subtotal: 73.45 ,
Plan review (25% of permit fee):
State surcharge (12% of permit fee):
Authorized sigmatire:
TOTAL PERMIT FEE:
Tr)`• X
1 18/27 , 2008 10:49 FRAHLER ELECTRIC 4 95035981960 NO.828 I01
• •
Development � .. Community REC p
Request for Permit Action AUG 27 2C
I II AICIt _ CifYOFTIGARD
TO: CITY OF TIGARD
BUILDING DIVISION
Building Division Services Coordinator
13125 SW Hall Blvd., Tigard, OR 97223
Phone; 503.718.2430 Fax: 503.598.1960 www.tigard-or.gO 'tr
FROM: ❑ Owner ❑ Applicant [o Contractor ❑ City Staff
(cheek one)
REFUND OR Name: FR.AJ LER ELECTRIC COMPANY
INVOICE TO: (Bus or Individual)
V 0 Mailing Address: 11860 SW GREENBURG ROAD
City /State /Zip: TIGARD, OR 97223
V o Phone No.: 503 - 639 -4627
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (I):
El CANCEL PERMIT APPLICATION.
REFUND PERMIT FEES (attach receipt, if available).
❑ INVOICE FOR FEES DUE (attach case fee schedule and explain below).
❑ REMOVE CONTRACTOR FROM PERMIT (do not cancel permit).
Permit #: ELC2008 -00285 •
Site Address or Parcel #: 14850 SW 100 AVENUE
Project Name: ROBERT ODELL RESIDENCE
Subdivision Name: Lot #:
EXPLANATION:
CUSTOMER DECIDED TO CANCEL THE PRO ECT
Signature:
,
•.` Date: 08/27/08
RW.i
Print Name:
•
Befimrl Policy
1. The Director or Building Official may authorize the refund of.
a) any fee winch was erroneously paid or collected.
b) not more than 80% of the land use application fee when an application is withdrawn or canceled before any review effort has been expended.
c) not more than &I%4 of the land use application fee for issued permits.
d) not more than 80% of the building plan review fee when an application is canceled before any plan review effort has been expended.
e) not more than 80% of the building permit fee for issued pm-nuts prior to any inspection requests.
2. Refunds will be returned to the original Payer in the same method in which payment was received. Please allow 1 -2 weeks for processing refunds.
1- '012..0 J'IUE I ISE ONJ.X
` ( L Rte to Bid• Admin: Date i 17 = ilr�
Rte to S Adrain: Date -
Refund Processed: Date — - i Ocp- B Invoice Processed: Date B
Fesmit Canceled: Date
Parcel Tag Added: Date B'
•
Q�d�� t. //' 8
City of Tigard
TIGARD Tidemark Refund Request
This form is used for refund requests of land use, engineering and building application fees.
Receipts, documentation and the Request for Permit Action or Refund form (if applicable) must be
attached to this form. Refund requests are due to Tidemark System Administrator by Friday
at 5:00 PM for processing each Monday. Accounts Payable will route refund checks to Tidemark
System Administrator for distribution. Please allow 1 -2 weeks for processing.
PAYABLE TO: Frahler Electric Company DATE: 9/16/08
11860 SW Greenburg Rd.
Tigard, OR 97223 REQUESTED BY: Dianna Howse
Attn: R. W. Frahler
TRANSACTION INFORMATION:
Receipt #: 2008 -1721 Case #: ELC2008 -00285
Date: 5/20/08 Address /Parcel: 14850 SW 100th Ave.
Pay Method: Check Project Name: Odell
EXPLANATION: Per applicant's request as job was cancelled. Refund 80% of permit fees.
REFUND INFORMATION:
Fee Description From Receipt Revenue Account No. - Refund
Example: [BUILD] Permit Fee Example: 245 - 0000 - 432000 $ Amount
[ELPRMT] ELC Permit 220 - 0000 - 431510 $58.76
[TAX] 12% State Surcharge 100- 0000 - 207020 7.05
TOTAL REFUND: $65.81
APPROVALS:
If under $500 Professional Staff
If under $7,500 Division Manager `'
If under $22,500 Department Manager
If under $50,000 City Manager
If over $50,000 Local Contract Review Board
FOR TIDEMARK SYSTEM ADMINISTRATION USE ONLY
Case Refund Processed: Date: I `j !v i' By: 1 ,,,,
1:\ Building \12efunds \RefundRequest.doc 05/23/07
City of Tigard, Oregon • 13125 SW Hall Blvd. • Tigard, OR 97223
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•
T I GARD
October 7, 2008
Frahler Electric Company
11860 SW Greenburg Rd.
Tigard, OR 97223
Attn: R. W. Frahler
Re: Permit No. ELC2008 -00285
Dear Mr. Frahler:
The City of Tigard has canceled the above referenced pern it(s) and enclose a refund for the
following:
•
Site Address: 14850 SW 100 Ave.
Project Name: Odell
Job No.: N/A
Refund: ® Check #59671 in the amount of $65.81.
❑ Credit card "return" receipt in the amount of $
❑ Trust account "deposit" receipt in the amount of $ .
Notes: Per applicant's request as job was cancelled. Refund 80% of permit fees.
If you have any questions please contact me at 503.718.2430.
Sincerely,
. "Cr(5414(74&- .
Dianna Howse
Building Division Services Supervisor
Enc.
1:\ Building \ Refunds \ Administration \LtrRefund- CancelPemvtdoc 01/16/07
Phone: 503.639.4171 • Fax: 503.684.7297 • www.tigard- or.gov • TTY Relay: 503.684.2772
CITY Of TIGARD 8/27/3008
13125 SW IJail Blvd. I 0:54:55AM
Tigard, OR 97223 503.639.4171
TIGARD
Receipt #: 27200800000000001721
Date: 05/20/2008
Line Items:
Case No Tram Code Description Revenue Account No Amount Paid
ELC200S - 002$5 [ELPRMT] ELC Permit 220- 0000- 4315I0 73.45
ELC2008 -00285 [TAX] 12% State Surcharge 100- 0000 - 207020 8.81
Line Item Total: $82.26
Payments:
Method Payer User ID Acct. /Check No. Approval No. Flow Received Amount Paid
Check I=RAHLER ELECTRIC COMPANY BTT 040165 In Person 82.26
Payment Total: $82.26
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