Permit CITY OF TIGARD ELECTRICAL PERMIT
a COMMUNITY DEVELOPMENT Permit #: ELC2010 -00449
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/26/2010
Parcel: 2S 111 CCO5100
Jurisdiction: Tigard
Site address: 15930 SW CENTURY OAK CIR
Subdivision: SUMMERFIELD NO. 1 Lot: 74
Project: Gander
Project Description: Provide grounding after water line replacement.
Owner: FEES
GANDER, PAUL & MARIA Quantity Description Date Amount
15930 SW CENTURY OAK CIR
TIGARD, OR 97224 1 ea Reconnect Only 08/26/2010 $67.84
PHONE: 503-620-6831 1 ea 12% State Surcharge - 08/26/2010 $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 per is issued ' ct to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be d e in accordance with pproved •tans. 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 --quir y• to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 01 -0010 through OAR 952 -4 -0101 Y• may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issue • 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:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' — _ % ��Q u `_ Date: ( /
LICENSE NO.
CaII 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 - - 1 o R o F r i r is 1 s 11 ()NI.,
City of Tigard g'/p f ,, Permit No.: e oVO— e0 ci
l'ilh: 13125 SW Hall Blvd., Tigard, OR 97223 2 Plan Review
C Phone: 503.639.4171 Fax: 503.598.196M U G �+ 6 Z O 1 O Date/By: Other Permit.
Inspection Line: 503.639.4175 Date Ready/By: 1uis: M See Page 2 for
T I G A I: D
Internet: w.vw.tigard- or.gov a Notified /Method: Supplemental Information ! �
TYPE OF WORK ± • '. ` PLAN REVIEW
❑ New construction ® Addition/alteration/replacement Please check all that apply (submit a sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 1 0,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
® 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi-famlly ❑ Master builder ❑ Other ❑ Fire pump. ❑ Installation of 75 KVA or
❑ Emergency system larger separately derived system.
JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor Load of ❑ "A ", "E ". "1 -2 ", "1 -3 ",
Job no.: 6 7 7 8 3 Job site address: 15930 SW CENTURY OAK CIRCLE 1001-1P or more. occupancy.
El Six or more residential units. ❑ Recreational vehicle parks.
❑Health-care facilities. ❑Supply voltage for more than
City /State/ZIP: TIGARD OR 97224 _ ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: GANDER RESIDENCE ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Des 1 Qa• l Fee- 1 Total 1 •
' New residential single- or mold-family dwelling milt.
Includes attached garage.
Subdivision:
Lot no.: 1,000 sq. It- or less 16834 4
• Ea. add'1 500 a9, R. or portion 33.92 1
Tax map /parcel no.: 2 S 111 CCO5100 Limited energy, residential
(with above s q. ft-) 75.00 2
DESCRIPTION OF WORK -
Limited energy, multi- family 75.00 2
PROVIDE NEW GROUNDING AFTER WATER LINE IS REPLACED residential (with above sq. ft)
Services or feeders i nstallatlon, alteration, and/or relocation .
200 amps or less 100.70 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name: 601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and/or
City/State/ZIP: relocation
Phone: ( ) Fax: ( ) 200 amps or leas 59.36 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not 168.54 2
according to ORS 447, 449, 670, and 701. 401 to 599 amps
intended for sale, lease, rent, or exchange, Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: _ A. Fee for branch circuits with
above service or feeder fee, 7.42 2
❑ APPLICANT ❑CONTACT PERSON each branch circuit
Business name: B. Fee for branch circuits without
cervix or feeder fee, first 56.18 2
Contact name: branch circuit _
- Eaeh ada'I ;ranch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
Each manufactured or modular 67.84 2
City /State/ZIP: dwelling, service and/or feeder
`
Phone: ( ) Fax: : ( )
Reconnect only 1 67 67.84 2
Pump or irrigation circle 67.84 2
E -mail. Sigrt or outline lighting 67.84 2
CONTRACTOR Signal circuit(a) or limited- energy
panel, alteration, or extension. _ Page 2 _ 2
Business name:
FRAHLER FT .E(;11ZIC COMPANY Each additional inspection over allowable in any of the above
Address: 11860 SW GREENBURG ROAD Additional inspection (1 hr min) 66.25/ hr
Investigation (1 hr min) 66.25/ hr
City/State/ZIP: TIGARD, OR 97223 Induatriat plant (1 hr min) 78.18/ hr
Phone: ( 503) 639-4627 Fax: (503 ) 639 -4673 Inspections for which no fee is 90.00/1u
specifically listed (% hr min)
CCB Lic.: 37410 Electrical Lic.: 34 -13C Suprv. Lic.: 1816S ELECTRICAL PERMIT FEES
n � � � Subtotal: 67.84
Suprv. Electrician signature, required: /.�iu/i��ov`'Wti Plan review (25% of permit fee):
Print name: R W. FRAHLER Dec 08/25/10 State surcharge (12% of permit fee): 8.14
TOTAL PERMIT FEE: 75. 98
Authorized signature: This pernilt application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Date: • Number of inspections allowed per permit
Electrical Permit Application - City of Tigard •
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined .. $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918 -309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Qock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations