Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2011 -00213
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/26/2011
Parcel: 1S135DD03301
Jurisdiction: Tigard
Site address: 11945 SW PACIFIC HWY 206
Project: Wells Wigs Subdivision:PARK PLACE GARDEN APARTMENTS Lot:
Project Description: Modification of (5) branch circuits for new tenant.
Contractor: FRAHLER ELECTRIC CO Owner: TIGARD PLAZA LLC
11860 SW GREENBURG RD 8320 NW HWY 99
TIGARD, OR 97223 VANCOUVER, WA 98665
PHONE: 503 -639 -4627 PHONE:
FAX: 503 - 639 -4673
FEES
Quantity Description Date Amount
5 crt Branch Circuits wo /Purchase 04/26/2011 $85.86
Specifics: Service or Feeder
1 ea 12% State Surcharge - 04/26/2011 $10.30
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $96.16
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTE ION: Ore law requir ou to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -00 thro gh OAR 9 - 001 -00 . You ma obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332. 344.
Issued B • Permittee Signature:
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' � . �, / Date:
. �.
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Electrical Permit Application E) E) ED FOR OFFICE t'sl: ON l.1
RECEIVED Received
City of Tigard Date /B : _/� Permit No.: 4� i ` -Oaf
13125 SW Hall Blvd., Tigard, OR 97223 2 6 Plan Review
l
= Phone: 503.718.2439 Fax: 503.598.1960 4PR Date B Other Permit:
TIGARD Inspection Line: 503.639.4175 Date Ready /By: Juris fa See Page 2 for
Internet: www.tigard - or.gov CITY OF TIGARD Notified/Method: Supplemental Information
TYPE OF A$IWkDING DIVISION PLAN REVIEW
❑ New construction ® Addition /alteration /replacement 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.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ I- and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", 't -2 ", "l -3 ",
Job no.: 68421 Job site address: 11945 SW PACIFIC HIGHWAY 100HP or more. occupancy.
❑ 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.: 206 Project name: WELLS WIGS T. 1. ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description P I Oty. I Fee. I Total I"
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'I 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi - family 75.00 2
WIRING INSIDE REMODELED TENANT SPACE OFFICES residential (with above sq. ft.)
Services or feeders installation, alteration, and /or relocation
200 amps or less 100.70 2
❑ PROPERTY OWNER ❑ TENANT 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: ( ) Fax: ( ) 200 amps or less 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
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee 7.42 2
each branch circuit
Business name: B. Fee for branch circuits without
service or feeder fee, first 1 56.18 56.18 2
Contact name: branch circuit
Each add'I branch circuit 4 7.42 29.68 2
Address: Miscellaneous (service or feeder not included)
City /State /ZIP: Each manufactured or modular 67.84 2
dwelling, service and/or feeder
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E -mail:
Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s) or limited - energy
Business name: FRAHLER ELECTRIC COMPANY panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: 11860 SW GREENBURG ROAD Additional inspection (1 hr min) 66.25/ hr
66.25/ hr
City/State /ZIP: TIGARD, OR 97223 Investigation (1 hr min)
Industrial plant (1 hr min) 78.18/ hr
Phone: (503) 639 -4627 Fax: (503) 639 -4673 Inspections for which no fee is 90.00/ hr
specifically listed (1/2 hr min)
CCB Lie.: 37410 Electrical Lie.: 34 -13C Suprv. Lie.: 1816S ELECTRICAL PERMIT FEES
Suprv. Electrician signature, reefed: t Subtotal: 85.86
Plan review (25% of permit fee):
Print name: R. W. FRAHLER Date: 04/22/11 State surcharge (12% of permit fee): 10.30
TOTAL PERMIT FEE: 96.16
Authorized signature:
This permit 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.
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