Permit CITY'OF TIGARD ELECTRICAL PERMIT
TIGARD PERMIT #: ELC2008 -00567
COMMUNITY DEVELOPMENT DATE ISSUED: 10/7/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1 S134CD 03200
SITE ADDRESS: 12055 SW 119TH AVE ZONING: R -4.5
SUBDIVISION: LERON HEIGHTS NO.3 LOT : 067 JURISDICTION: TIG
PROJECT: QUANTUM MANAGEMENT CORP
Project Description: Repairs to existing wiring for reconnection of power. Job No.66154
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:
QUANTUM MANAGEMENT CORP FRAHLER ELECTRIC CO
7327 SW BARNES RD 11860 SW GREENBURG RD
PORTLAND, OR 97225 TIGARD, OR 97223
Phone: Contact #: FAX 503 - 639 -4673
PRI 503 - 639 -4627
FEES
Description Date Amount Reg #: ELE 34 -13C
[ELPRMT] ELC Permit 10/7/2008 $73.45 LIC 37410
[TAX] 12% State 10/7/2008 $8.81 SUP S l I 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 -t forth in OAR 952 - 001 -0010 through OAR 952 -001 -0100. You may obtain copies of these rules or direct questions to OUNC at
503.246.66•' or 1.8111 + - - 4.
Issued B / I Permittee Signature: L � ` �
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.
• 111vctrical Permit Application . �� I'OR OFFICE USE ON L1'
Cif o Ti and Received
�' g 0� Date/By: 10 6 0 t 'k y Permit No.: e t c 014e:4 - 5 CO C 77
a 13125 SW Hall Blvd,, Tigard, OR Plan Review
C Phone: 503.639.4171 Fax: 503. 8.1960 % c ^O 1 • Date Other Permit:
Inspection Line: 503.639.4175 �'(
l' I G A R D \ ` a Re
Date edyBy: 3uris: la See Paget for
Internet: www.tigard or.gov ' (3 )V Notified/Method: t Supplemental Information
o-..,:r.:.:,,
„
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F W _ 'r
❑ New construction ❑ Service e k all l that - � � der 400 am apply (submit
or m bmit 2 sets of plans w/items checked below):
❑ Building over three stories
� Addttton/altt;ral ant Please check
j
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
: : r'.; exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
CATE ; - ,.:.,• . .;'. ,. - - .,
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 - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
17:1 Emergency system larger separately derived system.
., JOB''SITE'= INFORMATION •• A :;'LOCATION . - ❑ Addition of new motor load of ❑ "A", 'B" "1 "1
Job no.: 66154 Job site address: 12055 SW 119th AVENUE 10013P 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.: Project name: RESIDENCE ❑ Service or feeder 600 amps or more.
, ',: " '3 :FEE: SCHEDULE. ,
Cross street/directions to job site: Description _ 1 Q<s• I Fe& I Taal I
New residential single- or multi -family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'! 500 sq. R or portion 33.40 1
Tax map/parcel no.: -
. ,. .._ residential
..,. ,.,:: .. , ,- ,� „ 7500 2
,
.DESCR)1'TIO1V. ! >� - ��r':1 ^ 'i;
._. ., . , . ... ,. :.., , _•. ;OF; WORK'” _ - with above s
Limited energy, multi - family 75.00 2
REPAIRS TO EXISTING WIRING FOR RECONNECTION OF POWER residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 80 30 2
58,:: PROPERT OWNER ;, W T'ENA`NT" _ 201 amps to 400 amps 106.85 _
Name: 2
( �� s n i- t-1 Q ��� 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 _ 2
Address: 7 3 2 7 1 P aa2)f_5 Over 1,000 amps or volts 454.65 2
City /State/ZIP: P-ruo 9 7 9,g-~S-7 Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made, on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
:'❑.- APPLICANT `; : :: ` : ' :' ❑ CONTACT:;P,-ERSON : above service or feeder fee,
each branch circuit 6.65 2
Business name: B. Fee for branch circuits
without service or feeder fee,
Contact name: first branch circuit 1 46.85 46.85 2
Address: Each add'l branch circuit 4 6.65 26.60 2
City/State/ZIP: /State/7.TP: Miscellaneous (service or feeder not included)
' Each manufactured or modular 90.90 2
Phone: dwelling, service and/or feeder
( ) Fes ' ( ) Reconnect only 66.85 2
E-mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Business name: FRAHLER ELECTRIC COMPANY signal circuit(s) or limited -
energy panel, alteration, or
Address: 11860 SW GREENBURG ROAD extension. Describe: Page 2 2
city /State/7:1P: TIGARD, OR 97223 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( 503) 639 -4627 Fax: (503 ) 639 -4673 Investigation per hour (1 hr min) 62.50 -
CCB Lic.: 37410 Electrical Lic.: 34 -13C Suprv. Lic 5110S • Industrial plant per hour 73.75
:: ,`. E LECTRICAL: PERMrf..FEES
Suprv. Electrician signature, required:
ide,,t' ( Subtotal: 73.45
PIint name: D ate: Plan review (25% of permit fee):
ADAM EIEIERINGTON 10/01/08
- State surcharge (12% of permit fee): 8.81
Authorized signature: TOTAL PERMIT FEE: 82.26
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
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CITY OF ��nu m ��u wu���mnn��
BUILDING DIVISION PERMIT ~~~~^~~~~^^~~� ~~^~^~~"~~"~ � ELC2OO8-O0567
1312G8VV Hall Blvd, Tigard, DRQ7223 DATE ISSUED: 10/7/2008
Phone: (5O3)G39'4171
Inspection Requests (24Hmj: (503 ) 639~4175
INSPECTION WORKSHEET FOR DATE: � TIME: PAGE:
1O/16K2008 � 7:O1AKA � 27
•
SITE ADDRESS: CLASS OF WORK:
�
12U5SE%�11�7H�VE
�
GUBD|V|S|ON� � �
LOT #: TYPE
LER[)NHB C>
HEIGHTS 067
PROJECT NAME:
� QUANTl)&4&4ANAGBMEMTCQRP
DESCRIPTION:
Repairs to existing wiring for reconnection of powei. Jub@o.6O154
OWNER: PHONE #:
� QUANTUM � PHONE # •
� F��AMLER�]'ECJF�|<�C0 503-639-4627
Inspection Request Scheduled For' Date: Pour Time:
�
� ' 10K16/2008
Code # Inspection Description C Contact # Message
199 Electrical i��ne| P6780-01 l 503-639-4627 N
Corrections/Comments/Instructions:
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�� ~ASS �� PARTIAL . / CANCEL / / NO ACCESS
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FAI CALL FOR INSPECTION L ADDITIONAL FEES ASSESSED
Inspector: '��--' e%g /- C; Date: 1 01 401 1416 / Phone #: /503\ 718- w�/
. .