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Permit 5 /(0 /// kpr ' c / ud,_ , roc vvdm, , ... CITY OF TIGARD ELECTRICAL PERMIT IN COMMUNITY DEVELOPMENT Permit #: ELC2011 -00229 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/03/2011 Parcel: 2S102CA00929 Jurisdiction: Tigard Site address: 13320 SW VILLAGE GLENN DR Project: Jackson Subdivision: VILLAGE GLENN Lot: 29 Project Description: This permit created so licensed contractor can take over work originally permitted under MST2011 -00042 by owner. Scope of work is (1) branch circuit. 5/5/11, reprinted to correct project description. 5/6/11, reprinted to add grounding. Contractor: FRAHLER ELECTRIC CO Owner: JACKSON, RAY E LILA M 11860 SW GREENBURG RD 13320 SW VILLAGE GLENN DR TIGARD, OR 97223 PORTLAND, OR 97223 PHONE: 503 - 639 -4627 PHONE: 503 - 639 -0399 FAX: 503 -639 -4673 FEES Quantity Description Date Amount 1 crt Branch Circuits wo /Purchase 05/03/2011 $56.18 Specifics: Service or Feeder 1 ea 12% State Surcharge - 05/03/2011 $6.74 Type of Use: SF Electrical Class of Work: ALT 1 ea Reconnect Only 05/06/2011 $67.84 Type of Const: 8 12% State Surcharge - 05/06/2011 $8.14 Occupancy Grp: Building Total $138.90 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 - 001 -0090. You ma obtain a • • •f the rul questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: ...---..../—"--- �_ . Permittee Signature: t �'iA�� —,.A �' 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. CITY OF TIGARD ELECTRICAL PERMIT I II g; COMMUNITY DEVELOPMENT , Permit #: ELC2011 -00229 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 •� Date Issued: 05/03/2011 Parcel: 2S102CA00929 Jurisdiction: Tigard Site address: 13320 SW VILLAGE GLENN DR Project: Jackson Subdivision: VILLAGE GLENN Lot: 29 Project Description: This permit created so licensed contractor can take over work originally permitted under yMST2011 -00042 by owner. Scope of work is (1) branch circuit. 5/5/11, reprinted to correct project description. Contractor: FRAHLER ELECTRIC CO Owner: JACKSON, RAY E LILA M 11860 SW GREENBURG RD 13320 SW VILLAGE GLENN DR TIGARD, OR 97223 PORTLAND, OR 97223 PHONE: 503 - 639 -4627 PHONE: 503 - 639 -0399 FAX: 503 - 639 -4673 FEES Quantity Description Date Amount 1 crt Branch Circuits wo /Purchase 05/03/2011 $56.18 Specifics: Service or Feeder 1 ea 12% State Surcharge - 05/03/2011 $6.74 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $62.92 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 - • -nce w - .prove. •fans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. AT' NTION: Oregon la -quires you to follow the rules adopted by the Oregon Utility Notifi ' nter. Those rules are set forth in OAR 952 -001 1010 thr.ugh OAR 952-00 0 0090 ' ay obtain a copy of the rules or direct questions to OUNC by mg 503.232.1987 or 1.800.332.2344.^ i Issue By: �"- 4. /_ /_ Permittee ' nature: - /i 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. CITY OF TIGARD ELECTRICAL PERMIT `• COMMUNITY DEVELOPMENT Permit #: ELC2011 -00229 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/03/2011 Parcel: 2S102CA00929 Jurisdiction: Tigard Site address: 13320 SW VILLAGE GLENN DR Project: Jackson Subdivision: VILLAGE GLENN Lot: 29 Project Description: Contractor: FRAHLER ELECTRIC CO Owner: JACKSON, RAY E LILA M 11860 SW GREENBURG RD 13320 SW VILLAGE GLENN DR TIGARD, OR 97223 PORTLAND, OR 97223 PHONE: 503 - 639 -4627 PHONE: 503 - 639 -0399 FAX: 503 - 639 -4673 FEES Quantity Description Date Amount 1 crt Branch Circuits wo /Purchase 05/03/2011 $56.18 Specifics: Service or Feeder 1 ea 12% State Surcharge - 05/03/2011 $6.74 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $62.92 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- -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.2321987 or 1.800.332 344. Issued By: 74–e— Permittee Signature: –_ ' �`"' 7 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 FOR OFFICE USE ONLY City of Tigard 4/ Received r Date/B /� Permit No.. • 13125 SW Hall Blvd., Tigard, OR 97223 .......••• • J- ,to a - an Phone: 503.718.2439 Fax: 503.598.1W � ~ Datte,/ eW Other Permit: '�� v .••• • TIGARD Inspection Line: 503.639 �/ Q � Date Ready/By: Juris: ® See Page 2 for Internet: www.tigard- or.gov � 6 > � Not 7-7:e Supplemental Information TYPE O ORKA-e- 0 'c PLAN REVIEW O Please check all that apply (submit 2 sets of plans w /items checked below): I:] New construction ® Addition /alteration /rep ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Other: whe re the available fault current L � 0 Marinas and boatyards. CATEGORY OF CONSTRUC1 N exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural El 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 JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system. ❑ Addition of new motor load of ❑ "A ", "E ", "1 - ", "1 - ", Job no.: 68435 Job site address: 13320 SW VILLAGE GLEN DRIVE 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.: Project name: JACKSON RESIDENCE ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: Description I Qty. I Fee. I Total 1 New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4 Tax map /parcel no.: Ea. add'l 500 sq. ft. or portion 33.92 1 Limited energy, residential 75.00 2 DESCRIPTION OF WORK (with above sq. ft.) Limited energy, multi family INSTALL WIRING IN NEW BATHROOM AND INSTALL FAN residential (with above sq. ft.) 75.00 2 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 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 Branch circuits — new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with El APPLICANT I ❑ CONTACT PERSON above service or feeder fee, each branch circuit 7.42 2 Business name: B. Fee for branch circuits without service or feeder fee, first I 56.18 56.18 2 Contact name: branch circuit Each add'I branch circuit 7.42 2 Address: Miscellaneous (service or feeder not included) City /State /ZIP: Each manufactured or modula 67.84 2 dwelling, service and/or feeder Phone: ( ) Fax: : ( ) Reconnect only 67.84 2 E-mail: Pump or irrigation circle 67.84 2 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 City /State /ZIP: TIGARD, OR 97223 Investigation (1 hr min) 66.25/ hr Industrial plant (I hr min) 78.18/ hr Phone: (503) 639 - 4627 Fax: (503) 639 - 4673 . Inspections for which no fee is 90.00! hr Su Lic.: 1816S specifically listed (%2 hr min) Suprv. CCB Lic.: 37410 Electrical Lic.: 34 - 13C p ELECTRICAL PERMIT FEES Suprv. Electrician signature, reckrfed: ,,,,litov�i�j(r. Subtotal: 56.18 �` "� Plan review (25% of permit fee): Print name: R. W. FRAHLER Date: 05/02/11 State surcharge (12% of permit fee): 6.74 Authorized signature: TOTAL PERMIT FEE: 62.92 This permit application expires if a permit is not obtained within 180 Print name: days after it has been accepted as complete. Date: • Number of inspections allowed per permit. 1:\ Building \Permits\ELC- PermitApp.doc 07/01/10 440- 4615T(I1 /05 /COM/WEB Electrical Permit Application FOR OFFICE USE ONLY Received / n� - � — PIP City of Tigard Date/By: 376 // v/ / Permit No.: ELC2011 -00229 ADD TO 1 3125 SW Hall Blvd., Tigard, OR 97223 Plan Review / Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit: TIGARD Inspection Line: 503.639 Date ReadyBy: �''�}�G�j� l�_ ® See Page 2 for Internet: www.tigard - or.gov Notified/Method: /yL� Supplemental Information TYPE OF WORK PLAN REVIEW ❑ New construction E 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 ® 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 JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system. ['Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "I -3 ", Job no.: 68435 Job site address: 13320 SW VILLAGE GLEN DRIVE 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.: Project name: JACKSON RESIDENCE ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: Description Descption 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 ADD GROUNDING FOR ELECTRICAL PANEL DUE TO WATER LINE residential (with above sq. ft.) REPLACEMENT 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 2 401 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 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 401 amps to 599 amps 168.54 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits — new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with ❑ APPLICANT El 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 56.18 2 Contact name: branch circuit Each add'] branch circuit 7.42 2 Address: Miscellaneous (service or feet er not included) City /State /ZIP: Each manufactured or modular 67.84 2 dwelling, service and/or feeder Phone: ( ) Fax: : ( ) Reconnect only 1 67.84 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 City/State /ZIP: TIGARD, OR 97223 Investigation (1 hr min) 66.25/ hr 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 ('/2 hr min) CCB Lic.: 37410 Electrical Lic.: 34 -13C Suprv. Lic.: 1816S ELECTRICAL PERMIT FEES Subtotal: 67.84 Suprv. Electrician signature, required: Plan review (25% of permit fee): Print name: R. W. FRAHLER Date: 05/04/11 State surcharge (12% of permit fee): 8.14 TOTAL PERMIT FEE: 75.98 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. I:\ Building \Permits1ELC- PermitApp.doc 07/01 /10 440- 4615T(t1/05 /COM/WEB