Permit CITY OF TI GARD ELECTRICAL PERMIT
PERMIT #: ELC2002 -00059
) ��� DEVELOPMENT SERVICES DATE ISSUED: 5/2/02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S 114A0 -01500
SITE ADDRESS: 17005 SW 92ND AVENUE
SUBDIVISION: ZONING: R -12
BLOCK: LOT : JURISDICTION: TIG
Project Description: Maintenance Building - Phase II of Cook Park Master Plan Expansion.
• 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: 1 W /SERVICE OR FEEDER: 18 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 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:
TIGARD, CITY OF FRAHLER ELECTRIC CO
13125 SW HALL 11860 SW GREENBURG RD
TIGARD, OR 97223 TIGARD, OR 97223
Phone: Phone: 639 -4627
Reg #: LIC 37410
SUP 1816S
ELE 34 -13C
FEES Required Inspections
Type By Date Amount Receipt Elect'I Service
Rough -in
Elect'I Final
Total
•
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 -0080. Yo . , .. - .• ies of these rules or direct questions to
Permit Signature: ` Issu:d By: „ 4
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 639 -4175 by 7:00pm for an inspection the next business day
HA 1 1 - 1 &
:* ' Electrical Permit Application
Date received: , 70A Permit no.: Ezi , -oe057
'i'1.1' Ilx City of Tigard Project/appl. no.: Expire date:
City ofTigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: By: Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: COP 02ereo -- ®Q9 I
;' n..- a h l t `: TF 'Ft t,'' , i a '„,, 4'::::-::,%.•:..,' Yt eY• 'F' :`
#' fi TYPE OF h
❑ 1 & 2 family dwelling or accessory ❑ Commercial /industrial ❑ Multi - family ❑ Tenant improvement
, New construction ❑ Addition/alteration/replacement ❑ Other: LI Partial
m
r i , kT g , :Pr r ; ;- r a - t ,,. ,r �r 'JOB SITE INFORMATION ; k-* • , R 4 '!;
Job address: /1065 - //j). -- W 1 J . Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: (Block: (Subdivision: '
Project name: (4 /0, j� r p1� Description and location of work on premises: H a.l���.) A C 6,44 l�b Na
Estimated date of completion/inspection:
i ti : }„ CONTRACTOR° APPLICATION �, ,„ "�,.
,+r • ,f _, .. a. Y .,:�FEE ` 'SCHEDULE « i ' t 3 , , xV
-- Max
Frahler Electric Company Description Qty. Total no. insp
11860 SW Greenburg Rd New residential -single or multi- family per
dwelling unit. Includes attached garage.
Tigard OR 97223 Service included:
503- 639 -4629 CCB #: 37410 1000 sq. ft. or less 4
_ ELC#: 34-13C SUP#: 181 6S Each additional 500 sq. ft. or portion thereof /
Limited energy, residential ---2 City /metro lie, no.: Limited energy, non- residential 2
Each manufactured home or modular dwelling
Signature of supervising electrician (required) Date Service and/or feeder 2
Sup. elect. name (print): License no: Services or feeders - installation, •
, alteration or relocation:
• *Y • .,... PROPERTY OWNER a x= :':.- . . ` ' 200 amps or less r 2
(P ) CI o f T 201 amps to 400 amps `- [� • 2
Name rint : t l 401 amps to 600 amps __ 2
Mailing address: 17 j -t
3 . /17 /lJb • 601 amps to 1000 amps __ 2
2
City: , Stat e:0,e (ZIP q7,3 Over 1000 amps or volts __
Phone: 0 " t /t Fax:
E Reconnect only Ill 2 1
Owner installation: The installation is being made on property I own ervicesorfeeders -
which is not intended for sale, lease, rent, or exchange according to installation, tion,orrelocation:
ORS 447, 455, 479, 670, `0 0 / Temporaryservic 200 amps or less
201 amps to 400 amps 2
Owner's signature: �'.;yr,, il, ,ek, Date: eV it ^V - 1 401 to 600 amps MI 2
it ENGINEER ` • Branch circuits - new alteration,
or extension per panel:
Name. A. Fee for branch circuits with purchase of 1 V t
Address: service or feeder fee, each branch circuit V 1 2
City: State: ZIP: B. Fee for branch circuits without purchase
�— — of service or feeder fee, first branch circuit:. 2
Phone: Fax: E - mail:
Each additional branch circuit:
PLAN 'REVIEW (Please check " all that apply) Misc (Service or feeder not included)
❑ Service over 225 amps commercial ❑ Health - care facility Each pump or irrigation circle • 2
❑ Service over 320 amps rating of 1&2 ❑ Hazardous location Each sign or outline lighting 2
family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
❑ System over 600 volts nominal more residential units in one structure alteration, or extension* 2
❑ Building over three stories ❑ Feeders, 400 amps or more *Description:
O Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
❑ Egress/lighting plan ❑ Other: Per inspection I I
Submit sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application
Permit fee $ —2,0 0 i 0
❑ Visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ %) $ _
Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $ _ I ►
Expires accepted as complete. TOTAL $
Name of cardholder as shown on credit card l ! t to
Cardholder signature $ ' � Amount 440 -4615 (6 /00 /COM)
•
ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES
Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Restricted Energy Fee $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
I Service included: Items Cost Total 4, Check Type of Work Involved:
Residential - per unit
1000 sq. ft. or less $145.15 4 I Audio and Stereo Systems
Each additional 500 sq. ft. or
portion thereof $33.40 1 n Burglar Alarm
Limited Energy $75.00 -
Each Manufd Home or Modular I Garage Door Opener
Dwelling Service or Feeder $90.90 2
Services or Feeders n Heating, Ventilation and Air Conditioning System*
Installation, alteration, or relocation p
200 amps or less ) $80.30 3 0 30 2
201 amps to 400 amps $106.85 2 I I Vacuum Systems
401 amps to 600 amps $160.60 2
601 amps to 1000 amps $240.60 2 [] Other
Over 1000 amps or volts $454.65 2
Reconnect only $66 85 2
Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Installation, alteration, or relocation Fee for each system $75.00
200 amps or less $66.85 2 (SEE OAR 918 - 260 -260)
201 amps to 400 amps $100.30 2
401 amps to 600 amps $133.75 2 Check Type of Work Involved:
Over 600 amps to 1000 volts,
see "b" above. n Audio and Stereo Systems
Branch Circuits
New, alteration or extension per panel ❑ Bollpr Controls
•
a) The fee for branch circuits
•
with purchase of service or n Clock Systems
feeder fee. i
Each branch circuit j $6.65 J I q. 1 D 2 n Data Telecommunication Installation
b) The fee for branch circuits
without purchase of service n Fire Alarm Installation
or feeder fee.
First branch circuit $46.85 �
Each additional branch circuit $6.65 I l HVAC
Miscellaneous n Instrumentation
(Service or feeder not included)
Each pump or irrigation circle $53.40 n
Each sign or outline lighting $53.40 Intercom and Paging Systems
Signal circuit(s) or a limited energy
panel, alteration or extension $75.00 [7 Landscape Irrigation Control
Minor Labels (10) $125.00
Each additional inspection over n Medical
the allowable in any of the above
Per inspection $62.50 n Nurse Calls
Per hour $62.50
In Plant $73.75 n Outdoor Landscape Lighting
Fees: n Protective Signaling
Enter total of above fees $,q0 040 n Other
8% State Surcharge $ I bi PO Number of Systems
•
25% Plan Review Fee 1
See "Plan Review" section on $ * No licenses are required. Licenses are requird for all other installations
front of application.
Fees:
Total Balance Due $ 0 2) , D 0
0 Enter total of above fees • $
•
0 Trust Account # 8% State Surcharge $
Total Balance Due $ \
•
is \dsts \forms \elc- fees.doc 06/07/01
CITY OF TIGARD 24 -Hour •
DUILDNNG Inspection Line: (503) 639 -4175 •
INSPECTION DIVISION Business Line: (503) 639 - 4171 MST
BUP
Received Date Requested / t 1 ( AM PM ✓ BUP
Location l700C a d )-e_ Suite t � MEC �J
Contact Person FU .� Ph ( ) c' 3 g� 7 � PLM
Contractor - \ Ph ( ) ,?/q ° SWR
BUILDING Tenant/Owner ELC 06)6
Footing c — 066 Ce
Foundation Access:
Ftg Drain + ELF - ts �
Crawl Drain ��
Slab Inspection Notes:
Post & Beam 62.4—
Shear Anchors
Ext Sheath /Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing -r i.
Firewall rip
Fire Sprinkler 411
Fire Alarm
Susp'd Ceiling
Roof 1 / / /�
g \7
Other:
Final /Z) Z
PASS PART FAIL
PLUMBING
Post & Beam ll
Under Slab
Rough -In
Water Service •
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final rct \(> •
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fir- larm
40 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SI 111 Please call for reinspection RE: Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk Date Atim 1 0? Inspector • Ext
Other:
V
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL