Permit CITY OF TIGARD ELECTRICAL PERMIT
A DEVELOPMENT SERVICES PERMIT #: ELC97 -0835
DATE ISSUED: 12/24/97
__.. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 18135AB -00100
SITE ADDRESS...:1O255 SW 90TH AVE
SUBDIVISION -TOWN OF METZGER ZONING:R -4.5
BLOCK ° LOT °005 JURISDICTION: TIG
Project Description : Installation, alteration, or relocation of atemorary 200 AMP
or less sevice and one (1) branch circuit to an existing school.
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS - 0 0 — 200 amp • 1 PUMP /IRRIGATION ° 0
EACH ADD'L 5O0SF...: 0 201 — 400 amp • 0 SIGN /OUT LINE LTG...: 0
LIMITED ENERGY ° 0 401 — 600 amp - 0 SIGNAL /PANEL - 0
MANE. HM/ SVC /FDR..: 0 601 +amps -1000 volts.: 0 MINOR LABEL (1O)...: 0
- - -- SERVICE /FEEDER - - -- - - -- BRANCH CIRCUITS -- -ADD'L INSPECTIONS-- -
0 — 200 amp - 0 W /SERVICE OR FEEDER: 1 PER INSPECTION ° 0
201 — 400 amp - 0 1st W/O SRVC OR FDR.: 0 PER HOUR 0
401 — 600 amp - 0 EA ADD'L BRNCH CIRC: 0 IN PLANT : 0
601 — 1000 amp ° 0 PLAN REVIEW SECTION
1000+ amp /volt - 0 > =4 RES UNITS > 600 VOLT NOMINAL..:
Reconnect only ° 0 SVC /FDR >= 225 AMPS..: CLASS AREA /SPEC OCC.:
Owner: FEES
TIGARD TLN DISTRICT #23J type amount by date recpt
13137 SW PACIFIC HWY PRMT $ 55.00 GEO 12/24/97 97- 302035
TIGARD OR 97223 -0000 SPCT $ 2.75 GEO 12/24/97 97- 302035
Phone #:
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Contractor: - --
FRAHLER ELECTRIC CO $ 57.75 TOTAL
11860 SW GREENBURG RD
REQUIRED INSPECTIONS
TIGARD OR 97223 Ceiling Cover Underground Cove
Phone #: 639 -4627 Wall Cover Elect'1 Service
Reg ft..: 000374
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon 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 the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-10 through OAR 952 -001 -1987. You may obtain a copy
of these rules or direct questions to OUNC by calling )246 -1987.
Permittee Signature: Issued By: 4 1
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 : (I-7L) - DATE: /, �‘07 Y 97
LICENSE NO ° 9;/6 � 5
7
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
is
CITY , OF TIGARD Electrical Permit Application Plan Check #
13125 SW HALL BLVD. Rec'd By
TIGARD OR 97223 Date Rec'd
Date to P.E.
Phone (503) 639 -4171, x304 Date to DST
Inspection (503) 639 -4175 Print or Type Permit# CGC - Cis53
Fax (503) 684 7297 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development TIGARD TUALATIN SCHOOL DISTRI Number of Inspections per permit allowed
Name (or name of business) METZGER ELEMENTARY SCHOOL Service included: Items Cost Sum
I
Address 10255 SW 90th AVENUE 4a. Residential - per unit
City/State/Zip TIGARD, OR EGON 97223 1achaddtional 500 $110.00 4
ty P Each additional 500 sq. ft. or
Commercial ® Residential ❑ portion thereof $25.00 1
Limited Energy $25.00
Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
(Attach copy of all current licenses) 4b. Services or Feeders
Electrical Contractor FRAHLER ELECTRIC COMPANY Installation, alteration, or relocation
Address 11510 h SW GRFENBURG ROAD 20 amps to or less $60.00 2
201 amps to 400 amps $80.00 2
City TIGARD State OR Zip 97223 401 amps to 600 amps $120.00 2
Phone No. • 639 -4627 601 amps to 1000 amps $180.00 2
Job No. 57860 Over 1000 amps or volts $340.00 2
Reconnect only $50.00 2
Elec. Cont. Lice. No. 34 - 13C Exp.Date 10 -1 -90
OR State CCB Reg. No. 37410 Exp.Date 7/2/98 4c. Temporary Services or Feeders
COT Business Tax or Metro No. 1.987 :p.Date 12/1198 Installation, alteration, or relocation
200 amps or less $50.00 50.00 2
Signature of Supr. Elec'n 201 amps to 400 amps $75.00 2
401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License No 1816 S Exp.Date 10/ 1/ 98 see "b" above.
Phone No 639 -4627 4d. Branch Circuits
New, alteration or extension per panel
2b. For owner installations: a) The fee for branch circuits with
purchase of service or
Print Owner's Name feeder fee.
Address Each branch circuit 1 $5.00 5.00 2
b) The fee for branch circuits
City State Zip without purchase of
Phone No. service or feeder fee.
First branch circuit $35.00 2
The installation is being made on property I own which is not Each additional branch circui $5.00 2
intended for sale, lease or rent. 4e. Miscellaneous
(Service or feeder not included)
Owner's Signature Each pump or irrigation circle $40.00 2
Each sign or outline lighting $40.00 2
3. Plan Review section (if required): * Signal circuit(s) or a limited energy
panel, alteration or extension $40.00 2
Minor Labels (10) $100.00
Please check appropriate item and enter fee in section 5B.
4 or more residential units in one structure 4f. Each additional inspection over
Service and feeder 225 amps or more the allowable in any of the above
System over 600 volts nominal Per inspection $35.00
Classified area or structure containing special occupancy Per hour $55.00
as described in N.E.C. Chapter 5 In Plant $55.00
* Submit 2 sets of plans with application where any of the above apply. 5. Fees:
Not required for temporary construction services. 5a. Enter total of above fees $ 55.00
5% Surcharge (.05 X total fees) $ 2_75
NOTICE Subtotal $
5b. Enter 25% of line 5a for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Sec.3) $
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY
TIME AFTER WORK IS COMMENCED. ❑ Trust Account # $ 57.75
Total balance Due
I: \DSTS \ELC96.APP Rev 9/96
5/12/99 Activities for Case #: ELC97 -00839
9:46:28 AM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELCC001 Application received 12/24/97 GEO RECD CTR 12/24/97
ELCC003 Permit created 12/24/97 GEO 'DONE CTR 12/24/97
ELCC799 Elect'I Final 12/24/97 CTR 12/24/97
ELCC500 (F)lssue permit 12/24/97 GEO PASS CTR 12/24/97
ELCA799 Elect'l Final 3/26/98 CD PASS CD 3/26/98 sub -panel added only, no load
increase.
ELCA800 Case finaled 3/26/98 CD PASS CD 3/26/98 sub -panel added only no load
increase.
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