Permit CITY OF TIGARD ELECTRICAL PERMIT
-' COMMUNITY DEVELOPMENT Permit #: ELC2011 -00441
TIGAR.D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/04/2011
Parcel: 2S 110D D06600
Jurisdiction: Tigard
Site address: 10650 SW SUMMERFIELD DR
Project: Summerfield Civic Association Subdivision: Lot:
Project Description: (3) branch circuits to connect poolhouse equipment.
Contractor: FRAHLER ELECTRIC CO Owner: SUMMERFIELD CIVIC
11860 SW GREENBURG RD ASSOCIATION
TIGARD, OR 97223 10650 SW SUMMERFIELD DR
TIGARD, OR 97224
PHONE: 503 - 639 -4627 PHONE:
FAX: 503 - 639 -4673
FEES
Quantity Description Date Amount
3 crt Branch Circuits wo /Purchase 08/04/2011 $71.02
Specifics: Service or Feeder
1 ea 12% State Surcharge - 08/04/2011 $8.52
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $79.54
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 9 • .! -0090. You may ob -'. - • • of the rul r direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. ".
Issued By: _ _ _ -_ _ _ _ _ — 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.
E lee tri c a I Permit A p p I i c a tio n
,!:.:, .........- ',..,...(
11-7,.:t.c
City of Tigard R 5 V, /,----)- Permit N. ti..c -o
q 13125 SW Hall Blvd.. Tigard. OR 972?3 '-. P
Other Pet ;.'• , . k' '... Phone: .503.718.2439 FaN. 503.598.1960 Date/By:
...i-;,. Inspection Line: 503.639.417,5 im)s: RI See Page 2 for
.,:e1 . ..,71/4 cl.. N
.1.-
'.....!',„ Internet: wvvw.ti gard go v Supplemental information
s-S _ n,
:;'' 4vf,E, ,oir s.°7,,'.. ."`,-7,■.),.:,,I...,-,(.k -r:: 'il '..1. .-'i ipt,kiv:.*EVifsiv::,'!:. ii
0 New construction El Adclition/alteration/replakment,X;V:1\
Please check all that apply (submit 2 sets of plans wlitems checked below).
0 Service or feeder 401) amps or more 0 Building over three stories.
0 Demolition E Other: ..-. .\ 1.-. - -, . . , , . .. - where the available fault current 0 Marinas and boatyards.
(fIV.;;;: kaiiiv1-.6 .,,,, ' o l .„- i iiicia t if,,, N :H. ,Vi.Y.A.',,:•?-.':=:::,,,::.:', exceeds 10000 amps at 150 volts or 0 Floating buildings
, , :1).,,.-,,,;„ ,,I..,.;, i:.,„..-AvIN-7 . .',1;!'ll , :: ,.'.: ',"■'. ;
less to mound, or exceeds 14,000 0 Commercial-use agricultural
I- and 2-family dwelling 0 Commercial/industrial 0' Accessory building amps for all other installations. buildings.
0 Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 75 KVA or ,.. 0 Emergency system. larger separately derived system.
AY,1-;:H:241/444:/0;Ar`,4613:;;SfIrT7f,INECIliNIATOI■1::::AlS113,i100iiii3SP4i::;z-- :,.-fF,,-..:W.-i--.?,-,:i.,:,:',*-,_ 0 Addition of new motor load of
Job no.: 68672 Job site address: 10650 SW SUMMERFIELD DRIVE 1001-IP or more.
0 Six or more residenti occupancy al units. 0 Recreational vehicle parks.
City/State/ZIP: TIGARD, OR 97224 0 Health-care facilities. 0 Supply voltage for more than
0 Hazardous locations. 600 volts nominal.
Suite/bldg/apt. no.: Project name: SUMMERFIELD CIVIC ASSOC 0 Service or feeder 600 amps or more
440
Cross street/directions to job site: Description l Qty. i fee. 1 Total I
New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision:
• Lot no I AO sq. ft. or less • 168.54 4
.:
Ea. addl 500 sq. ft. or portion 33 92 1
Tax map/parcel no.:
Limited energy, residential 75.00 2
't4,434.1kJA'4-4.4`,At Xf--'V,,M.A7 (with above sq ' ft )
Limited energy, multi-family 75.00 2
CONNECT POOLHOUSE EQUIPMENT residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
'' 4 -: iiiikAir#Air3Mit.TV:0'', 201 amps to 400 am„ 133 56 :7
'''"'=:',e•-i-f.;1 ''`, e'l.Vkr =A --, .'i g:::-.
401 amps to 600 amps 200.34 I
-
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
-,
intended for sale, lease, rent, or exchange; according to ORS 447, 449, 670,. and 701. 401 amps to 599 amps . 168.54 • -
Branch circuits — new, alteration, or extension, ler panel
Owner signature: Date: A. Fee for branch circuits with
' 6 'i . "4 "1 in ';'ediSifkiiiiit iiZ'ii■A'F~P ':',--':' 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
Contact name: branch circuit
Each add'l branch circuit 2 7 42 14 84 2
Address: Miscellaneous (service or feeder not included)
Each manufactured or modular 1 1
City/State/ZIP: 8
dwelling, service and/or feeder 67.4 2
Phone: ( ) Fax: : ( ) Reconnect only 67 84
Pump or irrigation circle 67.84 2
E _ _., , Sign or outline lighting 67 84 2
gqmgk,iqt 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 mi) 66.25/ hr
.. .
' ' • ,
Industrial.plant (1 lii mm) . . 78.18/ hr
— - -
Phone: (503) 639 Fax: (503) 639 ' Inspections for which nofee_is 1 _ _ 9000/ hr
_. __ _ _ _ . . .. . _ . . specifically listed ( hr min). -
CCB.Lic.-:„37410 Electrical Lie.: 34-13C Suprv. Lic.: 51105 ' inaill:
-
' - — - - - • - - - - -- - . _ •
. _ . . . _ _ . . . Subtotal: 71
_ - 02
.
SUprv: Electrician signature. required. XL / .
Plan review (2f)'% of permit tee -
• '
Print name: ADAM ETHERINGTON Date: 08/02/11 - - - State surcharge (12% of permit fee): 8 52
TOTAL PERMIT FEE: 79.54
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
EABuIldingTermits\ ELC-PercnitApp.doc 07/01/10 140-4615T( I I /05/COM/WEB