Permit C ITY OF TI G w VH R D ELECTRICAL PERMIT
PERMIT #: ELC2006 -10098
A 4 DEVELOPMENT SERVICES DATE ISSUED: 3/31/2006
fII 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 102CA -00301
SITE ADDRESS: 09780 SW FREWING ST ZONING: R -4.5
SUBDIVISION: FREWINGS ORCHARD TRACTS LOT : 018 JURISDICTION: TIG
Project Description: 2 BRANCH CIRCUITS
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: 1 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:
FINKE, ALEX TRUSTEE PRAIRIE ELECTRIC INC
FINKE, LOTTE I TRUSTEE 6000 NE 88TH STREET
PO BOX 23562 VANCOUVER, WA 98665
PORTLAND, OR 97281
Phone: 503 - 244 -5821 Contact #: PRI 360- 573 -2750
FAX 360- 573 -9866
FEES
Description Date Amount Reg #: ELE 37-49IC
[ELPRMT] ELC Permit 4/6/2006 $66.85 LIC 60178
[TAX] 8% State Surcharge 4/6/2006 $5.35 SUP 3562S
Total $72 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 set
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 -6699 or
1- 800 - 332 -2344.
Issued By:
4
J / 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'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.
Electrical Permit • * �• t' "FOR OFFICE J E ONLY "
Citysof l lgard Received / Permit No.
13125 SW Hall Blvd., Tigard, OR 97223p Plan Rw O ' / / � D/
Phone: 503.639.4171 Fax: 503.598.19601 1 2006 / ins N 1 + e e Other Permit:
Inspection Line: 503.639.4175 �' I Date ReadyBy: ® See Pag 2 for •
Internet: www.tigard- or.gov ��r� A �� LIJE;`�s Notified/Method: Supplemental Information
1 - 1M I Y a ' )I Nt PLAN REVIEW
❑ New construction LI Addition/ Iteration/repla ment - Please check all that apply:
❑ Demolition • ,Other: `Q7ti/ — ��/Z - ❑Service over 225 amps, comm'I ❑Hazardous location
,7 0 Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION oft- and 2- family dwellings 4 or more new residential
I.- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi - family ❑ Master builder ❑Other: ❑Building over three stories ❑Feeders, 400 amps or more
❑Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION; ❑E plan RV park
5 - / / ❑Health - care facility ❑Other:
Job no.: Job site address: 7 k•9 . J � z / g . - J /
/�j �Q Z Submit 2 sets of plans with any of the above.
City/State /ZIP: l , •k)t °t (CJ,I / 7 p�/2 ry 3 The above are not applicable to temporary construction service.
FEE* SCHEDULE
Suite/bldg. /apt. no.: Project name: Si j..- ,Z i3e 4- Description I Qty. I Fee. I Total
Cross street/directions to job site: SJ fp- k ' � New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Ea. add'l 500 sq. ft. or portion 33.40 I
Subdivision: AZ A - + Lot no.: Limited energy, residential 75.00 2
Tax map /parcel no.:
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
PROPERTY OWNER • ❑ TENANT 201 amps to 400 amps 106.85 2
L� 401 amps to 600 amps 160.60 2
Name: 1 N K-e 601 amps to 1,000 amps 240.60 2
Address: p ijt /f 3 Over 1,000 amps or volts 454.65 2
Reconnect only .r-g 2
City / State/ZIP: di 7r� : . , 7 g/ Temporary services or feeders i ( nstallation, alUeration, and /or
��' relocation
Phone: (U3) �[..__ P A-
) Fax: ( ) /Air - , 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 600 amps 133.75 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
❑ APPLICANT ❑ CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: Lv .-t-t 7 F fh for branch �� �Q :f�.� B. Fee banch circuits
Contact name: U /J without service or feeder fee, 46.85 2
vi $G113 -� 0 first branch circuit
Address: Ct /e-Olt � 6-t.. ti-k_ _ Each add'I branch circuit 6.65 2
City /State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) F ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
extension. Describe: Page 2 2
Business name: n.T F Et elkV C.. /
Address: (0 60 Vg 8g • Each additional inspection over allowable in any of the above
Per inspection 62.50
City / State/ZIP: VA AJ V tp too*. 9.e& err Investigation per hour (1 hr min) 62.50
Phone: ( 36j) 373 •3-1 Fax: (360) 5 -Pitt- Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lic.: CC � Electrical • • 7- ,( Suprv. Lic.: 3.56.25 Subtotal 111 -
Suprv. Electrician signature, requir.. Plan review (25% of permit fee)
' / Al), � State surcharge (8% of permit fee) 3 f .
Aft. Print name: .9 Date:��� r0� °✓
I TOTAL PERMIT FEE 7
Authorized signatur • _,,(/ This permit application expires if a permit is not obtained within 180
e � ) days after it has been accepted as complete
Print name: � /( 4,1 , H Date :3 /3c / h • Fee methodology set by Tri- County Building Industry Service Board
�/'' • • Number of inspections per permit allowed.
I:\ Building\ Penn its \ELC - PermitApp doe 12/30/05 440- 4615T(10/02 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 Supplemental Information a
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning -
System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY:
Fee for each commercial system $75.00
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
•
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC .) -..
❑ Instrumentation „
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
•
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
•
•
❑ Protective Signaling
❑ Other
Total number of commercial systems: -
*No licenses are required. Licenses are required
for all other installations • -
1:\ Building \Permits\ELC- PermitApp.doc 17/30/05 y
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CITY OF TIGARD ^ .-C
BUILDING DIVISION PERMIT #:Z0p(, /e) d 7 sr
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 av l l ' 4
Inspection Requests (24 Hrs.): (503) 639 -4175 =__�
INSPECTION WORKSHEET FOR . DATE: TIME: PAGE:
c •
SITE ADDRESS: 17 FO CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
I pection Request Scheduled For: Date: �. � Pour Time:
C ode # Inspection Description Confirm # Contact # Message c:e...ex
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Corrections /Comments /Instructions:
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U PASS ❑ PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
K i FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
6 Inspector: Date: - 9-a6 Phone #: (503) 718 - WO
CITY OF TIGARD Eq___C
BUILDING DIVISION - PERM T #:2066 i d 9 g
13125 SW Hall Blvd., Tigard, OR 97223 DATE IS ED:
Phone: (503) 639-4171 �a� �/
Inspection Requests (24 Hrs.): (503) 639 -4175 ,': '__
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: 7786 'V- ` CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 1-1--51-6. . Pour Time:
Co.- # Ins.- . on Description Confirm # Contact # Message
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Inspector: Agi //` A Dat .' , Phone #: (503) 71 . As..