Permit C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00447
�. DEVELOPMENT SERVICES DATE ISSUED: 6/24/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S135CA-90137
SITE ADDRESS: 11048 SW GREENBURG RD 137 ZONING: R - 12
SUBDIVISION: ASH CREEK PARK CONDO LOT : JURISDICTION: TIG
Project Description: (2) branch circuit, replacement of parking lot light. Job # 63037.
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:
SMITH, CHERYL A FRAHLER ELECTRIC CO
11048 SW GREENBURG RD #137 11860 SW GREENBURG RD
PORTLAND, OR 97223 TIGARD, OR 97223
Phone: Phone: 503 - 639 - 4627
FEES Reg #: LIC 37410
Description Date Amount SUP 1816S
ELE 34 -13C
[ELPRMT] ELC Permit 6/24/2005 $53.50
[TAX] 8% State Surcharge 6/24/2005 $4.28 REQUIRED ITEMS AND REPORTS
Total $57.78
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: � ��� Permittee Signature: sz p
\
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.
' I ' t Electrical Permit Application- - , , _ . A , FOR OFFICE USE o; LY ,. ' ti'
•
City of Tigard =LP C. 0 It Received !/
DateB 7 .1--- /CJI Permit No:: d - i 9/ ,4;
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.19601 JUN /
0 2U� / ;4 ; , :rs 11 \ DatelBy: Other Permit:
f1 i �
Inspection Line: 503.639.4175 . ._1 j. W Date Ready/By: runs H See Page 2 for
Internet: www.ci.tigani.or.us CITY OF TIGAHU - Notified/Method: .�I l7 Supplemental Informati
4 4 �.- '.5 F e r j ..r £" -�'-� �` �. �- -Y i.G N -� & � .ke. *7 �� ms`s ��.��,. � e"�.. k d `r A . � d yrre�; ,"'-t,"„f' ?':
❑ New construction ry 61 Addition/alteration /replacement Please check all that apply:
['Service over 225 amps, comm'l ❑Hazardous location
❑ Demolition ❑Other.
r , . ,, n „� .. - . ❑Service over 320 amps - rating ❑ Buildng over 10,000
_. _s:--_ . 2- - .. _. r _ ' - ;' - ' _ A` i '!� _ 1i � ,', Accessor - `' , of 1- and 2- family dwellings 4 or more mew reside
❑ 1- and fa mil y dwelling !!! Commercial/industrial ❑ y building ❑System over 600 volts nominal units in on_e structure
❑Building over three stories [Weeders, 4100 amps or
❑ Multi- family ❑ Master builder ❑ Other
R ❑Occupant load over 99 persons ❑Manufactuared structu
,_ ".,u.:� , ..�:� „ 1.� _
_ . _ = - - q -_,11, . , �._ .. _.. _--- ___'" i ❑E>;��P��gP� RV park
Job no.: 63037 Job site address: 11048 SW GREENBURG ROAD [Wealth-care facility DOther:
City/State/ZIP: Submit 2 sets of plans with any of the above.
ty TIGARD OR 97223 The above are not applicable to temporary constru ction servii
- 7 4 r: ` .-. -. .. : ,y,. .zip iii -. ;.. - ^,, r 't '
Suite/bldg. /apt. no.: Project name: ASH CREEK PARK APARTMENT' `� ` -- � ° --` - Q -� � � =)
Description Qty. Fee. Total
Cross street/directions to job site: New residential single- or multi- family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15
Subdivision: Lot no.: Ea. add'1500 sq. ft. or portion 33.40
Tax map/parcel no
Limited energy, residential 75.00
t. , Limited energy, non - residential 75.00'
. S ; -.�> .... t Gr y `r F��� ' 1 - ...S _'f " - - , ^ Each manufactured or modular
LOT LIGHT REPLACEMENT dwelling, service and/or feeder 90.90
Services or feeders installation, alteration, and/ or renocati,
200 amps or less 80.30
_.. 1 w � Y >7 -- rte' =� 201 a s to 400 amps 106.85
3.,j_ ---- -- --... -_.., ".,...,._ - -'�_ __ _,_W___:". l' �_' �'.3�" -- .: 401 amps to 600 amps 160.60
Name: 601 amps to 1,000 amps 240.60
Address: Over 1,000 amps or volts 454.65
Reconnect only 66.85
City /State/ZIP: Temporary services or feeders installation, alte ration, and
Phone: ( ) I Fax: ( ) relocation
200 amps or less 66.85
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75
Owner signature: Date: Branch circuits- new, alteration, or extension, per panel
F � r, i -7 "" , ' s _ ,. t - k u t� i ' �+ ,,�., : "'���'"�, ^g A. Fee for branch circuits with
4, _ �,� - _.::.. -..1, , ?-_ �� 2-,"- --...,.. i:k! ... . service or feeder fee, each
Business name: branch circuit 6.65
B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85
Address each b1ch 1 46.85
Each add'] branch circuit 1 6.65 6.65
City/State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) I Fax : : ( ) Pump or irrigation circle 53.40
I Sign or outline lighting 53.40
E -mail: Signal circuit(s) or limited-
energy , erati on, or
>t;_.� �...�:_ .__ , � �:: �._.._ _ � . .� q �=.�_� _. -....� _ ".�___ _._ .� -_. extension Desc Page 2
Business name: FRAHLER ELECTRIC COMPANY
Address: 11860 SW GREENBURG ROAD Each additional inspection over allowable in any of the ab
Per inspection 62.50
City /State/ZIP: TIGARD ., O R 97223 - Investigation per hour (1 hr min) 62.50
Phone: ( 503)639 -4627 Fax: (503) 639 -4673 Industrial plain per hour _ 73.75 -
' 441: - E - j ..V .7 Rl_-x'`-- r-f;"'4
CCB Lic.: 37410 Electrical Lic.: 34 -13C Sup . Lic.: 1816S subtotal- 53.50
St Electrician signature, WAX& Plan review (25% of permit fee)
Print name: R , W. �Hj,ER �` " Date: 06/23/05 State surcharge (8% of permit fee) 4.28
TOTAL PERMIT FEE 57.78
Authorized signature: This permit application expires If a permit is not obtained within
days after it has been accepted as complete
Print name: Date: • Fee methodology set by Tri- County Building Industry Service Bow
•• Number of inspections per permit allowed.
isuBwld neetmfs\BLC- PemsitApp.doc 12/03 440- 4615Tp0ro2/COM/WEB -
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CITY ������U��
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BUILDING DUNG DIVISION , jii, PERMIT #: ELC2005-00447-- 1
13125 SW Hall Blvd., Tigard, OR "7223 DATE ISSUED: 0/24/2006
Phone: (503) 639-4171
Inspection Requo�a(24Hmj:(6O3) • 9-4175
�8�N� ^���
INSPECTION WORKSHEET FOR m'TE: 12/12/2005 TIME: 7: 02AM PAGE: 69
SITE ADDRESS: 110*8 SVYGREENB0R6 0 13 CLASS OF WORK:
SUBDIVISION: ASH CREEK PARK CON' LOT #: TYPE OF USE:
PROJECT NAME: ASH CREEK PARK COND'
DESCRIPTION: (2) branch circuit, replacement "f parking lot light. Job # 63037.
OWNER: SMITH, CHERYL A, PHONE #:
CONTRACTOR: FRAHLER ELECTRIC CO PHONE it: 503-63946I7
Inspection Request Scheduled For: Oat-' 12/12/2005 Pour Time:
Code # Inspection Description Confir # Contact # Message
199 Electrical final 023276- 1 503-939-8229 Y
Corrections/Comments/Instructions: \rJ ^ 1
.
� I I III �� N(]ACCESS
(61:-PA ~ / / �� . / /
|i FAIL 0 CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED
C=�*� � �� � �'����� �-��r��
Inspector: »��� y V^J ~~°�� »~��. Oate�» �~^ ~ �~� Phone #: /6D3)718' °— �^~�