Permit CITY OF TIGARD ELECTRICAL PERMIT
11 1 `! ' COMMUNITY DEVELOPMENT Permit #: ELC2011 -00661
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/30/2011
Parcel: 2S102AC00200
Jurisdiction: Tigard
Site address: 9180 SW BURNHAM ST
Project: Stevens Marine Subdivision: BURNHAM TRACT Lot: 4
Project Description: (1) branch circuit to connect shear.
Contractor: FRAHLER ELECTRIC CO Owner: STEVENS, PAGE N
11860 SW GREENBURG RD 9180 SW BURNHAM ROAD
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 503 - 639 -4627 PHONE:
FAX: 503 - 639 -4673
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo /Purchase 11/30/2011 $56.18
Specifics: Service or Feeder
1 ea 12% State Surcharge - 11/30/2011 $6.74
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $62.92
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 952 - 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503 232.1987 or 1.800.332.2344. -
/ / '1
Issued By: ��— _� ittee Signature: — —
% l
• ER 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.
Electrical Permit Application . OFFIE USE ONLY
RECEIVED PLasR. :;.t.t,. ,
111 City of Tigard Date /By. P No.-6 . O �r
d 13125 SW W Hall Blvd., Tigard, OR 97223 .
Phone: 503.718.2439 Fax: 503.598.1960 NOV 2 8 ��� - ; Other Permit
TIGARD Inspection Line: 503.639.4175 Date Ready /By: tuns. /. 0 See Page 2 for
Internet www.tigard-or.gov Notified /Method: I Supplemental Information T hon
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r.6- _. '7 ;. i. . , - IIPE OE i ` ,' a: ,_ > u. * � , eR, i ..4,:. ` x.`.. ,. RIAN -. ,, , ,, v x e,,,
❑ New construction ® Addition /alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
x uS i y GATEGORY Ot { T[ON ` '¢ Y exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ I- and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
1 r 4 �- i , cuss w - ❑ Emergency system. larger separately derived system.
1 JOB SITEx IN FORMAsTION AIS D LOCATION
������,:�'��� �,s�_ - �. a ,a��'� � ID Addition of new motor load of ❑ >' . `E' `<1.2 3
Job no.: 68997 Job site address: 9180 SW BURNHAM STREET 100HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: TIGARD, OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: Project name: STEVENS MARINE ❑ Service or feeder 600 amps or inure.
Cross street /directions to job site: 4 ., . ' „IEEE S HEDiiILE r .
I Description I Qty. I Fee. I Total
------ - -- - - - - - -- — New residential single- 01 multi- family dweiiittg unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'l 500 sq. ft. or portion 33.92 I
Tax map /parcel no.: Limited energy, residential
5± -' DESCRIPTION QF WORK ' 1 ' c (with above sq ft) 75 00 2
- „ u : ' - -.r . � .. ? ' - -- . c _ ' ' , � . , '' Limited energy, multi - family 75.00 2
CONNECT 5hp, 3 - PHASE SHEAR residential (with above sq. ft.)
Services or feeders installation, alteration, and /or relocation
% %, t - .' ir or . y p e •• f • : 11 /1 • I 11 200 amps or less 100.70 2
P J W 5 f;. i # - t " ; 201 amps to 400 amps 133.56 2
Name: x 401 amps to 600 amps 200.34 2
mix L i 601 amps to 1,000 amps 301.04 2
Address: 11 1/1 b Over 1,000 amps or volts 552.26 2
1i/ fi 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 2
Branch circuits— new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
above service or feeder fee
"' - t ,
"",;® APPLICANT, ; '. 1£ ® CONTACIPERSON 7.42 2
� �;�_.- � r �, � . 9 ,r �� ,� � � _� - �.. x �E � .. _.mss ,. - � K
- each branch circuit
Business name: B. Fee for branch circuits without
service or feeder fee, first , 5618 56.18 2
Contact name: branch circuit
Each add'I branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included) '
City /State /ZIP: Each manufactured or modular 67 84 2
dwelling, service and /or feeder
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 ' 2
E
�o Sign or outline lighting 67.84 2
' ` :�; , , -a CO4 1',OR 4 N -,fYre' .W l iE ' I ' S ignal circuit(5) or limbed- 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 hnnin) 66 25/ hr
Industrial plant (I hr min) 78.18/ hr
Phone: (503) 639 -4627 Fax: (503) 639 - 4673 inspections for which no fee is 90.00 / hr
specifically listed (%z hr min)
CCB Lic.: 37410 Electrical Lic.: 34 -13C Suprv. Lic.: 1816S ,7 4, y ,;ELECTRICALPE_RMT,T.FEES,t 3'
4/ �� Subtotal: 56.18
Suprv. Electrician signature, required: 4 "t✓ Plan review (25 °'0 of permit fee): _ -
Print name: R. W. FRAHLER Date: 11/22/11 State surcharge (12% of permit fee): 6.74
Authorized signature:
TOTAL PERMIT FEE: 62.92
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 pennit
I: \Building \Permits \ELC- PermitApp doc 07/01/10 440- 4615T( H /05 /COM /WEB