Permit "' CITY OF TIGARD CARD ELECTRICAL PERMIT
PERMIT #: ELC2004 -00648
,:4 IA DEVELOPMENT SERVICES DATE ISSUED: 10/7/2004
4" 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1S135DD-04401
SITE ADDRESS: 11860 SW GREENBURG RD
ZONING: C -
SUBDIVISION:
BLOCK: LOT : JURISDICTION: TIG
Project Description: Installation of (1) branch circuit & limited energy for security at rear retaining wall.
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: 1
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: 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:
FRAHLER, 1MLLIAM M TRUSTEE FRAHLER ELECTRIC CO
11860SWGREENBURG RD 11860 SWGREENBURG RD
TIGARD, OR 97223 TIGARD, OR 97223
Phone: 503 - 639 -4627 Phone: FX 639 -4673
Reg #: fin-4627 37410
SUP 1816S
FEES ELE 34 -I3C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 10/7/2004 $121.85
[TAX] 8% State Surcharge 10/7/2004 $9.75 Low Voltage Inspection
Rough -in
Total $131.60 Elect'l Final
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws.
All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules C 1-80 -in -SAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -60- 332 -x344.
, �-
Issu • � ' . _ l e Ai 1 _� . Permit Signatu erg — f (��
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CO TRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: dill■ ' % .R;='" Q Th - DATE:
LICENSE NO: /V/ 6 S
Call 639 -4175 by 7:00pm for an inspection the next business day
NE -= _- __ - - - _ — —
Ele Permit A D *anon n FOR OFFICE USE ONLY ,
City of Tigard ®� j 7 2 004 Received
DateB : IO iff q-/(� PermitNo.: r .., -,
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 �/ y %` /4P. ni; Date/B Oth erPermit:
Inspection Line: 503.639.4175 Coe'f OF TICa 1 —
Dat Re ady/By: 7 (a See Page for
Internet: www.ci.tigard.or.us Notified/Method: �I�I Notified/Method: / /a. Supplemental Information
:, 'tk . �.,u` .1 .... , ., elf' a .0 � r "� s1 .° a t :.a$a. . I v - 4 � 4 s, � i awa. :, pl "ir E t „N,,';., r
❑ New construction ® Addition/alteration/replacement Please check all that apply:
❑ Demolition ❑ Other: ❑Service over 225 amps, comm'l ['Hazardous location
r { yt � �� ,� l g & p c ❑Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft.,
„ , aR4 '- '..: - '1 ' 61..1 , .isuu � ,, . ` I 1 y - o f 1- an 2- family dw e llings • 4 or more €lew residential
❑ 1 - and 2- family dwelling l Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
['Building over three stories ❑Feeders, 400 amps or more
❑ Multi - family 0 builder 0
s -� r , ti , k >,�`� ❑Occupant load over 99 persons ❑Manufactu -red structures or
r_ `, '.' 0,'( d ” �t� 'I`�7 1i
640.4 a.t., ® 4 1k. ❑Egress/ l ightingplan
s RV park
' : .� h� ` .3: . _.. ' t er it c. v '
Job n O ther: o.: 62449 Job site address: 11860 SW GREENBURG ROAD ❑ Health -care facility ❑ -
Submit 2 sets of plans with any of the above.
City /State /ZIP: TIGARD, OR 97223 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no I Project name: FRAHLER ELECTRIC 1 k; 3 ill a �'i.�^ L._„,,,. td`'i.; lTYM:rt
v
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 4
Subdivision: J Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
Y 4 „ , � P t p� Limited energy, non - residential 75.00 2
. Sc-, } hh ! 0 t,` • is ° 1 t a , 0 b ` i, 7 rr y' y ;,
, :, s .' 0: ,� . L fc......: /�. .1 , s 4 � � , ' /� ,� I,,,. _e . Each manufactured or modular
CO FliNGE CA f•' A7'O S�� �]y dwelling, service and /or feeder 90.90 2
'Y�(•(•L Services or feeders installation, alteration, and /or relocation
e . - A . aepOildn46- l d /' 200 amps or less 80.30 2
w rya.- i , ,:., „k�. 201 amps to 400 amps 106.85 2
" '` " " 401 amps to 600 amps 160.60 2 •
Name: fr c _62 n-_eCr / 601 amps to 1,000 amps 240.60 2
Address: • _ Over 1,000 amps or volts 454.65. • 2
- , Reconnect only • 66.85 2
City /state /ZIP: • Temporary services or feeders installation, alteration, and /or ,,
Phone: (( ( 9 7l I Fax: ( ) relocation
Q 200 amps or less 66.85 1
Owner installation: This installation is eing 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
;P 1` r - . r y A t 1 " Al ' Vol a w . i '' A. Fee for branch circuits with
i 1€ . r t :tktl" w g _ a� service or feeder fee, each
Business name: branch circuit 6.65 2
Contact name: B. Fee for branch circuits
without service or feeder fee, 1 46.85 46.85 2
each branch circuit
Address: Each add'l branch circuit 6.65 • 2
City/State/ZIP: . • 4 11, Miscellaneous (service or feeder not included)
Phone: ( ) I Fax: : ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
, E -mail: Signal circuit(s) or limited -
' 'uiti a 7 2, 4( 1 ° , '., " x , 24 1 € ^1 ati energy Panel, alteration, or
Business name: FRAHLER ELECTRIC COMPANY extension. Describe: 1 Page z 75.00 2
SEC,IJUC' lxi
Address: 11860 SW GREENBURG ROAD Each additional inspection over allowable in any of the above
Per inspection 62.50 -
City/State/ZIP: TIGARD , OR 97223 Investigation per hour (1 hr min) 62.50
Phone: (503) 639 -4627 Fax: 503 ) 639 -4673 Industrial plant pe hour 73.7 _
CCB Lic.: 37410 Electrical Lic.: 34— 3C sum. Lic.: 1816S Subtotal (i� �
�l 122 1:85
Suprv. Electrician signature, foquirod: //. _ Plan review (25 °(0 of permit fee)
(�✓ State surcharge (8% of permit fee) 9.75
Print name: R. W. FRAHLER Date: 10/05/04
TOTAL PERMIT FEE 131.60
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as comp lete
Print name: Date: * Fee methodology set by Tri- County Building Industry Service Board
**Number of inspections per permit allowed.
is\ Building \Permits\ELC- PemtitApp.doc 12/03 440- 4615T(10 /02/COM/WEB
Electrical Permit Application - City of Tigard ,
Page 2 - Supplemental Information
LIlVIITED ENERGY PERMIT' FEES:
® � 4 ` 0 4Pa*Y q s rgar a 5 aY ke6r.r��t�;� '� �
t
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:
etas 1 ME"L AV' kite N.7:1"4" 6153112%
Fee for each commercial system $75.00
(SEE OAR 918 260 - 260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ B oiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ H VAC
❑ Instrumentation
❑ Intercom and Paging Systems �........__... .-
❑ L andscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling •
Egl Other ___ , 124;
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
r\ BuildingTermits \ELC•PertnitApp.doc 04/03
CITY OF TIGARD 24 -Hour
BUILDING Inspection Lined (503) 639 - 4175
INSPECTION DIVISION , Business Line: (503) 639 - 4171 MST
BUP
Received Date equested 11 AM PM BUP
Location / ( Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR s�
BUILDING Tenant/Owner ELC O � bd — (4g
Footing
ELC
Foundation
Access :.
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation k-\,\ \ Y r 1,,
Drywall Nailing `� v 1 J
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling •
Roof
Other: /
Final
-
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service •
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAILj�
MECHANICAL �'�� /
Post & Beam V 0 0"
16 � � �N / 6.h/
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage / 1/ a y
Eire Alarm ``
SS PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE Please call fo reinspection RE: Unable to inspect — no access
•
Fire Supply Line
A / /
FDA /
Approach /Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from th job site.
PASS PART FAIL