Permit C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2004 -00347
11 . DEVELOPMENT SERVICES DATE ISSUED: 6/11/2004
I
- I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S101 AC -01100
SITE ADDRESS: 07035 SW HAMPTON ST
SUBDIVISION: BEVELAND NO. 2 ZONING: MUE
BLOCK: LOT : 017 JURISDICTION: TIG
Project Description: Electrical TI, (10) branch circuits.
Job No. 62211
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: 9 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:
AFT - OREGON FRAHLER ELECTRIC CO
10725 SW BARBUR BLVD STE 50 11860 SWGREEN BURG RD
PORTLAND, OR 97219 TIGARD, OR 97223
Phone: 503 - 245 -9815 Phone: FX 639 -4673
Reg #: 161-4627 37410
SUP 1816S
FEES ELE 34 -13C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 6/11/2004 $106.70
[TAX] 8% State Surcharge 6/11/2004 $8.53 Rough -in
Elect'l Final
Total $115.23
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 fir i..re than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules a r set forth in b R 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503)
246 P.699 or 1-800-332- '
g 6(
Iss ed By: � CQ/j� ✓ Permit Signature: X ��
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 ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
a
Call 639 -4175 by 7:00pm for an inspection the next business day
_ .
. . .:
Electrical Permit Application FOR OFFICE. ..
USE ONLY , ,, '
City of Tigard
A
Received
Date/By: / ArOef MU Permit No.: e,„,,, 73/ ,
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 - A . 1 : 1 4VAlit Date/B : Other Permit:
Inspection Line: 503.639.4175 ;e: el I Date Ready/By: Juris: 0 See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
'q' ' MIKPFrVgrttiEla&aaVigW;t:SS.- ..' ' '
:r41,1445M4.),f: (5i:.;:wir1 ii,-,17,:mtv:07147,,F,
0 New construction 0 Addition/alteration/replacement Please check all that apply
E Service over 225 amps, comml DHazardous location
0 Demolition 0 Other: , _ _ _
0 Service over 320 amps - rating DBuildng over 10,000 sq. ft.,
- -, m„ ,.,...v ...,....
* ' ARNIX.; WigaliWoW&GAIVOgreV.NNAtA of 1 - and 2-family dwellings 4 or more new residential
7:ati Ze '' Accessory building - OSystem over 600 volts nominal units in one structure
Li Buildin over three stories OFeeders, 400 amps or more
0 Multi 0 Master builder 0 Other:
00ccupant load over 99 persons DManufactured structures or
''''''-' ' ' - -- °''''4LWICRIVA.!.: •!..
r , El E plan RV. park
EHealth-care facility DOther:
Job no.: 6 2 2 1 1 Job site address: 7035 SW HAMPTON Submit 2 sets of plans with any of the above.
City/State/ZIP: TIGARD, OREGON The above are not applicable to temporary construction service.
Suite/bldg./apt. no.: Project name: AFT - OREGON EMIIIMEWEB0,:t0MVIZYMIc:,-_,,v.:,T'
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: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 I
Limited energy, residential 75.00 2
Tax map/parcel no.: ,
Limited energy, non-residential 75.00 • 2
sragirleart VAMIW.Rj'.ltTAHgStit;t*ki.':':',VEVE:*ttrk,titk Each manufactured or modular
dwelling, service and/or feeder 90.90 2
REMODEL EXISTING OFFICE Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
4riciffoRtrahvgir6Wilanytig,g irtr:MarddLN4kNrlzAiPirk'-',MV;
201 amps to 400 amps 106.85 2
I 60.60 2
Name: 4 c ,-.- r -_-: - _ ,1 A..... (? -- -- /)
601 amps to 1,000 amps 240.60 2
), N e d ------
Address: 70 . e.j .- /940 I.4.W p 1%.) / Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State/ZIP :17:a A-g-t- cit 9 7 4 9-2- Temporary services or feeders installation, alteration, and/or
relocation.
Phone: (51)?3 ) 5- q g 6 Fax: ( )
4
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
'VP , ,LAN A. Fee for branch circuits with
' A
I''':"VI :,:','" ilrf" service or feeder fee, each
6.65 2
Business name: FRA.HLER ELECTRIC COMPANY branch circuit
B. Fee for branch circuits
Contact name: JOHN BARNES without service or feeder fee,
each branch circuit 1 46.85 46.85 2
Address: 11860 SW GREENBURG ROAD Each add'l branch circuit 9 6.65 59.85 2
City/State/ZIP: TIGARD, OR 97223 Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: (503 ) 639-4627 Fax: : (503 ) 639-4673 Sign or outline lighting 53.40 2
E Signal circuit(s) or limited-
EWZOISZT'M AtZeitWigtVii1010.AMIMIC:!VINK.M.PROMM energy panel D anel e , s a crb
alteration or
Page 2 2
Business name: SEE ABOVE
Each additional inspection over allowable in any of the above
Address:
Per inspection 62.50
City/State/ZIP: Investigation per hour (1 hr mm) 62.50
Phone: ( ) Fax: ( ) Industrial plant per hour 73.75
1 4 - 001 - XWIKM - r407$7 ,4 =1:Tar-Tain
CCB Lic.: 37410 Electrical Lie.: 34173C Suprv. Lic.: 2334S Subtotal 106.70
Suprv. Electrician signature, required: ' 1i(X4-17YL)17 Plan review (25% of permit fee)
State surcharge (8% of permit fee) 8.53
Print name: MIKE WAGNER Date: 06/11/04 TOTAL PERMIT FEE 115.23
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: * Fee methodology set by Tri-County Building Industry Service Board
** Number of inspections per permit allowed.
i \Building \Perrnits \ELC-PermitApp doe 12/03 440-461ST(10/02/COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
n Audio and Stereo Systems*
n B urglar Alarm
❑ G arage Door Opener*
❑ Heating, Ventilation and Air Conditioning
System*
❑ Vacuum Systems*
n Other:
CWirkeiIAL W ®RI , = Q1`tL a T i _ Kti
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
n Fire Alarm Installation
n HVAC
•
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
n Outdoor Landscape Lighting*
❑ Protective Signaling
n Other '
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
is \ Building \Permits\ELC- PermitApp.doc 04/03
CITY OF TIGARD 24 -Hour
BUELDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION' Business Line: (503) 639 -4171 MST
/ BUP
Received �`�" Date Request AM PM BUP
Location ` 0 5 5 �� Suite MEC
Contact Person Ph ( ) 639-- 4/6027 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC 4 6 (7
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
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof Ji A7Z L ' ssgA DV!!
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 FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
RT FAIL
LECTRIC!
Service
Rough -ln
UG /Slab
t4;#4
Low Voltage /)
Fir- larm
440
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
• ART FAIL
❑ Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL