Permit 1
CITY OF TIGARD ELECTRICAL PERMIT
: ! 2 . COMMUNITY DEVELOPMENT Permit #: ELC2009 -00499
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/24/2009
Parcel: 2S110AA00500
Jurisdiction: Tigard
Site address: 10580 SW MCDONALD ST 101
Subdivision: Lot: 0
Project: Ogden Building
Project Description: (1) branch circuit for new a/c unit.
Owner: FEES
OGDEN, JOAN Quantity Description Date Amount
24030 AIRPORT RD NE
AURORA, OR 97002 1 crt Branch Circuits 09/24/2009 $46.85
wo /Purchase Service or
PHONE: 503 - 678 -5330 Feeder
1 ea 12% State Surcharge - 09/24/2009 $5.62
Electrical
Contractor:
FRAHLER ELECTRIC CO
11860 SW GREENBURG RD
TIGARD, OR 97223
PHONE: 503 - 639 -4627
FAX: 503 - 639 -4673
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $52.47
Required Items and Reports (Conditions)
This permi ' issued subject to - regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be don= in accordance with approve. 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 req 'res ou to •Ilow the rules adopted by the Oregon Utility Notification Center. Those rules are set fort in OAR
952 901 -0010 thro gh OAR 952 - 001 -0109. Y. a • .tai - opy of the rules or direct questions to OUNC by calling ...99 or 1.800.332.2344.
I. sued 8 // / /. '//Ar ( ,, //
y: I ! ` �,1� .� I Permittee Signature: — �..�
/
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' y firiff /( /- Date:
9%44 9
LICENSE NO. 5110 �7
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.
p
Electrical Permit Application RECEIVE 0 FOR OFFICE USE ONLY
City of Tigard Received 9 2. of 909 Permit No.: E'LC.�jo9— (90 q' 9
~ 2 2 2009 Dan Review
0 Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit: KgC /ZeN, l�'... Oc yQ 7
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris: Ei See Page 2 for
Internet: www.tigard or.gov CITY OF TIGARD Notified/Method: Supplemental Information
Bin' DING DIVISIO
TYPE OF WORK PLAN REVIEW
❑ New construction IX 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 ❑ OtheI: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling E] Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
Job no.: 66970 Job site address: 10580 SW McDONALD STREET or es. c reanoeation
❑ Six Six o or r more a residential units. ❑ Recreational vehicle parks.
City /State/ZIP: TIGARD OR 97224 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: 1 1 Project name: THE OGDEN BUILDING ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site:
Description I Qty. I Fee. I Total
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
75.00 2
. DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi - family 75.00 2
CONNECT NEW AC UNIT residential (with above sq. ft.)
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 _
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City /State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 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 599 amps 133.75 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
A. Fee for branch circuits with
❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee, • 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
without service or feeder fee,
Contact name: first branch circuit 1 . 46.85 46.85 2
Address: Each add'1 branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City /State/ZIP: Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Signal circuit(s) or limited -
Business name: FRAHLER ELECl'IlIC COMPANY energy panel, alteration, or
Address: 11860 SW GREENBURG ROAD extension. Describe: Page 2 2
City/State/ZIP: TIGARD, OR 97223 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( 503) 639 -4627 Fax: ( 503 ) 639 -4673 Investigation per hour (I hr min) 62.50
CCB Lic.: 37410 Electrical Lic.: 34 -13C Suprv. Lic.: 5110S Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required:, jdo 4 4_ - Subtotal: 46.85
A D AM ETHERINGTON 09/18/09 Plan review (25% of permit fee):
D ate:
Print name:
State surcharge (12% of permit fee): 5.62
Authorized signature: TOTAL PERMIT FEE: S2 ..47
This permit application expires if a permit is not obtained within 180
Print name: Date:
days after it has been accepted as complete.
r -
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
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*
El Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
El Audio and Stereo Systems
El Boiler Controls
❑ l Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ InsuumeniaLion
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
El Outdoor Landscape Lighting*
El Protective Signaling
El Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations