Permit CITY OF TIGARD
� /100ll l DEVELOPMENT SERVICES ELECTRICAL PERMIT 97223 (503) PERMIT #: ELC96 -0657
DATE ISSUED: 10/16/96
PARCEL: 2S1O2BD -00100
SITE ADDRESS...: 1645 SW PACIFIC HWY
SUBDIVISION • NO.TIGARDVILLE ADDITION AMEND. ZONING:R -12
BLOCK • LOT •52
Project Description: INSTL SERVICES OR FEEDERS
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS • 0 0 – 200 amp • 0 PUMP /IRRIGATION : 0
EACH ADD'L 5O0SF...: 0 201 – 400 amp • 0 SIGN /OUT LINE LTG..: 0
LIMITED ENERGY 0 401 – 600 amp • 0 SIGNAL /PANEL • 0
MANF. HM/ SVC /FDR..: 0 601 +amps -1000 volts.: 0 MINOR LABEL (10)...: 0
- - -- SERVICE /FEEDER - - -- - - -- BRANCH CIRCUITS -- -ADD'L INSPECTIONS-- -
0 – 200 amp ° 1 W /SERVICE OR FEEDER: 0 PER INSPECTION 0
201 – 400 amp 0 1st W/0 SRVC OR FDR.: 0 PER HOUR • 0
401 – 600 amp • 0 EA ADD'L BRNCH CIRC: 0 IN PLANT • 0
601 – 1000 amp 0 PLAN REVIEW SECTION
1000+ amp /volt • 0 > =4 RES UNITS > 600 VOLT NOMINAL..:
Reconnect only • 0 SVC /FDR )= 225 AMPS..: CLASS AREA /SPEC OCC.:
Owner: FEES
ST ANTHONY'S SCHOOL type amount by date recpt
1 2645 SW PACIFIC HWY PRMT $ 32.35 TAT 10/16/96 96- 285220
SPCT $ 1.25 TAT 10/16/96 96- 285200
TIGARD OR 97223
Phone #: 639 -4979
Contractor:
FRAHLER ELECTRIC CO $ 33.60 TOTAL
11860 SW GREENBURG RD
REQUIRED INSPECTIONS
TIGARD OR 97223 Ceiling Cover Underground Cove
Phone #: 503- 639 -4627 Wall Cover Elect'1 Service
Reg #..: 37410
This permit is issued subject to the regulations contained in the < /r2 1 49(J
Tigard Municipal Code, State of Ore. Specialty Codes and all other Perm e Signature
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 L_i/ ,
than 18e days. I s ued By
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 for inspection – 639 -4175
Community Development ELECTRICAL PERMIT APPLICATION
• 13125 SW Hall Blvd. l)�o 5-7 Tigard, OR 97223 Planck/Rec. # � C - %
x h, , t Permit #
l' ".;�� Phone (503) 639 -4171 Date Issued
FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772 Issued by
Inspection (503) 639 -4175
1. Job Address: .
WORK ORDER # 56591 4. Complete Fee Schedule Below:
Name of Development ST. ANTHONY'S S C H 0 0 I _ Number of Inspections per permit allowed
Address 1 2 6 4 5 SA. PACIFIC H I G H W A Y Service included: Items Cost(ea) Sum
City /State/Zip TIGARD. O R E G O N 97 2 2 3 4a. Residential - per unit 4
1000 sq. ft. or less $110.00
-
Name (or name of business) ST. ANTHONY ' S S C H O (L S Each
portio addn itional thereof 500 sq. ft. or
$25.00 1
Commercial ® Residential ❑ Limited Energy $25.00
Each Manuf'd Home or Modular 2
Dwelling Service or Feeder $68.00
-
2a. Contractor installation only: 4b. Services or Feeders
Installation, alteration, or relocation 2
Electrical Contractor F R A H L E R ELECTRIC CO. 200 amps or less 1 $60.00 60.00 2
Address 11860 S ' W G R E E N B U R G ROAD 201 amps to 400 amps $80.00 2 - 401 amps to 600 amps $120.00
City TIGARD State n R Zip 9 7 2' 3 601 amps to 1000 amps $180.00 2
Over 1000 amps or volts $340.00 2
- Phone No. 6 3 9 - 4 F ? 7 Reconned only $50.00
Contractor's License No. 34-11C
Contractor's Board Reg. No. 374 j 0 4c. Temporary Services or Feeders
Installation, alteration, or relocation 2
Signature of Supr. Elec'n 200 amps or less $50.00 2
-
License No. 1 81 6 S Phone No. 639-4627 201 amps to 400 amps $75.00 2
401 amps to 600 amps $100.00
Over 600 amps to 1000 volts
2b. For owner installations: see •b• above.
Print Owner's Nam
RETURN APPLICATION 4d. Branch Circuits
New, alteration or extension per panel
Address a) The fee for branch circuits with
City purchase of service or feeder fee. 2
City Zlp Each branch circuit $5.00
Phone No. b) The fee for branch circuits without
The installation is being made on property I own which is purchase of service O1 feeder fee. 2
not intended for sale, lease or rent. First branch circuit $35.00 2 -
Each additional branch circuit $5.00
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): Each pump or irrigation circle $40.00 2 - Each sign or outline lighting $40.00
-
Signal circuit(s) or a limited energy 2
Please check appropriate item and enter fee in section 5B. panel, alteration or extension $40.00
4 or more residential units in one structure Minor Labels (10) $100.00
Service and feeder 225 amps or more
System over 600 volts nominal 4f. Each additional inspection over
Classified area or structure containing special occupancy the allowable in any of the above
as described in N.E.C. Chapter 5 Per inspection $35.00
Per hour $55.00
-
In Plant $55.00
-
Submit 2 sets of plans with application where any of the above
apply. Not required for temporary construction services. 5. Fees:
NOTICE 5a. Enter total of above fees $ 60_00
5% Surcharge (.05 X total fees) $ 3 nn
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25% of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec.3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. ❑ Trust Account # REFUND DUE $[29_401
Balance Due ELC96- 284828 $ 33.60
raGcantlavNlaoprm.aw
05/15/2000 Activities for Case #: ELC96 -00657
2:54:28 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELCC001 Application received 10/16/1996 TAT RECD TAT 10/16/1996
ELCC003 Permit created 10/16/1996 TAT PASS TAT 10/16/1996
ELCC500 (F)Issue permit 10/16/1996 TAT PASS TAT 10/16/1996
ELCC800 Case Finaled 10/17/1996 MJR PASS MJR 10/17/1996
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