Permit ELECTRICAL PERMIT /
CliTY OF TIGARD DATE I ISSUED: C 12 /08/95
COMMUNITY DEVELOPMENT DEPARTMENT
PARCEL: 2S 1 150C -01800
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (603) 839 -4171
SITE ADDRESS...: 175'85 SW PACIFIC HWY
SUBDIVISION • ZONING:
BLOCK • LOT •
Project Description: One branch circuit.
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS : 0 0 — 200 amp • 0 PUMP /IRRIGATION • 0
EACH ADD'L 500SF...: 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 • 0 W /SERVICE OR FEEDER: 0 PER INSPECTION • 0
201 — 400 amp • 0 1st W/0 SRVC OR FDR.: 1 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 - - --
FRAHLER ELECTRIC type amount by date recpt
11860 SW GREENBURG PRMT $ 35.00 CJS 12/08/95 95- 273705
5PCT $ 1.75 CJS 12/08/95 95- 273705
TIGARD OR 97223
Phone #: 503- 639 -4627
Contractor:
FRAHLER ELECTRIC CO $ 36.75 TOTAL
11860 SW GREENBURG RD
REQUIRED INSPECTIONS - -- - - --
TIGARD OR 97223 Ceiling Cover Elect'1 Service
Phone #: Wall Cover Elect'1 Final
Reg #• • .
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This permit is issued subject to the regulations contained in the -
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permittee 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 2 2 1 !95 _ L/
than 180 days. Issued 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 : ne7 Q��J . DATE: /a -4- 9S
LICENSE NO:
Call for inspection — 639 -4175
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Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
..
Tigard, OR 97223 Planck/Rec. # 9S
Permit # tzc9s 06//
i ro,,1'`;I�1'la Phone (503) 639 -4171 Date Issued /a- R- 9s
. FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772 Issued by chat r /�� r, �Lirr�, ��t
Inspection (503) 639 -4175
! 1. Job Address: W .0 , 55 ¢3 9 4. Complete Fee Schedule Below:
Name of Development U.S.A. SITE # D 0 2 6 Number of Inspections per permit allowed
Address 17585 S W PACIFIC HIGHWAY Service included: Items Cost(ea) Sum
"ROAMERS REST R.V. PARK"
City /State/Zip 4a. Residential - per unit 4
THOMAS GUIDE PG. 6 8 5 / B2 1000 sq. It. or less $110.00 -
ona
Each additional 500 sq. ft. or
Name (or name of business)SANITARY SEWER FLOW MONITOR portion thereof $25.00
1
Commercial ® Residential ❑ Limited Energy $25.00
- Each Manul'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 E L E C T R I C C 0. 200 amps or less $60.00 2
Address 1 1 8 6 O SW G R E F N R U R G ROAD 201 amps to 400 amps $80.00 2 - 401 amps to 600 amps $120.00 2
City TIGARD State Oft Zip 9722 3 601 amps to t000 amps $180.00 2 -
Phone No. 639-4627 Over 1000 amps or volts $340.00 2
Contractor's License No. 34-13C Reconnect only $50.00 -
Contractor's Board Reg. No. 37410 4c. Temporary Services or Feeders
I alteration, or relocation 2
y� ✓ ia
Signature of Supr. Elec'n /�r. ,G,�4lili 200 amps or less $50.00 2 - $75.00 2
License No. 1816 S Phone No. 639-4627 201 amps to 400 amps
- 401 amps to 600 amps $100.00
Over 600 amps to 1000 volts
2b. For owner installations: see 'b' above.
Print Owner's Name
RETURN APPLICATION 4d. Branch Circuits
New, alteration or extension per panel
Address a) The fee for branch circuits with
City StCQPY Zip purchase of service or feeder fee. 2
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 or feeder fee. 2
First branch circuit 1 $35.00 35.00 2
not intended for sale, lease or rent.
Each additional branch circuit $5.00
Owner' 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 inspectio $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 $ 35.00
5% Surcharge (.05 X total fees) $ 1 . 7 5
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 # $
Balance Due $ 36.75
woadbardNWcyrm.app
CITY OF TIGARD BUILDING INSPECTION NOTICE
• Inspection Line: 639 -4175 Business Phone: 639 -4171
• Footing Rain Drain Cov FINAL:
Foundation Water Line Cei - - Plumb.
• Post/Beam Mech. Shear /Sheath Framing -Mech.
PIbg.Und/Fir /Slab Plbg. Top Out Insulation - Elect.
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
1 _ Other.
Date: .. A.M. P.M. Entry:
. - Address: S .c e ��a
.. - - . Tenant: --, 34 /// Ste: MST
BUP:
Con/Own: t-f. I 1 e r MEC: • -
- PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
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Inspector. 7 t ! C �( f 't,L . di Datel 4 7 '.... " 4 ,g0 • •
• . X APPROVED _ DISAPPROVED /CALL FOR REINSP. dig) CO
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