Permit CITY OF TI G A R D ELECTRICAL PERMIT
PERMIT #: ELC1999 -00750
41 DEVELOPMENTSERVICES DATE ISSUED: 12/20/1999
13125 SW Hall Blvd., Tioard, OR 97223 (503) 639 -4171 PARCEL: 2S103AA -00101
SITE ADDRESS: 10865 SW WALNUT ST
SUBDIVISION: ZONING: R -4.5
BLOCK: LOT : JURISDICTION: TIG
Project Description: Installation of five (5) branch circuits.
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: 4 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:
SCHOOL DISTRICT NO 23 J FRAHLER ELECTRIC CO
13137 SW PACIFIC HWY 11860 SW GREENBURG RD
TIGARD, OR 97223 TIGARD, OR 97223
Phone: Phone: 639 -4627
Reg #: LIC 00037410
SUP 1816S
ELE 34 -13C
FEES Required Inspections •
Type By Date Amount Receipt
Elect'l Service
PRMT GEO 12/20/1995 $58.90 99- 320535 Elect'l Final
5PCT GEO 12/20/199E $4.71 99- 320535 O R I G I N A L
Total $63.61
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 are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987. /
PERMITTEE'S SIGNATURE ISSUED BY:
OWNER INSTALLATION ONL
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: 1 e"?-7 • DATE: J o? - ;74d
LICENSE NO: 1 cis/6 - S
Call 639 -4175 by 7:00pm for -an inspection the next business day
CI 'Y OF TIGARD RECEIVED Plan Check #
1325 SW HALL BLVD
Electrical Permit Application
DEC 171999 Recd e
,, TIGARD OR 97223 Date Rec'd
Date to P E
Phone (503) 639 -417
bUWNITY DEVELOPMENT Date to DST
Inspection (503) 639 -4175 Print of Type Permit # ( fff -00 75 -0
Fax (503) 598 - 1960 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development TIGARD /TUALATIN SCHOOL DISTRICT Number of Inspections per permit allowed
Name (or name of business) FOWLER MIDDLE SCHOOL Service included: Items Cost . Sum
Address 10865 SW WALNUT 4a. Residential - per unit
City /State /Zip TIGARD 1000 sq. ft. or less $ 117.75 4
Each additional 500 sq ft. or
portion thereof $ 26 25 1
Commercial ® Residential ❑ Limited Energy $ 60 00
Each Manufd Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder $ 72 75 2
(Prior to permit issuance, applicants must provide contractor license 4b. Services or Feeders
information for COT data base). Installation, alteration, or relocation
Electrical Contractor FRAHLER ELECTRIC COMPANY 200 amps or less $ 64 25 2
Address 11860 SW GREENBURG ROAD 201 amps to 400 amps $ 85.50 2
City TIGARD State OR Zip 97223 401 amps to 600 amps $ 128.50 2
y p 601 amps to 1000 amps $ 192.50 2
Phone No. (503) 639 -4627 Over 1000 amps or volts $ 363.75 2
Job No. 59722 Reconnect only $ 53.50 2
Elec. Cont. Lice. No. 34 -13C Exp.Date 10 /01 /00 4c. Temporary Services or Feeders
OR State CCB Reg. No. 37410 Exp.Date 07/02/01 Installation, alteration, or relocation
COT Business Tax or Metro No. 1987 Exp.Date 12/01/00 200 amps or less $ 53.50 2
/ L 9 ' y 201 amps to 400 amps $ 80.25 2
Signature of Supr. Elec'n y_./,/v`�� 401 amps to 600 amps $ 107.00 2
Over 600 amps to 1000 volts,
License No. 1816S Exp.Date 10 /01 /01 see "b " above.
Phone No. (503) 639 -4627 4d. Branch Circuits
New, alteration or extension per panel
a) The fee for branch circuits
2b. For owner installations: with purchase of service or
feeder fee.
Print Owner's Name Each branch circuit $ 5 35 2
Address b) The fee for branch circuits
without purchase of service
City State Zip or feeder fee.
Phone No. First branch circuit 1 $ 37.50 $37.50
Each additional branch circuit 4 $ 5.35 $71.40
The installation is being made on property I own which is not 4e. Miscellaneous
intended for sale, lease or rent. (Service or feeder not included)
Each pump or irrigation circle $ 42.75
Owner's Signature Each sign or outline lighting $ 42.75
Signal circuit(s) or a limited energy
3. Plan Review section (if required):*
panel, alteration or extension $ 60.00
Minor Labels bels (10) $ 107.00
Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection over
4 or more residential units in one structure the allowable in any of the above
Service and feeder 225 amps or more Per inspection $ 50.00
Per hour $ 50.00
System over 600 volts nominal In Plant $ 59.00
Classified area or structure containing special occupancy as
described in N.E.C. Chapter 5 5. Fees:
5a. Enter total of above fees $ 58.90
* Submit 2 sets of plans with application where any of the above apply. 8k% Surcharge (.0X8( total fees) $ 4./1
Not required for temporary construction services. Subtotal $
5b. Enter 25% of line 5a for
NOTICE Plan Review if required (Sec. 3) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $
IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FORA PERIOD OF 180 DAYS ❑ Trust Account #
AT ANY TIME AFTER WORK IS COMMENCED Total balance Due $ 63.61
is \dsts \forms \electric doc
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 •
BUP
Date Requested II/ 3/50 AM PM BLD
Location I v o (46 (�Gt.PiNtit�c �" Suite MEC
Contact Person —r—( vl6 Ph (p .11( . 7 PLM
Contractor (1146(61‘ Ph 1 SWR
BUILDING Tenant/Owner _Jt -Q/4 � Q Ai � 1 ELC f q q q - 00750
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final Or �<-
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers -
Final
PASS PART FAIL •
CT
Service
Rough In •
UG /Slab
Low Voltage
Fire Alarm
` PAS PART FAIL
Backfill /Grading •
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
4
Fire Supply Line [ ] Please call for reinspection RE: , [ ] Unable to inspect - no access
ADA — .� i
Approach/Sidewalk
Other Date/ 0 - D D Inspector i._ _ /11_ � � Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.