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Permit ,n CITY O F T I G A R® ELECTRICAL PERMIT PERMIT #: ELC2001 -00314 01. DEVELOPMENT SERVICES DATE ISSUED: 06/15/2001 13125 SW Hall Blvd.. Tigard, 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 (2) branch circuits for wire replacement fan motors. 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: 1 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 37410 SUP 1816S ELE 34 -13C FEES Required Inspections Type By Date Amount Receipt Elect'l Final PRMT CTR 06/15/2001 $53.50 2720010000( 5PCT CTR 06/15/2001 $4.28 2720010000( Total $57.78 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) 246-6699 or 1 -800- 332 -2344. / Permit Signature: /l 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: dIL Cy2&.',1' �G m'Z DATE: LICENSE NO: /9/0 Call 639 -4175 by 7:00pm for an inspection the next business day Electrical Permit Application iiiiiimmi... Date received: V/ c//0 / Permit no.: lrJ200 1 -093 / it ,-I,L I I! City of Tigard L � p � Project/appl. no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd, Ti 2 Date issued: By:0 Receipt no.: Phone: (503) 639 -4171 Fax: (503) 598 -1960 I I t , 2001 Case file no.: Payment type: .,vf� g � n Land use approval: GUMMIUNIIY UEVELUI'NMEIVF TYPE OF PERMIT . ❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family O Tenant improvement ❑ New construction GYAddition /alteration/replacement ❑ Other: ❑ Partial - .. , - JOB SITE INFORMATION - Job address: 10865 SW WALNUT Bldg. no.: Suite no.: Tax map /tax lot/account no.: Lot: I Block: I Subdivision: Project name: FOWLER MIDDLE SCHOOtDescription and location of work on premises: WIRE REPLACEMENT FAN MOTORS Estimated date of completion/inspection: Job no: 60682 Fee Max Description Qty. (ea.) Total no. insp Business name: FRAMER ELECTRIC COMPANY New residential- single or multi - family per Address: 11860 SW GREENBURG ROAD dwelling unit. Includes attached garage. City: TIGARD I State: ORI ZIP: 97723 Service included Phone: 639 -4627 I Fax: 639-46731E-mail: 1000 sq. ft. or less 4 CCB no.: 37410 I Elec. bus. lie. no: 34 -13C Each additional 500 sq. ft. or portion thereof Limited energy, residential I 2 City/metro ng.: 1 87 Limited energy, non- residential 2 , 06/12/01 • Each manufactured home or modular dwelling Signature of supervising electrician (required) Date Service and/or feeder 2 Sup. elect. name (print): R. W. FRAER License no: 1816S Servicesorfeeders — installation, I-IL alteration or relocation: - PROPERTY OWNER ' : 200 amps or less 2 Name (print): 201 amps to 400 amps 2 401 amps to 600 amps 2 Mailing address: 601 amps to 1000 amps 2 City: I State: ZIP: Over 1000 amps or volts 2 Phone: 'Fax: I E -mail: Reconnect only 1 Owner installation: The installation is being made on property I own Temporary services or feeders - - - which is not intended for sale, lease, rent, or exchange according to installation, alteration, or relocation: 200 amps or less 2 ORS 447, 455, 479, 670, 701. 201 amps to 400 amps 2 Owner's signature: Date: 401 to 600 amps 2 ENGINEER Branch circuits - new, alteration, or extension per panel: ivattie: A. tee for branch circuits with purchase of Address: service or feeder fee, each branch circuit 2 B Fee for branch circuits without purchase City: State: ZIP: of service or feeder fee, first branch circuit: 1 46.83 2 Phone: Fax: E Each additional branch circuit: 1 6.65 - • PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included): ❑ Service over 225 amps - commercial 0 Health -care facility Each pump or irrigation circle 2 O Service over 320 amps - rating of l &2 ❑ Hazardous location Each sign or outline lighting 2 family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, O System over 600 volts nominal more residential units in one structure alteration, or extension* 2 ❑ Building over three stories O Feeders, 400 amps or more *Description: ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable In any of the above: ❑ Egress/lightingplan ❑ Other. Per inspection I I - I• - Submit sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service. Other Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ 53.50 ❑ Visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ %) $ Credit card number: - / / within 180 days after it has been State surcharge (8 %) .... $ 4.28 • Expires accepted as complete. TOTAL $ 57 78 Name of cardholder as shown on credit card $ Cardholder signature Amount 440-4615 (6/00/COM) Electrical Permit Fees: Limited Energy Fees: - TYPE OF WORK INVOLVED - RESIDENTIAL ONLY Complete Fee Schedule Below: Restricted Energy Fee $75.00 .. ..- Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost - Total .1, Check Type of Work Involved: • Residential -per unit - 1000 sq. ft. or less $145 15 ' 4 n Audio and Stereo Systems Each additional 500 sq. ft. or portion thereof $33 40 1 . ❑ Burglar Alarm Limited Energy $75 00 Each Manufd Home or Modular n Garage Door Opener Dwelling Service or Feeder $90 90 2 Services or Feeders n Heating, Ventilation and Air Conditioning System* Installation, alteration, or relocation 200 amps or less $80.30 2 n Vacuum Systems 201 amps to amps $106.85 2 401 amps to 600 amps $160.60 2 ❑ 601 amps to 1000 amps $240.60 2 Other Over 1000 amps or volts $454.65 2 Reconnect only $66.85 _ 2 Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY Installation, alteration, or relocation Fee for each system $75.00 200 amps or less $66.85 2 (SEE OAR 918 - 260 -260) 201 amps to 400 amps $100.30 2 401 amps to 600 amps $133.75 2 Check Type of Work Involved: Over 600 amps to 1000 volts, n see "b" above. Audio and Stereo Systems Branch Circuits n Boiler Controls New, alteration or extension per panel a) The fee for branch circuits with purchase of service or n Clock Systems feeder fee. Each branch circuit $6 65 2 n Data Telecommunication Installation b) The fee for branch circuits -- - - without purchase of service - n Fire Alarm Installation or feeder fee. First branch circuit $46.85 HVAC Each additional branch circuit $6.65 Miscellaneous n Instrumentation (Service or feeder not included) , Each pump or irrigation circle $53.40 Intercom and Paging Systems Each sign or outline lighting $53.40 Signal circuit(s) or a limited energy panel, alteration or extension $75 00 in Landscape Irrigation Control* Minor Labels (10) $125.00 n Medical Each additional inspection over the allowable in any of the above Calls Per inspection $62.50 Per hour $ 62 . 50 _ _ ❑ In Plant $73.75 Outdoor Landscape Lighting Fees: 0 Protective Signaling Enter total of above fees $ n Other 8% State Surcharge $ Number of Systems 25% Plan Review F e e No licenses are required Licenses are required for all other installations See "Plan Review" section on $ front of application. • • • - . .. Fees: Total BalanceDue $ • Enter total of above fees $ E l Trust Account # 8% State Surcharge $ Total Balance Due $ i•\dsts \forms \cic -fees doc 10/09/00 ■ I CITY OF TIGARD BUILDING INSPECTION DIVISION MST • 24,Hour Inspection Line: 639 -4175 Business Line: 639 -4171 /D-7 BUP Date Requested 1 AM PM BLD Location / O t' n C C-! )0 Oiyt � � Suite MEC Contact Person A . Ph (03g- 46 2:7 PLM Contractor i ✓A 1/4-Q,o" Ph � C I -' y(o� - SWR BUILDING Tenant/Owner . tna ( Ul SP • 2- 3 J • ELC SOD/ —6 6 3 / 4 --4 Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN C • rawl Drain Inspection Notes: Slab SIT Post & Beam A Ext Sheath /Shear 2 FG PI /`�[ v iO r s — Int Sheath /Shear Framing . Insulation Drywall Nailing Firewall Fire Sprinkler. Fire Alarm Susp'd Ceiling Roof Misc: Final � P ASS PART FAIL � � - PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drain s Final PASS PART FAIL MECHANICAL Post & Beam • Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL" Service Rough In UG /Slab . . Low Voltage Fi - RT. FAIL - • Backfill /Grading " Sanitary Sewer Storm Drain V [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd - Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Other och /Sidewalk Date 7-3D-07 7 Inspector " Ext Final PASS PART • FAIL DO NOT REMOVE this inspection record from the job site: V •