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
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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:
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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
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CITY OF TIGARD BUILDING INSPECTION DIVISION MST
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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
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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 -
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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 •