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Permit CITY O F TIGARD ELECTRICAL PERMIT `� PERMIT #: ELC1999 -00642 DEVELOPMENT SERVICES DATE ISSUED: 10/27/1999 - JI 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2 S 103AA -00101 SITE ADDRESS: 10865 SW WALNUT ST SUBDIVISION: ZONING: R -4.5 BLOCK: LOT : JURISDICTION: TIG Project Description: Install 1 branch circuit. 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: 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 O R I G I N A L Reg #: LIC 00037410 SUP 1816S ELE 34 -13C FEES Required Inspections Type By Date Amount Receipt Elect'I Service PRMT KJP 10/27/199E $37.50 99- 319373 Elect'l Final 5PCT KJP 10/27/1995 $3.00 99- 319373 Total $40.50 This Permit is issued subject to the regulations contained in the Tigard Muniapal Code, State of OR. Spedalty 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 `ry ISSUED BY: //\<P__.e iz Arlvt. ja_ 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: G` cam DATE: A. .7 j LICENSE NO: 7 9'S Call 639 -4175 by 7:00pm for an inspection the next business day CITY OF TIGARD EI cal Permit Application Plan Check# 'x'125 'SW HALL BLVD. RECE Rec'd By TIGARD OR 97223 Date Rec'd Phone (503) 639 -4171, x304 OCT 2 71999 Date to P.E. I l Date to DST Inspection (503) 639 -4175 Fax (503) 598 -1960 COMMUNI� LOP MEN�Print of Type Permit # C 1 - C . , l 1 yy - oo 6Yz� Incompl or illegible will not be accepted Called 1. Job Address: 4. Complete Fee Schedule Below: Name of Development Number of Inspections per permit allowed Name (or name of business) FOWLER MIDDLE SCHOOL Service included: Items Cost Sum 4 ' Address 10865 SW WALNUT 4a. Residential - per unit City/State/Zip TIGARD, OR 97223 1000 sq. ft. or less $ 117.75 - 4 ty p 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 9 7223 401 amps to 600 amps $ 128.50 2 p 601 amps to 1000 amps $ 192.50 2 Phone No. (503) 639 -4627 Over 1000 amps or volts $ 363.75 2 Job No. 59612 Reconnect only $ 53.50 2 Elec. Cont. Lice. No. 34 -13C Exp.Date 10/01/ 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 12/01/99 200 amps or less $ 53.50 2 201 amps to 400 amps $ 80.25 2 Signature of Supr. Elec'n `1 401 amps to 600 amps $ 107.00 2 Over 600 amps to 1000 volts, License No. 784S 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 $ 5.35 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 imgation circle $ 42.75 Owner's Signature Each sign or outline lighting $ 42 75 Signal circuit(s) or a limited energy (if required):* pane alteration or extension $ 60.00 3. Plan Review section Minor Labels (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: Enter total of above fees $ 37.50 * Submit 2 sets of plans with application where any of the above apply. 6 th% Surcharge ( 0# total fees) $ 3.00 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 FOR A PERIOD OF 180 DAYS ❑ Trust Account # AT ANY TIME AFTER WORK IS COMMENCED Total balance Due $ 40.50 • i. \dsts \forms \electric doc