Permit ELECTRICAL PERMIT
CITY OF TIGARD DATE I ISSUED: 08 /08/96
COMMUNITY DEVELOPMENT DEPARTMENT
131 $$W @ I Ia Or o 97 23.8 03 19 ( 8-471
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PARCEL: i_S 103AA -0010 1
S ITE Ab17R.vd ..Tigrd : ' i iiF;� W�LIUL�
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SUBDIVISION ZONING :R -4.5
LOT
Project Dg Adding one service or feeder to 200 amps.
- - -- 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 ° 1 W /SERVICE OR FEEDER: 0 PER INSPECTION ° 0
201 - 400 amp : 0 1st W/0 SRVC OR FDR.: 0 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 -
FOWLER MIDDLE SCHOOL type amount by date recpt
10865 SW WALNUT PRMT $ 60.00 CJS 08/08/96 96- 282684
SPCT $ 3.00 CJS 08/08/96 96- 282684
TIGARD OR 97223
Phone #:
Contractor:
FRAHLER ELECTRIC CO $ 63.00 TOTAL
11860 SW GREENBURG RD
- REQUIRED INSPECTIONS -- - -- - --
TIGARD OR 97223 Wall Cover Elect'1 Final
Phone #: 503 - 639 -4627 Elect' 1 Service _
Reg #..: 37410
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 182 days of issuance, or if work is suspended for more
than 180 days. I s sued 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: DATE: e- 8
LICENSE NO:
Call for inspection - 639 -4175
•
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. # c 6 -8 D 68 "/
, ),„Ai Permit # ,ELC -O.5
.� I Phone (503) 639 -4171 Date Issued 8- .9- 96
" FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772 Issued byCk ries Sdhr,l'icL
Inspection (503) 639 -4175
I 1. Job Address: w . 0 . # 56348 4. Complete Fee Schedule Below:
Name of Development TIGARD S C H O O L D I S T. Number of Inspections per permit allowed
Address 1 0 8 6 5 S.W. WALNUT Service included: Items Cost(ea) Sum
City/State/Zip TIGARD, O R E G O N 97224 4a. Residential - per unit 4
1000 sq ft or less $110 00
Name (or name of business) FOWLER MIDDLE S C H , Each additional 500 sq ft or 1
portion thereof $25 00 -
Commercial 0 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
F R A H L E R ELECTRIC Installation, alteration, or relocation 2
E Contractor 200 amps or less 1 $60 00 60.00
Address 11860 SW GREENBURG ROAD 201 amps to 400 amps $80 2
City TIGARD G A R D State O R Zip 9 7 2 2 3 401 amps to 600 amps $120 00 2
`7 p 601 amps to 1000 amps $180 00 2
Phone No. 639-4627 Over loon amps or volts $340 00 2
Contractor's License No. 34-13C Reconned only $50.00
Contractor's Board Reg. No. 37410 4c. Temporary Services or Feeders
Installation, alteration, or relocation 2
Signature of Supr. Elec'n Ai 9.14.41.,_ 200 amps or less $5000 2
License No. 1816$ $75 00 2
Phone No. 6 3 9 - 4 6 2 7 201 amps to 400 amps
401 amps to 600 amps $10000
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 SfCOPY 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 $35 00 2
not intended for sale, lease or rent. Each additional branch circuit $5 00
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): Each pump or irngation 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 inspection $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 $ 60.00
5% Surcharge (.05 X total fees) $ 3.00
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF Sb. 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 $ 63.00
woidlmrtd.vlicpnn app
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Cover /Service FINAL:
Foundation Water Line Ceiling - Plumb.
Post/Beam Mech. Shear /Sheath Framing -Mech.
PIbg.Und /Flr /Slab Plbg. Top Out Insulation - Elect.
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other
. 2 . , ' ' ' ' . C A.M. P.M Ent :
Address: . 4 . _
Tenant: X 1 IMP :. �i I 7' MST:
BUP:
Con /Own: MEC:
PLM:
ELC: -1/
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
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Inspector: // ��- DateA4 apt
K APPROVED DISAPPROVED /CALL FOR REINSP. CF CO