Permit CITY OF TIGARD ELECTRICAL PERMIT
9 COMMUNITY DEVELOPMENT Permit #: ELC2013 -00257
Date Issued: 05/06/2013 •
T [ GARD 13125 SW Hall Blvd , Tigard OR 97223 503.718 2439 Parcel: 2S110DD90531
Jurisdiction: Tigard
Site address: 10910 SW MEADOWBROOK DR 53
Project: Brown Subdivision: SUMMERFIELD BROOKSIDE CONDO Lot: 53
Project Description: (1) 200 amps or less to replace electrical panel
Contractor: JRA INC. DBA FRAHLER ELECTRIC COMPANY Owner: BROWN, ROSE T
11860 SW GREENBURG RD 10910 SW MEADOWBROOK DR
TIGARD, OR 97223 TIGARD, OR 97224
PHONE: 503 - 639 -4627 PHONE.
FAX: 503 - 639 -4673
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 05/06/2013 $100 70
• Specifics: amps or less
1 ea 12% State Surcharge - 05/06/2013 $12.08
Type of Use: MF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $112.78
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable law 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 the 180
days. ATTENTION Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR
952- 001 -0010 through OAR By: . �/I XKX [X�t 52- 001- 00 / 99 /j 0 n , J'L You may / obtaainn a copy Permittee Signature: of the rules or direct questions to OUNC by calling 503 23321987 or 1 800 332 2344 U I 1
Issued B Oki 4 PP /t 7 ti
./
/ 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' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the Job site at the time of each inspection.
05- 06 -'13 08:25 FROM- Frahler Electric 5036394673 T -238 P0001 /0002 F -799
Electrical Permit Application RECEIVED FOR orriCE USE ONLY
City of Tigard Received S r Pen nitNo:
13125 SW Hall Blvd.,'itgard, OR 97223 1 '' �'' Y 0 6 2013 1D y ' f Ito ( 3 EL, aQ! 3 . ooa•5
. Plan Review
Phone: 503.718.2439 Fax: 503.595 1960 Date/ By. Other Permit:
TIGARD Inspection Line 503639A175 CITY OFTIGARD DateReady/By: J 111 See Page 2 for
Internet: www.tigard- or.gov s ' , , , • , • Notified/Method: / SO I Supplemental Information
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❑ New construction ® Addition/alteration/replacement Please check all that apply (submit g sets of plans w /items checked below)
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current M n
/±/�7��p�• a t [] ari as and boatyards.
! "�. ���! f:�g �,t`k } �.`�`1 '�•.i ✓•! 9 ,(ti , .e. ti•�dl,� =d ,,.,3,I
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. rt "' Kea +'.:i.,,.,: rf '•t�.la:':a.� si,\ .` Y' + l . , ?'ah {7 , ; ' '% ;� ;. 1 't, "v :,c'l`. "' ' exc to ground, 0 ar exceeds or ['Floating boildmgs
less ❑ Commercial -use agricultural
EI 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 RYA or
l s 1 , <. ,'; , F, Ig AY - i
a .� r•f s r, n , ,,. ,, Emergency system larger separately derived system.
>. la er se crate den
•'.:, ;i"' �;: 4, �3 „�:ll.,,: J;brtl�l.?�c! '%]IN O,Y iAx>°5�1,!(-% hIID rT;Q ; ON ∎ii.t` :; t�t� ^T„
• - ... , , ; ,,, t � ir.•:e - su•S�',� 3 +iii ❑Addition of new motor load of ❑ "A ", "H ", "1 -2 ", "1 -3 ",
Job no.: 70535 I Job site address; 10910 SW MEADOWBROOK DR. 100ItP or more, occupancy
❑ Six or more residential units. ❑ Recreational vehicle parks
City /State /ZIP; TIGARD, OR 97224 0 Health-care facilities 0 Supply voltage for more than
0 Hazardous locations 600 volts nominal
Suite/bldgJapt. no.: 53 Project name; TENANT CONDO 0 Service or feeder 600 amps or more.
yM.,i}' 0/ .:.5,;.,.k,l O,N,C 0, :,S 'rl F!4. ;t'.�- `1 }4? �� .4
Cross street/directions to job Site: narripilan I Qty. I pee_ J Total I
New residential single or multi - family dwelling unit.
µ Includes attached garage.
Subdivision; I Lot no.: 1,000 sq, ft, or loss 168,54 .. 4
Tax map/parcel no.: Ea. add•l 500 sq. ft or portion 33.92 1
Limited energy, residential
' i-;i � + i� j.�i�y: , t1`,!•''�t' %u1' -,n e � 4i ' A: " , .y3�•p - , ;'y i Y ,,, 75.00
,*, : s - ,,. �. -�::%, '; iNFZ •, . Y � ?; s ° '.I� aAir '�I( O .t?�.'� 04 .' y/', gi, <,.� i ; �• r.,:;e: ;,f ,''' , ; l� y '� (with above sa. ft.) 2
t �`:: ]r',:6;:R ;:K.. Limited energy, multi- family
REPLACE ELECTRICAL PANEL residential (with above set R) 75 00 2
Renewable Energy ❑ See Page 2
Services or feeders installation, alteration, and/or relocation
- 1�
„ .' p 0 1 •�V../� X : -,`; i�t`„-•, {' '• ;,,,, �:i } a" 200 am S Or less 1 10�.7
"'�,s�l Fr01pf •`,Y.P;G�SX`.L�t�Wl�lr�',It i f �,; �;':y .v =iii r<•d� ,C ,�,: ,'1T,.',S- 'n`,�y�'� 1'd. ?. "- "� �Y ir.,�100.10070 ,:1 , u , , .�!''I ;rS ",rotil•� -;'r u .... ,'M�'a .e'rat•.Te.�tlf�f�. •a Li. =a,.
201 amps to 400 amps 133,56 2
Name: 401 amps to 600 amps 200.34 2
Address: 601 amps to 1.000 amps 301.04 2
Over 1,000 amps or volts 552.26 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
Phone: ( ) I Fax: ( ) relocation
200 amps or less 59.36 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 899 amps 168,54
Owner signature; Date: Branch circuits - new, alteration, or extension, per panel
o + "'''s, " n : 1+' l t' ,� { �y i. will:
ii , n...i •.:".t':.Y'r !: x.ITAIK* ' :6.��.��, •,., . ?.i. + , +i ` `'i :1 ;? ?..t ...' 15*,,0 ?01, j -
��'�''�•° � A. � above Fee for service branch or feeder circuits fee
7.42 2
Business name: each branch circuit
B Pee for branch circuits without
Contact name: service or feeder fee, first 56.18 2
branch circuit
Address: Each add'/ branch circuit 7.42 2
City/State/ZIP: Miscellaneous (service o r feede not include
Each manufactured or modular
Phone: ( ) I Fax :: ( ) dwelling, service and/or feeder 67.84 2
Reconnect only 67,84 - 2
`Emai -mail:
:. ?:i, i ��'><3r,1 ,�;;'rr gyi pp „ � d'(,;,r •; " : r�,c;.y.: .•,r Pump orimgationcircle 67.84 2
,, r;•,:,.,,;t`:�. ;'.�[,k•''e.,3:4H';. . ,^n4�„`,� +"4.004,' „L�... _ :•1LV ,•. ,'1 ?;,:.ii,r,S <J:.w �aC. Sign or outline lighting
67.84 2
Business name: JRA, INC. dba FRAHLER ELECTRIC COMPANY Signal circuit(s) or limited-energy
_ panel, alteration, or extension, Pale 2 2
Address: 111860 SW GREENBURG ROAD Each additional inspection over allowable in any of the above
City/State /ZIP: TIGARD, OR 97223 Additional inspection (1 hr min) 66 25/ hr
Investigation (1 hr min) 66.25/ hr
Phone: (503) 639 - 4629 I Fax: (503) 639 - 4673 Industrial plant (1 hr min) 78.18 / hr
•
CC13 Lie.: 197172 I Electrical Lie.: C861 I Sup V. r Lie.: 51 1 OS Inspections for which no fee is
specifically listed (h hrr min) r' 9000// hr
f� ?iJ w Yy�, "� 'v. -i Q y �' CSC • <D� i `" '.•:(y,{Z . � Ns
Suprv. Electrician signature, required: L / "� g r '' " y' �•�'T ' 1k
f Subtotal, 100.70
Print name: ADAM ETHERINOTON I Date. 05/06/13 Plan review ( 25%
of permit fee)
State surcharge (12% of permit fee): 12.08
Authorized signature: TOTAL PERMIT FEE: 112.78
This permit application expires if a permit is not obtained within 180
Print name: Date; days after it has been accepted as complete- 1
Number of inspections allowed per permit
1.nuadisg}Permi,pRt.CJ6rmitArie 040913 doe 4a0- 4615r(r, /OS/COM/Waa