Permit 1111 CITY OF TIGARD ELECTRICAL PERMIT
r� • � COMMUNITY DEVELOPME Permit #: ELC2013 -00367
Date Issued: 07/02/2013
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439
Parcel: 2S103BB01900
Jurisdiction: Tigard
Site address: 12355 SW 124TH AVE
Project: Andre Subdivision: BROOKWAY Lot: 19
Project Description: Reconnect only.
Contractor: FRAHLER ELECTRIC COMPANY Owner. ANDRE, RONALD & MURIEL
11860 SW GREENBURG RD 12355 SW 124TH AVE
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 503 - 639 -4627 PHONE: 503 - 590 -2424
FAX: 503 - 639 -4673
FEES
Quantity Description Date Amount
1 ea Reconnect Only 07/02/2013 $67.84
Specifics:
1 ea 12% State Surcharge - 07/02/2013 $8.14
Electrical
Type of Use: SF
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $75.98
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 952 -001 -0090. You ay obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: OA/ /97 6 lV
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 603.639.4176 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.
06- 28 -'13 14:32 FROM- Frahler Electric 5036394673 T -294 P0001 /0002 F -968
Lle,ctrlcal'Permit Applrcatl . , l .' FOR UFI'1C1'. USE O,NL1
• City of Tigard ii �� Rtcaivm /+
I N - .- If •
13125 SW Hal Blvd . - 177 --. petals,. 7 • 3 ,, Permi - LC o -1�o3 7
Hall Tlgard, OR 9 - 3 .
Phone: 503. 718:2439' FaiC :503.598 -!c� �p Oth'erPermit
. i cctionLine: 503:639.4175 ' J'U'L' ' . ¶ 209
i ' t C,, R a DAta.Readyl8 : luris y lid See Pape 2 for
Internet: www tigard or gOv 1,11--- _ l r Notilled/Method: . t Supplemental 1'nfermation -- '
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I is . y�. LI //a l a R , � h � f FY /t 7 e y t 7 A • �j J� J.M J. /L � . le q 1 ;. � �'Ltn } , .G 7.i �. r —1 , �/ �� �'''
7 a �S.. 2,..(L -n..M _. , . 222 1 1�4 tY.�, a7+ . f✓ hd�. K e I y 1':, .'' . 7I' A6 :. igh /A •� G : =_ -, � '
F y ' T Please check all that apply submit 2 sets of plans ['New construction ® Addition /alto • Ytn /r r •p a "' PP Y ( p s wlice chayked below): • ' , • ❑ Service or feeder 400 amps or more ❑ Building over three stories. ;
0 Demolition �{� El Other: q ( q where the available fault current ❑ Marines and boatyards,
— 6F f - , + P,, r h % y41� N c,, .. 1. „�t.. d rl a d. .� , ,2,44 4 .. ,,. ' „ir'r,'•f# f k '�a p,0b J?
ext eeds 1 0,0 00 amps at 150 volts or ❑ Floatingbuildmgs
less to ground, or exceeds 14,000 ❑ Commercial -use agribiittlirat
E 1- and 2- family dwelling [] Commercial /industrial ❑ Accessory building amps for all other insrallations. buildings.
❑ Multi - family ❑ Master builder ❑ Other; ❑ Fire pump. ❑ Installation of i50 i�YA,or
/ (,/x / L i i 4 r , a aa / / ria. r r, ,�,rr+a ' » /il p , r , r ID Emergency system. larger separately d erived system. '. +t ally . e,. 'i /' 1. 4:� t d, �,, 1 I! r ,,-' r yd; !' 'l , a?di a/., r'R ' 41, „ „,54 ., , ['Addition of now moto load of g D Y stem.
Y
..r. ❑ ..A ....E.. "1-2-.."I -k
Job no.: 70751 Job site address; 12355 SW 124 AVENUE ' 100HP or more. occupancy. '
❑ Six or more residential unite. ❑ Recreational vehicle parks.'., .'
City/State /ZIP: TIGARD, OR 97223 ❑ Health -care facilities. • El Supply yoltage for•,horCahan':'
❑Ila2ardora locations. 600 volts nominal.'
Suite/bldg. /apt- no.: Project name: ANDRE RESIDENCE Service or feeder 600 amps or more.
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/¢ l JC/ .' ` ;'; � ��� r ✓h it,, i r �"�a'l.;^+J`'y ' �. 4%�' .
•
Cross street/directions to job site: Y Description QM Fee. Total
New residential single- or multi family dwelling unit.
•
Includes attached garage.
Subdivision: I Lot'nO.:, 1,000 sq, R. or less 168.54 4
Tax map /parcel no Ea. add'l 500 sq. ft. or portion 33.92 1
75.00 2
/,y� /..,, t r Limited energy, residential
-. d , t .. / / era 2 2 . / r`te/A ',' , .h/ �>;4 , b A l fi h,. ".,, rl.0.44 /t' t/! 1 ,, r , r ° i . .k, / , r ! •; (with above so. R.1
REGROUND ELECTRICAL SERVICE DUE TO WATER LINE limited energy, multi family 75.00 2
REPLACEMENT residential (with above . ft.
Services or feeders installation, alteration, and/or relocation
a y r� f her , Y � 4 , , ,, p, a r v r, p. , a we , 200 amps or less 2
y ; ; W' r f. *.'i' ) R ° D ; B AN,'d ' I 'O u i ,1^�+ 1 M i' :v o f ., A' ?'✓"+ h ' s '4 / nlu, ,1� P 100.70
• " "" Y ., ' T 2 01 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 17.
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
• relocation
Phone: ( ) 1 Fax: ( ) . • 200 amps or less • 59.36 • I
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 599 amps 168'54 2
Owner signature: Date: Branch circuits - new, alteration, or ex tension, cr panel
� J/ i � r � / (° . « ��� / � n , �t w,is�t' ^ . e., ;' , , i •'r t y r A. Fee for branch circuits loth
/ / d ��RA•I/lSr ' : i 2 , �airR�I.n.r ctr./4a f5 ,5 r `dif' h� p � ' • n.��Tt ' ' P�T . ;. b
, above service or t8edcr fee, 7 42 2
Business name. each branch circuit
• B. Fee for branch circuits without -
Contact name; service or feeder fee, firs 56.18
branch circuit 2
Address: Each add'► branch circuit 7.42 2
Miscellaneous (service or feeder not included)
City /State /ZIP: Each manufactured or modular
dwelling, service and/or feeder 67.84 2
Phone: ( ) I Fax: : ( ) Reconnect only 1 67.84 67.84 2
E - mail: Pump or irritation circle 67.84 2
' /� % �� 1 �'�,tm 4r- fi /, ;71 s�. ' • y , a �, , y�r % 1 Y -
tr X1 3 $"// � a l%7Nl 12M1 '�S .,,, ;,k <i.1)4ril ;, ” : if �• `i y ;,,,t7,.. , aq -r Sign or outline lighting 67.84 2
Business name: YR4, INC. dba FRAHLER ELECTRIC COMPANY Signal circuit(s) or limited - energy See
panel, alteration, or extension- Page 2 2
Address: 11860 SW GREENBURG ROAD Each additional inspection over allowable in anv of the above
Additional inspection (l hr min) 66.25/ hr
City /State/ZIP: TIGARD, OR 97223 Investigation (1 hr mitt) 66.25/ hr
Phone: (503) 639 -4627 I Pax: (503) 639 - 4673 Industrial plant (I hr tarn) 78.18 / hr
Inspections for which no fee is
CCB Lie.: 197172 I Electrical Lie.: C861 I Suprv, Lie.: 51105 , p.,r ��� S. cifical listed (V, hr min) 90 - 00/ hr
I / � +YS'
Suprv. Electrician signature, required: ' ./�. • '
/a' ' Subtotal: 67.84
Print name: ADAM ETHERINGTON Date: 06/28/13 Plan review (25% of permit fcc):
State surcharge (12% of permit fee): 8.14
Authori2ed signature: TOTAL PERMIT FEE: 75.98
This permit application expires if a permit is not obtained within 150
Print name: Date: days' after it has been accepted as complete.
• Number of inspections allowed per permit.
i:V3uilding'Permiie \RLC PermitADp-IL1r,,RE.dot Rev 05/212013 440-1 5151(1MS/COMM