Permit ELECTRICAL PERMIT
;: ", q CITY OF TIGARD
COMMUNITY DEVELOPMENT Permit #: ELC2010 -00177
Date Issued: 04/16/2010
T t GAR 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S1010800101
Jurisdiction: Tigard
Site address: 7420 SW HUNZIKER RD A
Subdivision: Lot: 0
Project: Petroadvisors
Project Description: (2) branch circuits copier and server, and (1) data telecommunications
Owner: FEES
HALLBERG HOMES INC Quantity Description Date Amount
C/O HUNZIKER PROFESSIONAL CENTER LL,
BY DIANNE CASSIDY, 18280 INDIAN CREEK 1 ea Limited Energy 04/16/2010 $67.84
2 crt Branch Circuits 04/16/2010 $63.60
PHONE: wo /Purchase Service or
Feeder
Contractor: 1 ea 12% State Surcharge - 04/16/2010 $15.77
Electrical
FRAHLER ELECTRIC CO
11860 SW GREENBURG RD
TIGARD, OR 97223
PHONE: 503 - 639 -4627
FAX: 503 - 639 -4673
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $147.21
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 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By:. . r ' Permittee Signature:
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: 41_//4/
LICENSE NO. -j710 5
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
(
Electrical Permit Application . FOR OFFICE USE ONLY : .
City f Tigard APR 1 6 201Q Received 0o:/O // !� n / 7 `J g Dete/By .43971/
t � Permit No� tro 6/(/ --.00/ / �/
P h
13125 SW Hall Blvd., Tigard, �T Pleb Re
0 . . Phone: 503.639.4171 Fax: 5 5A8.1 TIGARD Date/By: Other Permit:
T 1 G A It D Inspection Line: 503.639.41 �UI� ®I�(a DIVISIO Date Ready /By: luris • RI See Page 2 for
}. Internet: www.tigard- or.gov Notified/Method: Supplemental Information
{ a
y
❑ New construction ® Addition /alteration /replacement Please check all that apply (submit 2 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 ❑ Marinas and boatyards.
e r.: ' t a tCit 1X 11 `; 1 4i $ 5 '" exceeds 10,000 amps at 150 volts or ID Floating buildings.
"" "` less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1 and 2- family dwelling 2g Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi family ❑ Master builder ❑ Other: ❑ Fire-pump. ❑ Installation of 75 KVA or
O � s ". ❑ Emergency system. larger separately derived syst,
;�"t + ID Addition of new motor load of ❑ "A ", "E ", "I -Z ", "1 -3 ",
Job no.: 67479 Job site address: 7420 SW HUNZIKER ST. #.{�A 1 00HPormore. occupancy.
t #A ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: TIGARD, OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: A Project name: PEi'ROADVISORS ❑ Service or feeder 600 amps or more.
AVENUE p ri ion r tE s...y _ 'Total
I
• 72nd AVENUE Descnphon I Qty. I Fee. I 'Total , ,
Cross street/directions to job site:
New residential single- or multi - family dwelling unit.
includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54
Ea. add'I 500 sq. ft. or portion 33.92
Tax map /parcel no
Limited energy, residential
` tt � `te"* .' x ' ,.. C' fl T O- * °;t;, cf' , 'z .
6 4, h il*1 (with above sq. ft.) 67.84
�'
Limited energy, multi - family 67.84
(1) CIRCUIT FOR COPIER, (1) CIRCUIT FOR SERVER residential (with above sq. ft.)
(1) LIMITED ENERGY FOR ROUTE NEW PHONE LINES Services or feeders installation, alteration, and/or relocation
� 200 amps or less 100.70
a;
liti1?11IR iff OW . '" '' 4 " ' :a N .. .. , fi '' � ..' 201 amps to 400 amps 133.56
Name: 401 amps to 600 amps 200.34
601 amps to 1,000 amps 301.04
Address: Over 1,000 amps or volts 552.26
City/State /ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. - 401 amps to 599 amps 168.54
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: _ • A. Fee for branch circuits with
t a ,x Q "� 'Y', ,4 .• A , , ,: tii t .i 7i ...0*.,.: _ fr above service or feeder fee, 7 42
each branch circuit
Business name:
ACCT #0 B. Fee for branch circuits
Contact name: JOB #
4 r747 without service or feeder fee
1 56.18 56.18
first branch circuit
Address: DATE PAID: 49 Each -add'I branch circuit 1 7.42 7 /12
CHECK # Lia-07 7 Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular 67.84
Phone: ( ) `7V• /5 Z—.® dwelling, service and /or feeder
Reconnect only 67.84
E -mail: v1 X71 Pump or irrigation circle 67.84
a:E ..:a.?'y;"f :t. °, .?� nt_
1 .,-. r r � . ,F tj CTOR -s u 40 `x,. .' x 34 = tF.;'r Si or outline lighting 67.84
� ,..,. .
Business name: FRAHLER ELECTRIC COMPANY eneer panel, alteration, or
Address: 11860 SW GREENBURG ROAD extension. Describe: 1 Page 2 67.84
DATA
City/State /ZIP: TIGARD OR 97223 Each additional inspection over allowable in any of the above
Per inspection 66.25
Phone: ( 503 639 -4627 Fax: ( 503) 639 -4673 Investigation per hour (1 hr min) 66.25
CCB Lic.: Electrical Lic.: Suprv. Lic.: Industrial p lant per hour 78.18
37410 34 -13 p 5110S "1+EECTR1C RM10 sus
Suprv. Electrician signature, required: �/ / jr_ r _ Subtotal: 131.44
Plan review (25% of permit fee):
Print name: ADAM ETHERINGTON Date: 04/16/10 State surcharge (12% of permit fee): 15
Authorized signature: TOTAL PERMIT FEE: 147 .21
Print name: Date: This permit application expires if a. permit is not obtained within 180
days after it has been accepted as complete.
Number of inspections allowed per permit.
:\ Building \Perntlts\ELC- PermitApp.doc 10/01/09 445- 4615T(11/05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
erg. �, .
�,�'"�:P. >_ _ F 4 "' -3.k E vas Yr� '��ak,a.. - : .
Fee for all residential systems combined ... $67.84
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
• Garage Door Opener*
❑ H eating, Ventilation and Air Conditioning System*
❑ V acuum Systems*
❑ O ther:
Fee for each commercial $67.84
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
•
X Data Telecommunication Installation
❑ Fire Alarm Installation
HVAC
Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I:h &tiIding \Perm Os\ELC- Perm it App. doc 10/01/09