Permit f !I* CITY OF TIGARD ELECTRICAL PERMIT
f COMMUNITY DEVELOPMENT Permit #: ELC2010 -00301
I;=11;1 GAab 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 06/17/2010
a_ rte Parcel: 1S135BC00900
Jurisdiction: Tigard
Site address: 10855 SW CASCADE AVE
Subdivision: Lot: 0
Project: Right Angle
Project Description: TI
Owner: FEES
PAULSON LIMITED LIABILITY CO Quantity Description Date Amount
BY RICHARD G PAULSON SR, 10855 SW
CASCADE BLVD 1 ea Services or Feeders - 200 06/17/2010 $100.70
amps or less
PHONE: 20 crt Branch Circuits w /Purchase 06/17/2010 $148.40
Service or Feeder
1 ea 12% State Surcharge - 06/17/2010 $29.89
Contractor: 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 $278.99
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 OA' 952 - 001 -010 Y• •• - - •- opy of the les or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: -'� _ � Perm ittee Signature: � - ""�- 4/j"
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.
CaII 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 11 FOR OFFICE USE ONLY
. City of Tigard I) - l Received � � / �� i � , nn
g I L'' l 1 r J DateB k ■IISI = Permit No.: ELQo f v._ W
11111
13125 SW Hall Blvd., Tigard, OR 9 3. \ ) Plan Review
C ' Phone: 503.639.4171 Fax: 503.598.1960 . 7 2 01 0 Date/By: Other Permit: ( 0_ el U i 0
r
Inspection Line: 503 639 4175 JUN D ate Read /B Juris: Ins p JU Ready /By: See Page 2 for
Internet: www.tigard-or.gov th " 0 Notified/Method TT L Supplemental Information
„: •
C : fi 1 �+' Yhs ti ' Cti ' ^`V { � 0 f l� :. 4 i, 1 Fn . -Y
., ,. ., , , < , , : _ ,.,, � ,., -, DLO .i � . A. -,..A. 1 T .e; +. chec a E b ,,,,
❑ New construction n Addition /alte ;.;
r ' • '' Please AI J ` < 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
` ` 08�+,�;i *(+*.1, N exceeds 10,000 amps al 150 volts or ❑ Floating buildings.
s, � v r less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling [29 Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
❑ Emergency system. larger separately derived systi
i4Tfl$c51ot ��"Tt1 03a ` .•.., 4 91�T , _. rte.• u�__:<; ❑Addition of new motor load of • . `E ,. „ 1_�" "1.3',
Job no.: 67609 Job site address: 10855 SW CASCADE BLVD , #F 1 00HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: IGARD , OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations 600 volts nominal.
Suite /bldg. /apt. no.: .p Project name: RIGHT ANGLE RELOCATION 0 Service or feeder 600 amps or more.
Cross street/directions to job site: Description i. 3:D m 4 'T I
p 1 QM 1 Fee. Total irt
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54
Tax map /parcel no.: Ea. add'l 500 sq. ft. or portion 33.92
r .,._, ,4 y r Limited energy, residential 67
>r: ykt n'sro .�a x .... ; _.'4 >. -0. x ..
.. 4`k d9 ' 'j4}/ *** A .' .:x u".'" (with above sq. ft.)
Limited energy, multi - family 67.84
WIRING OF TENANT SPACE FOR RIGHT ANGLE PRINTING residential (with above sq. ft.)
Services or feeders installation, alteration, and /or relocation
200 amps or less 1 100.70 100.70 .
x k �: _'M 044 ' :0 ,. , s i q ; y <,. r, " 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
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
A. Fee for branch circuits with
x .. a , " , r '3 . . : , - - 1V .y :., 4 ,_ ::. r , .,• :.• . ..;`.,, , . ` . +d f� .::::e., .; _ above service or feeder fee, 48.40
each branch circuit
Business name: B. Fee for branch circuits
without service or feeder fee.
Contact name: 56.18
first branch circuit
Address: Each add'1 branch circuit 7.42
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular
dwelling, service and /or feeder 67.84
Phone: ( ) Fax: : ( ) Reconnect only 67.84
E -mail: Pump or irrigation circle 67.84
µ
m M�' : , k :. i� XCQTr R. : ; p a Sign or outline lighting 67.84
Business name: Signal circuit(s) or limited -
FRAHLER ELECTRIC COMPANY energy panel, alteration, or
Address: 11860 SW GREENBURG ROAD extension. Describe: Paget
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- 73 Investigation per hour (1 hr min) 66.25
✓CCB Lic.: / 1=;lectrical tic.: in d ustr i a l plant per Hour 78.18
37410 34- 3C p c.: 181 6S 1 ELEC1UCA1 yes .
Suprv. Electrician signature, retie' d �� ` : ' . , Subtotal: 749 -
Print name: ' �� Date: Plan review (25% of permit fee):
R. W. FRANT,FR 06/14/10 State surcharge (12 %ofpermit fee): • 29 .y
Authorized signature: TOTAL PERMIT FEE: 278.99
- Print name: Date: This permit application expires if a permit is not obtained within 18(1
days after it has been accepted as complete.
" Number of inspections allowed per permit.
1:\ Building \Permits\ELC- PermitApp.doc 10/01/09 440- 4615TI1 /WEB
. ....r tEc_Tzic x # 4, f t e _ per. ��ti - per,M..--A * ELL 2o1 cab►
- .. PANELBOARD B - - -. _.
125 AMPS 208/120 VOLTS 3 -PHASE 4 -WIRE
•
' - MLO SURFACE MOUNTED NEMA 1 ENCLOSURE
PL LOAD VA HP . PHW GND CON BKR PHA BKR CON GND PHW HP' VA LOAD PL
1 40 LAMINATOR 872 20/1 A 20/2 _ 1800 110 GBC PUNCH ' 2
3 ORK STATION 360 20/1 B 1800 4
5 •4° SCANNER 240 20/1 C 50/2 3080 62° LAMINATOR 6
7 OSON PLOTTER 180 20/1 A 3080 8 r
• 9 P 500 PLOTTER 24.0 20/1 .B 20/2 - 1760 8000 COPIER • 10
11 P 5000 PL1R /FDR 600 20/1 C
. ..... _.. .1760 12
13 OLOR COPIER 1440 20/1 A 20/1 �•P. iE. 14
15 YOCERA COPIER 1440 • 20/1 B 20/2 1430 7000' COPIER 16
17 IRK STATION 360 20/1 C • 1430 18
19 ONICA COPIER 1920 20/1 A 20/1 360 7000 COPIER 20
21 •070 COPIER 1200 20/1 3 20/2 , 1200. 3165 COPIER 22
23 ORK STATION 720 20/1 C • 1200
24
25 ORK STATION 790 20/1 A .. .20/1 , . .. . . _ • 360 . TTC 26
27 ORK STATION 360 20/1 B 20/1 TZi7 &WO CoPnER 28
1 29 20/1 C 20/1 30
31 20/1 A 20/1 32
33 20/1 B 20/1
34
35 , 20/ C 2 0/ 1 36
37 20/1 A 20 " 38
Q 39 20/1 8 20 40
41 20/1 C 20/1
42
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yu pgl" oS"Se 10 arc e
I0 73zw to 9390
A071.Cp,✓tc. A 0...2 ..,,,.; 11 T
s.e late.: g9.43A 37 72.25
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Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
Fee for all residential systems combined ... $67.84
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
WM7, < a4 a^ 4 w Til\i „ 5
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
❑ 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 \6u Iding \ Permits\ELC -Perm itApp.doc 10/01/09