Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2009 -00535
Date Issued: 10/08/2009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S111AB03100
Jurisdiction: Tigard
Site address: 14135 SW 93RD AVE
Subdivision: ELROSE TERRACE Lot: 27
Project: Schwarz
Project Description: Ground existing panel and add /alter (2) branch circuits.
Owner: FEES
SCHWARZ, CHARLES Quantity Description Date Amount
14135 SW 93RD AVE
TIGARD, OR 97224 3 crt Branch Circuits 10/08/2009 $71.02
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 10/08/2009 $8.52
Electrical
Contractor:
FRAHLER ELECTRIC CO
11860 SW GREENBURG RD
TIGARD, OR 97223
PHONE: 503 - 639 -4627
FAX: 503- 639 -4673
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $79.54
• 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: l 1 k jr- 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:
App INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' S 0 Q �\ p p Date:
LICENSE NO. "��/ �✓
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.
N
`ElI' Permit Application FOR OFFICE USE ONLY -- ,
City of Tigard ' CEIVED Received
IN - Date/By: ___.-A Permit No.:
'I 13125 SW Hall Blvd., Tigard, OR 972 3 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
TIGARD Inspection Lin 503.639.4175 0 C T • 2009 Date Ready/By 7 El See Page 2 for
Internet: www.tigard or.gov Notified/Method: 1 I c` Supplemental Information
TYPE OF GARD REVIEW
OF W PLAN REVIEW
? �I P lease check all that apply (submit 2 sets of plans whtems checked below
lip New construction �] Addition/alt e- ement pP y P
❑Service or feeder 400 amps or more 0 Building over three stories.
•
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
® I - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. ' buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system larger separately derived system.
❑ Addition of new motor load of ❑ `A ", "E ", "1 -2 ", "1 -3 ",
Job no.: 66995 Job site address: 14135 SW 93rd AVENUE I OOHP or more. occupancy.
❑ 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.: Project name: SCHWARZ RESIDENCE ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description ) Qty. I Fee. I Total
• New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
. DESCRIPTION OF WORK (with above sq. ft.) 75.00 2
Limited eid energy, wi abo sq. multi-family
residential 75.00 2
GROUNDING OF PANEL AND HOME REPAIRS
Services or feeders installation, alteration, and/or relocation
200 amps or less . ,.1 80.30 ":710 2
❑ PROPERTY OWNER ❑ , TENANT 201 amps to 400 amps s.) 1
* 06 .85 1_ 2
Name:. - ... 401 amps to 600 amps •. 160.60 2 • • 601 amp's to 1,000 amps 240.60 2
Address: O■er"1,000 amps or volts 454.65 2
City /State/ZIP: •• - - • - • - Temporary services or feeders installation, alteration, and/or
relocation • '
Phone: (, ) Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date:
A. Fee for branch circuits with 4 414.53, "
❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee, 7, - ; .65 i 2
each branch circuit
Business name: B. Fee for branch circuits
b t$o. 'a ■ 3b
Contact name: without service or feeder fee, l ` 2
first branch circuit
Address: Each add'I bunch circuit � 6.65 I 2
Miscellaneous (service or feeder not included)
City /State/ZIP: Each manufactured or modular 90.90 2
Phone: dwelling, service and/or feeder
( ) Fax: ( ) Reconnect only 66.85 2
E - mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Signal circuit(s) or limited -
Business name: FRAHLER ELECTRIC COMPANY energy panel, alteration, or .
Address: 11860 SW GREENBURG ROAD - extension., Describe: Page 2 2
City /State/ZIP: TIARD, OR 97223 Each additional inspection over allowable in any of the above
- _Per i nspection - 62.50
- Phone: (, ) F ax: ( ...) g p
503 639 -4627 503 639 -4673 Investi at op ei hour (1 hr min) 6230
CCB Lic.: 37410 Electrical Lic.: 34 -13 Suprv. hic:: 5110 h'd °tri p hour 73:75
-ELECTRICAL PERMIT FEES •
• Suprv. Electrician signature, required Subtotal
Plan review (25% of permit fee): • (0'
Print name: ADAM ETHERINGTON Date: 10/01/09
State surcharge (12% of permit fee):
Authorized signature: TOTAL PERMIT FEE: ,] 3 •
Print name: Date: This p ermit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
•
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
• Fee for all residential, systems combined • ...' $75.00 •
1
Check Type 'of : -Involved:_.: ... : .
❑ Audio and Stereo Systems *.
❑ Burglar Alarm
7 Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
n Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00 •
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
O Fire Alarm Installation
❑ HVAC
❑ Instrumentation -
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting* .: •
C Protective Signaling _ .. _ •
n Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations