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Permit
CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2011 -00144 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/22/2011 Parcel: 25111 CC09700 Jurisdiction: Tigard Site address: 15750 SW GREENS WAY Project: Brown Subdivision: SUMMERFIELD NO. 2 Lot: 124 Project Description: Ground existing panel (house being repiped) Contractor: FRAHLER ELECTRIC CO Owner: BROWN, HELEN 11860 SW GREENBURG RD 15750 SW GREENS WAY TIGARD, OR 97223 TIGARD, OR 97224 PHONE: 503 - 639 -4627 PHONE: FAX: 503 - 639 -4673 FEES Quantity Description Date Amount 1 ea Reconnect Only 03/22/2011 $67.84 Specifics: 1 ea 12% State Surcharge - 03/22/2011 $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. ATTENTI • • : • - • • -w requ' - . • to follow the rules adopted by the Oregon Utility�Center. Those rules are set forth in OAR 952- 001 -001 • rough OAR 952 -00 • •0. m. y obtain a copy of the rules or direct questions to O •y 503.23 . •87 or 1.800.332.2344. Issued :y: I ^ oj��i i L. � �L / Permittee . •ture: � � 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 IN ALLATION ONLY SIGNATURE OF SUPR. ELEC' ' - i , Date: / � e: p LICENSE NO. /e7 o 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. Electrical Permit Application FOR OFFICE USE ONLY 74 City of Tigard Received a a E doll — �/ 13125 SW Hall B lvd ., Ti gar d , OR 97223 Plan Review Permit No.: C Phone: 503.718.2439 Fax: 503.598,1960 Da Review Date/By: /By: Other Permit: 1 I c; A l; f ., Inspection Line: 503.639.4175 Date Ready /By: kris' Internet: www.tigard- or.gov Notified /Method: I S See Pent 2 nr 5 u pplemeatal Information • TYPE OF WORK PLAN :REVIEW ❑ New construction Addition /alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below) El Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition 173 Other: where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. 1 - and 2 - family dwelling El Commercial(industrial less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ 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 0 Emergency system. larger separately derived syster ❑ Addition of new motor load of ❑ "A ", "E ", "I - ", `9 - 3" Job no.: 68338 I Job site address: 15750 SW GREENS WAY 100HP or more. occupancy. ❑ Six or more residential units. ❑ Recreational vehicle parks. City /State /ZIP: TIGARD, OR 97224 ❑ Health -care facilities. ❑ Supply voltage for more than ❑ Hazardous locations, 600 volts nominal. Suite /bldg. /apt. no.: 1 Project name: BROWN RESIDENCE ❑ Service or feeder 600 amps or more. Cross street/directions to job site: FEE SCHEDULE Description I Qty. I Fee. I Total 1 New residential singe- or multi- family dwelling unit. Includes attached garage. Subdivision: I Lot no.: 1,000 sq. ft. or less 168.54 4 Tax map /parcel no.: Ea. add') 500 sq. ft. or portion 33.92 1 Limited energy, residential DESCRIPTION OF `WORK (with above sq. ft.) 75.00 2 Limited energy, multi-family above sq . residential (with above sq ft) 75.00 2 GROUND EXISTING ELECTRICAL PANEL. CURRENT WATER PIPE BEING REMOVED Services or feeders installation, alteration, and/or relocation 200 amps or less 100 2 ❑ PROPERTY OWNER I ❑ TENANT 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 relocation • Phone: ( ) Fax: ( ) 200 amps or less I 59.36 ) 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 I 168.54 2 Owner signature: Branch circuits — new, alteration, or extension, per panel Date: A. Fee for branch circuits with ❑ APPLICANT I ..❑ CONTACT PERSON above service or feeder fee, 7 42 each branch circuit 2 Business name: B. Fee for branch circuits without service or feeder fee, first Contact name: branch circuit 56.18 2 Address: Each add'1 branch circuit 7.42 2 Miscellaneous (service or feeder not included) City /State /ZIP: Each manufactured or modular 67.84 dwelling, service and/or feeder 2 Phone: ( ) I Fax: : ( ) Reconnect only 1 67.84 67.84 2 E - mail: Pump or irrigation circle 67.84 2 Sign or outline lighting 67.84 2 CONTRACTOR Signal circuit(s) or limited - energy Business name: FRAHLER ELECTRIC COMPANY panel, alteration, or extension. Page 2 2 Each additional inspection over allowable in any of the above Address: 11860 SW GREENBURG ROAD Additional inspection (I hr min P ( ) 66.251 hr City /State /ZIP: TIGARD, OR 97223 Investigation (1 hr min) 66.25/ hr Industrial plant (1 hr min) 78.18/ hr Phone: (503 ) 639 -4627 Fax: ( 503) 639 -4673 Inspections for which no fee is C "G, specifically liste (%a hr min) CB Lic.: 90.00 / hr 37410 Electrical Lic.: 34 -13C I Suprv. Lie.: 1©((S ELECTRICAL .PERMIT FEES Suprv. Electrician signature, re( red: �� f Subtotal: 67.84 �� "L_ Plan review (25% of permit fee): Print name: R. W. F'RAHI,ER Date: 03/21/11 State surcharge (1_ ib of permit fee): '° P 8.14 Authorized signature: TOTAL PERMIT FEE: 75 98 This permit application expires if a permit is not obtained within 180 Print name: Date: days after it has been accepted as complete. Number of inspections allowed per permit I Buildm \Permits\ELC- PermitApp.doc 07/01/10 440 -4615T(1 l /05 /COM/WEB