Permit Ar CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2002 -00061
1 DEVELOPMENT SERVICES DATE ISSUED: 5/2/02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S 114A0 -01500
SITE ADDRESS: 17005 SW 92ND AVENUE
SUBDIVISION: ZONING: R -12
BLOCK: LOT : JURISDICTION: TIG
Project Description: Picnic Shelter - Phase II of Cook Park Master Plan expansion.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL /PANEL:
MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 3 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
TIGARD, CITY OF FRAHLER ELECTRIC CO
13125 SW HALL 11860 SW GREENBURG RD
TIGARD, OR 97223 TIGARD, OR 97223
Phone: Phone: 639 -4627
Reg #: LIC 37410
SUP 1816S
ELE 34 -13C
FEES Required Inspections
Type By Date Amount Receipt Rough -in
Elect'I Final
Total
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable
laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification
Center, Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. Yo = • .: -'n copies of these rules or direct questions to
Permit Signature: ` l � Iss ed By: _ _,� � 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'N: DATE:
LICENSE NO: -
Call 639 -4175 by 7:00pm for an inspection the next business day
Electrical Permit Application
A l
Date received: , 7 ' Permit no.: _ , ,, _0496
. City of Tigard Project/appl. no.: Expire date:
Cityu(I'ig«re/ Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: By: Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: COP c20a)-- O 1 •
; ;, ' . `'_ ✓ . • TYPE OF PERMIT , .' . r�, ��,= . _; i r , _ I,� ,} r . ,$ , _ *
.
0 I & 2 family dwelling or accessory 0 Commercial /industrial 0 Multi - family ❑ Tenant improvement
,.. New construction 0 Addition /alteration /replacement LI Other: ❑ Partial
t <. .,' z . ' F .2 . ,;; , .: :• J OBSITE'INFORMATION ;,.., °°' ? ,. " :, ': . r . ' .:r
4I Job address: j 7 0 65 _-54, Cj I /L , Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: 'Block: 'Subdivision: .
Project name: 6t�K() r /} ;'b!,i Description and location of work on premises: l CN ( . &44 -E5.
Estimated date of completion /insction:
-. CONTRACTORCAPPLICATION " ' - .: .. f , . . .FEE SCHEDULE .: ' ` .., /" ., trt; a t:
Job no: Fee Max
Description Qty. (ea.) • Total no. insp
Frahler Electric Company New residential - single or multi - family per
11860 SW Greenburg Rd dwelling unit. Includes attached garage.
Service included:
• Tigard OR 97223 1000 sq. ft. or less 4
503- 639 -4630 CCB #: 37410 Each additional 500 sq. ft. or portion thereof
ELC #: 34 -13C SUP #: 1816S I Limited energy, residential 2
Limited energy, non - residential 2
Each manufactured home or modular dwelling
Signature of supervising electrician (required) Date Service and/or feeder 2
Sup. elect. name (print): License no: Services or feeders — installation,
alteration or relocation:
" .'.,':: PROPERTY OWNER s . ` . ' 200 amps or less 2
i
Name rint : / i D ,
G" T �t. 201 amps to 400 amps 2
(P ) G
g ' I / /L S 401 amps to 600 amps
Mailin address: i ` % D 601 amps to 1000 amps
City: , �7 I State:0, . ZIP: c7 7 .�3 Over 1000 amps or volts 2
1 Phone: -2 - `'t 1 / / I Fax: 1E-mail: Reconnect only 1
/ Owner installation: The installation is being made on property I own Temporary services or feeders -
which is not intended for sale, lease, rent, or exchange according to installation, alteration, or relocation:
200 amps or less 2
ORS 447, 455, 479, 670, ,0 . / 201 amps to 400 amps 2
Owner's signature: „Ai, / Date: /l -4 '3- - 401 to 600 amps 2
? ENGINEER, =.. Branch circuits - new alteration,
or extension per panel:
Name. • A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2 .
B . Fee for branch circuits without purchase
City: State: ZIP: • � 2
of service or feeder fee, first branch circuit: I
Phone: Fax: E - mail:
Each additional branch circuit: ADS I
.. = PLAN REVIEW (Please check all that apply) . Misc. (Service or feeder not included):
❑ Service over 225 amps - commercial ❑ Health - carefacility Each pump or irrigation circle 2
❑ Service over 320 amps- rating of I &2 ❑ Hazardous location Each sign or outline lighting 2
family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel.
❑ System over 600 volts nominal more residential units in one structure alteration, or extension* 2
0 Building over three stories ❑ Feeders, 400 amps or more *Description:
0 Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
❑ Egress/lightingplan ❑ Other: Per inspection I I I J
Submit sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Permit fee $ �D . 00 P
Not all jurisdictions accept credit cards, please call jwisdictiou for more information. Notice: This permit application
❑ Visa ❑ MasterCard expires if a permit is not obtained- Plan review (at %) $
Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $ 5 s 3 T L'
Expires accepted as complete. TOTAL $
Name of cardholder as shown on credit card ('?�• I
$ .
Cardholder signature Amount 440 -4615 (6 /00 /COM)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested / I
1 ( AM PM BUP _
Location
/ 7 00- C -
d a G --r �- Suite MEC
Contact Person I\../ c-'eA-d Ph ( _) 6 3q - 41{° �-1 PLM
Contractor e-1- '7\0..- Ph ( ) :3/ / 7 ' c13 1 SWR
BUILDING Tenant/Owner ELC — 06)6
Footing C — °cam C i
Foundation Access:
Ftg Drain ESC ,--- 6-66
Crawl Drain G ��
Slab Inspection Notes: SIT 3
Post & Beam El—e..—
Shear Anchors
Ext Sheath /Shear
Int Sheath/Shear
Framing
Insulation
Drywall q
Drywall Nailing �„n ' /
Firewall ' f
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof f7 I Co d
Other:
Final L)a__
PASS PART FAIL
PLUMBING
Post & Beam (1
Under Slab l
Rough -In
Water Service •
Sanitary Sewer
Rain Drains
Catch Basin / Manhole •
Storm Drain \ 7
Shower Pan \
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line •
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fir- ' larm
4 l 0 ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SI ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date /AIL !) (2a Inspector _ +�.. _ '��� Ext
Other: 1 mi
� Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL