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Permit CITY OF TIGARD, VAR®' ELECTRICAL PERMIT PERMIT #: ELC2004 -00280 : DEVELOPMENT SERVICES DATE ISSUED: 5/20/2004 " ,.:111 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - 4171 PARCEL: 2S114A0 -01500 SITE ADDRESS: 17005 SW 92ND AVENUE SUBDIVISION: ZONING: R 12 BLOCK: LOT : JURISDICTION: TIG Project Description: Install (2) branch circuits for concession stand. 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: 1 W /SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1 1st W/O SRVC OR FDR: PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 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 GREEN BURG RD TIGARD, OR 97223 TIGARD, OR 97223 Phone: Phone: FX 639 - 4673 Reg #: 169-4627 37410 SUP 1816S FEES ELE 34 -13C Description Date Amount Required Inspections [ELPRMT] ELC Permit 5/20/2004 $187.15 [TAX] 8% State Surcharge 5/20/2004 $14.97 Rough -in Elect'I Final Total $202.12 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 am set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246.6699 or 1 -800 -33 344. Issued By: / r Permit Signature: DA/ '! 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: DA✓ / ° 7 e_"9 "/ / DATE: LICENSE NO: Call 639 -4175 by 7:00pm for an inspection the next business day Elect -,• • .c ''4 �.(tl 1l(41 l � F tl \1 1 rical l"e to 1 ,1 t��n y.� � � 3,s, ,� a;.,_-!,t� - 1 , ii Data received 517 r ern* no . a 200" // - ,'i I ,( : , q City of Tiger Projectiappl. no.: Expire date: Ciry of Tigard Address: 13125 SW Hall Bilig 0 23 giki Phone: (503) 639 -4171 �P11Fh� �� Date issued: By: Receipt no.: Fax: (503) 598 -1960 1GpR0 Case file no.: Payment type: B Land use approval: CIUITY DI O� T DIVISION L 9 w i.A .4 , z . . . , , ` 3 '., 'Z'' VIII 4)I I,'_I 1 a U 11.1;, .. ,r;"t _ s t : i r.; ,,,z..,:....--r......, .,n t , , u t ., ® 1 & 2 family dwelling or accessory CI Commercial/industrial CI Multi- family O Tenant improvement O New comb II © Other: ❑ Partial .. s c i IA ' ,..,, a ;-, I +" P . , ,a , , gt 11,111'z 11.1 I \I'()1t1i \ji4i 1 $ I 4 .i;,, - ,i4 ; rl, A,i. - - , .1 , . ; `. , Job address: 17005 SW 92nd AVENUE Bldg. no.: Suite no.: Tax map /tax lot/accotmt no.: Lot: I Block: !Subdivision: Project name: COOK PARK 'Description and location of work on premises: C,ONCFS S IfN , Estimated date of completion/inspection: t t , s \'t t 0 du It , I U VI'I1 I I(, 3 . t t s' � 1:i ti i ,' 1 00 tji ` l e l l w tii r 111,U,1 °7 ( .. ,'?h y , Y ". � . " w w+d 4.. .. . dSei -::r r..t r.�. .E :, , a :� � l,*P a ` ,1�'- ',.. � ,b � kt � A;+ c « '.J � ;s� d08.s em: 62189 yes Max . Business name: FRAHLER ELECTRIC COMPANY IDesertadon Qty. I (oat) Total i nu.bs p Address: 11860 SW GREENBURG ROAD. �� e� - aingleorrrmld- baadi7per dweBleg�t.Iorludesatlached e. City: TIGARD I State: OR] ZIP: 97223 Sesrfcelncluded: Phone: 639 -4627 Fax: 639 -46731 E -mail: 1000 sq. ft or less - 4 J Elec. CCB no.: ec, bus. lic. no: 34 -13C 3 7410 Each additional 500 sq. ft. or portion thereof City/metro lie. no. Limited energy, residential 2 Limited energy, non- residemial 2 _ _ier.e& l ,, � 05/17_104 Each manufactured home or !nodular dwelling _ Signature of supervising electrician (required) Date Service and/or feeder 2 Sup elect. name (print) R W FRAHLER License no: 1816S Ser lees or feeders — tnstmldn v y y , I +tfi ` t t fi r. +,, 1 e ? F , alteration orrel treat - son: ' .4. ,�?7 se "` ' ?. atz. ng 12S),I_I Ital�,ly•(,)l1)x \I '; r^ s . ., 200 am or leer . 1 80.30 2 Name (print): ( 6 -T 6-04172b _ 201 amps to 400 amps __ �_.._. _ 10 , ,— Mailing address: 401 amps to 600 amps ____— • 2 601 amps to 1000 amps 2 City: a State: ZIP: Over 1000 amps or volts 2 Phone: Faxes E -mail: __ _ Reconnect ono 1 Owner installation: The installation is being made on property I own Temporary services or feeders - ir which is not intended for sale, lease, rent, or exchange according to `°eR °alien' )'a''`t "'` 'e"'c:Ar1' z' + I ORS 447, 455, 479, 670, 701. 200 am or less 2 _ .... 1 201 amps to 400 amps 2 I Owner's S ,,r title: Date: 401 to 600 amps 2 I 4 e , : -h-, ;;S ;;? i 5, ,.. ° ;rte r . Li '. t t \ I 1 , 12,, r . ` e• F , Rrmocb cfrcufta - nen,alteration. Name; A. Fee for brantb. circaltR with purchase of n Address: _ service or feeder fee, each branch circuit 0- 2 City State: ZIP: B. Fee for branch c purchase Phone: Fax; -mail: of service or feeder fee, first branch circui L 2 > i f i )., I - Each additional branch circuit „ d. 1, � i ; , i i i t lx111 ,1 iF t , t.ht t 1. e 111 1 1111 iI!l'I ,) ? ? § }/5 11$ isc. (Service or feeder not lncluded): U Service over 225 amps - commercial U Health -cafe facility Each pump or irrigation circle 2 O Service over 320 amps - rating of 1 52 U Hazardous location Each sign or outline lighting 2 family dwellings U Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, U System over 600 volts nomimul more residential units in one structure alteration, or extension* 2 U Building over three stories U Feeders, 400 amps or more °I?eacription: U Occupant load over 99 persons OManufactured structures orRVpark rtIanou bo _..__...._...._._._.. O Egress/lighting peen U Other: _ — �chadditlona5fnspecilonovertbertllowableismfofffieatw .e: per inspection L L 1 Subsntt _ _ wets of plans with any of the above, Investigation fee The above ore not applicable to temporary construction service. Other --- Permit fee — $ 187.15 Not all juriadictions accept credit cards, phase call jurisdiction for more information. Notice: This permit application ° - U visa Ch MasterCard expires• if a permit is not obtained Plan review (at ___ oIn) $ Credit card number. / / within 180 days after it has been State surcharge (8%) $ . 14 . 97 Name of cardholder as shown on c card --- Expire. TOTAL as complete. TO AL 202.12 $ - i _ . Cardholder signature '� — Amount �j,, 441M6'15 (6 /00/CON ' , r t � Mt1G' _el D P . • CITY OF TIGARD 24 -Hour . BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested AM PM BUP Location I - 70o S l - Suite MEC Contact Person 4 Ph ( ) 7 36 -- 3/ Fo PLM Contractor '''W' • Ph ( ) god — ®(S(10 SWR BUILDING Tenant/Owner /l ELC a OO LI -00 2 —Y 6 Footing 030 C. PA ELC Foundation Access: nn Ftg Drain C #L�( 10 c_ ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear k die. = !- ...:.:� . �; .a...._ _ — / -44 Int Sheath/Shear +'`_ ' Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling / Roof A RD V / Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / M_ anhole Storm Drain 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 Fire Alarm 140 PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SI El Please call for reinspection RE: ❑ Unable to inspect - no access Fire Supply Line �c ADA D 7 lc( Inspector - # 16# Apt6ItY Ext Approach /Sidewalk --ay P Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL