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Permit i ; �� CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2009 -00463 R Date Issued: 09/08/2009 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S112AB01600 Jurisdiction: Tigard Site address: 7455 SW BONITA RD Subdivision: Lot: 0 Project: Bonita Community Church Project Description: Replace electrical panel. Owner: FEES SUNDAY SCHOOL FELLOWSHIP Quantity Description Date Amount 11501 NE KLICKITAT ST PORTLAND, OR 97220 1 ea Services or Feeders - 200 09/08/2009 $80.30 amps or less PHONE: 1 ea 12% State Surcharge - 09/08/2009 $9.64 Electrical Contractor: 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 $89.94 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. ATT N: Orego law =+ ires you to follow the rules adopted by the Oregon Utility Notificatio Center. T.•.: rules are set forth in OAR 952 -001- 10 through OAR 952 -6:1 -0101. • may obtain a copy of the rules or direct questions to OUNC by calling 50 41;15t1.;,.! , .800: 2.2344. Ir `/ Iss ed By: �� �,r Permittee Signature: i �i 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 INSTALLATJON ONLY /// SIGNATURE OF SUPR. ELEC' � / �� � Date: c///�1 O 7 LICENSE NO. /F/6 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. • • Electrical Permit Application FOR OFFICE USE ONLY City of Tigard Received 9 e . Q 1 N " Date/By: ! d 7 Permit No.: 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 . Date/By: Other Permit: TIGARD Inspection Line: 503.639.4175 Date Ready/By: tuns: El See Page 2 for Internet: www.tigard - or.gov Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW ❑ New construction E Addition/alteration /replacement Please 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. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural • ❑ 1- 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 0 Emergency system. larger separately derived system. ❑ Addition of new motor load of ❑ "A ", E ", "1 -2 ", "1 -3 ", Job no.: 66931 Job site address: 7455 SW BONITA ROAD . 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.: Project name: BONITA COMMUNITY CHURCH ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross s reet/directions to job site: Description I 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 Tax map /parcel no.: Ea. add'1500 sq. ft. or portion 33.40 1 Limited energy, residential 75.00 2 • • DESCRIPTION OF WORK' (with above sq. ft.) • Limited energy, multi - family REPLACE ELECTRICAL PANEL residential (with above sq. ft.) 75.00 2 Services or feeders installation, alteration, and/or relocation 200 amps or less 1 80.30 80.30 2 ❑ PROPERTY OWNER ❑ . TENANT • . 201 amps to 400 amps 106.85 2 Name: 401 ainps to 600 amps 160.60 2 Address: 601 amps to 1,000 amps 240.60 2 Over 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 Owner Signature: Date: Branch circuits — new, alteration, or extension, ∎ er panel ❑APPLICANT A. Fee for branch circuits with ❑ CONTACT PERSON above service or feeder fee. 6.65 2 each branch circuit Business name: B. Fee for branch circuits Contact name: without service or feeder fee, 46.85 2 . first branch circuit Address: Each add'! branch circuit 6.65 2 Miscellaneous (service or feeder not included) City /State/ZIP: Each manufactured or modular 90.90 2 dwelling, service and/or feeder 1 Phone: ( ) Fax: : ( ) Reconnect only 66.85 2 E -mail: Pump or irrigation circle 53.40 2 CONTRACTOR Sign or outline lighting 53.40 2 Signal panel, er or limited - • Business name: FRAHLFR ELECTRIC COMPANY energy panel, alteration, or Address: 11860 SW GREENBURG ROAD extension. Describe: Page 2 2 City / State/ZIP: TIGARD, OR 97223 Each additional inspection over allowable in any of the above Per (503 ) 639 -4 67.3 Investigation ion 62.50 Phone: ( 503) 639 -4627 Fax: Investigation per hour (1 hr min) 62.50 CCB Lie.: 37410 Electrical Lie.: 34 -13C Su rv. Lic.: 1816S Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES Suprv. Electrician signature, 661: iiei / ,e .. Subtotal: 80.30 Pant name: D ate: Plan review (25% of permit fee): R. W. FRAHLER 09/08/09 State surcharge (12% of permit fee): q.64 ` Authorized signature: TOTAL PERMIT FEE: 89.94 Print name: This permit application expires if a permit is not obtained within 180 Date. days after it has been accepted as complete.