Permit ��--_-_-� --- . _----_--_-
ELECTRICAL PERMIT
qi i 'i � TI N�v� � ����������w� DATE ISSUED: 08/08/96
�'doMMUNUTYDEVELOPMENTDEPARTMENT
13125 SW Hall Blvd. Tigard, Oregon e7223°8199 (503) 639-4171 PARCEL: 25102C8-00100
SITE ADDRESS...: 12850 SW GRANT ST
SUBDIVISION....: NORTH TIGARDVILLE ADDITION ZONING:R-12
BLOCK..........: LOT ^41
Project Description: Adding one service or feeder to 200 amps.
_________ _ _ ____ _______
- --RESIDENTIAL UNIT---- ---TEMP SRVC/FEEDERS---- MISCELLANEOUS-----
1000 SF OR LESS ^ 0 0 — 200 amp ^ 0 PUMP/IRRIGATION ^ 0
EACH ADD'L 500SF. . . : 0 201 — 400 amp... . . . . : 0 SIGN/OUT LINE LTG. . : 0
LIMITED ENERGY.....: 0 401 — 600 amp ^ 0 SIGNAL/PANEL ^ 0
MANF. HM/ SVC/FDR..: 0 6014-amps-1000 volts.: 0 MINOR LABEL (10)...: 0
----SERVICE/FEEDER---- ----BRANCH CIRCUITS ---ADD'L INSPECTIONS---
0 — 200 amp..... . : 1 W/SERVICE OR FEEDER: 0 PER INSPECTION.....: 0
201 — 400 amp. .. .. . : 0 1st W/O SRVC OR FDR.: 0 PER HOUR... . . . . . . . . : 0
401 — 600 amp......: 0 EA ADD'L BRNCH CIRC: 0 IN PLANT...........: 0
601 — 1000 amp.....: 0 -----PLAN REVIEW SECTION— --------
1000+ amp/volt.....: 0 }=4 RES UNITS........: > 600 VOLT NOMINAL..:
Reconnect only.....: 0 SVC/FDR >= 225 AMPS..: CLASS AREA/SPEC OCC. :
Owner: --- FEES -----------
TIGARD TUALATIN SCHOOL DIST. type amount by date recpt
13137 SW PACIFIC HWY. PRMT $ 60.00 CJS 08/07/96 96-282658
5PCT $ 3.00 CJS 08/07/96 96-282658
TIGARD OR 97223
Phone #: 503-620-1620
Contractor: — --- — — -----
FRAHLER ELECTRIC CO $ 63.00 TOTAL
11860 SW GREEN8URG RD
REQUIRED INSPECTIONS -------
TIGARD OR 97223 Wall Cover Elect'l Final
Phone #: 503-639-4627 Elect'l Service
Reg #..: 37410
This it is issued subject to the regulations contained in the _ __ ______
Tigard Municipal Code, State of Ore. Codes . Syecia[ty Codes and all other Permittee Signature
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started
within 18N days of issuance, or if work is suspended for more
than 180 days. Issued By
— — -- —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: /�- '� - 9�
� ����� _
LICENSE NO: _ _
Call for inspection — 639-4175
J Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. # - 2
/���� Permit # r:LG96 -0
.) iI Phone (503) 639 -4171 Date Issued S '
~' °" FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772 Issued byChc��les S�m�cCf
Inspection (503) 639 -4175
1. Job Address: W " 0 . # 56362 4. Complete Fee Schedule Below:
Name of Development T I G . T U A L A T I N S C H. D I S T. Number of Inspections per permit allowed
Address 12985 S . W . GRANT Service included: Items Cost(ea) Sum
City /State /Zip TIGARD, 0 R 92723 4a. Residential - per unit 4
1000 sq ft. or less $110 00
—
Name (or name of business) C F TIGARD E L E M E N T A F Y Each additional 500 sq ft or 1
portion thereof $25.00
Commercial Residential ❑ Limited Energy
— $25 00
Each Manuf'd Home or Modular 2
Dwelling Service or Feeder $68 00
2a. Contractor installation only:
4b. Services or Feeders
Installation, alteration, or relocation 2
Electrical Contractor F R A H L E R ELECTRIC CO. 200 amps or less _I— $60 00 6().00 2
Address 1 1860 S W G R E E N B U R G ROAD 201 amps to 400 amps $80 00 2 — 401 amps to 600 amps $120 00 2
City TIGARD State 0 R Zip q722 3 601 amps to 1000 amps $180 00 2
Phone No. 639-4627 Over 1000 amps or volts $340 00 2
Contractor's License No. 34-13C Reconnect only $50 00
—
Contractor's Board Reg. No. 37 4c. Temporary Services or Feeders
� Installation, alteration, or relocation 2
Signature of Supr. Elec'n 4,,4 200 amps or less $50 00 2
License No. 1 81 6 S Phone No. 639-4627 201 amps to 400 amps $75 00 2
— 401 amps to 600 amps $100 00
Over 600 amps to 1000 volts
2b. For owner installations: see "b" above
Print Owner's Name RETURN APPLICATION 4d. Branch Circuits
New, alteration or extension per panel
Address a) The fee for branch circuits with
City Stgopy Zip purchase of service or feeder fee. 2
Each branch circuit $5 00
. Phone No. b) The fee for branch circuits withou
The installation is being made on property I own which is purchase of service or feeder fee. 2
First branch circuit $35 00 2
not intended for sale, lease or rent. Each additional branch circuit $500
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): Each pump or irrigation circle $40 00 2 — Each sign or outline lighting $40 00
Signal circuit(s) or a limited energy 2
Please check appropriate item and enter fee in section 5B. panel, alteration or extension $40 00
4 or more residential units in one structure Minor Labels (10) $100 00
Service and feeder 225 amps or more
System over 600 volts nominal 4f. Each additional inspection over
Classified area or structure containing special occupancy the allowable in any of the above
as described in N.E.C. Chapter 5 Per inspection $35 00
Per hour $55 00
—
In Plant $55 00
Submit 2 sets of plans with application where any of the above
apply. Not required for temporary construction services. 5. Fees:
NOTICE 5a. Enter total of above fees $ 60.00
5% Surcharge (.05 X total fees) $ 3.00
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25% of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec 3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. ❑ Trust Account # $
Balance Due $ 63.00
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