Permit CITY OF TIGARD ELECTRICAL PERMIT
111 a COMMUNITY DEVELOPMENT Permit #: ELC2009 -00267
Date Issued: 06/04/2009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S1026A00304
Jurisdiction: Tigard
Site address: 9826 SW TIGARD ST
Subdivision: Lot: 0
Project: Frye Electronics
Project Description: Install /alter (1) branch circuit to replace 5 ton condenser RTU.
Owner: FEES
TIGARD INDUSTRIAL LLC Quantity Description Date Amount
r 5805_JEA.N_RD�
LAKE OSWEGO, OR 97035 1 crt Branch Circuits 06/04/2009 $46.85
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 06/04/2009 $5.62 •
Electrical
Contractor:
WILLAMETTE HVAC
3075 SW 234TH AVE. #206
HILLSBORO, OR 97123
PHONE: 503 - 628 -6841
FAX: 503- 848 -2597
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $52.47
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. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through OAR 952- 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332. 4.
Issued By: 1111%--L__ � _ ' • �_ • Permittee Signature:
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' Date:
LICENSE NO.
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.
El eri4al Permit Application RECFVE I FOR OFFICE USE ONLY
•
City of Tigard Received
114 " �J g kj 9 Permit No.:' IC 2p.0 .al!1 (
13125 SW Hall Blvd., Tigard, OR 97223 JUN 0 4 2009 Date/By: Plan Review A� t CY
17 , ' Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit: (ti/JO 7.CXIQ • cy3t7(0'
TIGARD Inspection Line: 503.639.4175 C fIGARD Date ReadyBy: Juris: ® See Page 2 for
Internet: www.tigard- or.gov
MY " ~ I Notified/Method: Supplemental Information
EiU� DIVISION
^( q S u PP
TYPE OF WORK PLAN REVIEW
❑ New construction ® Addition /alteration/replacement Please check all that apply (submit 2 sets of plans w(tems 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
❑ Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A ", "E ", "I -2 ", "I - ",
Job no.: I Job site address: 9826 SW Tigard St 100HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: Tigard OR 97223 ❑ Health - care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: I Project name: - ��/ �gr 77t��i c 4' ❑ Service or feeder 600 amps or more.
/ ( FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total I •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK ( with above sq. ft.) 75.00 2
Reconnect conderser Limited energy, multi-family 75.00 2
residential (with above sq. ft.)
Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City/State /ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) I 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
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: Same as below B. Fee for branch circuits
Contact name: without service or feeder fee, 1 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
dwelling, service and /or feeder 90.90 2
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, or limited -
Business name: Willamette HVAC
energy panel, alteration, or
Address: 3075 SW 234 Ave Ste 206 extension. Describe: Page 2 2
City/State /ZIP: Hillsboro OR 97123 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (503) 628.6841 Fax: (503) 848.2597 Investigation per hour(l hr min) 62.50
CCB Lic.: 56951 Electrical Lic.: 3634 CRE Suprv. Lic.: 4025LEB Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal:
Print name: Mike Sicard Date: 6/4/09 Plan review (25% of permit fee)
�A/ State surcharge (12% of permit fee):
Authorized signature: s %G %/ TOTAL PERMIT FEE `(�
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:\ Build ing\Pernits1ELC- PermitApp.doc 05/23/06 440- 4615T(I I /05 /COM/WEB