Permit _ ,;;C IT 1 ' OF TIGARD GARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00682
I DEVELOPMENT SERVICES DATE ISSUED: 11/18/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S102BA -00302
SITE ADDRESS: 09908 SW TIGARD ST
SUBDIVISION: NO.TIGARDVILLE ADDITION AMEND. ZONING: I -P
BLOCK: LOT : 022 JURISDICTION: TIG
Project Description: Job #61878 Install 1 branch circuit.
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: 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 INDUSTRIAL LLC FRAHLER ELECTRIC CO
11336 SW BULL MOUNTAIN RD #103 11860 SW GREENBURG RD
TIGARD, OR 97224 TIGARD, OR 97223
Phone: Phone: FX 639 -4673
Reg #: 160-4627 37410
SUP 1816S
FEES ELE 34 -13C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 11/17/03 $46.85
[TAX] 8% State Surcharge 11/17/03 $3.75 Low Voltage Inspection
Elect'I Final
Total $50.60
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 -0100 You may obtain copies of these rules or direct questions to OUNC at (503)
246 -6699 or 1.800- 332 -2344.
Issued By: �,,/,C...) Permit 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'N: - DATE:
,
LICENSE NO: �X /eo5
Call 639 -4175 by 7:00pm for an inspection the next business day
_ ..
Electrical Permit Application (l1 r i ( 1: l s l ()Ni _ 1
Date received:// —/7 -0 3 Permit no .. .D 3 006..
�� 'r ? • Project/appl. no Expire date:
z ,; t . ' . City of Tigard
®�
City of Tigard Address: 13125 SW Hall Blvd, Ti • I I V E '' � Date issue Receipt no.:
Phone: (503) 639 -4171 NOV Fax: (503) 598 -1960 N 1 7 2003 Case file no.: Payment type:
Land use approval: Q I Y vl= - `�
1 : I I: (I; ;': 't'l' I
❑ 1 & 2 family dwelling or accessory eiCommercia1/industrial ❑ Multi- family ❑ Tenant improvement
❑ New construction ❑ Addition/alteration/replacement ❑ Other: ❑ Partial
.I()R SI I F. 1\FOI(,ll.\ I ION -
Job address: 9908 SW TIGARD STREET Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: Block: Subdivision:
' tlect name: I AI' ' DI' Wt) • bl 'T • i Description and location of work on premises: a . k i • pryl.
Estimated date of completion/inspection: ,
( O:\ I H \( l ()I( \ PP! .I(: ■ I IO\ III S(:III..1)1'I I..
Job no: 61878 Fee Max
Deception Qty. (ea.) Total no.losp
Business name: FR C' ELECTRIC COMPANY New residential- or �- fa�yper
Address: 11860 SW GREENBURG ROAD dwelling ®1t.lndudesatlachedgarage.
City: TIGARD State: OR ZIP: 97223 Setrvicelnchrded:
Phone: 639 -4627 Fax. 639 -467 E -mail: 1000 • .. It or less 4
Each additional 500 sq. ft. or portion thereof ___—
CCB no.: 10 Elec. bus. lie. no: 34 -13C Limited energy, residential MEM 2
City/metro lic. no.: , a (0 — ( - 0 Limited energy, non - residential 111111111.1 2
pliggigNMEIVirdiNg. 10/14/03 Each manufactured home or modular dwelling ■■
Service and/or feeder 2
up. elect. name (print): • *MD i 9 IN License no: • • Services or feeders - lnstalb+tlon, III
:. alteration or relocation:
. l'14011.12 I 1 U% ' \ I N 200 amp or less
Name (print). 201 amps to 400 amps __
401 ni 1000 amps —__ s to 00: �s 2
Mailing address: 601 snips to loon amps 2
City: State: ZIP: Over 1000 amps or volts ___ 2
Phone: Fax: E - mail: Reconnect onl EWE_ I
Owner installation: The installation is being made on property I own Temporary
installation, alteration, or relocation:
which is not intended for sale, lease, rent, or exchange according to
200 amps or less 2
ORS 447, 455, 479, 670, 701. ___ 2
201 amps to 400 amps
Owner's s' P t ture: Date: 401 to 600 amps ___ 2
1: \ (: I \ I , I If 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
City: State: ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: e 6.8' 2
Phone: Fax: E - mail: Each additional branch circuit: __
I'I. \\ RL\ II ■■ (Please cued. all Ih:il :iphlt 1 Misc. (Service or feeder not included):
❑ Service over 225 amps- commercial ❑ Health -care facility Each pump or irrigation circle ■■ 2
O Service over 320 amps -rating of 18t2 ❑ Hazardous location Each sign or outline lighting MI= 2 2
family dwellings O Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, IIIIIII
O System over 600 volts nominal more residential units in one structure alteration, or extension
❑ Building over three stories 0 Feeders, 400 amps or more *Descri ' ion:
❑ Occupant load over 99 persons O Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
❑ Egress/lighting plan ❑ Other: Per inspection __
Submit _ sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Permit fee $ 46.85
Not all jurisdictions accept credit cards, plisse call jurisdiction for more information. Notice: This permit application $
❑ Visa O MasterCard expires if a permit is not obtained Plan review (at _ %)
Credit card number I / within 180 days after it has been State surcharge (8 %) $ 3.75
Expires accepted as complete. TOTAL $ 50.60
Name of cardholder as shown on Credit card
$
Cardholder signature Amount 440 -4615 (6 /00 /COM)
ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT TEES V = w
Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Restricted Energy Fee _$75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total Check Type of Work Involved:
Residential - per unit
1000 sq. ft. or less $145.15 4 ❑ Audio and Stereo Systems'
Each additional 500 sq. ft. or
portion thereof $33.40 1
Limited Energy $75.00 ❑ Burglar Alarm
Each Manned Home or Modular
Dwelling Service or Feeder $90.90 2 ❑ Garage Door Opener*
Services or Feeders ❑ Heating, Ventilation and Air Conditioning System*
Installation, alteration, or relocation
200 amps or less $80.30 2
201 amps to 400 amps $106.85 2 ❑ Vacuum Systems
401 amps to 600 amps $160.60 2
601 amps to 1000 amps $240.60 2 n Other
Over 1000 amps or volts $454.65 2
Reconnect only $66.85 2
Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Installation, alteration, or relocation Fee for each system. *75.00
200 amps or less $66.85 2 (SEE OAR 918 - 260 -260)
201 amps to 400 amps $100.30 2
401 amps to 600 amps $133.75 2- Check Type of Work Involved:
Over 600 amps to 1000 volts,
see "b" above. ❑ Audio and Stereo Systems
Branch Circuits
New, alteration or extension per panel ❑ Boiler Controls
a) The fee for branch circuits
with purchase of service or ❑ Clock Systems
feeder fee.
Each branch circuit $6.65 2 ❑
b) The fee for branch circuits Data Telecommunication Installation
without purchase of service
or feeder fee. ❑ Fire Alarm Installation
First branch circuit $46.85
Each additional branch circuit $6.65 ❑ HVAC
Miscellaneous - -
(Service or feeder not included) - - • - - - - - - - 0 Instrumentation
Each pump or irrigation circle $53.40
Each sign or outline lighting $53.40 n . • Intercom and Paging Systems . . ..- ,
Signal circuit(s) or a limited energy . -
panel, alteration or extension $75.00 ❑ Landscape Irrigation Control'
Minor Labels (10) $125.00 - ' ' ' -
Each additional Inspection over ❑ Medical
the allowable In any of the above
Per inspection $62.50 ❑ Nurse Calls
Per hour $62.50
In Plant $73.75 ❑ Outdoor Landscape Lighting*
Fees:
n Protective Signaling
Enter totel of above fees
-
$ n Other -'
8% State Surcharge $ Number of Systems
25% Plan Review Fee
See "Plan Review" section on $ * No licenses are required. Licenses are required for all other Installations
front of application.
Fees:
Total Balance Due $
Enter total of above fees $
❑ Trust Account # 8% State Surcharge $
All New CommercialBulldings require 2 sets of plans.
Total Balance Due $
•
is \dsts\forms \elc- fees.doc 02/05/02
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPEG-�TIOIQ DIVISION Business Line: (503) 639 -4171 MST
BUP
Received /Z /5 "' Date Requested / a 0 3 AM PM BUP
Location 0 d. Suite — MEC
Contact Person p�v� n��i ir►�— Ph ( 5 0 ) d ' ? e / PLM
Contractor ,ccAQ
�.( Ph ( SWR 2 _
BUILDING Tenant/Owner 1 -' 1 e1
Footing
Foundation ELC
Access:
Ftg Drain
ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Ina Sheath /Shear
p Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling �7
Roof gq V 1 b\J\ f l`
Other: n` � (� t
Final � W G�la �� ) Tt 1-, I V v !
PASS PART FAIL nn pp
PLUMBING \IA Y`(\ kAs e -
Post &Beam 9/ - I
Under Slab
Rough -In
Water Service
Sanitary Sewer G= PL1 -i1 �' rT\01
Rain Drains
Catch Basin / Manhole H ot -M (�1/�1
Storm Drain H ( ' V
Shower Pan \f\\ yJ ®` fi�N z
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 ()Ye L 3
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
411r- 4411111M - ' RT FAIL
SIT E Please call for reinspe ion RE: • nable to inspect - no access
Fire Supply Line
ADA
Approach/Sidewalk Date J 6 Inspect . � . �
Other:
Final DO OT REMOVE this inspection record fr the job e.
PASS PART FAIL