Permit CITY OF T I G A R D ELECTRICAL PERMIT
PERMIT #: ELC1999 -00722
0 DEVELOPMENT SERVICES DATE ISSUED: 12/06/1999
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S103AA -00101
SITE ADDRESS: 10865 SW WALNUT ST
SUBDIVISION: ZONING: R -4.5
BLOCK: LOT : JURISDICTION: TIG
Project Description: Electrical TI - First branch circuit and limited energy for fire alarm
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: 1
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:
SCHOOL DISTRICT NO 23 J FRAHLER ELECTRIC CO
13137 SW PACIFIC HWY 11860 SW GREENBURG RD
TIGARD, OR 97223 TIGARD, OR 97223
Phone: Phone: 639 -4627
Reg #: LIC 00037410
SUP 1816S
ELE 34 -13C
FEES Required Inspections
Type By Date Amount Receipt Elect'I Service
PRMT BON 12/03/199& $97.50 99- 3120161 Elect'l Final
5PCT BON 12/03/199E $7.80 99- 3120161
Total $105.30 ORIGINAL
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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATURE �,��
11 C _ ma ISSUED BY: M � Q f� ,
c�.� 1 � a !l0%ck L�
l` 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: ( 1/L DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
CITY OF TIGARD Electrical Permit Application Plan Check j
1.3125 SW HALL BLVD. Rec'd By '1
Date Rec'd - z l �
TIGARD OR 97223
Date to P.E.
Phone (503) 639 -4171, x304 Date to DST
Inspection (503) 639 -4175 - Print of Type Permit # f ,oe't l-(t 7 Z2-
Fax (503) 598 - 1960 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Numbe of Inspections per permit allowed
Name (or n e of business) FOWLER MIDDLE SCHOOL Service included: Items Cost Sum
Address I �h SW WALNUT 4a. Residential - per unit ,
City /State /Zip TIGARD, OR 97223 1000 sq. ft. or less $ 117 75 4
Each additional 500 sq. ft. or
portion thereof $ 26.25 1
Commercial III Residential ❑ Limited Energy $ 60 00
Each Manufd Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder $ 72 75 2
(Prior to permit issuance, applicants must provide contractor license 4b. Services or Feeders
information for COT data base). Installation, alteration, or relocation
Electrical Contractor FRAHLER ELECTRIC COMPANY 200 amps or less $ 64 25 2
Address 11860 SW GREENBURG ROAD 201 amps to 400 amps $ 85.50 2
City TIGARD State OR Zip 9 7223 401 amps to 600 amps $ 128.50 2
Phone No. (503) 639 -4627 p 601 amps to 1000 amps $ 192.50 2
Over 1000 amps or volts $ 363.75 2
Job No. 59676 Reconnect only $ 53.50 2
Elec. Cont. Lice. No. 34 -13C Exp.Date 10/01/00 4c. Temporary Services or Feeders
OR State CCB Reg. No. 37410 Exp.Date 07/02/01 Installation, alteration, or relocation
COT Business Tax or Metro No. 1987 Ex .Date 12 /01/00 200 amps or less $ 53.50 2
201 amps to 400 amps $ 80.25 2
Signature of Supr. Elec'n j .1.../ 401 amps to 600 amps $ 107.00 2
Over 600 amps to 1000 volts,
License No. 1816S Exp.Date 10 /01 /01 see "b " above.
Phone No. (503) 639 -4627 4d. Branch Circuits
New, alteration or extension per panel
a) The fee for branch circuits
2b. For owner installations: with purchase of service or
feeder fee.
Print Owner's Name Each branch circuit $ 5.35 2
b) The fee for branch circuits
Address without purchase of service
City State> Zip or feeder fee.
Phone No. First branch circuit 1 $ 37.50 $37.50
Each additional branch circuit $ 5.35
The installation is being made on property I own which is not 4e. Miscellaneous
intended for sale, lease or rent. (Service or feeder not included)
Each pump or irrigation circle $ 42.75
Owner's Signature Each sign or outline lighting $ 4275
Signal circuit(s) or a limited energy , hre. Aw l-
3. Plan Review section (if required):*
panel, alteration or extension 1 ' $ 60.00 $60.00
Minor Labels bels (10) $ 107.00
Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection over
4 or more residential units in one structure the allowable in any of the above
Service and feeder 225 amps or more Per inspection $ 50.00
Per hour $ 50 00
System over 600 volts nominal In Plant $ 59.00
Classified area or structure containing special occupancy as
described in N E.C. Chapter 5 5. Fees:
5a. Enter total of above fees $ 97.50
* Submit 2 sets of plans with application where any of the above apply. (9% Surcharge ( O8X total fees) $ 7 80
Not required for temporary construction services. Subtotal $
5b. Enter 25% of line 5a for
NOTICE Plan Review if required (Sec. 3) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $
IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account #
AT ANY TIME AFTER WORK IS COMMENCED Total balance Due . _ $ 105,30
i. \fists \forms \e lectn c.doc
ti
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested — VC) AM PM BLD
Location /9 'b-3 !l /444— Suite MEC
Contact Person .-7 Ph &53 PLM
Contractor fib( , Ph 4,7/— ,( rf"CIC, SWR
BUILDING Tenant/Owner (011 ds�„J) ELC /41g —U (77�
Retaining Wall ELR
Footing Access:
_ Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: l 4'0v1-4/ SGN
Slab y � , � � SIT
Post & Beam /�
Ext Sheath /Shear 1 i 4 <�
Int Sheath /Shear
Framing
Insulation •
Drywall Nailing
Firewall
Fire Sprinkler ilia, /
I /-
L
Fire Alarm
Susp'd Ceiling
Roof
Misc: 167 ��
"' P
Final
PASS PART FAIL
PLUMBING ��•
Post & Beam
Under Slab
Top Out
Water Service •
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In -
Gas Line
Smoke Dampers
Final
PASS PART FAIL
T
Service
Rough In
UG /Slab
Low Voltage
Fi - • larm
aEr PART FAIL •
Backfill /Grading
- Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Date V/24/ Inspector Ext
Other p
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.