Permit 4
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CITY OF TIGARD ELECTRICAL PERMIT
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COMMUNITY DEVELOPMENT Permit #: ELC2012 -00624
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/31/2012
Parcel: 25101 BD00103 •
Jurisdiction: Tigard •
• Site address: 7805 SW HUNZIKER RD •
Project: Madison Furniture Subdivision: 1994 -025 PARTITION PLAT Lot: 2 •
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Project Description: (1) branch circuit to connect new dust collector
Contractor: JRA INC Owner: H G M CO
11860 SW GREENBURG RD BY NORRIS BEGGS & SIMPSON
TIGARD, OR 97223 ATTN: BLAKE HERING
121 SW MORRISON #200
PORTLAND, OR 97204
• PHONE: 503 - 639 -4627 PHONE:
FAX: 503 - 639 -4673
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo /Purchase 10/31/2012 $56.18
Specifics: Service or Feeder
• 1 ea 12% State Surcharge - 10/31/2012 $6.74
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
• Occupancy Grp:
•
Total $62.92
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 O R 52- 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: dU Permittee Signature: DAI APPL/64 -niO 4 /
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 the next available inspection date.
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.
10- 30 -'12 15:32 FROM- Frahler Electric 5036394673 T -066 P0001 /0002 F -185
tie .--
Electrical Perm �I FOR OFFICE USE ONLY
City of iga • , 2 ? L net B` t, Z sf Permit jbla- woo st
14 q 13125 SW Hall Bl [�')f g ' 77x23 Plan Review
S q • '' Phone; 503.718,2 TT F 0 $8c11960 p DatelB : Other Permit:
T I GA R.D Inspection Line�$ . fa({ D j Date Ready/By: E7 See Page 2 for
Internet: www ' dr,�1V - T I Notified/Method: WM Supplemental Information
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❑ New construction ® 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 tie available fault current in Marinas and boatyards.
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..:+,,. ..:::;; :'�':,. <•,::.:.: ... �.:;,......,,,...,:.,....., ,,:;:..... ;...;.- '.,.:.,�: �.; .; , exceeds 10,000 amps at 150 volts or ❑ Floating buildings. loss to aund orexceedS 140 Coxnmert; 1 sr ulnval
"::.. .. Sr , 00 ❑ is -use a is
❑ 1- and 2- family dwelling ® Commercial/industrial [J Accessory building amps focal' other installations. buildings. •
❑ Multi- family El Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
1 ., r .:..,: :; . ❑ Emergency system. larger separately derived system.
44� TE'4IF 9 i3 l' "T 150.0:* D LOCO riO' ; : °�� ,, .
:,:::, i:' �>;:; �::,, �C::::;..;,-: r',+....,....,.,..I"St,.,..,..._ ...., ., ...,... ,.. >.... ,._ r,......, ...: ,. ❑ Addition of new motor load of 0 ..A.,..E..,..12...,1_3.;
Job no.: 69220 Job site address: 7805 SW HUNZIKER STREET 100l1P or more. c
['Six or more residential units. . in Recreational vehicle parks.
City /State/ZIP: TIGARD, OR 97223 ❑ilealth - care facilities. ❑ Supply voltage for snore than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt, no.: Project name: MADISON FURNITURE ❑ Service or feeder 600 amps or more.
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Cross street/directions to job site: 1r,, :piton I ore I Pew 1 Total I •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1.000 sq. It. or less 168.54 4
Ea. add'/ 500 sq. ft. or portion 33.92 1
map/parcel Tax map no.: Limited energy, residential 71.00 2
,,,,; : _ ; °r..e ``y,^ ;. 7 _
Y)tiTY01Y': ;• W . •:R.,, ..;.;` ,�::z ; ;: .'." _ : •: (with above sq, ft)
Limited energy, multi - family
CONNECT NEW DUST COLLECTOR (40A, 30 PHASE, 208V) residential (with above sq. ft.) 75.00 2
Services or feeders installation, alteration, and/or relocation
TEMPORARY PERMIT FROM UNTILL 11/05/12 ' - 200 amps or less _ 100.70 2
';t'`PR ;`�'<:• Vl0104''; ::': ' ,. ':.;'; : gt8 x:: 201 amps to 400 amps 133.56 2'
401 amps to 600 amps 200.34 2
Name: 601 amps to 1,000 amps _ 301 "04 _ 2
Address: Over 1,000 amps or volts 552.26 2
• Temporary services or feeders installation, alteration, and/or
City /State /ZIP: relocation _
200 amps or less 5936 1
Phone; ( ) Fax: ( ) 201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 70I" Branch circuits— new, alteration, or extension, per panel
Owner signature: Date: A, Fee for branch circuits with
above service or t8eder foe,
D A PLC ®- L
N(A .�.. each circuit 742 2
_ - I ANT Q , Fj"1' % PFRSOIV� : ",. anchci cu it 7
B. Fee for branch circuits without
Business name: FRAIILER ELECTRIC COMPANY service or ti:eder fee, first 1 56.18 56.18 2
Contact name: SANDY HARRISON blanch circuit
Each add'/ branch Circuit 7.42 2
Address: 11860 SW GREENBURG ROAD Miscellaneous (service or feeder not included) _
Each manufactured or modular 67.84 2
City /State /ZIP: TIGARD, OR 97223 dwelling, service and/or feeder
Reconnect only 67.84 2
Phone: (503) 639 -4627 I Fax: : (503) 639 -4673 pump or irrigation circle 67.84 2
—
E -mail: sandy @frahler electric.com Sign or outline lighting 67.84 2
"- ' " ,' O T ' Signal circuits or limited-energy
panel, alteration, or extension. Page 2 2
Business name:.IEtA dba FRAHLER ELECTRIC COMPANY Each additional inspection over allowable in any of the above
Address: 11860 SW GREENBURG ROAD _ Additional inspection (1 hr min) 66.25! hr
investigation (1 hr min) 66.25! hr
City /State /ZIP: TIGARD, OR 97223 \14' Industrial plant (1 hr min) 78.18/ hr
Phone: (503) 639 -4627 'AL ILA \ Fax: (503) 639-4673 p11\t5 Inspections for which no fee is 90 / hr
specifieV listed (Si hr min) _
CCB Lie.: C861 Electrical Lie ": 197172 Suprv" Lie,: 51105 ..
;.:.. `:iY , ptMl7,i')5
Subtotal: 56.18
Suprv. Electrician signature, required: ; . j ", Plan review (25% of permit fee):
Print name: ADAM ETHERINGTON Date: 10/29/12 State surcharge (12% of permit fee): 6.74
TOTAL PERMIT PEE: 62.92
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: J Date: • Number of inspections allowed per permit.
I: euildiggTermils1ELC.PermitApp .doe 07/01/10 440461ST(11/05/COMMWED