Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2020-00263
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 8/27/2020
Parcel: 1 S 136 DB00201
Jurisdiction: Tigard
Site address: 11565 SW PACIFIC HWY
Project: City of Tigard • Subdivision: None Lot: None
Project Description: Panel replacement for red light camera installation. The panel location is in the northwest corner of the intersection
near the Fred Meyer and Les Schwab parking lot.
Contractor: GLOBAL ELECTRIC, INC. Owner: FRED MEYER STORES INC
PO BOX 162 STORE#375
NORTH PLAINS, OR 97133 1014 VINE ST
PROPERTY TAX 7TH FLOOR
CINCINNATI, OH 45202
PHONE:
PHONE: 503-647-5650
FAX: 503-647-5649
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 05/29/2020 $100.70
Specifics: amps or less
1 ea 12%State Surcharge- 05/29/2020 $12.08
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $112.78
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 160 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 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
�1
Issued By: ( L-- ' 1/1/1—' I sfiY Permittee Signature: (�V / �G / C / 7p�
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.
Electrical Permit Applicatiofir NED
FOR OFFiCE.USE ONLY
City ofg Tigard Received
= II 13125 Date/8 iy I i /L
1111 13125 SW Hall Blvd..Tigard,OR 97223 MAY 1 9 2020 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Pcrntit8:
7IGARD Inspection Line: 503.639.4175 CITY OFf,GARD T ReadyDateBy: NEM Si See Paget for
,
.n Internet: www.tigard•or.gov is ;Jii_DING DIVISION Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
❑New construction ®Addition/alteration/replacement Please chick all that apply(submit.sets of plans w/items checked):
0 Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
0 1-and 2-family dwelling E Conunerciallmduslrinl ❑Accessory building less to ground.or exceeds 14.000 0 Commercial—use agricultural
amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other. 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived
0 Addition of new motor load of system.
Job#: 1911048 Job site address: i 13 d S-- 5 i-s./ /A! fi-L ✓ 100HP or more. ❑"A"."E","1.2","1-3",
❑Six or more residential units. occupancy.
City/State/ZIP:Tigard,OR 97223 0 Recreational vehicle parks.
0 Health-care f:uilitics.
Suite/bldg./apt#: Project name:Tigard Red Light Camera 0 Hazardous locations. ❑Supply voltage for more than
/ 0 Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site:OR-99W&SW 72n1 f�/1"i- cl t- I( --xt.-sr FEE SCHEDULE
✓✓ Description I Qh. I Each I Total I
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
.�' ((��/��} �� 1,000 sq.0.or less 168.54 4
Tax map/parcel#: )5/ 67 o r !L�v,'U i Ea.add'1500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited mergy,residential
(with above sq.ft.) 75.00 2
Need(1)200 A Or less Service For A panel replacement On the NW corner of the Limited energy,multi-family
intersection.By the fred meyer parking lot
residential(with above sq.fr.) 75.00 2
ID PROPERTY OWNER El TENANT Renewable Energy 0 See Page 2
Services or feeders installation,atteroHon,and/or relocation
Name: 200 amps or less 1 100./0 100.70 2
Address: 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZiP: 601 amps to 1,000 amps 301.04 2
Phone:( ) Fax:( ) Over 1,00D amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 I
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08_ 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
0 APPLICANT ID CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name:Global Electric Inc above service or feeder fee, 7.42 2
each branch circuit
Contact name:Dustin O'Rear B.Fcc for branch circuits without
service or
Address:PO Box 162 branch rcutcdcrfcc,first
t c 56.18 2
City/Stale/ZIP:North Plains OR,97133 Each add'I branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(503)6475650 Fax::( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email:dispatchGr7globalelectricusa.com Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:Global Electric Inc. Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy ❑ Sec Page 2 2
Address:PO Box 162 panel,alteration.or extension.
City/State/ZIP:North Plains OR,97133 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(503)6475650 Fax:( ) Investigation(1hrmin) 90.00/hr
Email:dispatch(a�globalelectricusa.com Indusinalplant(ihrmin) 78.18/hr
Inspections for which no fee is 90.00/In.
CCB Lie.: 156838 Electrical Lie.: 34-655C Suprv.Lic.: 5210s specifically listed(Ya hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: X—
f�IP!, Subtotal: 100.70
Print name: Justin Spiering Date: 5/15/2020 0 Plan Review Required(25%of pet fee):
State surcharge(12%of permit fee): 12.09
Authorized signature: TOTAL PERMIT FEE: 112.79'715
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.
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