Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2008 -00049
COMMUNITY DEVELOPMENT DATE ISSUED: 1/8/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 102AA -04800
SITE ADDRESS: 15776 SW 74TH AVE ZONING: CBD
SUBDIVISION: TRI -MET COMMUTER RAIL LOT : JURISDICTION: TIG
PROJECT: COMMUTER RAIL
Project Description: installing 100 amp underground SVC. Address is approx. 1235 ft. North of SW Durham Rd.
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: 1 W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 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:
TRIMET MIDVALE ELECTRIC
710 NE HOLIDAY ST PO BOX 1023
PORTLAND, OR 97232 SUNNYSIDE, WA 98944
Phone: 503 - 962 -2169 Contact #: PRI 509 - 840 -0200
FAX 509 - 839 -4206
FEES
Description Date Amount Reg #: ELE C240
[ELPRMT] ELC Permit 1/28/2008 $80.30 LIC 137698
[TAX] 12% State Surchar 1/28/2008 $9.64 SUP 4590S
Total $89.94 REQUIRED ITEMS AND REPORTS
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: -e,% � Permittee Signature: � � 4 OWNER INSTALLATION ONLY UUUU
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:
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.
Electrical Permit Application FOR OFFICE USE ONLY '
City of Tigard v-
-� Received _
DDate/By: PermitNo.:
I
-
v 13125 SW Hall Blvd., Tigard, OR 97223 Plan Revie � p
o U g ����
���
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit: _
T I G ARD Inspection Line: 503.639.4175 Date Ready/By: Juris: 121 See Page 2 for
' Internet: www.tigard- or.gov Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
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 the available fault current ❑ Marinas and boatyards.
CATEG OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial-use agricultural
❑ I- and 2- family dwelling ommercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
lOOHP or more. occupancy.
Job no.: NIA Job site address: • 5 W 7 i. v -,
0 Six or more residential units. 0 Recreational vehicle parks.
City/State /ZIP: ''r' 7 e „,.. r I , 2 ,, 5- -77 (e ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: Tr ; M 17 ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description 1 Qty. I Fee. 1 Total 1 •
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
/�
/ Limited energy, multi - family
71 5 +0 . 'I ; ✓ j ) cx 4M p V ahrri r0u,� V S C- residential (with above sq. ft.) 75.00 2
,/ Services or feeders installation, alteration, and/or relocation
200 amps or less 1 80.30 X), 3c) 2
/PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name: Po r-FI ei af r v/ec�e -n ,•,1 r 4 401 amps to 600 amps 160.60 2 •
' l 601 amps to 1,000 amps 240.60 2
Address: 1 a 0O 5 LO v. I I e. K di , <-h ,.} 2,..o 0 Over 1,000 amps or volts 454.65 2
City /State /ZIP: n Temporary services or feeders installation, alteration, and /or
tC ° C. h ' ' .l7 .,- l/ `>" relocation
Phone: ( ) 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 Wit' CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: M �lyA le E. /€, d t-- : L B. Fee for branch circuits
without service or feeder fee,
Contact name:
S ,S(:),.,r /0 C k first branch circuit 46.85 2
Address: P O • 8 O, ) 0 a 3 Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State /ZIP: s t^ n el ,T , W t4 Each manufactured or modular 90.90 2
J ,A P dwelling, service atrl /or feeder
Phone: („5 ) 391 — 61 3 5 Fax:: (5(31 ) , 9 - -/'2,.O,-- Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Signal circuit(s) or limited -
Business name: o f ti /� ; o U q I e_ t. /'�c.,'f'r-c c. energy panel, alteration, or
Address: e 0- Cox 10 a- extension. Describe: Page 2 2
City/State /ZIP: 1 •� v �A 9r - ci u � Each additional inspection over allowable in any of the above
S U h n 9 f Per inspection 62.50
Phone: (,� ) / Fax: ( Son,) 3 9 —
y d — B O 2.O e Investigation per hour (1 hr min) 62.50
CCB Lic.: i. 3 Electrical Lic.: G a y p Suprv. Lic.: ii J ' O5 Industrial plant per hour 73.75 ELECTRICAL PE FEES
ex
Suprv. Electrician signature, required: : -77( i r Subtotal: 73(-):36
Print name: r Date: Plan review (25% of permit fee):
��IZP,q \�AN d ��Af! n � "� � State surcharge (12 %ofpermit fee): C f . GI(
Authorized signature: ` � TOTAL PERMIT FEE: S7 , C I L I
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.
1:\ Building \ Permits \ELC- PermitApp.doc 05/23/06 440- 4615T(l1/05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems: _
*No licenses are required. Licenses are required
for all other installations
I:\Building\Permits\ELC- PermitApp.doc 03/23/06
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2008.00049
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/28/2008
Phone: (503) 639-4171 44 /01•
,
Inspection Requests (24 Hrs.): (503) 639-4175 ---
INSPECTION WORKSHEET FOR DATE: 1/29/2008 TIME: 7:02AM PAGE: 36
SITE ADDRESS: 15776 3W 74TH AVE CLASS OF WORK:
SUBDIVISION: TRI COMMUTER RAIL LOT #: TYPE OF USE:
PROJECT NAME: COMMUTER RAIL
DESCRIPTION: installing 100 amp underground SVC. Address is approx. 1235 ft. North o SW Durham Rd,
OWNER: TRIMET, PHONE #: 50,3-.962-2169
CONTRACTOR: MIDVALE ELECTRIC PHONE #: 509-840-0200
Inspection Request Scheduled For: /Date: 1/29/2008 Pour Time:
Code # Inspection Description Confirm-#--- Contact # Message
199 Electrical final 061108-01 609.391-0135
Corrections/Comments/Instructions:
SI It 'II (LIK• g-e cJ rertc>) ?zsa44:41.
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pz PAS fl PARTIAL APPROVAL El CANCEL NO ACCESS
• FAIL I CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: h G6 LE: Date: t. E et Phone #: (503) 718- /141-frbe