Permit 111 ' r . �. P ITY OF TIGARD ELECTRICAL PERMIT
P E R MIT #: ICAL PERMIT 4
COMMUNITY DEVELOPMENT DATE ISSUED: 8/23/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 102 BA -R -O -W
SITE ADDRESS: SW NO ADDRESS ZONING:
SUBDIVISION: LOT : JURISDICTION: TIG
PROJECT: COMMUTER RAIL
Project Description: 100 amp pole service located at railroad tracks near intersection of SW 96th PI and SW Commercial St.
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: •
GENESEE & WYOMING RAILROAD SVC INC MIDVALE ELECTRIC
1200 -C SCOTTSVILLE RD STE 200 PO BOX 1023
ROCHESTER, NY 14624 SUNNYSIDE, WA 98944
Phone: 585 - 328 -8601 Contact #: PRI 509 - 839 -4204
FAX 509 - 839 -4206
FEES
Description Date Amount Reg #: ELE C240
[ELPRMTI ELC Permit 8/23/2007 $80.30 LIC 137698
'TAX] 8% State Surcharge 8/23/2007 $6.42 SUP 4590S
Total $86.72 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 -!; i • ough OA: '52- 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued B A. , / if Permittee Signature: / -' si „� lL�
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:
ONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: t "� /, /. 1��t' • ' C' — 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
s
? Land Use Approval
"_ Washington County. 155 N. 1` AV, Suite 350, MS 12, Hillsboro, OR 97124, Proj #
Rio ° Permit #
Phone: 503- 846 -3470, Fax: 503- 846 -3993, 47- D25q
Inspection Requests: 503- 846 -3699, www.co.washinRton.or.us
TYPE` OF =WORK - ' -- •- PL REVIEW '- .
X I New construction ❑ Addition /alteration /replacement ❑ Other: Please check all that apply:
❑ Service or feeder 400 amps ❑ Hazardous locations
or more where the available ❑ Service or feeder 600 amps or more
. "CATEGORY OF CONSTRUCTION , ° , . _ ` fault current exceeds
❑ Building over three stories
❑ 1 - and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building 10,000 amps at 150 volts or ❑ Marinas and boatyards
less to ground, or exceeds ❑ Floating buildings
❑ Multi - family ['Master builder ® Other: 14,000 amps for all other
❑ Commercial -use agricultural
°,, ' ° 1: 7:10E. E �I
OB, SITNFOR_MATIOM AND 'LOCATION' ' ° : i nstallations. : buildings
❑ Fire pump
Job no.: Job address..3 Co;nm eR C. i i d 5 5 - w 9h /h f z, ❑ Emergency system ❑ Installation r KVA or larger
separately derived d system
City/State /ZIP: _i `, /�
I=1 Addition of new motor 1=1 "A," "E," "1 -2," "I -3" occupancy
t1 Afc t/ /L load of 100HP or more
(21 Recreational vehicle parks
Suite/bldg. /apt. no.: Project name: ❑ Six or more residential units
El Health-care facilities El Supply voltage for more than
, t • ° 600 volts nominal
Cross street/directions to job site:
sw C AeRc1 A L SI- f SIN ° ., . a ',' �x, , ,
9h
x� � ` " FEE °SCHEDULE.'w °� '�� °�� °` `a���
h A- Ce A1 -ir- fU RAC ®., of ° ° ,u -
Pf ,��( 'L /t'�A�) T2fJG�g Description Qty,. Fee Total l
Subdivision: /\ / p_ Lot no.: N Residential singlet= pi"inulti- faiuily_dwelliug utiit:7 ' - =`; %.,,,,,,,,
t 1 /� Includles attached'gar,`age. " _- _ ° ° " ,, °, ; , i° , '- . 7,4.1
Tax Tax map /parcel no.: Al p l 0941- _ Q.t,O 1,000 sq. ft. or less 150.00 4
° DESCRIPT 'OF WORK ': ` ' ° , -; - Ea. add'I 500 sq. ft. or portion 42.00
Limited energy, residential 60.00 2
/D(, 4 pate_ S e. tJ t c e- (with above sq. ft.)
/ Limited energy, multi- family 66.00 2
residential (with above sq. ft.)
�.� ° .. °, RI1 PROPERTY OWNER , ° ` j ' ®: TENANT 7 , Services or feeders .installation, alteration; and/Or relocation.
O 200 amps or less / 9�2 rd0 .54) 2
Name: C? en/ t . e 3 �f W / 0'; AJ Cj RAi ✓ C ....e. /tic. 201 amps to 400 amps 120.00 2
Address: IZOO 5r d s vi / >P ,ed, G u Zoo 401 amps to 600 amps 180.00 2
City/State /ZIP: R o (L A e....5 4 eR New yoR ! I� /4 4 z f) 601 amps to 1,000 amps 270.00 2
7 `T" Over 1,000 amps or volts 504.00 2
Phone: ( 5 6'S ) ZS f3601 Fax: � ) 32 b�� ZZ p orar y ' Te m services or feedersifnstallat a' °and /o"r `
? °� �.
relocation . � °. ". - oo , _,� ° . : lieration ,,e, °'= ,
2 Owner installation: This installation is being made on residential or farm property owned by me or a member of 200 amps or less 78.00
my immediate family. This property is not intended for sale, exchange or rent. (ORS 479.540(1) and 479.560(1). 201 amps to 400 amps 108.00 2
Owner signature: Date: 401 amps to 599 amps 150.00 2
;' ❑' APPLICANT ,.. - ❑ °CONTACT PERSON Branch° circuits — new,, alteration,or perspaneL °a :
". ° A. Fee for branch circuits with
Business name: / .,I; t� l 9 A L e E1 e ?(. ,e ; above service or feeder fee, 8.50
V each branch circuit 2
-
Contact name: -J s I s ii i ? � k/ B. Fee for branch circuits
` I without service or feeder 60.00
Address: P 0,1 R0 /023 fee, first branch circuit 2
�f Each add] branch circuit 8.50
City/State /Z1P: v J
S u l �e' um ��" Miscella'neous service.or not included i 1,,! 1,,! a`°
Phone: (� ) 3 91- 0 � / 35 Fax: (50 3 9 4L ? ' Z p Each manufactured or modular 102.00 2
E -mail: �- I J _ [/, �� � /1 + !� 7; w Pi dwelling, service, and /or feeder
+a�� 5��2�— G Reconnect only 78.00 1
° 'CONTRACTOR" Pump or irrigation circle 60.00 2
Business name: '7
i d v ,4 .. Z
1 e ec ) /e � Sign or outline lighting 60.00 2
e b g g
Signal circuit(s) or limited -
Address:
� 6e)X /023 energy panel, alteration, or
Lei extension. Describe: 60.00
City/State /ZIP: 5 u N N y s i jP_ Le)4 ? e e /44z 2
Phone: 507 ) Q3 9 4i7Z.
2 Fax: (5� ) g3 7 _ 4 6, er ins ildiiional ins over- allowable.in any of" above.,
P
! < <�� Per inspection 90.00
E - mail: CCB lie. no.: , 3 6q
I nvestigation fee (see compliance)
Electrical lie. no.: C or metro lie.: Other:
Su ervisin electrician ELECTRICAL PERMIT FEES, a sa ' -,
P g Q �„
signature, required: Subtotal U�� �(J
Print name: (4 Re y � 1 �� � Date: ' - 7 0 Plan review (25 %of permit fee
Authorized � / State surcharge (8% of permit fee) '
signature: �% TOTAL PERMIT FEE g ( 7,2
This permit application expires if a permit is not obtained
Print name: / ii- . � Date: i -/S _0
r ^ ye, r/
1^ de G �' within 180 days after it has been accepted as complete
/ *Number of inspections allowed per permit. Revision 06/26/06
CITY OF TIGARD
BUILDING DIVISION `R PERMIT #: ELC2007 -00694
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/23/2007
Phone: (503) 639 -4171 puvi g
Inspection Requests (24 Hrs.): (503) 639 -4175 : ' `
INSPECTION WORKSHEET FOR DATE: 8/2412007 TIME: 7:00AM PAGE: 76
SITE ADDRESS: SW NO ADDRESS CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: COMMUTER RAIL
DESCRIPTION: 100 amp pole service located at railroad tracks near intersection of SW 96th PI and SW Commercial
St.
OWNER: GENESEE & WYOMING RAILROAD SVC INC, PHONE #: 585-328.8601
CONTRACTOR: MIDVALE ELECTRIC PHONE #: 509-839 -4204
Inspection Request Scheduled For: Date: 8/24/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final ;54666.01 609-391-0135 N
Corrections /Comments/ Instructions:
I
/\\\\
PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
FAIL I I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
•
Inspector: 08 LE
Date: $1 214' 0 Phone #: (503) 718- 2-411