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Permit
CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2007 -00593 COMMUNITY DEVELOPMENT DATE ISSUED: 8/23/2007 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S 102AD - R - O - W SITE ADDRESS: SW NO ADDRESS ZONING: SUBDIVISION: LOT : JURISDICTION: TIG PROJECT: COMMUTER RAIL Project Description: 100 amp pole service at railroad tracks near SW Hall Blvd 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 IELPRMT] 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 -• -I • I •ugh OAR *52- 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344. Issue. By: // Permittee Signature: „del T7 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: .00 i fc- 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. • e 0� l G' ,x x e,tov c 2.5 �,. _ Electrical Permit Application Land Use Approval e r t Washington County, 155 N. 1 AV, Suite 350, MS 12, Hillsboro, OR 97124, Proj # °cco‘.4 Phone: 503 - 846 - 3470, Fax: 503 846 - 3993, Permit # El C1D07 -eo573 Inspection Requests: 503- 846 -3699, www.co.washington.or.us : ° TYPE 'OF' WORK" ° ' , - PLAN REVIEW' X New construction ❑ Addition /alteration /replacement ❑ Other: Please check all that apply: ❑ Service or feeder 400 amps ❑ Hazardous locations CATEGORY , OP CONSTRUCTION' - or more where the available ❑ Service or feeder 600 amps or more r - , s e, rem 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 ❑ Multi family ❑Master builder Other: 14,000 amps for all other El Floating buildings ❑ Commercial -use agricultural ,JOB SITE INFORMATION - AND LOCATION _ ° _ ° : :' °: :,: :°'= installations. , buildings d f.1 t / ', ❑ Fire pump El Installation of 75 KVA or larger Job no.: Job addressSW /4/91Z L t�L v fl Mel .4/ S f ❑ Emergency system separately derived system ❑ Addition of new motor Ci ty 7 - 7 /State /ZIP: !7 9 R d cl load of 1 OOHP or more ❑ separately ate( "1-2,""1-3" occupancy y Suite/bldg. /apt.no.: Project name: / /�� El or more residential units ❑Recreational vehicle parks /V ❑ Supply voltage for more than ❑Health -care facilities 600 volts nominal Cross street /directions to job site: s w /ALL Az l7� . /� r . ` ' _ ,,,FEE = ";� _, $-• a 1 , . r, ,' S fR e e 4 t 'I'�I t° /z41L2d4 d T/t i9GlCS Description Qty. Fee Total � * Subdivision: by /l _ Lot no.: A dl , Residential, single- or•-n iulti-farnilwd`welling u,°1�: nit:' . °e,,:q a T � , u .Includes , attached" garage. ; - _ :. _ 7 � ° `7Z,;,7' Tax map /parcel no.: N 4 ,25 1 0 2 14 -7, - -�� -to 1,000 sq. ft. or less 150.00 4 ° ° ` DESCRIPTION OF ,WORK' - '.� :'= Ea. add'I 500 sq. ft. or portion 42.00 ° Limited energy, residential /004 m p i_e Se ,eV /6-e. (with above sq. ft.) 60.00 2 J-j /" Limited energy, multi- family 66.00 2 residential (with above sq. ft.) l PROPERTY .OWNER` . _ .' III ° '' ❑, `TENANT , ,,, ' - Services or feeders installation, alteration, and /or'r,elocation: ' .".See. l� 0M / / V , i xoA 1 200 amps to or less p 2 gD 2 Name: Gew C / V `� /C t (1 201 amps to 400 amps / 120.00 2 Address: ZOO C ScaS v i / -Le , d SN ;') e zoo 401 amps to 600 amps 180.00 2 / 601 amps to 1,000 amps 270.00 2 City /State /ZIP:R t h &STP� 19 6 24' Over 1,000 amps or volts N y©R1( 504.00 2 Phone: (505) Fax: `Tem ora s or feeders, i nstallation alteration`<-and / or g �328�g6 (58.5) 3 h z a ' ° p i on .,- relocati ° _ a �, ; _ 4 ,� ` �� ° V, 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 2 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 ,' ' � � � 1= " . s ` 53; CONTACT PERSON , °, _, 'Branch: circuits - new, alteration, or• extension, per°panel`; ° =; A. Fee for branch circuits with Business name: /yt , d l) A- L e E er 4 c_ above service or feeder fee, 8.50 Contact name: /, each branch circuit 2 =lily / U/ Lo G t'c B . Fee for branch circuits P n r / / without service or feeder 60.00 Address: : / , 0 6319 / 0 Z , / 3 ' fee, first branch circuit 2 City/State /ZIP: 5 U AiA) 5 t de_ t/v ig. q e7 /1 /f Ea ch add'l branch circuit 8.50 L Miscellaneous (service; or °feeder not "included).. r° ", ; . ° Phone: (5o1) 31) —0/ 3 I Fax: (.5e97) LI 0 / ) 03 _ � Each manufactured or modular 102.00 x z 2 ° E-mail: dwelling, service, and /or feeder Reconnect only 78.00 1 : ° ° _ ' ®" • , :CONTRACTOR ' ' ' s Pump or irrigation circle 60.00 2 ,, / e / / � -� ; c . Sin or outline lighting 60.00 2 Business name: I L L Sign g Address: P, 0, BOX / 0 Z3 energy p a ne l, a) or limited- energypanel alteration, or 60.00 extension. Describe: City /State /ZIP: 5 p ( sr5t P ,4 G 1' el 4 L_ 2 I) Q p / 7 z/ �r Fax: 7 it / :Each additional inspection over allowable in any of.the above' Phone: �5 0 /) v3 / 2 4 Z (S � s 7 2 0 [o Per inspection 90.00 E -mail: CCB lie. no.: Invests 3 � �� Investigation fee (See compliance) Electrical lie. no.: 'O City or metro lic.: Other: Supervising electrician ELECTRICAL- PERMIT FEES x, ° signature, required: .jam 4 ' Subtotal in 30 ° Plan review (25% of pennit fee) Print name: G R e R, G R R Date: g.JL c _ Q 7 Authorized z(J t / State surcharg (8% of pennit fee) 4 . signature: j 4 ' (07 TOTAL PERMIT FEE g , 79- Print name: . i I, l Date: _ This permit application expires if a permit is not obtained f�i/t, 4�n CI t' GV a�l � E /5 - (�7 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 PERMIT #: ELC2007- 00593 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/23/2007 Phone: (503) 639- 4171 �i� ll ° Inspection Requests (24 Hrs.): (503) 639-4175 ,,,-114' ` �' L ' INSPECTION WORKSHEET FOR DATE: 8/24/2007 . TIME: 7:00AM PAGE: 72 SITE ADDRESS: SW NO ADDRESS CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: COMMUTER RAIL DESCRIPTION: 100 amp pole service at railroad tracks near SW Hall Blvd and Commercial St. OWNER: GENESEE & WYOMING RAILROAD SVC INC., 1 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 054575 -01 509-391 -0135 N Corrections /Comments /Instructions: \V , i A/ . PAS n PARTIAL APPROVAL n CANCEL I I NO ACCESS I I FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: 6---- • N B I Date: Si 2 -4 C9 Phone #: (503) 718- 2441)