Permit ELECTRICAL PERMIT
CITY OF TIGARD
PERMIT #: ELC2008 -00522
°.; COMMUNITY DEVELOPMENT
DATE ISSUED: 9/10/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S112DD
SITE ADDRESS: SW NO ADDRESS ZONING:
SUBDIVISION: LOT : JURISDICTION: TIG
PROJECT: RAILROAD CROSSING
Project Description: Replacing existing service for railroad crossing at SE corner of Upper Boones Ferry Rd. and railroad crossing.
Job no: 4331.
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:
PHOENIX ELECTRIC
PO BOX 14037
PORTLAND, OR 97293
Phone: Contact #: PRI 503 - 886 - 9930
FAX 503 - 266 -8394
FEES
Description Date Amount Reg #: ELE C89
[ELPRMT] ELC Permit 9/10/2008 $80.30 LIC 162753
[TAX] 12% State Surchar 9/10/2008 $9.64 SUN 169S
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 Permittee Signature: � , ,
Y' g 1��/
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'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.
Sep 08 09 04:43p Terry Koch�(�D 503- 266 - 8394 p. 1
• .
Electrical C Permit of Tigard Application
FOR OFFICE USE ONLY
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'J g �e` � R c i ed / O i PennitN
• 13125 SW Hall Blvd., o. R : JA
d, Ti , ,- ew Other Permit:
Tigard, OR 97223 �•�� G .tai. '
is o,, .. c's • .
ins 503.639.4175 Phone: 503.639.4171 Fax: 503.598.1960 Q 1 '
inspection Line: 503.63. C ` G vj Date Ready/By: 1 . El See Page 2 for
TIGAttp p a```` +� Notified/Method: SupplementalInrormalfon
Internet www,tigard "or.gov U
TYPE OF WORK .' PLAN REVIEW
Please check all that apply (submit 2 sets of plans w /items checked below):
❑ New construction Add1hOT1/altElat]On/replHCemerit ❑ Service or feeder 400 amps or more ❑ building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
CATEGO}X OF CONSTRUCTION less to ga d or exceeds 14,000 ❑ Comroercial•use agricultural
❑ 1- and 2- family dwelling Commercial/industrial ❑ Accessory• building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
❑ Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION • ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
1 ` r � , -- ,n p ❑ S i x oPoo res. occupancy.
S _ -
Job no.: 1 ( Job site address: 10904 �( , S x or more o residential units. ❑ Recreational vehicle parks.
❑ Health -care facilities. ❑ Supply voltage for more than
City/State/ZIP: 774/172.b r 012 r 97 ?2 f ❑ Hazardous Locations. 600 volts nominal.
Suite/bldg. /apt no.: f Project nante: /e /M 2) 5 Ail ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: 57y 3i• a,� OF L(A0i,. Description 1 Qty. 1 Fee. I Total 1 '
New residential single- or multi- family dwelling unit.
^t S hcQ /J _/ p� A 912- '' »v Includes attached garage.
t9LJU /Cai 1,000 sq. R or less 145.15 4
Subdivision: Lot no.:
Q ` Ea. add'l 500 sq. ft or portion 33A0 1
Tax map /parcel no.: OZ c 1 127�7J 2
- -O-to d Limited energy, residential 75.00 2
DESCRIPTION OF WORK . (with above sq. ft.)
/ Limited energy, multi- family 75.00 2
W e- . T�il to _ Ae i ! /45 ` �j , / d Ice_ � % (� Ale residential (with above sq. R.)
� -� [ � ! j � -�
Services or feeders installation, alteration, and /or relocation
/Op 7 SERI ,4 /hd&)4 / e�sS/�[ 200 amps or less / 80.30 Q0,40 2
❑ PROPERTY OWNER . ❑ TENANT . 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
-
Name: 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Temporary services or feeders installation, alteration, and/or
City/State/MP: relocation
Phone: ( ) 1 Fax: ( ) 200 amps or less 66.85 1
201 amps to 400 amps 100.30 2
Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 133.75 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits - new, alteration, or extension, 4 _ r panel
Owner signature: Date: A. Fee for branch circuits with
feeder fee
f
service to ee fee, ❑ APPLICANT ❑'CONTACT PERSON above sery 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
without service or feeder fee, 46.85 2
Contact name: first branch circuit
Each add'l branch circuit 6.65 2
Address:
Miscellaneous (service or feeder not included)
City /State/ZIP: Each manufactured or modular
90.90 2
dwelling, service and/or feeder
Phone: ( ) Fax: : ( ) 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: �ftos,U/ 5 'Gl,ei energy panel, alteration, or
Address: i Q , af /119 37 extension. Describe: Page 2 2
City /State/ZIP: A k ria -�_, D p 4. 97 ,„2 9 3 Each additional inspection over allowable in any_of the above
_ Per inspection 62.50
Phone: (03) .,2-3 i -- v-00 ea Fax: (' J 3,2357_4_30 o Investigation per hour ( hr min) 62.50 -_
CCB Lic.: /6,775 Electrical Lic.: G.19 Suprv. Lie.: $7j / 5• Industrial plant per hour 73.75
�Q `M � = L l ELECPRICAL PERMIT FEES
Suprv. Electrician signature, requir � Subtotal: fit,
T= �� Plan review (25% of permit fee):
Frith name: l na Cnn / 4. Date: (9....0i Slate surcharge (12% of permit fee): KIM
Authorized signature' TOTAL PERMIT FEE: t a 4
�� / �1'/ ( a Thts permit application expires if a permit is not o •t fled th n 180 nalne: 1/� G Date: S -O i` days after it has been accepted as complete.
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC200R 00622
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 91/0100013
Phone: (503) 639 -4171 . �eu�i�n�upjlla�
Inspection Requests (24 Hrs.): (503) 639 -4175 .: .
INSPECTION WORKSHEET FOR DATE: 9/16/2008 TIME: 7:01AiVi PAGE: 9
SITE ADDRESS: SW NO ADDRESS CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: RAILROAD CROSSING
DESCRIPTION: Replacing misting service for railroad crossing at SE corner of Upper Bol nes Ferry Rd. and railroad
crossing. Joh no: 4331.
OWNER: PHONE #:
CONTRACTOR: PHOENIX ELECTRIC -Ta . PHONE #: 503 - 806.9930
L
Inspection Request Scheduled For: Date: 9/16/2008 Pour Time:
Code # Inspection Description nyrr# Contact # Message
115 Electrical service /6509-01 603- 806 -9930 Y
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Corrections /Comments /Instructions:
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fU PASS ❑ PARTIAL APPROVAL n CANCEL n NO ACCESS
FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: • () "°--' Date: 4 1(14% Phone #: (503) 718- 2 K