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Permit
prl ,. /CITY OF 1'r 3 ARD ELECTRICAL PERMIT PERMIT #: ELC2007 -00741 COMMUNITY DEVELOPMENT DATE ISSUED: 11/1/2007 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S103BB R O W SITE ADDRESS: SW NO ADDRESS ZONING: SUBDIVISION: LOT : JURISDICTION: TIG PROJECT: CITY OF TIGARD Project Description: Install service for flashing beacons for crosswalk at 121st Ave, Katherine St and Lynn St. Service is located on the NW corner of intersection. Job No. 64512 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: CITY OF TIGARD E C COMPANY 13125 SW HALL BLVD PO BOX 925 TIGARD, OR 97223 ALBANY, OR 97321 Phone: 503 - 639 -4171 Contact #: PRI 541 - 926 -4266 FAX 541 - 926 -4269 . FEES Description Date Amount Reg #: ELE 22 - 15C [ELPRMT] ELC Permit 11/1/2007 $80.30 LIC 49737 [TAX] 8% State Surcharge 11/1/2007 $6.42 SUP 32575 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 t fort ry OAR 2- 001 -0010 through OAR 952 -001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6 9 or 1 .800.332.2 . Issued l - Permittee Signatu 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: � A2 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. ." ' ' Nov. 1. 2007 8:13AM No. 3088 P. 1 E1ecrr Permit Applica r - City of Tigard CE�U D may: // / 417 Permit 4o.: E U6 7/l 13125 SW Hall Blvd., Tigard, OR 97RA ii Plan Rcvicw Phone: 503.639.4171 Fax: 503.59 MA - 1 l U U I 1 �. caw Permit T!G:1I:r) lespoctron f,.ine: 501639,4175 ath/8y' "' Sea Page Internet; www,ttgerd - otgov ® j ¥ O F' n T7nle e Neaifiedl;ricthod: (n, Supplemental Information • . TYPE 1 M C ® � N i'. 'PLAN. REVIEW' ❑ New construction 4 AdditIon /altcratlonhcpleccmcnt zit all teat apply(sahmit i acre a plans *Maas oheckcd below): • 0 0 Demolition R t �t--•yy in Se,viee or feeder 400 amps m TB= ❑ Building hver time stones, . El Other where the nv, ilnble A,@ current Q Marinas and bcrtyorcie! i s 10,000 amps et 110 vellt or ❑ Fleadna buildings. - - • .. - . . ,. :. CATEGORY OF COIV • mtecod lean to mend, or ettaceda 14,000 ❑ Commercial - unc agricultural ❑ 1- and 2- family dwelling S Comrnetclai/industrlal (j] Accessory building amp, it r all ether installations. buildings. E] Multi- thmlly ❑ Master builder Q Other: CI Fir; pump. ❑ Tnstallation of 75 K V A or " . , JOS SITE INFORMATION A o I,OCA,TIOIN , ' . Dn t loge ,trlmatelydeoMdsreran. , } S-1 ['Addition of new motor Iced of O ».n", t3 ", "1-2" "1-3”, I� Job no.: 645 a J Job site address: AV lt,r3.0 v n� a. �t�� 7oaliPormora. c +mraeY- mq, ❑ Six or more residential units, ❑ Re.ni mat vel,iete parks, i City/Stale/VP: "�`( r 0 D Hettlth.cre facilities. 0 Htuardoua legations D Supply voltage for more tban 600 volts nominal. Suite/bldg, /apt. no.: Project name: 1 ' / W a44s tivrq e is t ulal k D Service ce feeder son amps ar mom- . F1 , SC iE,ULJ�$' . Cross strect/dircctions to job site: my, 14A 7,04 , NIIA S - New'resldectial stagle• or multi- family dwelling unit. N'rr`rv4 AVt , LA.. % 5 4,-, Inelndn attached gunge. Subdivision: Lot no„ 1.000 a•. R. or laaa 111111111M1 -0 Pa. edd'I 500 ayt ft. or portion 33.40 1 Tax map/parocl no,: Limited energy, residential 75.00 2 . " 'DESCRIPTION OF WORK - ` (with stove sal. it) • r United enemy, muld•l5trtlly 75.00 2 'T1r t n -ill -t t C t A5 k' CN l)!� c 7•)ri 5 1811- residantial (with ebo.e sq. R.) I A _ n" r� n Services or feeders Installation idhratlon II (w reI •,- ti , n 'Tr) "F C - i /� o (�C.J `cam 200 amps or less 80,30 ...-. , - . .. { E&oFERTY OW R ' : ' 1 ' ' ' ❑ TENANT ' . 201 amps to 400 amps II 106.85 � H Name: 1 401 am ■ . to 600 a - 160.60 MI© 1 ^�-" 0: 1-1 � ` cy A - 601 amps to 1,000 amps 240.60 _ 2 Addreelist Over 1,000 amps or volts 454,65 2 City/StaterilF: Temporary scnt(eel or feeder's installation, alteration, and/or relocation Phone: ( ) Fax: ( ) 200 amps or less At 6635 .,1 . r I Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps III 100,30 2 intended fbr sale, (ease. rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2 Owner signature: Date: Branch *mitts -new. alteration, or extension, • •r peril A, Foe for branch circuits with abov 5ervit:e or feeder fee, • APPLI CANT <: I: ? ❑ GO1NT • P PNTtSC?Irl 6.65 2 Business name: each branch circuit . .. _ B. Fcc for branch circuits - obtuse service ai r feeder fed Contact name: 46.85 2 - — -- first branch circuit Address: Each addi branch circuit 6.65 2 Mlocetlsmeaas (service or feeder not Included) City/State/ZIP: Each mam►feclured or modular 9090 2 dwellht - service and/or feeder Phone: • ) Fax:: ( ) Rcounncctonly 66.85 2 E-mail: Pump or iirigaTlon circle 53.40 2 CON RACTOR.. • • . Sign or outline lighting 5140 2 Business name: 5 - Signal circuit(s) or limited- orgy penal, altotwtion, or • Address: - Pa 11 pt.= I � extsnaion. Describe: Page 2 2 • CitylStatc/ZIP: R r- p _ , Ledi ltddlfloaal a over alla�asle is a • of the above , G. _ Pcr Inspection 62.50 Phone: (59 ) C1 .. " _ _ _ ' Investigation per hour (I ht min) 1 62.50 - . COI Lic.: C4 9- -' ..ti 7 Electrical Lic.: _ a.1 dii Suprv. Lio,: _ 1 Industrial plant per hour 73,75 Suprv. Electrician sigruttttre, required * r �E'IR1tCAi; 1'F.)i21 FBKS AO- ••P i Sulxotsl: - Print name: /LE./ /Z C� ; Date: f p - 3 / -0 - Plan review (25% of permit foe): • State surcharge (8% of permit fix); 3 Authorized signature: TOTAL PERMIT FEE; • Print name: Date: w: pa • ■poll at(os mini tf a permit is sat obtalned,dtlt s 18o days alter x Ya hear er sa compkta • Number of inspec11anc allowed per permit. hrau:t,npliwn� .,C.,+aa,¢,.... c 05f21C uo.satrrtiiro0ICoMtw6t! (J'� CITY OF TIGARD BUILDING DIVISION 53 t''' PERMIT #: LLC2007- 00741 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/1/2007 Phone: (503) 639 -4171 11 lit Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 812/2008 TIME: 7:0tlAhli PAGE: SITE ADDRESS: S NO ADDRESS CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: CITY OF TICARD DESCRIPTION: Install service for flashing beacons for crosswalk at 121st Ave, Katherine St and Lynn St. Service is located on the NW corner of intersection. Job No. 64512 OWNER: CITY OF TIGARD, PHONE #: 503. 639.4171 CONTRACTOR: E C COMPANY PHONE # : 541-926-4266 Inspection Request Scheduled For: Date: 84 12/2008 Pour Time: Code # Inspection Description Conf rim # Contact # Message t 199 Electrical final 074052 -01 . 541 -826-4266 N Corrections /Comments /Instructions: 6-41. 9341.0681 , V SAW A). N \ ( c- \\\ q PASS ❑ PARTIAL APPROVAL 7 CANCEL I I NO ACCESS n CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED Inspector: CT■ K66 Date: ly 1 Phone #: (503) 718- 1)+11