Permit 4 ° . CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00604
Ml DEVELOPMENT SERVICES DATE ISSUED: 10/24/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S136CC-02100
SITE ADDRESS: 11744 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: LOT : JURISDICTION: TIG
Project Description: Temporary electrical service. Job No. 12236
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: 1 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: 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:
WESTERN PCS CORP. OREGON ELECTRIC GROUP
75353 NE AMBASSADOR PL. 1010 SE 11T1-1 AVE
PORTLAND, OR 97220 PORTLAND, OR 97214
Phone: 503 - 284 -8714 Contact #: FAX 503-535-276
PRI 503- 234 -9900
FEES
Description Date Amount Reg #: ELE 26 - 95C
[ELPRMT] ELC Permit 10/24/200( $66.85 LIC 203
[TAX] 8% State Surcharge 10/24/200( $5.35 SUP 4460S
Total $72.20 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 f• •• • - than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules a : -t forth in O • • 9 - - -0 1 1010 through OAR 952 - 001 -0100. You may obtain copies of these r - - •r direct questions to OUNC at
503 -2 '6-6699 or 1-800-3:2-2 -1 , -
Issu : d By: • , _ l ,t < / ure
Permittee Signat: ...../ r ,01/1 . "jo—ti_
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:
TRACTOR INSTALLATION ONLY
r l,./
SIGNATURE OF SUPR. ELEC'N: 1111111111 -- DATE: 4/v54
LICENSE NO: W66
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.
,OCT -23 -2006 04:20PM FROM -OR ELECTRIC SVC 5035352763 T -213 P.002/002 F -183
1aectrieill permit A V I � IED
City of Tigard I1aI /0 .M 0 / P.11 Pemlit No.: 79 / �O
e/ay l0 /� r t c'�l •
13125 SW Hall Blvd, Tigard, OR 97223
OCT T 3 2006 6 Plan Review Other Permit
Phone: 503.639.4171 Fax 503.598.1960 '5 "A!tCx i 'i` Date/By:
Inspection Line: 503.639.4175 ,-.1141,- " Dote Ready/Br .Pun l ® See Page 2 for
Internet www.ci.tigard_or.us � D' 8%ON NotifiedlMetLod C � Supplemental latortnadon r
TYPE OF WORK PLAN REVIEW
Please check all that apply:
El New construction Addition /alteration /replacement ❑Service over 225 amps, comm'I ❑Hasardous location
❑ Demolition ❑ Other: ['Service over 320 amps - rating ❑13uildng over 10,000 sq. ft,
CATEGORY OF CONSTRUCTION of I- and 2 -family dwellings 4 or more new residential
❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
['Building over three stories ❑Feeders, 400 amps or more
❑ Multi - family ❑ Master builder El Ot her. ❑Oeaupsnt load over 99 pawns ID Manufactured structures or
JOB SITE INFORMATION AND LOCATION OEgress/lighling plan RV park
['Health-care facility ['Other:
Job no.: 12236 I Job site address: 11744 SW PACIFIC FIWY Subunit 2 sets of plans with any of the above.
City/State/ZIP: TIGARD, OR 97223 T The above construction not applicable to temporary cotuction service.
FEE* SCHEDULE
Suite/bldg. /apt. no.: I Project namc: CRICKET CELL TWR IN TIGARD oaQipuou Qty. PR � T aral ( ••
Cross street/directions to job site: New residential single -or multi- family dwelling unit.
Includes attached garage.
1,000 sq. R or less 145.15 4
Subdivision: 1 Lot no.: Ea. add 500 sq. R or portion 33.40. 1
Limited energy. residential 75.00 2
Tax map/parcel no.: -
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each menuEsetured or modular
TEMP POWER TO CELL TOWER Services or and/or feeder 90.90 2
Servies or feders installation, alteration, and/or relocation
200 amps or leas 80.30 2
201 arils to 400 amps 106.85 2
❑ PROPERTY OWNER ❑ TENANT 401 amps to 600 amps 160.60 2
Name: CRICKET COMMUNICATIONS 601 amps to 1,000 amps 240.60 _ 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 _ 2
City/Statc/ZIP: Temporary services or feeders installation, alteration, and/or
Phone: ( ) I Fax: ( ) relocation
200 amps or leas i _ 66.85 (06.45S 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 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
❑ APPLICANT I ❑ CONTACT PERSON A Fee for branch circuits with
- service or feeder fee, each
6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee,
46.85 2
each branch circuit
Address: Each add'I branch circuit _ 6.65 _ 2
Ci ty/State/ZIP; Misceuaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) Fax: ( ) Sign or outline lighting 53.40 2
E - mail: Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
extension. Describe: Page 2
Business name: Oregon Electric Group _ _
Address: 1010 SE 11th Ave Each additional inspection over allowable in any of the above
- - Pcr inspection 62.50
City /State/ZIP: Portland, OR 97214 Investigation per hour (1 hrmin) 62.50
Phone: (503)2344900. I Fax: (503) 535 - 2763 Indus plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lie._ 203 I Electrical Lic.: 26 -95C I Suprv. Lit.: 4460S Subtotal 44 .$
Suprv. Electri -' a e -' , • • : MarIA e. '� e,vI ne, Plan review (25% ofpermit fee)
Print name: / ' i / I Date: 10/23/06 State surcharge (8% of permit fm) 5 _ .5
L TOTAL PERMIT FEE 1 .1., aD
Authorized signature : mo b `' �Q,Y K . j. 'r,t.l1 l l ej j Mils permit appileadon Capires sr a permit Is pot obtained within IN
days after It has been accepted as complete
Print name: �/ i Date: 10/23/06 • Fe e methodology set by Tn- County Building lndutlry Service roam
f- � , ,A .... •• Number ofinspeealans per permit allowed.
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2006-00604
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/24/2006
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639-4175 ..
INSPECTION WORKSHEET FOR DATE: 10/26/2006 TIME: 7:04AM PAGE: 20
SITE ADDRESS: 11744 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: WESTERN PCS MONOPOLE
DESCRIPTION: Temporary electrical service. Job No. 12236
OWNER: WESTERN PCS CORP., PHONE #: 503-284-8714
CONTRACTOR: OREGON ELECTRIC GROUP PHONE #: 503-234 -9900
Inspection Request Scheduled For: Date: 10/26/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
1 electrical service 038883 -01 503 - 849-3291 V
Corrections /Comments/ ructions: CH
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G• , v 6e) Date: _ 1'OI2, c j Phone #: (503) 718 - 1-441,