Permit - CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2013 -00127
Date Issued: 02/21/2013 •
I I GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439
Parcel: SEG1242
Jurisdiction:
Site address:
Project: 217 Active Traffic Management Subdivision: Lot:
Project Description: (1) 200 amp service and (1) branch circuit for message signs for Hwy 217 corridor. This sign is located 2000' south
of southbound on ramp of Hwy 217 and Pacific Hwy (99 W), nearest cross street is SW Beveland.
Contractor: SIGNAL CONSTRUCTION GROUP Owner: ODOT
10780 SW CLUTTER RD TIGARD, OR
SHERWOOD, OR 97140
PHONE: 503 - 682 -2252 PHONE:
FAX: 971 - 216 -0079
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 02/21/2013 $100 70
Specifics: amps or less
1 crt Branch Circuits w /Purchase 02/21/2013 $7.42
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 02/21/2013 $12 97
Electrical
Type of Const:
Occupancy Grp:
•
Total $121.09
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable law. 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 the 180
days. ATTENTION Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through OAR 2- 090 You may obtain a copy of the rules or direct questions to OUNC by calling 503 232 1987 or 1 800 332.2344.
Issued By: Permittee Signature:
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 _ Date: Z Z I — Z0/3
LICENSE NO.
CaII 503.639.4175 by 7:00 a.m. for the next available Inspection date.
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 ApplicationRECFJ \F !!l 1 FOR OFFICE USE ONLY
City of Tigard .� Received o. a� /3 Received Permit No
° 131 Hall lvd , Tigard,OR 97223 FEB 2 1 2013 Plan Review
Date/By < %v L�Lt% D� /
7 Phone' 503 718.2439 Fax. 503.598 1960 Date/By Other Permit
T I G A R D Inspection Line' 503.639.4175 CITY OF TIGARD Date Ready/By Juris ® See Page 2 for
Internet www.tigard-or ov
BUILDING DIVISION Notified/Method 'rl� Supplemental Information
g gov
TYPE OF WORK PLAN REVIEW
ew construction ❑ Addition/alteration/replacement Please check all that apply (submit 2 sets of plans whtems checked below)
❑ Service or feeder 400 amps or more ❑ Building over three stones
❑ Demolition ❑ Other: where the available fault current ❑ Mannas and boatyards
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling ❑ CommerciaUindustrial ❑ Accessory building amps for all other installations buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system larger separately denved system
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
Job no.: I Job site address: aq- ��' IOOHP or more occupancy
t ❑ Six or more residential units ❑ Recreational vehicle parks
City/State /ZIP: Sa �it) d LG-c- . ❑ Health -care facilities ❑ Supply voltage for more than
❑ Hazardous locations 600 volts nominal
Suite/bldg. /apt. no.: I Project name: aq pti lJ� �J .�u \l�l0..)7 ""\mac Service or feeder 600 amps or more
� ��� , ��` Q � . ,�� `' , FEE SCHEDULE
Cross street/directions to job site: RQs .. �
-k. 'jk � Deseription 1 Qty. I Fee. I Total - 1—
/ c „� ^ � 1� 6 e3 0 ,a cGrn) � cR New residential sin r multi-family dwelling unit.
� � � k Includes garage.
es attached ara e.
/Subdivision: S A' J�/.2..., Lot no.: 1,000 sq. ft or less 168 54 4
Ea. add'I 500 sq ft. or portion 33 92 1
Tax map /parcel no.: Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq ft)
-
Limited energy, multi - family 75 00 2
\ . � y Y, J�C `�k- ¶v'\ ; /g C C-U( residential (with above sq ft.)
Services or feeders installation, alteration, and/or relocation
- c0( 3 (C,& (,1; j j` S � 200 amps or less I 100 70 2
U PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133 56 2
Name:
nOO ` 401 amps to 600 amps 200 34 2
601 amps to 1,000 amps 301 04 2
Address: Over 1,000 amps or volts 552 26 2
City/State /ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax. ( ) 200 amps or less 59 36 l
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not
intended for sale, lease. rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168 54 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A Fee for branch circuits with
❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, ! 7 42 2
each branch circuit
Business name: B Fee for branch circuits without
service or feeder fee, first 56 18 2
Contact name: branch circuit
Each add'I branch circuit 7 42 2
Address: Miscellaneous (service or feeder not included)
City /State /ZIP: Each manufactured or modular 67 84 2
dwelling, service and/or feeder
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
Pump or Irrigation circle 67 84 2
E - mail:
Sign or outline lighting 67 84 2
/ CONTRACTOR Signal circuit(s) or limited- energy
J Business name: �' ` ��� �.S ^�0 \( C . \�� G���� ���
panel, alteration, or extension Page 2 2
' Each additional inspection over allowable in any of the above
Address: ( C t JA eX dQ8 Additional inspection (1 hr min) 66 25/ hr
City/State /ZIP: 02 047 l(_k(1 Investigation (1 hr min) 66 25/ hr
1 �JJ industrial plant (1 hr min) 78 18/ hr
Phone: ( O3) 6K — gal:6Z Far: ( ) Inspections for which no fee is 90 00/ hr
i ? specifically listed (%A hr min)
CCB Lic.: lj� .�7 (3 E lectrical Lic.: Suprv. Lic.: 5- ELECTRICAL PERMIT FEES
Subtotal.
Suprv. Electrician signature, require ��- Plan review (25% of permit fee):
Print name , -CA _ - 1 Date: � l— i3 State surcharge (12 %ofpermit fee)
�� "`� ` l TOTAL PERMIT FEE.
Authorized si •nature:
7 Thi permit application expires if a permit is not obtained within 180
r days after it has been accepted as complete.
Print n: , e:', - _ Date: Z— a • Number of inspections allowed per permit
\Building\Fermits\ELC -Perms pp .oc 1 7/01/10 440 -46t5T(tt /05 /COM/WEB
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
, TIGARD, OR
Commercial - Electrical
115 Electrical service
2013-12-17 00:00:00
ELC2013-00127
PASS
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
, TIGARD, OR
Commercial - Electrical
199 Electrical final
2014-02-26 (null)
ELC2013-00127
PASS - No C of O
Violation Summary:
Inspector Contractor