Permit CITY OF TIGARD ELECTRICAL PERMIT
` � N
I • COMMUNITY DEVELOPMENT Permit#: ELC2014-00131
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/19/2014
Parcel: SEG1073
Jurisdiction: Tigard
Site address: SW NO ADDRESS
Project: Main Street Lighting Subdivision: Lot:
Project Description. Install(2)branch circuits. Work location:next to path behind 12549 SW Main St.
Job No 65535
Contractor: E C COMPANY Owner: CITY OF TIGARD
PO BOX 925 TIGARD. OR
ALBANY OR 97321
PHONE 541-926-4266 PHONE
FAX 541-926-4266
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo/Purchase 03/19/2014 $63.60
Specifics: Service or Feeder
1 ea 12%State Surcharge- 03/19/2014 $7 63
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total 571 23
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. ATTENTI on law requires you to follow the rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR
952-001-001 rough OAR' 52- 9 You may obtain a copy of the rules or direct questons to OUNC by calling 503-292 1987 or 1 800 332.2344
Issued I \ J� 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' LA y 9 Date:
LICENSE NO.
Call 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.
From:E C Company Bids /Fax:1477)751-8339RECEIVEI Fax: +1 t503r 588.1960 Page 2 of 3 03/1812014 11:33
Electrical Permit Application FOR oFFl(F I SF O\l.1
iill City of Tigard MAR 18 2.014 DAISEMI Pemrit Flo ze / MIN
• 13125 SW hall Blvd_,Tigard,OR 97223 Plan Review
a Phone: 503.718.2439 Fax: s SOF TIGARD Other Permit:
]7mwD
r 1 A p„ Inspection Line:g 03.63.4175 IILDING DIVISION »ffie Resdyi8y l see Pane 2 for
Internet: www.ti ardor. o Dati6ed/MetLod: Supplemental Information
-,• TYPE OF WORK` -: - i - PLAN REVIEW • •
❑New construction ®Addition/alterationlreplact meet
--- I Please check all that apply(submit 2 sets of plans w/items checked below)
❑Service or feeder 400 amps or more ❑Building ever three stories
❑i)etnolition ❑Other: where the available fault current ❑Marinas and bualyarJs.
-CATEGORY OF CONSTRUCTION' . exceeds 10,000 amps at t 50 volts or ❑Floarurg building's.
lets to ground,or exceeds 11,000 ❑Commercial-use agricultural
❑ 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building amps for all other mstnlarions. buildings. •
•
❑Multi-family ❑Master builder ®Other: JI ❑Fire pinup. ❑Installation of 150 K VA or •
1 ❑Emerge.rcy system. larger separately derived system.
' JOB.SITE:INFORMATION AND iO
_ ❑Addition of rxw motor load of ❑"A" "=°'`I "1-3"
Job no.:65535 Job site address:12549 Main St. 6/(,, i 0—T-5)----- I tw xr or more. OCCANCIZy
❑Six or more residential units. O Recreereational vehicle parks.
City/State/ZIP:Tigard,OR ❑Heahh-care facilities ❑Supply voltage for more than
❑llazardors loo lions. 600 volts nominal.
Suite/bldg./apt.no.: . Project name:Main Street Lighting ❑Service or feeder 600 snips or more.
Fn: SCHEDULE .
Cross street directions to job site:Next to path behind 12549 Main St. oesr-Jams, :.T.Qii_ 1--Fee. I Total i •-
New residential siamie-or multi-family dwelling unit.
includes attached garage.
Subdivision: Lot no.: 1,000 sq.tt.or less 168.54 4
Tax map/parcel no.: Ea.attd'I 500 sq.R or ptwtion 33.92 1
' Limited energy,residential 75.00 2
DESCRIPTION OF.WORE (with above sq.ft)
. • — — Limited energy,multi-family 75.00 2
Install branch circuit wiring to existing circuit breakers residcmtral(with above sq.ft.)
- Renewable Energy _ ❑ See Page 2
Semites orfccders inxtanatioataltsratioo,and/or relocation
: •:+'PROPERTY OWNER •• ' ' :I. . .. ❑`JF.NANI. 200 amps or less 100.70 1 2
201 amps to 400 amps 133.56 2
Name:ODOT 401 amps to 600 amps 200.34 2
C Address: 601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts , 552.26 2
City/State/LIP: 'temporary services or feeders installation,alteration,and4rr
Phone:( ) Fax:( ) relocation
200 amps or less 59.36 1
Owner installation:This installation is being mane on property that I own which is not '
201 amps to 4_00 amps 125.08 2
intended for sale,lease,rent,or exchange,according to ORS 447.449.670.and 70I. •
401 amps m 594 amps 168.54 2
Owner signature: Ike: ' Branch circuits-new,situation,or extension,per panel T
® APPLICANT 1 •--D CONTACT PERSON I A.Fee fir branch tarcuia with
above service or feeder tee, 7.42 2
Business name:E C Company 1 I each branch circuit
It.Fee for branch tareuits withrnrr
Contact name:Sharma Fullbright service or feeder fee,first I 5618 56.18 2 •
branch circuit
Address:P O Box 925 i rich add'!branch circuit 1 1 7.42 7.42 12
Miscellaneous(service or feeder not induded)
City/Stale/ZIP:Albany,OR 97321 hash manufncturcd or modular
67.84
2
Phone:(541)926-4266 Fax::(541)926-0165 dwelling,service and/or feeder •
Reconnect only 67 84 2
E-mail:shannaf @e-a-eo.com , Pump or irrigation circle 67.84 2
LONTRACI'OR•:.••.• Sign or outline lighting 67.84 2 .
Business name:E C Company Signal circuit(s)or limited energy See
panel,alteration,or extension. Page 2 2
Address:P O Box 925 Each additional inspection over allowable In any of die above
Additional inspection(I hr min) 66.25/hr I
City/Sune/ZIP:Albany,OR 97321 lnvestigatior(1 hr min) 66.25/hr
Phone:(541)926-4266 Fax:(541)926-0165 Indusrnal plant(1 hr`run) 78.18/hr
inspections for which no fee is 9000/hr
CCB l.ic.: 49737 Electrical Lie.: 22-15c Suprv.Lie.: 3257s specifically listed(%hr mm) -
-ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal: 63.60
Print name: William R.Coburn , Date:0/ 1 t 10�4 Plan review(25%of permit fec):
t__—_ State surcharge(12%of permit fee): 7.63
Authorized signature: TOTAL PERMIT FEE- 71.23
This permit application expires if a permit is not obtained within 180
Print name: f .,,,Mr.9 /1 • C, t'a..a \J Date: 3^/9 .,/I days after it has been accepted as complete.
LO 5( ) .
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
SW NO ADDRESS, TIGARD, OR
Commercial - Electrical
199 Electrical final
PASS - No C of O
ELC2014-00131
Chip Barnett
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
SW NO ADDRESS, TIGARD, OR
Commercial - Electrical
199 Electrical final
PASS - No C of O
ELC2014-00131
Chip Barnett
Violation Summary:
Inspector Contractor