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Permit CITY OF TIGARD ELECTRICAL PERMIT ■ COMMUNITY DEVELOPMENT Permit#: ELC2015O0111 T I G A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/25/2015 Parcel: SEG1808 Jurisdiction: TIGARD Site address: SW No Address Project: ODOT Subdivision: Lot: Project Description: Traffic signal electrical service cabinet along the West side of the intersection of Canterbury Ln and Pacific Hwy on the island. Contractor: PRAIRIE ELECTRIC INC Owner: 6000 NE 88TH ST VANCOUVER,WA 98665 PHONE: 360-573-2750 PHONE: FAX: 503-576-7422 FEES Quantity Description Date Amount 1 ea Services or Feeders-200 02/25/2015 $100.70 Specifics: amps or less 2 crt Branch Circuits w/Purchase 02/25/2015 $14.84 Type of Use: COM Service or Feeder Class of Work: ALT 1 ea 12%State Surcharge- 02/25/2015 $13.86 Electrical Type of Const: Occupancy Grp: Total $129.40 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 952-001-0090. You may obtain ^ f-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: 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. �EIVE" Electrical Permit Applic I I i IN."I "' I I I (1`...1 ` City f Tigard Received - *� 1S=Qd(1 1 ri g �}�� Deem : i .v 13125 SW Hall Blvd.,Tigard,()RF97223 2 3 2015 plan Review per Permit: Phone: 503.718.2439 Fax: 503.598.19,60_ l' Date/I3 : 1 t I_) Inspection Line: 503.639A175�iTV TIGA�D Date Ready/By: . 0 See Page 2 for Internet www tigard-or r ' 1 Notified/Method: ■�� Supplemental Information C r `Si, j i r.rl ,`- .rr 7,417'.!-1:::,'W;;,.,:1,.fir 1 ■ l, 1 1 -, 'iz +.'4� ' L;1. ,,, `- ' ^M� 1 ,•,1..:,�3 4_i,.,• ;°1, ,yo-r. ,,•�.' 7 ..r? -lease check that°..i•}•�"'�-'... ? .. "__ ,�.`._ P ch all apply(submit 2 sets of ptarrs w/items checked below): ❑New construction ®Addition/alteration/replacement ❑Service or feeder 400 amps or more ❑Building over three stones. ❑Demolition ❑Other: where the available fault current ❑Marinas and boatYarda. -t;-i -e4: :5. 3F effi' y f"°" 'y exceeds 10,000 amps at 150 volts or El Floating buildings. less to ground,or exceeds 14,000 ['Commercial-use agricultural ❑ 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building amps for all other installations. buildings. ❑Multi-family ❑Master builder ❑Other: pump. Installation of 150 KVA or y CI Fire t1m ❑ s' ` Lr : T..•t 1 iw r, µ nr.Y-7, • ?:+ski '-" ,; ,+ ❑Emergency system. larger separately derived system. ❑Addition of new motor load of ❑"A"."E","I-2",-1-3•' 100I1P or more. any. Job no.:400162 Job site address:-14101 SW Pacific Hwy. ❑Six or more residential units. ❑Recreational vehicle parks. ��Y ❑Health-care facilities. ©Supply voltage for more than City/State/ZIP:Tigard,OR.97223 0 Hazardous locations. 600 volts nominal. Suite/bldg./apt.no.: i Project name: ❑Service or feeder 600 amps or more. 1 i? t y-'rs Cross street/directions to job site:SW corner of the intersection of Description Qty. Fee. Tout New residential single-or multi-family dwelling unit. SW Pacific Hwy and SW Canterbury Lane Includes attached garage. _ Subdivision: Lot no.: 1,000 sq.ft.or less 168.54 ^ 4 Ea.edd'1500 sq.ft.or portion _ 33.92 1 Tax map/parcel no.: Limited energy,residential __. _ . ' � . ,r' . " t • r 7:,7"71;,','. (with above sq.ft.) 75.00 2 Limited energy,multi-family Traffic Signal Electrical Service Cabinet o-..L r�u3 ( .-)ec.eJ) residential(with above s9 ft.) 75.00 2 Re ewable:Ed�i „ .0 Sec ages2 • . Services or feeders installation,alteratlon,and/or relocation 7_--._ „— 100.70 -..e � � Y y _ �� �"" 200 amps or less 1 100.70 L1...�... .`./. ,:'.1. ` .,.,. " _, ...E.+: ,_1.....1:.....,. .`.'.r1.,; :'...,., `.... - 133.56 2 _201 amps to 400 amps Name: 401 amps to 600 amps 200.34 2 Address: 601 amps to 1,000 amps 301.04 2 ' Over 1,000 amps or volts 552.26 2 City/State/ZIP: Temporary services or feeders installation,alteration,and/or relocation Phone:( ) I Fax:( ) 200 amps or less 1 59.36 1 Owner installation:This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 2 Owner signature: Date: Branch circuits–new,alteration,or extension, r panel ---u.- r a•- , + r _a .'y v A.Fee for branch circuits with k. . ;'_ ...:.." . _I .. ., � .' la «. _ --:. .>�::. above service or feeder fee, 2 7.42 14.84 2 Business name:Prairie Electric Inc. each branch circuit B.Fee for branch circuits without Contact name:Wally Halberg service or feeder fee,first 56-18 2 branch circuit Address:6000 NE 88 Street Each add'l branch circuit 7.42 _ 2 City/State/ZIP:Vancouver,WA.98665 Miscellaneous(service or feeder not included) Each manufactured or modular 6784 2 Phone:(360)607-0359 1 Fax: :(360)397-0501 dwelling,service and/or feeder Reconnect only 67.84 2 E-mail:windyh@prairielectric.com com Pump or irrigation circle 67.84 2 M( M "-r., < .. _.. ,? i ',...t I '.h o:.r`,a..A.� .. w:•.,._.. �,,,,,,,,,,,,,:t,., Sign Of outline lighting 67.84 2 Business name:Prairie Electric Inc. Signal circuit(s)or limited-energy See panel,alteration,or extension. Page 2 2 Address:6000 NE 88 Street Each additional inspection over allowable in any of the above ' Additional inspection(1 hr min) 66.25/hr City/State/ZIP:Vancouver,WA.98665 Investigation(I hr min) 66.25/hr Phone:(360)573-2750 1 Fax:(360)397-0501 Industrial plant(1 hr min) 78,18/hr Inspections for which no fee is 90,00/hr CCB Lic.: 60178 Electrical Lie.: 37-491 Suprv.Lic.: l 3 s ificall listed 4 hr min Suprv.Electrician signature,required: Subtotal: 115.54 Print name: Bill Halberg sate: 2/10/15 Plan review(25%of permit fee): . State surcharge(12%of permit fee): 8 /3oc, Authorized signature: V TOTAL PERMIT FEE: —i,q , This permit application expires if•permit is not obtained within 180 Print name: Bill Hal : 2/10/15 days • after it has been accepted es co • Number of inspections allowed per permit. •/00 . i Budding\Perenits\ELC PuotitApp_ELR_ERE.doc Rev 03/21/2013 440.4615T(11/OS/COMAVEB 0 ... 1 • EE1.p 60 2 3 4 5 6 9, Ia KO. a • f ' 0 ,;.n r iIY LX.n a' ; .0224,.s>. 'i k • x Gredaomy. +1, Q9 . S�.` d•`' ftL Cn S1 gQ e r iv j "qty G. - Lit t Paft tz' I '^ a y4 Yt C:O'PCAE5'Sf '� _ Cr' -.*'T+. w b .Y i't:\:i`! aNWISH"i..T7N �( r R'4 iF .,„ ±5:.r, '_..-r k." ..�f 1 - f�." 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