Permit (250) CITY OF TIGARD71 ELECTRICAL PERMIT
'��� COMMUNITY DEVELOPMENT
Permit#: ELC2016-00968
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/27/2016
Parcel: SEG419
Jurisdiction: Tigard
Site address:
Project: Scholls Ferry Apartments Subdivision: Lot:
Project Description: (1)service and(4)branch circuits for street lighting cabinet on northeast corner of Scholls Ferry Road and 135th
Avenue.
Contractor: GLOBAL ELECTRIC, INC. Owner:
PO BOX 162
NORTH PLAINS, OR 97133
PHONE: 503-647-5650 PHONE:
FAX: 503-647-5649
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 12/27/2016 $100.70
Specifics: amps or less
4 crt Branch Circuits w/Purchase 12/27/2016 $29.68
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 12/27/2016 $15.65
Electrical
Type of Const:
Occupancy Grp:
Total $146.03
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 N. -'o, Center. T ose rules are set forth in OAR
952-001-0010
Issued B •• �._ q :7 or /:r 32.234
through• ::52-001-0090. You ma _ es or direct questions to OUNC by calling 50•
Y — 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.
Electrical Permit Application 4,--,vs
Ci o Tigard �')
--
City g !; DateBy �i�7 G Perm": 96f V V(.C/�/141S
13125 SW Hall Blvd.,Tigard,OR 972 r, Plan Review
0 Phone: 503.718.2439 Fax: 503.598.1960 ! G1 Date/By: Related Permit#:
Inspection Line: 503.639.4175 C
_ + � ReadY Date/
By: 3 ® See Page 2 for
Internet: www.tigard-or.gov , i.2i.2
-13,k;>,, i. Notified/Method: Supplemental Information
0t:J
New construction4 a l :4( b 2 set i checked):
r.�4� a
0 Addition/alterati�;. =, ,�' exit Please check all that apply(submit 2 sets of plans w/items ch
0 Demolition 0 Other: ❑Service or feeder 400 amps or more ❑Building over three stories.
where the available fault current 0 Marinas and boatyards.
'A ci `= i`'°1, 'I' ',0-;f l>c.. "z ,. ;u , exceeds 10,000 amps at 150 volts or 0 Floating buildings.
❑ 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
❑Multi-family ❑Master builder 0 Other: amps for all other installations. buildings.
❑Fire pump. 0 Installation of 150 KVA or
* ..t l2I'' . S Y 0�' 1 i s7: , " 4" ❑Emer enc s stem. lar
��r. (.F s , �. � �,� �_, .- �, -�()�,r�w � `' �-�s� g Y Y ger separately derived
Job#: �/ ❑Addition of new motor load of system.
Job site address: /) arei - T. „At/2f-1y1q 100HP or more. 0"A","E","1-2","1-3",
City/State/ZIP: '7721-4,e4 de q'7.43 "�✓ t ❑Six or more residential units. occupancy.
❑Health-care facilities.
0 Recreational vehicle parks.
Suite/bldg./apt.#: V (Project name: ❑Hazardous locations. 0 Supply voltage for more than 1
❑Service or feeder 600 amps or more 600 volts nominal
Cross street/directions to job site: �x `
.z �', '�r, _��",'�rI'A 1 , , -e+s'.. y
Description Qtr. .;.._. Each Total *
New residential single-or multi-family dwelling unit.
Subdivision: I Lot#: Includes attached garage.
Tax map/parcel#:
1,000 sq.ft.or less 168.54 4
Ea.add'l 500 sq.ft.or portion 33.92 1
-.. t_x i-r;gt„ .r. rty i /) &'- '..'-_:-,P:', -,,7'-`,''''' '` , Limited energy,residential
��jj (with above sq.ft.) 75.00 2
S k re� I + q Lt-f A el 5.c �a 1 I s Fe rr y Kt) Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
` .<. aRenewable Energy0 See Page 2
- -3 -1. ` ,' 1 L$Jui, i` * , ' ah. _ x 3 : Services or feeders installation,alteration,and/or relocationName: VVa s 11 f 49.-1,-‘44 (U
� N-t- 200 amps or less / 100.70 l�1 e,7 2
Address: "J 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: 601 amps to 1,000 amps 301.04 2
Phone:( ) I Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
riallita.:''.:::g.j f41,47.Z4VRIatitat.gZ 5 ' >n , Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: /v C a fc-t- f above service or feeder fee, q 7.42 ,2!? (Q3 2
each branch circuit
Contact name: C:_..k.‘ t' I c. f0 t. r C G „l B.Fee for branch circuits without
Address:
service or feeder fee,first
G
t
N O� 1 6 2- branch circuit 56.18 2
City/State/ZIP: G/4-L7 pi a a S 177 3 3 Each add'l branch circuit 7.42 2
t ) tJ - I Fax: : Miscellaneous(service or feeder not included)
Phone:(
7 ( ) Each manufactured or modular 67.84 2
Email:
dwelling,service and/or feeder
Reconnect only 67.84 2
.�-� Pump or irrigation circle 67.84 2
Business name: 4 t�J t74 I r� ' C r c /c Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
Address: t 0 . O x l 6 'zpanel,alteration,or extension. ❑ See Page 2 2
City/State/ZIP: .00 c-4 t..1t s Each additional inspection over allowable in any of the above
�
y Additional inspection(1 hr min) 66.25/hr
Phone:6 IS ) 8 yl - S171 Fax:( ) hr min Investigation(1
g ) 90.00/hr
Email: Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
CCB Lic.: /5-6 e'3 ' Electrical Lic.:3 '-6•53, Suprv.Lic.: 5-;,..‘. !o S' specifically listed('/z hr min) 90.00/hr
to ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required:
d'' Subtotal: j 30
Print name: 4$4.00044 240/i zz J.4 I Date: /1—V-/,6 0 Plan Review Required(25%of permit fee):
�� State surcharge(12%of permit fee): V
Authorized signature: TOTAL PERMIT FEE: rt((,i)3
This permit application expires if a permit is not o tamed within 180
Print name: J ► a .91ede J4j Date:,Z-Z' - days after it has been accepted as complete.
* Number of inspections allowed per permit.
i:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB