Permit (3) IN • ,, CITY OF TIGARD ELECTRICAL PERMIT
I ' COMMUNITY DEVELOPMENT Permit#: ELC2020-00026
T[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/23/2020
Parcel: 2S110DCO2300
Jurisdiction: Tigard
Site address: 11555 SW DURHAM RD
Project: Traffic signal service repair Subdivision: 1998-128 PARTITION PLAT Lot: 1
Project Description: Replacing (1)200 amp service and(10)branch circuits at the corner of Durham and Pacific Highway.
Contractor: GLOBAL ELECTRIC, INC. Owner: HIP WILLOWBROOK LLC
PO BOX 162 BY HARSCH INVESTMENT CORP
NORTH PLAINS, OR 97133 PO BOX 2708
PORTLAND, OR 97208
PHONE: 503-647-5650 PHONE: 503-647-5650
FAX: 503-647-5649
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 01/20/2020 $100.70
Specifics: amps or less
10 crt Branch Circuits w/Purchase 01/20/2020 $74.20
Type of Use: Service or Feeder
Class of Work: 1 ea 12%State Surcharge- 01/20/2020 $20.99
Electrical
Type of Const:
Occupancy Grp:
Total $195.89
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 952-061-0090. 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: -f.....'
y: --7 Permittee Signature: tiW 1747Q4/e://---7762 I
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 ApplicatioIlECjVEt FOR OFFICE USE ONLY
City of Tigard Date/Bea �� /, P I aft SII r- (d
- 't 13125 SW Hall Blvd.,Tigard,OR 97223 J/1 AI y (�
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960' HIV 1 (D 2020 DateB : %, :� I �'ZiitV
111114
Inspection Line: 503.639.4175 Ready Date/By: Juris: El See Fagg 2 for
P {{'yy
TIGARD Internet: wtvtv.tigard-or.gov i V� �� Notified/lbfethod: Supplemental Information
RI 11! niNG TYPE OF WORK t�1 iISft../f PLAN REVIEW
❑New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
0 Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition ❑Other where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
0 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
D Multi-family 0 Master builder 0 Other: 0 Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system larger separately derived
//-- ❑Addition of new motor load of system.
Job#:2001068 Job site address: //S S , Ski 4t c(44./ii 1001-IP or more. ❑"A"•"E."1-2"."1-3"•
❑Six or more residential units. occupancy.
City/State/ZIP:Tigard,OR 972240 Health•care facilities
0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: 99 Durham Service Repair 0 Hazardous locations. ❑Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site:OR-99W&SW Durham Rd FEE SCHEDULE
Description I Qty. I Each I Total I •
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax neap/parcel#: Ea.add'l 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
75.00 2
Need(1)200 A service&(10)circuits to remove and replace service (with above sq.ft.)
Limited energy,multi-family 75.OU 2
that was run over and damaged on NE Corner Of Intersection residential(with above sq.ft.)
Renewable Energy 0 See Page 2
❑ PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation
Name: 200 amps or less 1 100.70 100.70 2
Address: 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:( ) 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
0 APPLICANT 0 CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name:Global Electric,Inc. above service or feeder fee, 10
7.42 74.20 2
each branch circuit
Contact name:Dustin O'Rear B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Address:PO Box 162 branch circuit
City/State/ZIP:North Plains OR 97133 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(503)647-5650 Fax::(503)647-5649 Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email:dispatch@globalelectricusa.com Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:Global Electric,Inc. Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy ❑ See Page 2 2
Address:PO Box 162 panel,alteration,or extension.
City/State/ZIP:North Plains OR 97133 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(503)647-5650 Fax:(503)647-5649 Investigation(1 hr min) 90.00/hr
Email:dispatch@globalelectricusa.com Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lie.: 156838 Electrical Lie.: 34-655C Suprv.Lie.: 5210S specifically listed(Va hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: i Subtotal: 174.90
Print name: Justin Spiering F Date: 1/16/2020 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): 20.99
Authorized signature: TOTAL PERMIT FEE: 195.89
This permit application expires If a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
* Number of inspections allowed per permit.
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