Permit (2) CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2019-00875
Date Issued: 12/24/2019
-FIG A R.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 251016B00401
Jurisdiction: Tigard
Site address: 11880 SW PACIFIC HWY
Project: Red Light Cameras Subdivision: TIGARD ROAD GARDENS Lot: 5
Project Description: Installing(6)branch circuits for red light cameras on the corner of Hall and Pacific Highway.
Contractor: GLOBAL ELECTRIC, INC. Owner: RSK ASSENAV LLC
PO BOX 162 11880 SW PACIFIC HWY
NORTH PLAINS, OR 97133 TIGARD, OR 97223
PHONE: 503-647-5650
PHONE: 503-647-5650
FAX: 503-647-5649
FEES
Quantity Description Date Amount
6 crt Branch Circuits wo/Purchase 12/19/2019 $93.28
Specifics: Service or Feeder
1 ea 12%State Surcharge- 12/19/2019 $11.19
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $104.47
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 a to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR -001-0 0. Y may obtain copy of e rules or direct questions to OUNC by calling 503.23 987 or 1.800.332.2344.
Issued By: , i^ Gas4 Permittee Signature: e
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 FOR OFFICE USE ONLY
City of Tigard -CEov1 Received
13125 51V Hall Blvd.,Tigard,OR 97223 Date/B.: a� 9 .I
g Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 1 6 2019 Date/B : Related Permit 8:
Inspection Line: 503.639.4175 Ready Date/By: Ms: El Sec Page 2 for
T[GARD
., Internet: www.tigard-or.gov RD Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
❑New construction ®Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
❑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.
❑ 1-and 2-family dwelling ® Commercial/industrial ❑Accessory building less to ground,or exceeds 14.000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family ❑Master builder 0 Other: 0 Fire pump. 0 installation of 150 1-VA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
Job#:1911048 Job site address: I!' -'8.--p g4.)a,GtgG 0 Addition I001-1P or momv motor load of system.
more. ❑"A","L","I?","I-3",
City/State/ZIP:Tigard,OR 97223 ❑Six or more residential units. occupancy.
0 Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Tigard Red Light Cameras 0 Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site:SW Hall&Pacific Highway West FEE SCHEDULE
Descrlpllon I Qty. I Each I Total I •
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
Tax map/parcel#: 1,000 sq,ft.or Ices 168.54 4
Ea.add'!500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
(with above sq.ft.) 75.00 2
Need To Add(6)Branch Circuits For Red Light Cameras Limited energy,multi-family
residential(with above sq.E.) 75.00 2
Renewable Energy ❑ See Page 2
❑ PROPERTY OWNER I 0 TENANT Services or feeders installation,alteration,and/or relocation
Name: 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Address:
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 properly 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 16854 2
0 APPLICANT I ❑ 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, 7.42 2
each branch circuit
Contact name:Colton Perdew B.Fee for branch circuits without
service or feeder fee,first 1 56.18
Address:PO BOX 162 branch circuit 56.18 2
City/State/ZIP:NORTH PLAINS OR 97133 Each add'I bi-- 5 7.42 73.10 2
NW- " 'der not included)
Phone:(503)647-5650 Fax: :(503)647-5649 67.64 2
EmEmail:dispatch@globalelectricusa,com t`� fr.,iiI✓
6784 2
CONTRACTOR 6 67.84 2
Business name: GLOBAL ELECTRIC INC 1,L t/1'"` 67.84 2
Address:PO BOX 162 '7]�� �� See Page 2 2
City/State/ZIP:NORTH PLAINS OR 97133 nowablc in any of the above
..am) 66.25/hr
Phone:(503)647-5650 Fax:(503)647-5649 _.,min) 90.00/hr
Email:dispatch(iglobalelcctricusa.com aI plant(ihrmin) 78.18/hr
inspections for which no fee is 90.00/hr
CCB Lic.: 156838 Electrical Lic.: 34-655C Suprv.Lic.: 5210S specifically listed(Vs hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal: 93.28
Print name: Justin Spiering Date: 12/16/2019 0 Plan Review Required(25%of permit fee):
State surcharge(12•,a of permit fee): 11.19
Authorized signature: TOTAL PERMIT FEE: 104.47
This pemilt application expires if a permit Is not obtained within 180
Print name: 9.,,; ` ,q........_________ Date: 12/16/2019 days after it has been accepted as complete.
• Number of inspections allowed per permit.
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