Permit • ��� ��� ELECTRICAL PERMIT
` CITY OF TIGARD
- COMMUNITY DEVELOPMENT Permit #: ELC2010 00309
" r r Date Issued: 06/23/2010
T1 f rARD' 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: S /23/20 890
Jurisdiction:
Site address: SW NO ADDRESS
Subdivision: Lot:
Project: Main St/Pacific Hwy Traffic Signals
Project Description: (1) 200 amp service and (3) branch circuits for street luminaires located on the SE corner of Main
St. and Pacific Hwy (in Liberty Park right -of -way).
Owner: FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 06/23/2010 $100.70
amps or less
PHONE: 3 crt Branch Circuits w /Purchase 06/23/2010 $22.26
Service or Feeder
1 ea 12% State Surcharge - 06/23/2010 $14.76
Contractor: Electrical
PRAIRIE ELECTRIC INC
6000 NE 88TH ST
VANCOUVER, WA 98665
PHONE: 800 - 573 -2750
FAX: 360- 573 -9866
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $137.72
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 throug AR 952 - 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. _ /
1><
B :
Issued y -- Permittee Signature: o /v ��/° 6- / e �/ / rV
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 an inspection that business day.
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.
06/22/2010 11:34 FAX 360 573 9866 Prairie Electric Inc. Fj002 /003
Electrical Permit Application . FOR OFFICE USE ONLY
City of Tigard Received , �_ Permit No.: el
�_ , i ji
13125 SW Hall Blvd., Tigard, OR 97223 Dane : �3 /(�
; Phone: 503.639.4171 Fax: 503.598.19603UN 9 D
2, (. . I :� ia Review
Date/By: Other Permit:
T 1 G ARD Inspection Line: 503.639.4175 Date Ready/By: Juris' ® See Page 2 for
Internet: www.tigard or.gov r F T1GARD Notified/Method: Supplemental Information
.. r- 7 ,,,. SF V ,' ..tr x ® to.r,. r ,r � ■ c i 41 k .tu .a ..., � iaht rt,l-a e7inh` L _ , iii
k g a:+ i.Y -1 ...�4 ' pp .._. •• , ._ -�... .. . - ..I• -S.C`. : -.,_ ,,j y n y} ,sger yi SF.N M
❑ New construction ® Addition/alteration /replacement
Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current
❑ Marinas and boatyards.
-4'E, , ,#z.. v 8 4 .� ' i @ _.A ]� 4 El t. . exceeds 10,000 amps at 150 volts or ID Floating buildings.
M:s,:a
;..,h'c >I'tAlt i ef - '4 y .4al r > ,, r : 5' `a
- ' - =!.. =_ :t a rti.iF r". /6 .. i .... ,
• 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: ❑ Fire pump. ❑ Installation of 75 KVA or
h r n x 3 nr c t i i }. .� A - --- m ,s - 4, ▪ ❑ Emergency system. larger separately derived system.
., a i:. ,.,...- .,._. �,..,. .,a r ; ix - >. At.. ;,, a r t i, , .... ' = _'� ❑ Addition of new motor load of ❑ „ .. x .. .. 3 ..
Job no.: / Job site address: �,� 4 I1 or more occupancy.
/ yrr -L (7 " /„ rr ■ S ix or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP:
/ ! 0 � 7-1
j'j ❑ Health -care facilities. El Supply voltage for more than
/ ❑ Hazardous locations. 600 volts nominal
Suite/bldg. /apt. no.: Project name. f o �e j4 ❑ Service or feeder 600 amps or more.
M A 1t l\1 6 eh '; alt "3.sn : ` O . Ei i ' 1 1f1m ss .a:a rt �a as t
Cross street/directions to job site: Description Qty. Fee. Total •
New residential single- or multi - family dwelling unit.
TA1 -�F C 5 f6 m- -S Includes attached garage.
Subdivision: Lot no.:
1,000 sq. R. or less 168.54 4
Ea. add'l 500 sq. R. or portion 33.92 I
Tax map/parcel no -5-6-6—P' �/ p
7 / Q 9 Q Limited energy, residential
�..: m� - , ra t.,' ,Y :w c* wth bo s R. 67 -84 2
,..f}9ik^�]T'.�.e�' 4.Yra1.6 >r .�'�fu . � � r :. �T .... ,,.w � ��'.�- T/I�'�+' 'tY, + • '.t .L. _.. � C , t.' ( -1' )
”` Limite e , multi - family 67.84 1 2
Service and Circuits for Street Luminaires ,, _,, \ 9-' residential (with above sq. ft.) _
,5 CC 1 �� G /. Q t Services or feeders installation, alteration, and/or relocation
200 amps or less 1 1 00.70 100.70 2
' y 1 i a - " " 6 201 amps to 400 amps 133.5 2
401 amps to 600 amps 200.34 2
Name: 601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and /or
City/State /ZIP: relocation _
Phone: ( ) Fax: ( ) 200 amps or less 59.36 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Branch circuits— new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
e 1 ti ro x i I t k,:r.a} Y , above service or feeder fee, 3 22.26
;�. 04 L �? - ' :,s : _e,.,. ..� Ic a _ W �� C 1 , , .. f i each branch circuit 7.42 2
Business name: Prairie Electric, Inc. B. Fee for branch circuits without
service or feeder fee, first
Contact name: Anita Paso branch circuit 56.18 2
Each add'I branch circuit 7.42 1 2
Address: 6000 NE 88 Street Miscellaneous (service or feeder not included)
City/State/ZIP: Vancouver, W A 98665 Each manufactured or modular 67.84 2
1 y dwelling, service and/or feeder
Phone: (360) 573 - 2750 Fax: : (360) 573 - 9866 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E anitap @pralnelectric corn Sign or outline lighting 67.84 2
......i s, < z > x.. _ g " .0;Vga : _k2, _ ,.,,l= r . ,,r _ _ :- Si circuit(s) or limited - energy
_
Business name: Prairie Electric, Inc. panel, alteration, or extension. Page 2 12
Ler Each additional inspection over allowable in any of the abov
Address: 6000 NE 88 Street s ,,q,1,4 Additional inspection (I hr min) 66.25/ hr
r li A City/State /ZIP: Vancouver, WA 98665 Investigation (I hr min) 66.25/hr
j J� G V Industrial plant (1 hr mw) 78.18/ hr
Phone: (360) 573 - 2750 f Fax: (360) 573 - 9866 V Inspections for which no fee is 90.00 / hr
specifically listed (/2 hr min)
CCB Lic.: 60178 Electrical Lic : 37 -491 C Suprv. Lic.: 3562S a e; tt 1;tiA'pEAfifllS `,;
Suprv. Electrician signature, required
Subtotal: 122.96
Plan review (25% of permit fee): _
Print name: Bill Halberg f Date: 6 - - State surcharge (12% ofpemul fee): 14.76
TOTAL PERMIT FEE: 137.72
Authorized signature: 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.
11BuildingWerm its lELC- Permii App .doc 10/01/09 440 -461 ST(11 /05 /COM/WEB
4/Z3 .TO E+ J l,- E A