Loading...
Permit CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2007 -00592 COMMUNITY DEVELOPMENT DATE ISSUED 8/23/2007 TI 'ARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1 S 135CB -R -O -W SITE ADDRESS: SW NO ADDRESS ZONING: SUBDIVISION: LOT : JURISDICTION: TIG PROJECT: COMMUTER RAIL Project Description: 200 amp power pole located at SW Tiedeman Ave, SW of SW North Dakota St. RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10): SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: 1 W /SERVICE OR FEEDER: PER INSPECTION: • 201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA /SPEC OCC: Owner: Contractor: GENESEE & WYOMING RAILROAD SVC INC MIDVALE ELECTRIC 1200 -C SCOTTSVILLE RD STE 200 PO BOX 1023 ROCHESTER, NY 14624 SUNNYSIDE, WA 98944 Phone: 585 - 328 -8601 Contact #: PRI 509- 839 -4204 FAX 509 - 839 -4206 FEES Description Date Amount Reg #: ELE C240 [ELPRMTJ ELC Permit 8/23/2007 $80.30 LIC 137698 TAXI 8% State Surcharge 8/23/2007 $6.42 SUP 4590S Total $86.72 REQUIRED ITEMS AND REPORTS This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. 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 than s: - days. • ` NTIO■ : •regon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 9 - 001 -0010 through • ; ' 952 00 *100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 o0.800.332.2344. Issue By: - �� � Ll _,� � ` Permittee Signature: i/r A 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'N: ✓ /.: 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. Ot � of �� C YAN i� a Electrical Permit Application z i d i . �p caon Land Use Approval - � i�:.. ;r- Washington County, 155 N. 1 AV, Suite 350, MS 12, Hillsboro, OR 97124, Project # __ � " Phone: 503- 846 -3470 Fax: 503- 846 -3993 Permit # Aro /,/ I►I akiGa; Inspection Requests: 503 -846 -3699, www.co.washington.or.us , ° TYPE' OF , WORK • a ' PLAN' REVIEW " ZNew construction ❑ Addition /alteration /replacement ❑ Other: Please check all that apply: ❑ Service or feeder 400 amps ❑ Hazardous locations _ . or more where the available ❑ Service or feeder 600 amps or more CATEGORY OF ,CONSTRUCTION , - fault current exceeds ° ` ° ❑ Building over three stories ❑ I- and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building 10,000 amps at 150 volts or Marinas and boatyards less to ground, or exceeds ❑ Floating buildings ❑ Multi family El Master builder Other: 14,000 amps for all other , "JOB' SITE° INFORMATION AND LOCATION , .. installations. ❑Commercial -use agricultural buildings ❑ Fire pump ❑ Installation of 75 KVA or larger Job no.: Job address: ( /IA Ave. S l e CI Emergency system separately derived system ❑ Addition of new motor City/State/ZIP: i [� AR(1 D2 load of 100HP or more ❑ A," "E," "I -2," "1 -3" occupancy J ❑ Recreational vehicle parks Suite/bldg. /apt. no.: Al A Project name: �!' ,� \/ /� CI Six or more residential units ❑ Supply voltage for more than ❑ Health -care facilities 600 volts nominal Cross street /directions to job site: cdem :FEE SCHEDULE t .Md ° °r ° on. RoAd TRAc,K S 3W O SW Noe-117 Dgko+ 5 Description Qty. Fee Total * ■,. Subdivision: A l F L no.: , R esiden _ ttial single- or, multi - family dwelling unit: - g , ° ;, , Includes attached gara ° . - :,? °l ° - r ® Tax map /parcel no.: I 51550_6 — k- O'1,(3 1,000 sq. ft. or less 150.00 4 t .. ° '° ° . DESCRIPTION `OF WORK . x ° . ° ~ : Ea. add'l 500 sq. ft. or portion 42.00 ° Limited energy, residential 60.00 2 M J ZOO Aflip poLP_ SeRv t Ge- (with above sq. ft.) Limited energy, multi - family residential (with above sq. ft.) 66.00 2 PROPERTY OWNER' : ' , ❑,,'TENANT ` Ser or°feeders installation ;'alteration, and /or relocat_iony °° % Name: N e S �� /� r / � J ?A � t� C, - I 200 amps or less 9 2 if Y0 m / �l ` .7 I� G 201 amps to 400 amps 120.00 2 Address: 1 Zoo G Sra` - i' i rL Le ie .S u je. z �V 401 amps to 600 amps 180.00 2 City/State /ZIP: A 601 amps to 1,000 amps 270.00 2 oc, • ' • . .1 q r 1 - •. 7021 4 6 2 Over 1,000 amps or volts 504.00 2 Phone: F ax: T e rn orar °,services4oi`• feeders .installation,alteration, and/or A.: °' \ e.... Phone: 32� 8�0� � 585> 3z 2 p y • relocation „'. ... .. ° . .. -'. , -.° � , ,,. . "�q'>: Owner installation: This installation is being made on residential or farm property owned by me or a member of 200 amps or less 78.00 2 • my immediate family. This property is not intended for sale, exchange or rent. (ORS 479.540(1) and 479.560(1). 201 amps to 400 amps 108.00 2 ■ _ V Owner signature: Date: 401 amps to 599 amps - 150.00 2 ' ° �q, . - . Branch new, alteration, or`estension,'per `.. ', : El, . APPLICANT e `1 ° - a `7" CONTACT .PERSON : z Brah ci - A. Fee for branch circuits w gh Business name: AA. • T' . , ` - above service or feeder fee, 8.50 each branch circuit 2 Contact name: J'" o a 1,426 B. Fee for branch circuits , jjj((( ,,, /// ) / // / rvithout service or feeder 60.00 Address: ", P �t tV0 / OL fee, first branch circuit 2 q �/ ��)) Each add'l branch circuit 8.50 tty/State /ZIP: 5 ufvmiS►cle. / eei 4z" 'Miscellaneous (service or °feeder not_inc ° 7: „ h Phone: (507) 3 / 0 j :.7 Fax: (5 - ) '3 -. - Z© 6 Each manufactured or modular 102.00 2 � dwelling, service, and /or feeder E - mail: _R '•oR40 42 /9 Al 6 Reconnect only 78.00 1 ° ° . 7 ° CONTRACTOR , • _ . Pump or irrigation circle 60.00 2 , Business /• ' = Z ,, A Sign or outline lighting 60.00 2 Signal circuit(s) or limited - Address: P, 0, Bo?( /oz 3 energy panel, alteration, or / extension. Describe: 60.00 City/State /ZIP: S uns NV s; ()P- wig" 9Q y 4z 41- 2 / Fax: Each addit insp ect ion over allowable,in.anysofthe` above : 1 j> 83 420 � 5 - .�zo� Phone: 1 Per inspection 90.00 i E - mail: CCB lic. no.: 3 f I , t Investigation fee (See compliance) Electrical lic. no.: . eol City or metro lie.: Other: Supervising electrician /o/ le 7 'ELECTRICAL PERMIT FEES =a ' signature, required: �9"47/ %� .5---Y40 6 Subtotal g0 , c5� . Print name: l7 VA R Ai 4 e. 6 ..F.' I Date: 8,- 15— •7 Plan review ( 25% of permit fee) Authorized State surcharge (8% of permit fee) . 49■ signature: p 44i i TOTAL PERMIT FEE 6.7g � � / T �Q is permit application expires if a permit is no obtained (/ Print name: Sve ='Y1 CK () I/ - 14 f- Date: e-_ J 7 within 180 days after it has been accepted as complete IC * Number of inspections allowed per permit. Revision 06/26/06 CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2007 -00592 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/23/2007 Phone: (503) 639 -4171 emu' n� I nspection Requests (24 Hrs.): (503) 639 -4175 . �_ . INSPECTION WORKSHEET FOR DATE: 8/24/2007 TIME: 7:00AM PAGE: 76 SITE ADDRESS: SW NO ADDRESS CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: COMMUTER RAIL DESCRIPTION: 200 amp power pole located at SW Tiedeman Ave, SW of SW North Dakota St. OWNER: GENESEE & WYOMING RAILROAD SVC INC, PHONE #: 5585. 328 -8601 CONTRACTOR: MIDVALE ELECTRIC PHONE #: 509- 839 -4204 Inspection Request Scheduled For: Date: 8/24/2007 Pour Time: Code # Inspection Description # Contact # Message 199 Electrical final 064564 -01 509 -391 -0136 N Corrections /Comments /Instructions: . \ . '‘ 'v t I , ,PAS S ) n PARTIAL APPROVAL n CANCEL n NO ACCESS FAIL ❑ CALL FOR INSPECTION H ADDITIONAL FEES ASSESSED - Inspector: & ■ W Date: .( 24 2-9i O Phone #: (503) 718- 2.14