Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2012 -00431
13125 SW Hall Blvd., Tigar OR 97223 503.718.2439 Date Issued: 07/23/2012
T IGARD Parcel: 2S112DD01300
Jurisdiction: Tigard
Site address: 15650 SW UPPER BOONES FERRY RD
Project: 1 -5 Ramp Meter near Burgerville Subdivision: 1994 -006 PARTITION PLAT Lot: 2
• Project Description: (2) 200 amp service and feeder for ODOT ramp meter.
Contractor: PRAIRIE ELECTRIC INC Owner: CHARTER PROPERTIES III LLC
6000 NE 88TH ST RYAN, JOANNE C & BOB L SMIT
VANCOUVER, WA 98665 280 LIBERTY ST SE #300
SALEM, OR 97301
PHONE: 800 - 573 -2750 PHONE:
FAX: 360- 573 -9866
FEES
Quantity Description Date Amount
2 ea Services or Feeders - 200 07/23/2012 $201.40
Specifics: amps or less
1 ea 12% State Surcharge - 07/23/2012 $24.17
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
•
• Total $225.57
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 OA 952- 001 -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: - Permittee Signature: 04 . ?/Z /
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 603.639.4175 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.
07/19/2012 11:36 FAX 360 57 CT EDrairie Electric Inc. 0001/002
Electrical Permit Applicatio JL 1 9 2012 FOR OFFICE USE ONL.I
City g CIT YOFTIGARD Received Permit No.'
Ci of Tigard DazdB : e?3 /02, i�Ir �.„ a /2 - //'
q 13125 SW Hall Blvd., Tigard, TQf Plan Review
a �tjjgg I Other Permit:
Phone: 503.718.2439 Fax: 0 Dale/B
Inspection Line: 503.639.4175 Date Ready /By: El See Page 2 for
T l G A 1r D Internet: www.tigardor.gov Notified/Method: IM Supplemental Information
.,, -, . - - - , - -.as y ' L- •i Vii' ` - - - 7 »~`M 9s -_a iErrI. .4. 55'
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uli y .4iFir4 .1?- t: 0iS �� -r. ., .:hips q . :2 - - i ,j-ati i:g:ii- fir i iS 4 ,,y..?•1,
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Please check all That apply (submit 2 sets of plans w /items checked below):
❑ New construction ® Addition/alteration /replacement ❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
- xr ^s} „-..t -, , ` -,- ,' •. -• tz : � 5 let l el i exceeds 10,000 amps at 150 volts or '❑ Floating buildings.
h o f f r. 4r - •_ . : -t:.•..... - F t?'01 B ) gf 4 > � 5 1 L agricultural
,; -: _ _.�'�;._ _�,� s ,•,� � ; - �.' - . -'- • ._ �' '- ~ r- ^ ° �`t l ess to ground, or exceeds 14,000 0 a icultural
❑ I - and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ® Other: ['Fire pinup. ❑ Installation of 75 KVA or
❑ Emergency system. larger separately derived system.
'awl
- ' :a 0• :, --- c t 7 -r.ifr- :• =waT .l �....
tom..: : . ,. _ 4 ; )R6 =' 1 , 02! == ='4 5 ❑ Addition of new motor load of ❑ "A" " 1-2" "1-3"
a 100HP or more. occupancy.
Job no.: Job site address: 15650 SW UPPER BOONES FERRY RD ❑ Six or more residential units. 0 Recreational vehicle parks.
OR 97035 ❑ Health -care facilities. ❑ Supply voltage for more than
City /Slate/ZIP: TIGARD, ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.; Project name: BURGERVILLEIRAMP METER - ❑ Service or feeder 600 amps or more.
,
Cross street/directions to job site: Description Qte. Fee. Total •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'I 500 sq. ft. or portion 33.92 I
Tax map /parcel no.: Limited energy, residential 7500 2
w_- acs. r -KP . v,a h^ r:to -- ,.kr _
..aa _mr un �7� •- 4•r y ' I � r- �Im^r.,���s � - ,.s'�� �''Fa.
,dT`t.'i' ,p l h air - L•e.fnc� r -- ' - a e,- - _il"" ?,!�ni. - '-' = • I , u '''"..,._. '�-, '-'-; „ -::r " (with above sq. ft.)
t- '�==- ������� - ` ^- � ••' Limited energy, multi- family 75.00
SERVICE AND FEEDER FOR O.D.O.T. RAMP METER residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less e2 100.70 Z1n1 ICU 2
v ,,. ... ;1 133.56 r 2
"y5 �?�� ;��, =� ����.. ,� '�r� "•tsu -- „�:_ ;iM ; a t77ln i 201 amps to 4008mps
.rye ,_� _. � .4 - .: [- . G 3.7+ " • i p: •lr =aa is c r:lt Citi la. .,, � . ^`r' " �.
-•iC- ,,:fib• ... :'� "kC.:'F4F- r 'Jia.G1• = c: -:-- !n..
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: ( ) I Fax: ( ) 200 amps or less 59.36 I
-
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not
401 amps to 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits - new, alteration, or extension, er panel
Owner signature: Date: A. Fee for branch circuits with
�_, ; _ ;; x;; .•.._ - ; :, _::, - -:�: s- .= ;. above service or feeder fee, 7.42 2
..
� .. ,. ::, -: - -• �.
Iy I S �. rr yyF . eigM1 i� 41 Eite ` ' ' . ":.; :IT !. ,. :.;.+ 1 f! Efn _ g tc- each branch circuit
Business name: PRAIRIE ELECTRIC, INC. B. Fee for branch circuits without
service or feeder fee, first 56.18 2
Contact name: ANITA PASO branch circuit
Each add'I branch circuit 7.42 2
Address: 6000 NE 88 STREET Miscellaneous (service or feeder not included)
Each manufactured or modular 67.84 2
City/State/ZIP: VANCOUVER, WA 98665 dwelling, service and/or feeder
Phone: ( ) 503.286.9209 I Fax: : (360) 573.9866 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E - mail: anitap@prairielectrie.com Sign or outline lighting 67.8 2
" . 1W d r • i c � or =z:K, °
�. . a �: d • a + ��$� _� v^ Signal circuit(s) or limited energy
Business name: PRAIRIE ELECTRIC, INC. panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the abov
Address: 6000 NE 88 STREET _ Additional inspection (I hr min) 66.25/ hr
Investigation (I hr min) 66.25/ hr
City/State /ZIP: VANCOUVER, WA 98665 industrial plant (1 hr min) 7 8.18/ hr
P 1 +ne: ( ) 503.286.9209 I Fax: (360) 573.' 866 Inspections for which no fee is 90.00 / hr
i /5. Ificall listed (% hr min •
/ j1:4- R - PY.'t a u 1,:..' it iHF l
CCB Lic.: 60178 f/ Electrical Lic 3 491C Su. •, & . - -
I I - Subtotal: 1. t
Suprv. Electrician signature, required A. i Mr Plan review (25% of permit fee): v
IV
Print name: BILL HALBERG Date: 7.18.201 State surcharge (12% of permit fee): 7./ I (T
- TOTAL PERMIT FEE: .‘"111./
Authorized signature: This permit application expires If a permit is not obtain ed ithi 180
days after it has been accepted as complete. g
Print nam Date: a Num ' s alto 1. de • I:\BuildinglP 7/01/ Mi i 440 /CO 0 ,