Permit (113) CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2018-00697
Date Issued: 10/22/2018
T(GAR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: SEG1994
Jurisdiction: Tigard
Site address:
Project: ODOT Subdivision: Lot:
Project Description: SEG1994:Replacing(1)panel and(3)branch circuits for damaged traffic signal in NW corner of Pacific Hwy and
Beef Bend Rd.
Contractor: E C COMPANY Owner:
PO BOX 10286
PORTLAND, OR 97296
PHONE: 503-224-3511 PHONE:
FAX: 503-295-3012
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 10/22/2018 $100.70
Specifics: amps or less
3 crt Branch Circuits w/Purchase 10/22/2018 $22.26
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 10/22/2018 $14.76
Electrical
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 through 952-001-0090. You ma ••ain a c•• - - - or direct questions to OUNC by calling 503.232.1987 ; e!14 4.
Issued By: _ - Permittee Signature: f�'
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 OFHCE SE ONL1
City of Tigard ! Received f
Iii
• 13125 SW Hall Blvd.,Tigard,OR 97223 2 2 7-\./
O I DateB : 6 j �� r, ,�� +
ii Phone: 503.718.2439 Fax: 503.598.1960 \�C.;� 1 3:,_ ;SIIIIIIIMI Related Permit#:
Inspection Line: 503.639.4175 r( ,..' ' a to/By: H See Page 2 for
T I G A R I> r i +�,I :fit ethod: Supplemental Information
Internet: www.tigard-or.gov Li� �� � �i
TYPE OF WORK U�I. � 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.
❑ 1-and 2-family dwelling ®Commercial/industrial 0 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 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#:66155-17 Job site address:SW 99 Pacific Hwy&Beef Bend iCi,r 10011P or more. ❑°°A","E","1-2","1-3",
Ci /State/ZIP:Tigard,OR 97223 1
0 Six or more residential units. occupancy.
g 0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Traffic Signal 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:NW Corner of SW 99 Pacific Hwy and Beef FEE SCHEDULE
Bend Road Description Qty. I Each I Total
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#:
Ea.add'l 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
75.00 2
Replacing damaged traffic signal service for ODOT (with above sq.ft.)
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
0 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 ® CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name:EC Company above service or feeder fee, 3 7 42 22.26 2
each branch circuit
Contact name:Lou King B.Fee for branch circuits without
service or Address:PO Box 10286 branch circuit der fee,first
56.18 2
City/State/ZIP:Portland,OR 97296 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(503)849-8633 Fax: :(503)242-0953 Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email:kathy.kelley@ecpowerslife.comReconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:EC Company Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy See Page 2 2
Address:PO Box 10286 panel,alteration,or extension. ,
CitylState/ZIP:Portland,OR 97296 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(503)224-3511 Fax:(503-)242-0953 Investigation(1 hr min) 90.00/hr
Email:kathy.kelley@ecpowerslife.com Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lie.: 49737 Electrical Lic.: 6-45C Suprv.Lie.: 5978S specifically listed('Y hr min)
CI
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal: 122.96
Print name: Jeff Roberti Date: 10/17/18 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): 14.76
Authorized signature: TOTAL PERMIT FEE: 137.72
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.
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(1 I(05/COM/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
DescriptioFee for all residential systems combined: $75.00 Renewable Qty.m : Each 1 Total I
}' electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
n Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
n B• urglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
n Garage Door Opener* >100 kva(fee in accordance
with OAR 918-309-0040) 552.26 2
❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System* Each additional kva over 25 7.42 3
n Vacuum Systems* >100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
Fl O• ther: Each additional inspection is 66.25/hr 1
charged at an hourly(1 hr mm)
Inspections for which no fee is 90.00/hr
specifically listed(%hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):
3 ' Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
n C• lock Systems
❑ Data Telecommunication Installation
n F• ire Alarm Installation
❑ HVAC
n Instrumentation
n Intercom and Paging Systems
n Landscape Irrigation Control*
n M• edical
❑ Nurse Calls
n Outdoor Landscape Lighting*
n Protective Signaling
n Other:
Total number of commercial systems: 1
*No licenses are required. Licenses are required for all
other installations
L\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
Record Type: Record ID:
Commercial - Electrical ELC2018-00697
Inspection Type: Inspector:
115 Electrical service Jeff Grove
Result:
PASS
Comments:
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
November 19, 2018 at
10:24:05 AM
Record Type: Record ID:
Commercial - Electrical ELC2018-00697
Inspection Type: Inspector:
199 Electrical final Chip Barnett
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor