Permit r
CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2009 -00081
COMMUNITY DEVELOPMENT DATE ISSUED: 2/26/2009
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 11380 - 00600
SITE ADDRESS: 16580 SW 85TH AVE ZONING: I -P
SUBDIVISION: SEWER TREATMENT PLANT LOT : JURISDICTION: TIG
PROJECT: CLEAN WATER SERVICES
Project Description: Install (1) branch circuit.
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: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 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:
CLEAN WATER SERVICES CHRISTENSON ELECTRIC, INC.
2550 SW HILLSBORO HWY 111 SW COLUMBIA STREET # 480
HILLSBORO, OR 97123 -9379 PORTLAND, OR 97201
Phone: 503 - 681 - 3600 Contact #: PRI 503 - 419 - 3300
FAX 503 - 419 -3728
FEES
Description Date Amount Reg #: ELE 26 -34C
[ELPRMT] ELC Permit 2/26/2009 $46.85 LIC 458
[TAX] 12% State Surchar 2/26/2009 $5.62 SUP 1994S
Total $52.47 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All
work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for
more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344. Issued By: C 1 Permittee Signature: , Ma k y \ Q._ J\ 9„0
- A\ ') 0 \ ( N ric\ (01 )
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
- • FE9 -26 -2009 THU 11:35 AM CH ,- : mmit ii INC FAX NO. 95034193695 P. 01/02
Electrical Permit App � -""- �
. -- -- —. Application �� ' r(lit OFFICE I lse l)m.v
City of Tigard
FEB 2 6 2009 Received ;
Permit No.: + s .. • 4,0046,2 DareJQ : • Ojos `' 1 3125 SW Hall Blvd., Turd, OR 97223 plan Review Other Permit:
1 114
t 4 Phone: 503,639,4171 Fax 503.59$.19t5�`i OF TIGARD , Date/BY:
Date Rea Jun: El See Page 2 for
[' I G a Inspection Line: 503.639.4175 ' DING D IVISIDij 1 NonKcd ( Supplemental information
11! 11f I S u p emental 1 forma
Interact: wwwtigard- or -gov 11! tJi n F`
... .. y, . r:h�•, ,.r ] r ru. I .A f ru ',!.�I M eL °r '. , . , i - 11 "�'f flL y�,,I r ',n 1 �rli y ' h 1 101-01•10,,:11 'j f k !1 .I� ..0; ,f4„p
..:, 4,., w it ,, r Cr'' I , r �. i, I T I F� li'r I '.. 1 <'� X1 ] n7 ii 11! '%t�r t lir1 F77 # is a rq::l7{I'r4rt�l ':idl"1. fi, i ,., f-'415 n '� :�4`,F lr I milt
,
5 w 1 : 4 :4 A 4 f , %,1'" v' *l . .`, :aBlli9,�ff '.f "i�q� / }7FQI �,,,. dii�r,.., „ t 1
1 Please check all that apply (submit 2 sets of platys w /items checked below):
lew construction Addition/alteration/repl acement [] Service or feeder 400 amps or more ❑ Building over three stories.
Demolition Other: � g wham the available fault current ❑ Marinas and boatyards
c � yNS P l 6 t11 t r iii 7 ;✓ i1 t l t ,. „ fit 46, h , exceeds 10,000 mops at ISO volts or El Floating buildings.
�r / s i , h + , 1 1 1 ( , t ! 1 f`jl I C I ' F U : ..it'', , I a ri less to ground, or exce 14,000 El Commercial -use ag
0 1 and 2- family dwelling i Commercial/industrial Q Accessory building amps for all other installations. ❑ buil of 75 KVA or
1 .. .�1�[ { } 4 E c pump,
Multi family • Master builder 0 Other: ❑ ❑Eme pum p , system- ln l stio of 75 KVA o system. .
t
p r ' r 4 14v . r!l Ni ay r�rt► I i { ''T'f �[ IR�"s Y t� p� `, u^- r P/;` T,i�f ❑ Addition of new motor load of ❑ "A "E ", "1 -2 , •1.3 .. ,
!1j 1 4 � � ./ p i.�*r l h,i�l7i �� !t !"'*ll�". r'�'��I . ,., � N r
f.-� IAM , Icy .A ];, r!5 1Rh',r! occupancy.
V
5O, . Sv3 �54F1 1ix or more.
Job no.: Job site address: r (7 Six or more residential units. ❑ o Recreational vehicle parks-
(� ❑ Health -care facilities- ❑ Supply voltage for More than
City/State/ZIP: /�l c. 09.,_ `' + ❑ Hazardous locations 600 volts nominal.
Q Seance or feeder 600 amps or mom.
Suite/bldg./apt. no.: Project name: C • ! I % ! y r / .', Jt ``r l (;
YY 1 � .�. E ,� r�, A� 1 SCIIf 13lU 1i'; r ,s /' rt i r , , f r c,;ir:
peacrtptton Qt y ree. j__.1_,,_ T aut
Cross street/directions to job site;
New residential single- armulti- family dwelling unit,
'66,7 n �� ` L''h , . t t ]ncludes attached garage.
, ~"t X11 1,000 sq. ft. or less 145.15 4
Subdivision: Lot no
� —
Ea. add 500 sq. fl, or portion _ 33.40
Tax map/ parcel no . Limited energy, residential 75,00 2
F'p � J ""‘,1:;,!; °1 1: - r IS M te?,,o, ,,:4?.!, + ' ., (with above 3q. R.)
Uf r I >, ., a . y/ 4!,•4,4
q ?, n , l?I��l Rli Q a .,r l i , r ! i I
:. ' .r _ . Limited energy, multi - family 75.00 2
residentialiwith above sq. ft.)
Services or feeders installation alteration. and/or relocation _
�r y� 1.;#14,' 200 amps or less 80.30 2
{ N ikkOpE 'I O E1St { r11 ; ;; ,t�, ,7 ,,'rfi�,o= ,ylril l ,NT ! i. : 1,r,o,, ;ar,�d;; 201 a mps to 400 amps 106.8$ 2
I N ' 401 amps to 600 amps 160.60 2
Name: 601 am s to 1 000 amps 240.60 ^ 2
Address: Over 1,000 amps or volts 454.65 2
Temporary services or feeders Installation, alteration, and/or
-./State/211): relocation
) I Fax: ( )
r
200 amps or less II 66.85 1
201 amps ',one: ( 100.30 2
w 400 amps
Owner installation: This installation is being made on property that I own which Is not 401 amps to 599 amps 133.75 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits new alteration, or extension, peryanel
Owner signature Date A. Fee for branch circuits with •
r,f �I 1 ,, ' q p 7 ink itr -E,, , i ,: Ii �y I iij above service or feeder fee, 6.65 2
,•lux I! of 41 f i; I r.I ! 1!,. # f 1 ';'4 ! r!. 0'Y r. fi,r r..t,n ll, -; 7 r l' IIi�Y ,, A!IWT`r+MP.2, V each branch circuit _2
Business name; B. Fee for branch circuits
— without service or feeder fee. I 46.85 ” M 0 6 2
Contact name:_ first branch circuit
Each add'l branch circuit 6.6$ 2
Address: ,—,�_ Miscellaneous (service or feeder not Included)
City /State /ZIP: —� Each manufactured or modular 90.90 2
dwe service and /or feeder 66.85 2
Phone. ( )---------Ti; c : ( ) Reconnect only 53.40 2
Pump or irri circle
E-mail: 2
i i ttinac1'Q - 53.40
' ', I or outline h hula
r,.. f r i nl A A r' I ' � S�� g g
,, t , . liy.., t I : i ,. urE w 4 r r ti , !�ir n Ji' r o,
., "rr ,i` ; {I `: 1 _ -- ,. , Signal circuit(s) or limited-
Business name; Christenson Electric, Inc. energy panel, alteration, or
extension. Describe: Page 2 2
Address: 11I SW Columbia, Suite 480 L
City /State/ZIP: Portland, OR 71201 Each additional inspection over allowable In any of the above
Per inspection 62.50
Phone: (503) 419 - 3300 3 L - Fax; (503) 50s- i I nvestigation per hour p be min) 62.50
Industrial plant per hour 73.75
CCB Lie.: 458 Electrical Lic.: 26 - 34C Suprv. Lie.; 1994S 1,;iil`{r r (. .. E CTE A1r:.IPER 'l1lT FEES'/ , � i il C � ' � J i
Suprv.
-� Subtotal: Hu t 0 i J
rv. Electrician signature, required; 4 -
. -r�l 4 70 it
. . I1 Plan review (25% of permit fee)_
�7
Print name: Robert Axt Datc f✓t i S ta te surcharge (12%a of permit fee): �Q L.—
TOTAL P1 RMIT FEE i T+
lorized signature:
This permit application expires If a permit Is not obtained within lso
Print name: l Date: days after it has been accepted as complete.
• Number of lnsperto allowed per permit.
4t0- 4615TiI I /05/COM/NEa CTS �( L \
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:"'tiii:ili' %_ 10 1 OF 1 p ® •
ELECTRICAL PERMIT
s.
p PERMIT #: ELC2009 -00081
° COMMUNITY DEVELOPMENT
DATE ISSUED: 2/26/2009 .
T i, n-K p 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 113B0 -00600
SITE ADDRESS: 16580 SW 85TH AVE ZONING: I -P
SUBDIVISION: SEWER TREATMENT PLANT LOT : JURISDICTION: TIG
PROJECT: CLEAN WATER SERVICES
Project Description: Install (1) branch circuit. •
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: SIGNAUPANEL:
MANF HMI SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10): .
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 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:
CLEAN WATER SERVICES CHRISTENSON ELECTRIC, INC.
2550 SW HILLSBORO HWY 111 SW COLUMBIA STREET # 480
HILLSBORO, OR 97123 -9379 PORTLAND, OR 97201
Phone: 503 - 681 -3600 Contact #: PRI 503- 419 -3300
FAX 503 - 419 -3728
FEES
Description Date Amount Reg #: ELE 26 -34C
[ELPRMT] ELC Permit 2/26/2009 $46.85 LIP 458
[TAX] 12% State Surchar 2/26/2009 $5.62 SUP 1994S
. Total $52,47 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 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: Q `� Vk .t y \ k a1 i ;1 .\ C y , Permiftee Signature: ) - 1 (� ++
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.
INSPECTOR'S SIGNATURES ARE NOT
Inspections Required for: cW200q ,0008 REQUIRED ON GREEN INSPECTION CARD.
✓ . • .. Code Inspection Description :' I,. PASS Date- I B ✓ ' Code • , - Inspection Descnptior- -' PASS'Date : I B y
BUP - Building Permit ELC - Electrical Permit
405 Excavation 105 Underground /slab cover
410 Fill 110 Temporary electrical service
415 Grading 115 Electrical service
205 Footing 120 Electrical rough -in
805 MFG - Structure grading /footing 125 Wall cover
210 Foundation walls 130 Ceiling cover
215 Footing drain - 135 Low voltage
220 Slab 140 Sign installation
310 Crawl drain 145 A/C or heating unit circuit
- 225 Post /beam structural 150 Hot tub /spa /pool
230 Underfloor insulation 195 Misc. inspection:
235 Shear walls /anchors 199 Electrical final
240 Exterior sheathing
245 Firewall
250 Roof nailing ELR - Restricted Energy Permit
255 Wtr proofing basement walls 135 Low voltage
260 Tilt -up panel 195 Misc. inspection:
265 Masonry 199 Electrical final
270 Reinforcing steel (rebar)
275 Framing
810 MFG - Structure set -up MEC - Mechanical Permit •
280 Insulation 605 Post /beam mechanical
285 .Drywall nailing 610 Gas line
287 Suspended ceiling • 615 Mechanical rough -in
295 Misc. inspection: 620 Hydronic piping
899 MFG - Structure final 625 Duct work
498 Grading inal'
g 630 Fire damper
299 Final inspection 635 Smoke detector shutdown
640 Exhaust hood
• 695 Misc. inspection:
699 Mechanical final
BUP - Fire Protection System Permit
905 Sprinkler underfloor /slab PLM - Plumbing Permit
910 Sprinkler rough -in
915 Fire alarm rough -in 305 Plumbing underslab
920 Suppression trip test 310 Crawl drain
995 Misc. inspection: 315 Post /beam plumbing
998 Alarm final 320 Plumbing rough -in
•
999 Sprinkler final 322 Shower pan
330. Water service
335 Rain drain
340 Storm drain
SIT - Site Work Permit 505 Sanitary sewer
405 Excavation 345 Culvert /catch basin
410 Fill 350 Septic tank
. ; 415 - Grading 395 Misc. inspection:
205 Footing 399 Plumbing final
210 Foundation walls
215 Footing drain -
420 Sprinkler supply lines SWR - Sewer Permit ,
495 Misc. inspection: 505 Sanitary sewer
498 Grading final 595 Misc. inspection:
499 Final inspection 599 Final inspection •
\Building \Forms \InspCard- AOP- Blank.doc 02/02/07 •