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Permit
ti * f CITY OF TIGARD ELECTRICAL PERMIT I 41 * COMMUNITY DEVELOPMENT Permit #: ELC2009 -00356 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/21/2009 Parcel: 2S113B000600 Jurisdiction: Site address: 16580 SW 85TH AVE Subdivision: SEWER TREATMENT PLANT Lot: 0 Project: CLEAN WATER SERVICES Project Description: Add (1) one feeder 200 amps or less to permit ELC2008 -00679 Owner: FEES CLEAN WATER SERVICES Quantity Description Date Amount 2550 SW HILLSBORO HWY HILLSBORO, OR 97123 1 ea Services or Feeders - 200 07/21/2009 $80.30 amps or less PHONE: 503 - 681 - 3600 1 ea 12% State Surcharge - 07/21/2009 $9.64 Electrical Contractor: OREGON ELECTRIC CONSTRUCTION INC 1010 SE 11TH AVE PORTLAND, OR 97124 PHONE: 503 - 234 -9900 FAX: 503 - 535 -2763 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Total $89.94 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 thro gh OAR 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. Issued By: alt. f Vi � RA ..._ Signature: ,Q. APi° 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. » J `:t1 / - 13:31 FROM- OREGON ELECTRIC -MAIN RECEIVE:, 5032349900 T -963 P.001 /002 F -363 Juice Lrlca .rer mm.L ii iicauon FOR OP 1 IISE O;NL.y City of Tigard JUL 17 21 rived 1 PermitNo.: d 00 - II • 13125 SW Hall Blvd, Tigard, OR 97223 — A Phone: 503.639.4171 Fax: 503.598.1960 CITY OF TIG ERS1111111.11111 ot Permit: TIGARD Inspection Line: 503.639.4175 BUILDING DIV `l#ly ' �y' J""'° ® Sec Page 2 for Internet: www,tigard-or•gov ethod Supplemental Information • TYPE OF WORK PLAN 'REVIEW Q New construction ® Addition /alteration /replacement Piuue check all thu spp1y (submit sets ofplaas wlitems checked below); Cl Demolition 0 Other ❑ Service or feeder 400 amps or mom 171 Building over three stories, where the available fault current ❑ Marinas and boatyards, . CATEGORY OF . CONSTRU ' exceeds 10,000 amps at 150 volts or ❑ Floating buildings, 1- 2 -Famil dwelling less to ground or exceeds 14,000 ❑ Commercial -usc agricultural ❑ y g ® Commercial/industrial © Accessory building amps for all other installations, buildings, ❑ Multi - family ❑ Master builder ❑ Other: U Fire pump. 0 Installation of 75 KVA or • JOB SITE INFORMATION ANA. LOCATION ❑ Emergency system. larger separately derived system, © Addition of new motor load of Job no.: 25150 Job site address: 16060 AO ; 4- U ■ 10oI>P or more occupancy. El Six or more residential units, 0 Recreational vehicle park:. City /State/ZIP: TIGARD OR 97224 ❑ Health -care facilities. ❑ Suppl voltage for more than ❑ Flaiardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: STRUVITE RECOVERY ❑ Service or feeder 600 amps or more. Cross street/directions to job site; SCHEDULE Darriptien Qt Fee Total • New residential single- or multi- family dwelling unit- Includes attached garage. Subdivision: Lot no.: 1,000 sq. It or less 145.15 4 Tax map/parcel no.: Ea. add'! 500 sq. ft or portion 33.40 — 1 Limited energy, residential 75.00 2 DESCRIPTION OF WORK • (with above sq. it.) _ ADD ONE FEEDER TO PERMIT # ELC200S - 00679 Limited energy, multi - family 75 2 residential (with above sq, ft.L Services or feeders installatinnn and/or relocation 200 amps or less I 1 80.30 80.30 2 0. PROPERTY - OWNER I . 0 TENANT . • 201 amps to 400 amps 106.85 2 • Name: 401 amps to 600 amps _ 160.60 2 _ Address: • 601 amps to 1,000 amps 240.60 2 Over 1,000 amps or volts 454.65 2 City /State/ZIP: Temporary services or feeders installation, alteration, and /or relocation Phone: ( ) Fax: ( ) _200 amps or less 66.85 1 Owner installation; This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 40 1 amps to 599 amps 133.75 2 Owner signature: Date: Branch circuits - new, alteration, or extension, pe r panel A Fee for branch circuits wlrft _ ❑' APPLICANT L © CONTACT PERSON above service or feeder fee, 6.65 2 Business name: each branch circuit B. Fcc for branch circuits Contact name: without stry feeder or fee, 46.85 2 — first branch circuit Address: Each add'! branch circuit 6.65 2 City/State/ZIP: Miscellaneous (service or feeder not included) - Each manufactured or modular 90.90 2 Phone: dwelling, service and/or feeder ( ) Fax:: ( ) Reconnect only 66.85 2 E -mail: Y Pump or irrigation circle 53.40 2 • CONTRACTOR Sign outline lighting 53.40 2 Business name: OREGON ELECTRIC GROUP Signal circuit(s) or limited- energy panel, alteration, or Address: 1010 SE 11 AVE extension Describe: Paget 2 City /State/ZIP: PORTLAND OR 97214 Each additional inspection over allowable In any of the above Phone: (503) 234 -9900 Per inspection 62.50 Fax: (503) 535 -2763 Investigation per hour (1 hr min) 62.50 r CCB Lie.: 203 I Electrical Lie.; 25 - 96 ,Suprv. Lie.: 45495 t• t Istria' plant per hour 73,75 Suprv. Electrician signature, require —* �(�(� s �14,0, LECTRICAL PERMi7 )FEES �''x' �L Subtotal: 80.30 Print name: RICHARD MCELLIOTT Date: 7 - - Plan review (25% of permit fee): State surcharge (12% of permit fee): 9.63 Authorized signature TOTAL PERMIT FEE: - 89:93 -- 9 7 �y Print name: RICHARD MCEI,LIOTT Date: 7 s permit appllcadon e:ps. if n permit Is not obtained within ISO days after it has been accepled as complete. l:\ air [aing�i+c,mi�1ELC.YamMgpy,doc • Q523 /e.6 • Number of inspections allowed per permit. 440 - 46157(1 mi /commas ■