Permit r+ A.. CITY OF TIGARD ELECTRICAL PERMIT
" PERMIT #: ELC2007 -00153
COMMUNITY DEVELOPMENT DATE ISSUED: 3/13/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 113 B0 -00600
SITE ADDRESS: 16580 SW 85TH AVE ZONING: I -P
SUBDIVISION: SEWER TREATMENT PLANT LOT : JURISDICTION: TIG
PROJECT: CLEAN WATER SERVICES
Project Description: #6312 - Room 5020, cooling unit. Install feeder for new air handling unit.
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:
CLEAN WATER SERVICES VANGUARD ELECTRIC INC
2550 SW HILLSBORO HWY 3800 MORRIS
HILLSBORO, OR 97123 -9379 NEWBERG, OR 97132
Phone: 503 - 681 - 3600 Contact #: PRI 503 - 537 -5006
FAX 503 - 537 -5019
FEES
Description Date Amount Reg #: ELE 36 -104C
[ELPRMT] ELC Permit 3/13/2007 $80.30 LIC 164865
[TAX] 8% State Surcharge 3/13/2007 $6.42 SUP 4880S
Total $86.72 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Munidpal 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 f e than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center.
Those r s are set forth in OAR 952 - 001 -0010 through OAR 952 -001 -0100. You may obtain copies • these rules or direct questions to OUNC at
503.24 .6699 or 1.800. . 3 . ' // •
Issue By: Permittee Signatur 4,(/ .� � rr�—L__
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:
- •• NTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: :i j �� r ` DATE:
LICENSE NO:
i
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.
Chris Strange (503)537 -5019 p.2
4
Electrical Permit Application FOR OFFICE USE ONIA
City of Tigard Received
1 . `J g Da Permit No.: e
13125 SW Hall Blvd., Tigard, OR 97223 y' °3 C �/b 7 r QD is-3 M Plan Review
Phone: 503.639A171 Fax: 503.598.1960 Date/By: Other Permit:
Ti G A R U Inspection Line: 503.639.4175 C ^ D ' !^ Date Ready/By: i H See Page 2 for
Internet: www.tigard or.gov M L ^ — O`C/ V Notified/Method: ) I r , Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction /Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w/items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition El Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ['Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family El Master builder ❑ Other: El Fire pump. ❑ Installation of 75 KVA or
❑ Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A ", "E' . "1 -2', 1 -F',
Job no.: Job site address: SSG s w S15 �1 i' 10013P or more. occupancy.
/ .
❑ Six or more residential units. 0 Recreational vehicle parks.
City /State/ZIP: 7=g Q.rd , 01 9773 0 Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg./apt. no.: Project name: p 1,0 tt r p ❑ Service or feeder 600 amps or more.
Cross street/directions to job site: / FEE SCHEDULE
j 9 91,E to Durham Rd .IjJ j Description � Qty. ( Fee. I Total •
- �
L
I- New residential single- or multi- family dwelling unit.
0 s(.() D p 5 1-1 Includes attached garage.
Subdivision: Lot no.: 1,000 sq. R or Ices 145.15 4
Ea. add'l 500 sq. ft or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
75.00 2
DESCRIPTION OF WORK (with above sq. it.)
e - I L imited energy, multi - family
1 n s fa i l --)- e - cl e +-- le ne-t ii a 1 i- A z. img residential (with above sq. ft.) 75.00 2
J Services or feeders installation, alteration, and/or relocation
tin / L 200 amps or less 1 80.30 i ;.. 2
❑ PROPERTY OWNER [ ❑ TENANT 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City /State/7.1P: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 I
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. 401 amps to 599 amps 133.75 2
Owner signature: Date: Branch circuits --new, alteration, or extension, . er panel
A. Fee for branch circuits with
❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee,
each branch circuit 6.65 2
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, qb 85 2
first branch circuit
Address: Each add'l branch circuit 6 2
Miscellaneous (service or feeder not included) _
City/ State/ZIP: Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E - mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
/ Signal circuit(s) or limited-
Business name: van 9 tiara r^- C `eGir Ci l/] C . energy panel, alteration, or
Address: 3 eVD() Nl o rris 5-1--- extension. Describe: Page 2 2
City / State/ZIP: N ewberg, OK 97732- Each additional inspection over allowable in any of the above
5-3 �t Per inspection 62.50
Phone: ($6 3) 537 5006 Fax: (503 ) 7 �j t) 1 Investigation per hour (1 hr min) 62.50
CCB Lic.: l (6 - I 0 4 5 Electrical Lie.: 36, - /0 yC Suprv. Lic.: l/' >O -S Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: �, Subtotal: :S E\' :5' 0
l- , .- S - a J-1. Date: Plan review (25% of permit fee):'- -
Print name: Ch r Chris t . S + ? ,9 e 3 - 7 - 7 7 ro.r State surcharge (8% of permit fee): �. g ( p ) -• H -
,
Authorized signature: C A'1;w_, 9 TOTAL PERMIT FEE: 3(- ,,,13"--.
Print name: ch r l , f t ' ? 9 Date: 3 -7 -c 7 This permit application expires if a permit Is not obtained within 180
days alter it has been accepted as complete.
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007.00153
13125 SW Gall Blvd., Tigard, OR 97223 DATE ISSUED: 3/1 :V200
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 9/12/2007 TIME: 7.O1AM PAGE: 9
SITE ADDRESS: 16680 SW 86TH AVE CLASS OF WORK:
SUBDIVISION: SEWER TREATMENT PLANT LOT #: TYPE OF USE:
PROJECT NAME: CLEAN WATER SERVICES
DESCRIPTION: #6312 - Room 5020, cooling unit. Install feeder for new air handling unit.
OWNER: CLEAN WATER SERVICES, PHONE #: 603-681-3600
CONTRACTOR: VANGUARD ELECTRIC INC PHONE #: 6 03-637 -50
Inspection Request Scheduled For: Date: 9/12/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 055586.01 503 - 793-2673 V
Corrections /Comments/ Instructions:
L-
C. . : G i
X pASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: -- L /IVE Date: i Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION ' • PERMIT #: ELC2007- 00153
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/13/2007
Phone: (503) 639 -4171 ''4 I ' ii f �
Inspection Requests (24 Hrs.): (503) 639 -4175 .'f J..
INSPECTION WORKSHEET FOR DATE: 6/13/2007 TIME: 7:01AM PAGE: 27
SITE ADDRESS: 16580 SW 86TH AVE CLASS OF WORK:
SUBDIVISION: SEWER TREATMENT PLANT LOT #: TYPE OF USE:
PROJECT NAME: CLEAN WATER SERVICES
DESCRIPTION: #6312 - Room 5020, cooling unit. Install feeder for new air handling unit.
OWNER: CLEAN WATER SERVICES, PHONE #: 503 -681 -3600
CONTRACTOR: VANGUARD ELECTRIC INC PHONE #: 503. 537 -5006
Inspection Request Scheduled For: l ate: 6/13/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
106 Underground/slab cover 050151 -01 503-793-2673 N
.- /K -
Corrections/Comments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: �' tPtib L Date: (4(3(0 1 _ Phone #: (503) 718- Z