Permit • CITY OF TIGARD ELECTRICAL PERMIT
w a r PERMIT #: ELC2005 -00982
DEVELOPMENT SERVICES DATE ISSUED: 12/29/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S113B0 -00600
SITE ADDRESS: 16580 SW 85TH AVE ZONING: I -P
SUBDIVISION: SEWER TREATMENT PLANT LOT : JURISDICTION: TIG
Project Description: Install power & controls for new Tertiary control valve, install power for new jib crane. (contact Scott Harnar for
location: 503-860-8198).
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: 1
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: 3 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 POWR MAINTENANCE RESOURCES, INC.
2550 SW HILLSBORO HWY 2130 NE GRIFFIN OAKS ST #700
HILLSBORO, OR 97123 -9379 HILLSBORO, OR 97124
Phone: 503 - 681 -3600 Contact #: FAX 503 -681 -4823
PRI 503- 681 -4664
FEES
Description Date Amount Reg #: LIC 142759
[ELPRMT] ELC Permit 12/29/200: $141.80 ELE 5 -33C
[TAX] 8% State Surcharge 12/29/200: $11.34 SUP 2121S
Total $153.14 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: S � Permittee Signature: 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:
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.
'Electrical Permit Application FOR OFFICE USE ONLY
�
Date d % 4 � // 11 xt
V �' ` Permit No.: _ et `-'• - - n
City of Tigard
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 " r/ /'` ll)f1i ° Date /B : Other Permit
Inspection Line: 503.639.4175 _, Date Ready /By: lain ® See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
..a r � ... h, ; =, =;;; "nr, * :.cap £.::: "a >� . .,.. a ' .<, ::a:. �Z •� y . .. <<,; ,.�:•., sJ: ar �,'', 3':e
,' y,,: a.a < f q r< » l •• , . .<:r>, . OMMINA •�. r 1 ,,. ,{+ • :.• :c ,,,,,, , , , , , , ,,, w ,,, , ,,, , ,, — , .3 .,
b•.. r, = �o: -... _s ^ =. ° .: r., ,< iS �. u;s:.s°Y,. :A;,,,;0;:0:,4,:060:0,,,,, � . �� ,hra".?3C7<"Wl: =; ^, I a.. : vsk3<.3,' ....., ; ., .3SR ? ?•�i�,..r`''vr aiz?3�: ♦ „ 3:.. , .3.d =•s
El New construction ® Addition/alteration/replacement Please check all that apply:
❑ Demolition ❑ Other: ❑ Service over225 amps, comm'l ['Hazardous location
..: �:. - ,
t3 =�, ^�;� �•_ a, =- � � � ¢ �, � � ,v�� � � ; an �. € Sery ['Service over 320 amps rating Buildng over 1 ,000 sq.
i
0r; , :5 il A � � 16 ". * ** * 11 1, lel, - ", „F of 1- and 2- family dwellings 4 or more new residential
1:1 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building ❑ System over 600 volts nominal units in one structure
❑ Multi - family ❑Master builder ['Building over three stories [Weeders, 400 amps or more
❑ Other Manufac red structures or
3,t � �;} ,� �� ���, � ❑Occupant load over 99 persons ❑ to
�, "k a u s� ['Egress/lighting P RV
<` . a Yi � «., �l s rr f t � � ;,..., : 1 s s.._ mk»e •i M. �., plan park
P
Job no.: 1589 Job site addre 16060 SW 85 Avenue ❑Health care facility El Other
Submit 2 sets of plans with any of the above.
City/State/ZIP: Tigard, Oregon 97224 7657 O The above are not applicable to temporary construction service.
Suite/bldg. /apt. no I Project name: Durham WWTP : <' 01111111 ... `�0£:•;.3 : _
Description Qty. I Fee. Total l *`
Cross street/directions to job site: Durham Rd. New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: I Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: n residential 75.00 2
energy,
Limited a ergy, re ntiai .
r t x 6 t n ji ,� i et* 4W4 �' %� 0. , § ;'y ,' Each manufactured or modu lar
:' ; �- .�_. K tt�. .,, ,....., �.,� :��:� �• i ach mactla
Install power and controls for new Tertiary control valve dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
Install power for a new Jib Crane 200 amps or less 80.30 2
wsi i s , m sib � » m E 201 amps to 400 amps 106.85 2
Was P �` ` ` `�'' 1 •" �'•' " •' °' "° ° ' 401 amps to 600 amps 160.60 2
Name: 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only . 66.85 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
Phone: ( ) I Fax: ( ) relocation
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. 401 amps to 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
ut :$s,.,,;',nVZ °� r;�,:. . ^...:�. h : »3f'.; , . , =< ...�`r'� 3'x4:�g:%' ::3,'i; :: =F:3. �`v"� : �,:
V ` A. Fee for branch circuits with
` " ""' service or feeder fee, each
Business name: branch circuit 6.65 2
B. Fee for branch circuits
Contact name: without service or feeder fee,
Address: first branch circuit 46.85 4/
� 8 S 2
Each add'l branch circuit 3 6.65 j ct '15 2
City/State/ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) I Fax:: ( )
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited-
��` ...,. �` (; � ` rs iii l panel, alteration, or
� ... . ?_ .: ii- ,� "lIQ', :..a....l x.. ,, ,1:..:::. ,.., ,.:, extension. Describe: i Page 2 75 ° 2
Business name: Power Maintenance Resources, Inc Controls circuit in existing pnl.
Address: 2130 NE Griffin Oaks Street, Suite 700 Each additional inspection over allowable in any of the above
Per inspection 62.50
.. City/State/ZIP: Hillsboro, Oregon 97124 Investigation per hour (1 hr min) 62.50
Phone: (503 ) 681 -4664 Fax: (503 ) 681 -4823 Industrial p per hour 73.75 'g
,� CCB Lie.: 142759 Electrical Lie.: 5-33C Suprv. Lie.: 2121S Subtotal t 4 j . 8- ° °
Suprv. Electrician signature, required: ,.1"./."(,,2,74;02,4„-Z.- Plan review (25% of permit fee) —6.
ley State surcharge (8% of permit fee) /1 , 3
Print name: F3E2 - D /) l'� y / Date:/,2/:,?9/45— tit
TOTAL PERMIT FEE 153 .
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: Date: * Fee methodology set by Tri-County Building Industry Service Board
** Number of inspections per permit allowed.
1 i:\ Building \Permits\EL.C- PermitApp.doc 12/03 440- 4615T(10 /02 /COM/WEB
CITY OF TIGARD e A
BUILDING DIVISIdN PERMIT #: ELC20nt''009112
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/29/200!) Phone: (503) 639 -4171 / �r �diNu� y �ii q ' i llP��� 1l �
Inspection Requests (24 Hrs.): (503) 639 -4175 AA
:
INSPECTION WORKSHEET FOR DATE: 7/312006 TIME: 7:03AM PAGE: 1.ra
SITE ADDRESS: 16580 SW 85TH AVE CLASS OF WORK:
SUBDIVISION: `EWER TREATMENT PLANT LOT #: TYPE OF USE:
PROJECT NAME: CLEAN WATER SERVICES
DESCRIPTION: Install power & controls for n Terti� control valve 'nstall power fo new jib Crane (contact Scott
rn
Haar for location: 503- 860 -8198 .
OWNER: CLEAN WATER SERVICES, PHONE #: 503 6f31.3500
CONTRACTOR: POWR MAINTENANCE RESOURCES, INC. PHONE #: 503 - 6131 -46CA
Inspection Request Scheduled For: Date: 7/3/2006 Pour Time:
ode # Inspection Description Confirm # Contact # Message
199 Electrical final 032608 -02 503 -961 -2890 N
Corrections /Comments /Instructions:
C
K IPASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1\I • n Imo` Date: / 713 a Phone #: (503) 718- 2-`lq I