Permit '>a-Ab °
M I P CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00057
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/6/2007
PARCEL: 2S 113 B0 -00600
SITE ADDRESS: 16580 SW 85TH AVE ZONING: 1-ID
SUBDIVISION: SEWER TREATMENT PLANT LOT: JURISDICTION: TIG
PROJECT: DURHAM ADMIN BLDG.
Project Description: Voice and data cabling.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
CLEAN WATER SERVICES NETVERSANT CASCADES INC
2550 SW HILLSBORO HWY 9740 SW NIMBUS
HILLSBORO, OR 97123 -9379 BEAVERTON, OR 97008
Phone: 503- 681 -3600 Contact #: PRI 503- 646 -0533
FAX 503- 641 -6613
FEES Reg #: ELE 34- 589CLE
LIC 150328
Description Date Amount SUP 2903LEA
[ELPRMT] ELR Permit 3/6/2007 $75.00
[TAX] 8% State Surcha 3/6/2007 $6.00 REQUIRED ITEMS AND REPORTS
Total $81.00
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: Permittee Signature: Lh GTi)7'e G4er• — -
fJ
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.
MAR-05-2007(MON) 20:31 NETVERSRNT CRSCRDES INC P.001/002
Elcctri Permit Application — FOR OFFICE USE ONLY
City of Tigard Received -
13.1e/li /50 * p l'enilit Nil..
---- " 1312:i SW Hall 131vrt„ Tigard. 0 Man neva:
Phone: 503.639.417! Fax: 50 ,S , . T
til‘I1E Other Permit:
Deiral ;
TIGARD , Inspection Line: SO3,639.4175 Paw lkilayill),: .1441
i , M SNP r44ER 2 fur
nterneu tvww,1182111-01.,gov MAR 0 '''' NutinciiimiallatIt F Sottlitrotattrul It rorma Ilan
_..—
—
' • •
.. ' -, '!Tykr, oieLitg% . . .. 1.1..41st .REvigw...: .: . .! ,
. .. .
1:17rew ccirA;IEITot cekttiUniii: — Please cheek all that atinly (stibmli 1 sets of plank wiiIce la gligkga lig 111W)t
in SerVit wailer ann amps or m 0 aie tottlital ovar ilaw H tiel-t o s,
0
Demolition Ce ti
tion 0 Other: whore the available fault eurnmi 0 Marinas and boalyards.
CA Or 'CONSTRUCTION, : ,. 'I:" ;- ..; ceeeeds 10,00u amps al tan volts or 0 Floating buildings.
lca to y1014114. lir cioatIlib 14,000 CI C001011.111:1■11.01w AStICtillUt141
CI I - and 2-family dwelling E Commercial/industritil El Accessory building amp. air all other Instatiallaus. litillitlitits.
Cl Multi-family Cl Master builder Cl Other: 1:1 Vac pump, 1:1 installation or 75 KVA or
. 0 Emoventy srastil. lamer 1411141311ely dativccl ian.
.101 .$11t.'.INVORMATt ON: 'AND LOCATION ., .. • I. 1 • 0 Addition anew motor load or 0 "A". r
-, -1 Br
.2",•1.3".
lob Ito.: 107700 En Job Site adcireits: 1r SO 1 I Sioil 6 S 143 Plior.ke, main' or more. itecatiancy.
- 0 SIR or mom toithmiltd mills. 0 ltecrendonal weltlele parks,
City/State/Zit': 71 & *CD fl F.-- e l /Z-Z-4 t:t Health-mu ikciiitim I:1 smpply waila fur alum thou
I - 0 Ilakaulinta locations. Ei00 vollii iiiiiiiinel,
i .
Silitenlidg./11111, no.: Project name:D____6 UW 7 . 7r t:Iti.. r4 ot boo awns iir mine.
FEESCI1KblIt„t.,.', •,: , .:. . • ,' I !, • -
Cross street/directions to job site;
'--- ir'tla' -"----- C7) " r7 v...
- New residential sinele- or multi-Family dwelling min.
Includes attached g a rage.
----.........--
Subdivision: 1 Lott,' 1,000 sq. ft, or less 145,15 4
... Ett, arld'i 500 an. O.. or portion 33,40 1
I ax maplptircel no.:
--,-,—. Li ttlited energy, resideniial - -
75.00
, ' • L 1 " ' l/r.SCRIT,T4Oril • Or ! iVOItt . ' :,, ' .' '. '' : 9•, '.' : i•IIH, ..,; f sqt above sg.1..) •
Valee, .1),90{-6k abiin/A Limited energy. multt.ramily
trItidellt 141 rww, 75.011
% Services Or (ceders 'intonation A lieflillulz, timUor relocation ,
200 amps or less 80.10 2
.. • i o, ,-.0i,.0,30.x.owstir,k.'.i .1: '1 ' . ;.; ' '1 li ., . ' : . i: VENANIT;'''.: '.: :'' 201 amps to 400 amps 106:85 2
Ntitne: 401 amps to 600 ening l�0,60 2
........—.......... 6131 form I l m p g 240,60 2
Address:
Over 1.000 :emit or irons 454.6S 2
City/State/ZI I): Temporary scrvice thin, andio I
relocation
Phone; ( ) Fax: ( ) 200 limn or less n 66,85 1
Owner InsinlIatintit This installation Is being made on property that I own which is not • 201 mots 10400 amps 100,30 -*
.
intended for r.tie. lease, rcnt, or exchange, according to OILS 447. 449. 670, and 701. 4101 am s to 599 atom NM I 33.75 2
Iirtincli circuits - new olterotion, or extension. jispanet
Owner signature: Date:
- . . Aran for branch circuits with
').. . ' 1.mr11;44Nf!.;•!.,,::'.....• I 1 '':,. . ';':,dONirA& :ilkieicir4.1.''':10il!'.:. gbovc service ar rcuicr fcc.
--...—,......--......:.......
... each brunch circuit ' 2
,--
..-............—
Business mane:
B. ree for branch circuits —.
without setvice ar feeder fee,
Contact natne: 46.8S 2
(list branch circuit
.---....------..................----..--
Address: rsach midi branch circuit 6.65 2
MiSeciititiams /041210E or feeder not inclintedi
CityiStute/ZIP: Each manufactured or modular
90.90 2
—........- ' dwelling and/or feeder
Phone:( ) Fa , x: : ( ) Reconnect only 66.41S 2
E PUMp nr luta:Ohm circle 53.40 2
1Y ' .,..J„.,.. •.' .....2 CONTRACI _Sip or outline lighting $3,40 2
. Sionnl clreull(sJ or litni
Business name: N_E±ALELlsan±zikj Iv L_ . energy panel, alteration, or ...,„,..4#
Address: 1 IP./ 0 s brj 6 1 0 1 , 1 s 8 v ell ci e _ . extentetierlbe: ‘ Page 2 - /S 2
City/Stole/ZIP: gel Ve 1 In 1 oR ‘17608 gACII Additi011111 ilispcctiont.4 ,.. a ............................_ 1 lin orthEt ahlwe --
Per ituipection (12.50
Phone: (93 ) toLi & ■05 33 Fax: ( SZ3 ) (o. 4 // - /PIP / 3 Investigation per hour (1 lir Hain 62.50 .,
CCI3 Lie.: 15 g Electrical Lic.:3 Supri.0, Lie.: w ohslq Industrial plant Per hour 73.7S '
., .. '.: • ,..F:LEC.MICAL P.ERIVIIT :FITS ' I ' .
Stiprv. Electrician si --
gnature, required: -D L7Y ,
Subtotal:
f ?
--,..—„„...—._„„,„,„„___ zr
piunrcv17 (2374. or permit fee):
Print rime: ___
State surclittrue (WA of permit Then ki . 0 0
Authorized signature: TOTAL PURN1 rt. FEE;
This permit aptilleallon sinless ir ll Perri* Is not obtained within Jan
Print name: Dote: thin after It has been accepted as ctimrdetr.
'
' Number or ittanattinto showed per permit,
1:41■IiImigimitiiii0mc.rermileie.doe Or.13)14 4.111-4iilfer(iimiicomtw1111
CITY OF TIGARD
BUILDING DIVISION A PERMIT #: F 11000 00M 7
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/612'007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 - 4175
INSPECTION WORKSHEET FOR DATE: 3/2212007 TIME: 7MOAM PAGE: r;
SITE ADDRESS: 16E:430 SW O % =TI 1 AV(: CLASS OF WORK:
SUBDIVISION: SEWER TREATMENT PLAN LOT #: TYPE OF USE:
PROJECT NAME: DURHAM ADMIN BLDG.
DESCRIPTION: Voice arid data cabling,
OWNER: CLEAN WATER '' >ERVU2 S, PHONE #: b0;3 -t €8
CONTRACTOR: NETVERSANT CASCADES INC PHONE #: 503 05
Inspection Request Scheduled For: Date: 3/212007 Pour Time:
Code # Inspection Description - _ •. Contact # Message
199 Electrical final 0452204 1 503-330-1703
Corrections/Comments/Instructions:
Q
X PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
I FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: N 66 LE Date: 31 1 Phone #: (503) 718- 144