Permit CITY OF TIGARD ELECTRICAL PERMIT
t• COMMUNITY DEVELOPMENT Permit #: ELC2011 -00086
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/15/2011
Parcel: 2S11313000600
Jurisdiction: Tigard
Site address: 16060 SW 85TH AVE
Project: Clean Water Services Subdivision: SEWER TREATMENT PLANT Lot: 0
Project Description: Aeration Basin - (2) branch circuits and low voltage for instrumentation for dissolved oxygen sensor.
Contractor: VALLEY ELECTRIC CO LLC Owner: CLEAN WATER SERVICES
19707 GRANT RD 2550 SW HILLSBORO HWY
MONMOUTH, OR 97361 HILLSBORO, OR 97123
PHONE: 503 - 828 -0447 PHONE: 503 - 681 -5100
FAX: 503 - 838 -1000
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 02/15/2011 $63.60
Specifics: Service or Feeder
1 ea Signal circuit or Limited 02/15/2011 $75.00
Type of Use: COM Energy Panel
Class of Work: ALT 1 ea 12% State Surcharge - 02/15/2011 $16.63
Electrical
Type of Const:
Occupancy Grp:
Total $155.23
Required Items and Reports (Conditions)
This per• is issued subj to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law All work will
be do - in accordance with a. 'rove. glans 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 --quires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -0 ∎ 1 -0010 thro gh OAR 952 -00 r 09/ • ou ay obtain a copy .f the rules or direct questions to OUNC by calling 5087 o 1.800.332.2344.
Issue :y: * //J / Permittee Signature: ...s� / .1.41■1144.16A I
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 INS LLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
I -
LICENSE NO.
all 503.639.4175 by 7:00 a.m. for the next available inspection date.
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.
Feb 08 2011 3:20P ENCa��pp `1�.1g1 d '�
t y rlectric Co. LLC (503) 838 -1000 p.2
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Electrical Permit Appliiatlon 8 2011 FOR OFFICE USE ()NIA' Ci Of Tigard Received e // _. / Permit No' cczeaioly Qev g�j
�' g OF TiGD Date /By.
13125 SW Hall Blvd., Tigard, OR 97223 CITY Y e� Plan Review
Phone: 503.639.4171 Fax: 503.598.19 G ILDING DIVISI�"'n,.t o 1 �; � i� ' I , Date/By: -. J OthrrFermit:
Inspection Line: 503.639,4175 L Date Ready/By: : � (3, uris. la See Page 2 for
Internet: www et is ard or us Notified/Method. t � 7 // Supplemental Information
row, ' . t ,17 -7 —• ' ^.F +,SS n - "�'ril l - '. �7 e+ � q � ,;, V� / //. ..�...__.,..., , r...t1�i•r" e -,r E a14` .
4 ' ... s e_. 31 ,a�'>J or Vo" till uAl n , f • l W �, r _IFM.Fnz,_;
❑ New construction ® Addition /alteration /replacement r ase check all f3 .ply:
❑Service over 22 amps, comm'I ❑Hazardous location
❑ Demolition a Other
c . aI t 1 . ,4siir 3—r rurti R tt ❑Service over 320 amps — rating ❑Bmldngover 10,000 sq. ft.,
1 • -. t� S , .,, 1 ,1: 41 7».1, - •u, I `' 1 -I ...: , .- . ,.CFI. of 1- and 2- family dwellings 4 or more new residential
� � , ,t, ' . i:9.,
❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building System over 600 volts nominal units in one structure
❑Building over three stories ❑Feeders, 400 amps or more
❑ Multi- family ❑ Master builder
❑ Other: [Occupant load over 99 persons ❑ Manufactured structures or
,a� ,t�. t p,' ' 1 a r� �I t r ti �'ilk ^ E �. d 4 ; ..' i f li t 1 . j � ! ❑Egress /lighting plan RV park
,
:. 0 ;.oit .._•F I) 8111 it I t a )1,1t - �.� f . idle- ..._t44 - 1 In�. Di • :..s
Job no.: 11 -141 Job site address: 16060 SW 8th St. ❑Health -care facility [Other:
Submit 2 sets of plans with any of the above
City/State /ZIP: Tigard OR 97224 The above are not , '; 1''Cr� .aa.:
applicable t��otemporary construction service,
De .' M a a' -- o'" - ,
Suite/bldg, /apt. no.: I Project name: Durham Aeratiin Basin Improv°
p tian Qty. Fa. Total
Cross streeb'directionsto job site: 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'I 500 sq. ft or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.: �' Limited energy, non - residential 75.00 2
+ } i'E III, fl ,.�. CiiItr- V tv' T f " H �f S t ti l4 off C °..,}. tt r lu, - i i " 'z1r (fie, ' ,l J r-`' 'I-
- .z,„wk„kL����.�iT- w�.._ °,t 111 � _•. ,. n�s .P.�, ,�t, Each manufactured or modular
Add and modify the Dissolved Oxygen Sensor. dwelling, service and/or feeder 90.90 2
Services or feeders Installation, alteration, and /or relocation
LOW Jo LTA& f - c3a- f OS H10174naaa 200 amps or less 80.30 2
_ r.lu np if .,O -. aI t 1 s t t . t v tl �:d�� 201 amps to 400 amps 106.85 2
`. �I,TL I ..t>_.. r 7,4;le:1, , V�;l - ' _.". I �' - t etgL".,t'1 ', 1�:,* . '
'• '�` `�' �' '—� � 401 amps to 600 amps 160.60 2
Name: Clean Water Services 601 amps to 1,000 amps 240.60 2
Address: 2550 SW Hillsboro Highway Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City /State /ZIP: 97213 Temporary services or feeders installation, alteration, and /or
Phone: (503) 681 -5100 I Fax: (503) 681 -4439 relocation
2.00 amps or less 66.85
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
lit: : ' s ry r« M1 ^. i1 u - l " ".1. iI " ..; f - �s bwdp ?,q�!mr AT yy v , 1.1h'.1. ` - , , 1• A. Fee for branch circuits with
Nil : 5"du .: : . J iB 161 , ' ,.. '` " i
:. service or feeder fee, each
Business name: Valley Electric Co., LLC branch circuit 6,65 2
B. Fee for branch circuits If 66 .
Contact name: Jeff Landauer without service or feeder fee, 1 r 2
each branch circuit
!
Address: 19707 Grant Rd. al5r
Each add'I branch circuit � �•�6'65 7 2
City/State/ZIP: Monmouth, OR 97361 Miscellaneous (service or feeder not included)
Phone: (503) 838 -0447 ( Fax:: (503) 838 -1000 Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail valleyelectricco®netzero.com Signal circuit(s) or limited- era
*? 1-� h r7 ' , q, t t i i 4't`i i energy pastel, alteration or ? j "
n i ' '._xr.� 1�. '1.1.L�::,.ur.� _ wjI? �� n. .:..,- a extension. Describe: 4-20 MA / Page 2 . 2
Business name: Valley Electric Co., LLC SIGNAL CIRCUITS
Address: 19707 Grant Rd. Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State /ZIP: Monmouth, OR 97361 Investigation per hour (1 hr min) 62.50
Phone: (503) 838 -0447 I Fax: (503) 838 -1000 Industrial plant per hour 73.75 D
1 . , r (0
CCB Lie,: 153264 (� `' 4 . Electrical Lie.: 27 -78C I Suprv. L ic.: 39805 Subtotal ` !
Suprv. Electrician signature, required: 1l WI // Plan review (25% of permit fee)
Print name: 07 6 ,
,, ate: 2!0812011 State surcharge (8% of permit fee) l�!'S� lh,
� w 1 TOTAL PERMIT FEE piii555 9,5
Authorized signature: This permit application expires if a permit is not obtained within 180 iL •
'' / ' � tl' days after it has been accepted as complete b
Print name: f .:_ _,,,� Date: 2/08/2011 ' Fee methodology set byTri- County Building Industry Service i ..... 1
' Ili 1 �s���' d " Number of inspections per permit allowed. I ^
i:�Puilding\Perm:h' .(>n
PenitApp doe 12/03 440 4515T(]0 /32'COM/WRB (� min'
Feb 08 2011 3:21PM Valle 3 Electric Co. LLC (503) 838 -1000 p. 3
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
Fee for all residential systems combined... $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
7 Burglar Alarm
U Garage Door Opener*
n Heating, Ventilation and Air Conditioning
System*
❑ Vacuum Systems*
n Other:
7 i ��..j„ �IfF " ^l ` te'e' - 'il c''�t 4a�i rl;�.t1li
fim. �w�l§$... �Y >,... 1 .i.,.,.., . 1 ..
Fee for each commercial system ....................... $75.00
(SEE OAR 918 - 260 - 260)
Check Type of Work Involved:
n Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
El Data Telecommunication Installation
n Fire Alarm Installation
❑ HVAC
® Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
U Medical
I I Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
I 1 Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
\BuildingPermicslELC- PermiLApp doc 04;03