Permit �t%n5 /fi CITY OF TIGARD
ELECTRICAL PERMIT
PERMIT #: ELC200700378
COMMUNITY DEVELOPMENT
DATE ISSUED: 6/6/2007
[GARiD 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: CLEAN WATER SERVICES
Project Description: Job NO. 11530 -300 (1) branch circuit with service at cell site (roof work).
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: 1 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 OREGON ELECTRIC GROUP
2550 SW HILLSBORO HWY 845 NE COLUMBIA BLVD
HILLSBORO, OR 97123 -9379 PORTLAND, OR 97211
Phone: 503 - 681 - 3600 Contact #: FAX 503 - 247 - 0108
PRI 503 - 546 -6085
FEES
Description Date Amount Reg #: ELE 26 -95C
[ELPRMT] ELC Permit 6/6/2007 $86.95 LIC 203
[TAX] 8% State Surcharge 6/6/2007 $6.96 SUP 48185
Total $93.91 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 B . � �; ' / Permittee Signature: __Q), `i rkr TV'1
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.
06/06/2607 09:42 5032470108 OREGON ELECTRIC GRPU PAGE 01
electrical �'e�mit t1,gpl� catiol FOR o i R T l' r, O,NI.l
.�l,.iV �, {> _ Received
City of Tigard '
�...._, � DeteJB : � tid III �a1
13125 SW Halt Blvd., Tigard, OR 97 Plan Review
'� r _ 2 ' Phone: 503.639.4171 Fax: 503.598 DatelB ; Odtert�armit:
Ins ection Line; 303.639.4175 . -. _ . Date Reedy/Ely: 61 See Psge2 for
I' 1 ,� 1, 1'3 p Notiftsd/ ethod: - Supplemental Informed
Internet: www.tigard- ar.gov
,., .!_: �,Y.r. ice. _ :rte:: .: :- • ��,;.
:: t•:' a!;.} i.' 1. i ":g: :,; -,t :' :. ftittt;•Vtigt ..l`T::T,:;!K
.,
j. . 1t ' ::i • : 'j i : !: ' . , „}'� i1 • "::i�• • c: f l::';:'.•'•tSr � ..... � �.
- `4',,; �i�i ���i !�`Q1� r.: r .. Q 1C�� ... r < a " w � ' : ' :: ? -;
' Addition/alteration/replacement
check all that apply (submit a Seh orplans w/items checked Wow):
El construction
CI Service or feeder 400 amps tar moto EI Building ova three stenos.
0 Demolition �. "� � 0 Other where the available thult current Q?Amines and boatyards.
J y i"
'* ;-"- .' "'. C/Y'tE . wt,(('X : ':fry .` e ,. r. exceeds 10,000 amps at 150 wtlacr l]Flotatesbuitdlttys.
- .. • •. •• ••- •- ■ • O ff' . •�N • -• • ;t "` _• tees to ground, or oxcceds 14,000 O Commercial -nay agricultural
El 1- and 2- family dwelling k.4 Commercial /industrial [7 Accessory building amps for all otheriuiiatlations. buildings.
y ❑ to builder O O PI re pump_ 0 Installation of 11 KVA or
Matti £atn11 Master O Emergency system, larger separately derived mum,
r' ..'`'.'" °e:.1:�s:h °i. !•J j ' :t 4NgV4 1 !";.. AiIV)[ 1 ` S+I%!>, �N �i e." ' , . 4 .'''' c I::..1. - I ;C <._ D Addition of new motor load of 0.. .,Ew 1-2", -1,3., •
tootle or mete, oxupaaor
lob no.: 11530400 lob site address, 16580 SW 85 AVE.
in Six or more residential (inns. ❑ Recreational velikda patios.
City/State /Z1P: 7'1GARD OR 97224 0 Heettb -eara Nullities. El Supply voltage fit more than
„_ In Hamrdous locations. 600 volts nominal.
: name: CLEARWIRE-POR 072 D Service` r feeder 600 acme or more. ti _
Suite/bldg./apt. n0. Project nom 130i
,i iiLi4g1141g t 5 b tg ;ii'ice,' , ( i :j
l q� ,t�•tdC•1�4. "ar. f1 Y`�`*3 - '�.- ..`��5 i�t4�St Ir�
Cross street/directions to job site: trettelotton ()Jr. I les 1 lut■1
u - New resldendei single - or multl- flaatlty dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft or less - 145.15 1 4
Ea, ad El 500 sq. ft. or portion 33,40
Tax map /parcel no.: Limited energy. residential 75.00 2
V �. et I ,,r:.. K. t ,c,: �,._ -:rr.r ,,� -. .. r: , ._ u .la'
al PIP �, d&, (ir G o" ;ir ' " i t ' s ..i r1 F_ ...,d-i.„ = ; •i• __'• F ....0, ii t l lt :F (with above sq. A,)
. I ; 4$ ; p r4 : i ? i s ,,: c :L r. _. i if7X .OTI k` i4!�11I " .. . ., .t.
Limited energy, multi- family
g\ \ z — ? br M reaidentlal'(withabove sq.. ft.) 75,00 2 ■ Services or feeders lnatallatlgn and/or relocaito
200 amps or less X 80.30 2
•tr « _ f±� . : • -1 e a:iw_' gg �,, °- T ' ; J -'` ' ' jF • _�.. j r vpp 20 •• t em Ps 400 amps 1 06 2
itx!r:u . 'tJ:.s'' r �)t<. ! . a .. ';�l! .'d! y ' : v � lC' - -• 1 �:d _ . : � - V • ��:;:. ,954: p t0 P
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 L 2
Ci /State/Z1P: Temporary services or feeders inftatlatlon, alteration, and /or
tY _ relscatlpn
Phone: ( ) Fax: ( ) 200 amps or less 66,85 1
Owner installation: This installation is being made on property that 1 own which is not 201 tamps to 400 amps - 100,30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. - 401 erupt to 594 amps 133.75 i -
tiranch circuits _ sew, alterafoe, o r extension, per panel
Owner signature: Date: — A. Fee Orr branch clmults with
a ']• r , °u above serVlce or feeder fee 7C
r. i to r , -.i - �s+ , em If'.>a �,:i , , above serve circuit 6.63 2
Business name: Oregon Electric Group B. Fez for branch circuits
Contact nettle: Eva)lrt(pe May without service or feeder fee, 46.85 2
Y first branch circuit
µ Address: 845 NE COLUMBIA BLVL) 1 Bach add'! brand( circuit 1 6.65 2
- . Miscellaneous (service or feeder not included)
City/Slate /ZIP: PORTLAND, OR 97211 Each manufactured or modular - 90,90 , 2
{ Fax : :503 217 -0108 dwelling, advice and for
Phone:
(503)546-6085 _ ( ) Iteoonnect onlx 46.85 2
E -mail: e.a,may®oregon- eleetrlc.com Pump OF irrigation Circle 53.40 2
������'w .y� N�{ (v•••,�p n �. 1ti g ._ y , s'yv 7 r Sl or outline li m .40 2
id3H4 =5!?.ii'�`' _kTigtE , �.l,ed" l;,' :9 r , °, O 0 s t d :k( : i* sign F • ,g 53
Oregon Electric Group Signal cireult(s) or alteration, limited-
Business name: Or
e$ p energy panel, alteration, or
Address 845 NE COLUMBIA BLVD. extension. Describe: Page 2 2
City /State/ZIP: PORTLAND, OR 97211 Hach additional inspection over allowable In it of the above
Per Inspection 62,50
` Phone: (503) 546 -6085 Fax: (503)247 -0108 Investigation per hour (I hr min) , 62,50
CCB Lie.: 203 Electrical Lic„ 26 -95C Suprv. Lie.: industrial lantprhour 73.75
- tr y zTIdr ,::l,
Suprv. Electrician signature, required ∎ .1� L Subtotal': (
Print name: Mark Weinbendcr s ate: 6/5/07 Plan row#cw C,t39/o of penult fee) n
W
State surcharge (8% of permit fee): (4),
Authorized signature: ailffr r ��� furls TOTAL PERMIT ME:
This permit spplitsdoa 0'2ft 11 a permit is not ebtatneA wltbia 180
Print name: Mark Weinbender Date: 6/5/07 days after it hu been accepted as template,
— a Number of inspections allowed per permit.
fi\ B ,dldlneermll,rtatC•pmnkApp.doo 05/13/06 440 -461ST(I /o3/e0MiWIB