Permit CITY OF TIGARD ELECTRICAL PERMIT
H_ COMMUNITY DEVELOPMENT Permit#: ELC2013-00594
• TI CARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/31/2013
Parcel: 2S113B000600
Jurisdiction: Tigard
Site address: 16580 SW 85TH AVE
Project: Clean Water Services Subdivision: ROSEWOOD ACRE TRACTS Lot: D
Project Description: Wire new AWWTF turbo blower,install new circuit at panel MCTTA&perform other misc.electrical upgrades.
Contractor: MILL PLAIN ELECTRIC INC Owner: CLEAN WATER SERVICES
6115 NE 88TH ST 2550 SW HILLSBORO HWY
VANCOUVER,WA 98665 HILLSBORO,OR 97123
PHONE: 503-574-7265 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Services or Feeders-401 to 10/31/2013 $200.34
Specifics:, 600 amps
1 ea Plan Review Electricial 10/31/2013 $50.09
Type of Use: COM 1 ea 12%State Surcharge- 10/31/2013 $24.04
Class of Work: ALT Electrical
Type of Const:
Occupancy Grp:
Total $274.47
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may ob a copy o •- direct direct questions to OUNC by calling 503.232.1987 or 1.8000.332.23444.
Issued By: Permiftee Signature: 11'f i 91-AVT25.2
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' Date:
LICENSE NO.
Call 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.
RECEIVED
Electrical Permit Application FOR OFFICE USE'ONLY
illCity of Tigard OCT 14 2013 Received ®��� Permit No.:& - if(3_c06-p�
_ Date/B : /D /„
° 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review /�
Phone: 503.718.2439 Fe .6 ;1 ARD Date/B : l7/�"�� Other Permit Hee�l 3_ �
TIGARD Inspection Line: 503.6 9. Date Ready/By: `�� furls: El See Page 2 for
Internet: www.tigard-SUJLDING DIVISION Notified/Method: / /Q J 7. 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 ❑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 ❑ Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ID Emergency system. larger separately derived system.
❑Addition of new motor load of ❑"A "E","1-2","I-3",
85th 100HP or more. occupancy.
Job no.: Job site address: 16580 SW 85 Avenue
❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP:Tigard,OR 97224 ❑Health-care facilities. ❑Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt. no.: Project name: Durham AWWTP Turbo Blower ❑Service or feeder 600 amps ormore.
' FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total I
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: • Lot no.: 1,000 sq.ft.or less 168.54 4
Ea.add'l 500 sq.ft.or portion 33.92 1
Tax map/parcel no.:
Limited energy,residential
DESCRIPTION OF WORK (with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
Alter existing feeder for for OWNER supplied turbo blower residential(with above sq.ft.)
Renewable Energy :' -' • ❑'See Page 2''.: ' ;_ ' . '
. Services or feeders installation,alteration,and/or relocation
0 PROPERTY OWNER ❑ TENANT 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Name:Clean Water Services 401 amps to 600 amps I 200.34 '200.34 2
Address:2550 SW Hillsboro Highway 601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts 552.26 2
City/State/ZIP: Hillsboro,OR 97123 Temporary services or feeders installation,alteration,and/or
Phone:(503)547-8177 Fax:( ) relocation
200 amps or less 59.36 1
Owner installation:This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale, lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 2
Owner signature: Date: _Branch circuits-new,alteration,or extension,Per panel
' ' ®'APPLICANT . , . ❑ CONTACT PERSON . A.Fee for branch circuits with
` above service or feeder fee,
Business name:Clean Water Services each branch circuit 7.42 2
B.Fee for branch circuits without
Contact name:Joel Borchers service or feeder fee,first 56.18 2
branch circuit
Address: 16060 SW 85th Avenue Each add':branch circuit 7.42 2
City/State/ZIP:Tigard,OR 97224 Miscellaneous(service or feeder not included)
Each manufactured or modular 67.84 2
Phone:(503)547-8177 Fax: :( ) dwelling,service and/or feeder
Reconnect only 67.84 2
E-mail: borchersj @cleanwaterservices.org Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name: MILL PLAIN ELECTRIC,INC. Signal circuit(s)or limited-energy See
panel,alteration,or extension. Page 2 2
Address:6115 NE 88TH STREET Each additional inspection over allowable in any of the above
City/State/ZIP: VANCOUVER,WA 98665
Additional inspection hr min) hr min) 66.25/hr
7����� Investigation(I hr min) 66.25/hr
Phone:(360)574.7265 •:(360)573.9866 Industrial plant(1 hr min) 78.18/hr
t• Inspections for which no fee is 90.00/hr
CCB Lie.: 63021 115114 Electrical Lie.: ti; 1 1 CIE' r��t .: 2534S 0 ,1147 specifically listed(%hr min)
ELECTRICAL PERMIT FEES
Suprv. Electrician signature,required: ./T ' ' t' VjT$ ' ' Subtotal: 200.34
Print name: ARTHUR I-IALB/'G Date: 10.14.;: Plan review(25%of permit fee): 50.09
State surcharge(12%of permit fee): 24.04
Authorized signature: - 3 TOTAL PERMIT FEE: 274.47
f S / This permit application expires if a permit is not obtained within ISO
Print name: la i Date: G •/X-` days after it has been accepted as complete.
* Number of inspections allowed per permit.
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