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Permit CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit#: ELC2015 00542 ME TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 M Date Issued: 07/21/2015 Parcel: 2S 1138000600 Jurisdiction: Tigard Site address: 16580 SW 85TH AVE Project: Clean Water Services Subdivision: ROSEWOOD ACRE TRACTS Lot: D Project Description: Re-routing conduit for lights in compactor room and in right-of-way outside of the screen room. 7/30/2015 REPRINT permit to add(1)branch circuit. Contractor: TICE ELECTRIC Owner: BURLINGTON NORTHERN INC 5405 N LAGOON AVE. PROPERTY TAX DEPT PORTLAND, OR 97217 PO BOX 961089 FORT WORTH, TX 76161 PHONE: 503-872-8230 PHONE. FAX: 971-230-3330 FEES Quantity Description Date Amount 2 crt Branch Circuits wo/Purchase 07/30/2015 $63.60 Specifics: Service or Feeder 1 ea Plan Review Electricial 07/30/2015 $15.90 Type of Use: COM 1 ea 12%State Surcharge- 07/30/2015 $7.63 Class of Work: ALT Electrical Type of Const: Occupancy Grp: Total $87.13 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 o• • : 41,,. 001-0f s0. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.8003332.2344. 4 / Issued By: - Permittee Signature: QN (9—/°/()(--/C1--/ /c) 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. ,t CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit#: ELC2015-00542 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/21/2015 Parcel: 2S113B000600 Jurisdiction: Tigard Site address: 16580 SW 85TH AVE Project: Clean Water Services Subdivision: ROSEWOOD ACRE TRACTS Lot: D Project Description: Re-routing conduit for lights in compactor room and in right-of-way outside of the screen room. Contractor: TICE ELECTRIC Owner: BURLINGTON NORTHERN INC 5405 N LAGOON AVE. PROPERTY TAX DEPT PORTLAND, OR 97217 PO BOX 961089 FORT WORTH,TX 76161 PHONE: 503-872-8230 PHONE: FAX: 971-230-3330 FEES Quantity Description Date Amount 1 crt Branch Circuits wo/Purchase 07/21/2015 $56.18 Specifics: Service or Feeder 1 ea Plan Review Electricial 07/21/2015 $14.05 Type of Use: COM 1 ea 12%State Surcharge- 07/21/2015 $6.74 Class of Work: ALT Electrical Type of Const: Occupancy Grp: Total $76.97 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in actor•- - wi -••roved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENT•N: Oregon la re. - y• to follow the rules adopted by the Oregon Utility Notification Cente. Those rules are set forth in OAR 952-001-001$ hrou• OAR 952-001 '•90. Yo.y obtain a copy of the rules or direct questions to OUNC by calling 503.232.1 r 00.33 Issued B — — r, s ' �:.� Permittee Signature: 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' _ • ' y/ r. ( 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. Electrical Permit Application r�'t FOR OFFICE USE ONLY City of Tigard g1 C � L1 D a B" AgrA - '. 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Revie A P Phone: 503.718.2439 Fax: 503.598.1960 Date/B : �(`��/[!• I Related Permit#: Inspection Line: 503.639.4175 uL 1`� 2p1� Ready DateBy: „��ra S See Page 2 for TIGARD Internet: www.tigard-or.gov \ / Notified/Method: 1/��111)�r ' Supplemental Information NMI - TYPE OF WOR . -.' r•l1 " ' 'rrt ■ PLAN REVIEW ❑New construction ® Addition/alteratio I . Please check all that apply(submit 2 sets of plans w/items checked): . ❑Service or feeder 400 amps or more ❑Building over three stories. ❑ Demolition ❑Other: s where the available fault current ❑Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings. ❑ 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural amps for all other installations. buildings. ❑ Multi-family ❑ Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived ❑Addition of new motor load of system. Job#: 'AD.1 i I'd I Job site address: 16580 SW 85th Ave l OOHP or more. ❑"A","E","t-2",~t-3", CI /State/ZIP:97224 ❑Six or more residential units. occupancy. ❑Health-care facilities. ❑Recreational vehicle parks. Suite/bldg./apt.#: I Project name:Clean Water Services ®Hazardous locations. ❑Supply voltage for more than El Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site:85"and Durham Rd FEE SCHEDULE Description I Qty. I Each I Total I " New residential single-or multi-family dwelling unit. Subdivision: I Lot#: Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add'l 500 sq.ft.or portion 33.92 I DESCRIPTION OF WORK Limited energy,residential Re-route conduit for GO-NO-GO lights in classified locations (with above sq.ft.) 75.00 2 Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Renewable Energy El See Page 2 ❑ PROPERTY OWNER I ❑ TENANT Services or feeders installation,alteration,and/or relocation Name:Clean Water Services 200 amps or less 100.70 2 Address:16060 SW 85th Ave 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP:Tigard 601 amps to 1,000 amps 301.04 2 Phone:(503)547-8185 Fax:( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installat-ion,alteration,and/or Email: relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 I intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 Branch circuits—new,alteration,or ex_-tension,per panel ❑ APPLICANT ❑ COV'1':1CT PERSON A.Fee for branch circuits with Business name: above service or feeder fee, 7.42 2 each branch circuit Contact name: B.Fee for branch circuits without Address: service or feeder fee,first 1 56.18 56.18 2 branch circuit City/State/ZIP: Each add'l branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:( ) I Fax::( ) Each manufactured or modular dwelling,service and/or feeder 67.84 2 Email: Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: 'TI a Elec l'A4 Sign or outline lighting 67.84 2 +,,. Signal circuit(s)or limited-energy ❑ See Page 2 2 Address: S�0S Ni (-a.594n /.W Q panel,alteration,or extension. City/State/ZIP: p,;><J.r� J Each additional inspection over allowable in any of the above ®+Z el 7 a 17 Additional inspection(1 hr min) 66.25/hr Phone:(5V) ) 233•col I Fax:(61* ) B't2-San Investigation(1 hr min) 90.00/hr Email: �^-, Industrial plant(1 hr min) 78.18/hr ,141t^ 3 4 iced a.ite,c,can Inspections for which no fee is CCB Lie.: i be I Electrical Lie.: I Suprv.Lic.: 3940s specifically listed('L,hr min) 90.00/hr ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: 3c,t d 466 Print name: 46 4.40.3✓ Date: 7-f0_?ors Plan Review Required(25%of permit fee): ...-1,-bit!tp1.. S State surcharge(12%of permit fee): . y (4;76/ Authorized signature: TOTAL PERMIT FEE: '` 8,6 This permit application expires ifs permit is not obtai d within ISO Print name: Date: days after it has been accepted as comple e. ' Number of inspections allowed per permit. %:S I:\BuildingTermits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/CON/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Fee for all residential systems combined: $75.00 Description Qty. Each ► Total y Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 2 5.01 to 15 kva 133.56 2 ❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: n Burglar Alarm 25.01 to 50 kva 301.04 2 50.01 to 100 kva 552.26 2 n Garage Door Opener* >100 kva(fee in accordance 552.26 2 with OAR 918-309-0040) ❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 ❑ Vacuum Systems* >100 kva—no additional charge 0.0 3 Each additional inspection over allowable in any of the above: ❑ Other: Each additional inspection is 66.25/hr I charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed(/2 hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Fee for each commercial system: $75.00 Subtotal(Enter on Page I): *(SEE OAR 918-309-0000) Number of inspections allowed per permit. Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls 1 I Clock Systems Data Telecommunication Installation ❑ Fire Alarm Installation n HVAC n Instrumentation ❑ Intercom and Paging Systems n Landscape Irrigation Control* 1 1 Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* n Protective Signaling 1 I Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations 1:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 16580 SW 85TH AVE, TIGARD, OR, 97224 Commercial - Electrical 199 Electrical ﬁnal PASS - No C of O ELC2015-00542 Jeff Grove Violation Summary: Inspector Contractor