Permit (24) . CITY OF TIGARD ELECTRICAL PERMIT
7s' COMMUNITY DEVELOPMENT Permit#: ELC2016-00388
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/16/2016
Jr C,/r k_> g Parcel: 2S1060001801
Jurisdiction: Tigard
Site address: 17480 SW CLEMENTINE ST
Project: Clean Water Services River Terrace Pump Station Subdivision: 2002-032 PARTITION PLAT Lot: 3
Project Description: Electrical for a new sanitary sewage pump station to serve River Terrace.
Contractor: WIRE RITE ELECTRIC INC Owner: CLEAN WATER SERVICES
PO BOX 1959 16060 SW 85TH AVE
VANCOUVER, WA 98665 TIGARD, OR 97224
PHONE: 360-687-3879 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Services or Feeders-401 to 05/31/2016 $200.34
Specifics: 600 amps
42 crt Branch Circuits w/Purchase 05/31/2016 $311.64
Type of Use: COM
Service or Feeder
Class of Work: NEW 1 ea Plan Review Electricial 05/31/2016 $128.00
Type of Const: 32 ea Info Process/Archiving-Lg 05/31/2016 $64.00
Occupancy Grp: $2.00(over 11x17)
1 ea 12%State Surcharge- 05/31/2016 $61.44
Electrical
Total $765.42
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. ATTEN .': •re•= law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-001'.through OAR 9 •-001-Q 9' You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.234
\ Permittee Signature: ��
Issued = `► iL�_���
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: i /./(7L
LICENSE NO. 7 sloes
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 RECEIVED FOR OFFICE USE ONLY
City O Tigard Received // � �i pier
f g MAY 0 4 2016 Date/By ,V �ennit 6. �/r„ /
'I 13125 SW Hall Blvd..Tigard.OR 97223 Plan Review -{�Ji �l/p �O�D
':i . Phone: 503.718.2439 Fax: 503.598.19�Q IGAD Date/By: �Vbf, Related Penny[ jz�a
Inspection Line: 503.639.4175 l�I I T n��I `, Ready Date/B turfs: wv� 0 See Page 2 for
TIGARD Internet: www.tigard-or.gov
BUILDING �IUIS10NNotified/Method: 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):
acervice or feeder 400 amps or more 0 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.
El -and 2-family dwelling [v�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. p,trtstallation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: Job site address: HP or more. ❑"A","E","I-2","I-3
114 SW Cl�errtine t• 100
0 Six or more residential units. occupancy.
City/State/71P:
Tioerd OR, q-i aa4
0 Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name: araazardous locations. ❑Supply voltage for more than
RiverTexna v S]r�l [ rvice or(ceder 600 amps or more 600 volts nominal.
Cross street/directions to job site: Rimp station rlrrr,21.,,AONirl FEE SCHEDULE
1 Description I Qty. I Each I Total I
S t7lF Soho seer L\P.Afit V4 (2, tI RcmU,RQOjex% Oyu. New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
•[ 1,000 sq.ft.or less 168.54 4
fax ma
p'p`reel#: Ea.add'(500 sq.ft.or portion 33.92 I
DESCRIPTION OF WORK Limited energy,residential 75 Qf 00 2
r (with above sq.ft.)
Elee*- iCal ifl -�ya1n A,afi0JYY1� Limited energy,multi-family 75.00 2
�� �� residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
❑ PROPERTY OWNER I 0 TENANT Services or feeders installation,alteration,and/or relocation
Name: Clean Water Se,V Ids 200 amps or less 100.70 2
VV 201 amps to 400 amps 133.56 2
Address: lloC?lo0WAve.. 2
S S A 401 amps to 600 amps 200.34
City-/State/71P: T•-cu-di OR O� a� 601 amps to 1,000 amps 301.04 2
1
Phone:(So3)(D$k _ 3 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Finatl: relocation
fit Owner installation: This installation is being made on property that I own which is not 200 amps or less 59.36 1
intended lbr 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
I
❑ CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
[APPLICANT
A.Fee for branch circuits with
Business name: W fright £\ect-r ic, kn� above service or feeder fee. �Z 7.47 2
1 each branch circuit
Contact name: Je, Tapani
B.Fee for branch circuits without
Address: poem nservice or feeder fee,first
�/� sci
1 branch circuit 56.18 2
Cit�p
'Slatc/IIP: Each add'(branch circuit 7.42 2
�^""`e �' `'�+nd " O1- Miscellaneous(service or feeder not included)ch manufactured or modular
67.84 Photic:13 1 W O�- nig Fax: :(� t
) GJ%1�,�"� Ea2
dwelling.service and/or feeder
l.mail: jecc&W.trerVt(e1ect1r ,.corn Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: � 0� Sign or outline lighting 67.84 2
-
Signal circuit(s)or limited-energy ❑ See Page 2 2
Address: panel,alteration,or extension.
Each additional inspection over allowable in any of the above
zia
Citv State/7IP:
Additional inspection(1 hr min) 66.25/hr
Phone:( - - f Fax:( Investigation(1 hr min) 90.00/hr
Industrial plant(1 hr min) 78.18/hr
I:matl:
nets. 1v omotO &rot- 4t
\ C_1�Y1/1 Inspections for which no fee is 90.00/hr
CCB I.ic.: Electrical Lic.: . . .�� � ,rv. Lie
• `"'�' -- .` Ob' ow 1 5 specifically listed(/z hr min)
ELECTRICAL PERMIT FEES
Supra. Electrician signature.required: J(> 1 I its Subtotal:
Print name: - , -'rte'R Date: .7-7- /6 ID Plan Review Required(25%of permit fee):
Mfr�,
� State surcharge(12%of permit fee):
Authorized signature: TOTAL PERMIT FEE:
i" This permit application expires if a permit is not obtained within 180
Print name: - r . • . ' Date: 3 —3 —/,� - days after it has been accepted as complete.
* Number of inspections allowed per permit.
I nuilde e Pcnnits[[C PermitApp_ELR_ERE doe Rev 06/17/2015 440-4615T(11/05/COM/WEB
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
17480 SW CLEMENTINE ST, BEAVERTON, OR,
97007
Record Type:
Commercial - Electrical
Inspection Type:
199 Electrical final
Result:
PASS- NoCofO
Comments:
Violation Summary:
Inspector
Tel: 503.718.2439
Inspection Date:
Record ID:
ELC2016-00388
Inspector:
Jeff Grove
Contractor