Permit (39) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
11'' COMMUNITY DEVELOPMENT Permit#: ELR2016 00123
T/GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/29/2016
Parcel: 2S113B000600
Jurisdiction: Tigard
Site address: 16580 SW 85TH AVE
Project: Clean Water Services-Durham Treatment Plant Subdivision: None Lot: None
Project Description: Low voltage for thermostats in electrical room of Solids building.
Contractor: ALLIANT SYSTEMS LLC Owner: CLEAN WATER SERVICES
1600 NW 167TH PL#330 2550 SW HILLSBORO HWY
BEAVERTON, OR 97006 HILLSBORO, OR 97123
PHONE: 503-619-4066 PHONE:
FAX: 503-230-9238
FEES
Description Date Amount
Specifics: Restricted Energy Permit 06/29/2016 $75.00
12%State Surcharge-Electrical 06/29/2016 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 0
Audio&Stereo: 0 Boiler Controls: 0
CCTV: 0 Clock Systems: 0
Data&Telecommunications: 0 Fire Alarm: 0
HVAC: 1 Instrumentation: 0
Intercom/Paging: 0 Landscape/Irrigation: 0 I
Landscape Lighting: 0 Medical: 0
Nurse Calls: 0 Protective Signal: 0
Security Alarm: 0 Other: 0 Total $84.00
Other Desc: 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 obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: _ '� _ Permittee Signature: �i / .t.--e,, .in
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.
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Electrical Permit Application ‘,...CC,i9'
FOR OFFICE USE ONLY
O Receivedty: C�;t i 3
II - City of Tigard '�� ePermit#:
't 13125 SW Hall Blvd.,Tigard,OR ' Plan Review
Phone: 503.718.2439 Fax: 503.'`'.il d l '\.,� Related Permit#:, / 1 A0I i '
late/By: ,�
Inspection Line: 503.639.4175 �p� .(,,__`,`S\� Ready Date/By: Juris: Ed See Page 2 for
T I G AR D Internet: www.tigard-or.gov `� �,v Notified/Method: /c b�+ I Supplemental Information
�%ff , rrVrgL., ,,t ,' r 4&& ,, >fSSA y'rtW*gf1 r� f7: rF::,IorJ' �/�.f/ .< i :<
❑New construction ®Addition/alteratio 4ement
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: where the available fault current
CQ''t
Marinas and boatyards.''�"M / ' jgfi1 '�rr • � f' / ff ; exceeds 10,000 amps at 150 volts or
0 Floating buildings.
❑ 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑ Multi family D Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
ffr ll,IiF rfi ,, ,,� is fy t+ 'f t '/ ,' ,� P rFy xr« ,rx�fir`%'�
� �rx �,,�,!. ,,,v-,,,/� -���� � ,,�r;;,.1 ���'`„ ,11�! � I�,'.r�� ,x�®. �rr. ,��'f.���l������ ❑Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: Job site address: 16060 SW 85th IOOHP or more. ❑°°A "E",°°t-z",°°I-3",
City/State/ZIP:Portland,OR,97224 ElSix or more residential units. occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name:CWS Durham Solids ['Hazardous locations. ❑Supply voltage for more than
El Service or feeder 600 amps or more 600 volts nominal
Cross street/directions to job site: /r%,' f f`�` f r, f ) i,ti� ' f�` ,`
Description
Qty. Each Total
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#:
g Ea.add'l 500 sq.ft.or portion 33.92 1
''A' r,,. 'f g r r I_, I'�M 1> 2 e 1 , f ff ,rr' r }'f:!?n f F.,
�- r -� -c.fr�. � fJ., �..4- ' � em>���x� f>'irf«l f..� ,��, Limited energy,residential
(with above sq.ft.) 75.00 2
Low voltage signal wire for new thermostat in Electrical room. Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
si t ;0t1 ? ff# rSfa t / ioat- s-, r -'vrTmrij Services oler feeders installation,al❑teraSteieonP,aagned t/
or relocation
Name: 200 amps or less 100.70 2
Address: 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: 601 amps to 1,000 amps 301.04 2
Phone:( ) I Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,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 1
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
bti t f f f f „ /, f t t r,,,.:7;,•A7,174,440 Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name:Alliant Systems above service or feeder fee, 7 42 2
each branch circuit
Contact name:David Russell B.Fee for branch circuits without
service or feeder fee,first
Address:351 NW 12th branch circuit 56.18 2
City/State/ZIP:Portland,Oregon 97209 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(503)572-7761 Fax: :(503)230-9238 Each manufactured or modular 67.84 2
Email:d.russell@alliant-systems.com dwelling,service and/or feeder
rReconnect only 67.84 2
rrV, srgf °. � „ « fry✓W � ;
Pump or irrigation circle 67.84 2
Business name:Alliant Systems Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
Address:351 NW 12th panel,alteration,or extension. 0 See Page 2 75 2
City/State/ZIP:Portland,Oregon 97209 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(503)572-7761 Fax:(503)230-9238 Investigation(1 hr min) 90.00/hr
Email:d.russell@alliant-systems.com Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
90.00/hr
CCB Lic.: 153420 Electrical Lic.:34.—,(6(//R Suprv.Lic.: 3757LEB specifically listed(YY hr min)
7.7•YiAAiI//77II_y�._II� I]�-Iw-�.11�-"__ ..✓� X�„lrff
Suprv. Electrician signature,required: 1 Subtotal: 75.00
Print name: Ole Westrum Date:051(4/f 6 ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): 9.00
Authorized signature: TOTAL PERMIT FEE: 84.00
This permit application expires if a permit is not obtained within 180
Print name: David Russell Date:o 5/(8/16 days after it has been accepted as complete.
* Number of inspections allowed per permit.
C\Building\Permits\ELC_PermitAppELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB
s '
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
„ ,,, ,Il° .r,.., .,ftr ,r,.:, �, '.,/,',r�,+b'` /'.�r,.. F.�/.,r r%r,,.. ,''. ,,,,sir„J„f„r �'<rf; is rJrf � -,`f1 ....,, .�. C �P „ ''ft'� fG;%r'/✓rrr ref
Fee for all residential systems combined: $75.00 Renewew°° Qty. Eaeh Total
wable 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 to25 kva 200.34 2
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
❑ Garage Door Opener* >100 kva(fee in accordance
with OAR 918-309-0040) 552.26 2
❑ 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 1
charged at an hourly(I hr min)
Inspections for which no fee is 90.00/hr
specificall listed(%:hr min)
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/4///j6g✓ is 3 � ffi'''',',511111.161111111
Subtotal(Enter on Page 1):
Fee for each commercial system: $75.00 * Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
I:\Building\Permits\ELC_PermitAppELR_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 Limited Energy
198 Low voltage final
PASS - No C of O
ELR2016-00123
Jeff Grove
Violation Summary:
Inspector Contractor