Permit CITY OF TIGARD ELECTRICAL PERMIT
i. , " PERMIT #: ELC2007 -00070
il 1 I COMMUNITY DEVELOPMENT
DATE ISSUED: 1/29/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S101 DD -00800
SITE ADDRESS: 14020 SW 72ND AVE ZONING: I -L
SUBDIVISION: LOT : JURISDICTION: TIG
Project Description: Electrical service for new collocation. Job No. 12335
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: ( W /SERVICE OR FEEDER: 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:
I S PROPERTIES LP OREGON ELECTRIC GROUP
PO BOX 87908 1010 SE 11TH AVE
VANCOUVER, WA 98687 PORTLAND, OR 97214
Phone: Contact #: FAX 503 - 535 - 2763
PRI 503 - 234 -9900
FEES
Description Date Amount Reg #: ELE 26 -95C
[ELPRMT] ELC Permit 1/29/2007 $80.30 LIC 203
[TAX] 8% State Surcharge 1/29/2007 $6.42 SUP 44605
Total $86.72 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 ore than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center.
Those rul are set fo in 0 r 9 . - 001 -0010 through OAR 952 -001 -0100. You may obtain copies of t ese rules or direct questions to OUNC at
503.246. 699 or 1.800.33
Issued B , 1 a Permittee Signature: J i , 0 1 lta •
I'
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:
CO RACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: P rI 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.
Ilk JAN -24 -2007 10:04AM FROM -OR ELECTRIC SVC 5035352763 T -878 P.001 /002 F -448
ia,Ca:1.1!teal -E'er r. 117.1 -i•3�!. • _1 f y • t•'11I2 OI'I't( i; i;,,i: ()NIA
of Tigard _ - ; 4 ' 1 Received
13125 SW Hall Blvd., Tigard, OR 97223 > /ay, e Q� j ! /) ? /f y Permit No,: li Qq� 70
Phone: 503.639.4171 Fax: 503.59$$p pa� Plan Review Jh1 Q ] 4 "' +� i : �„ t�/9 . Other Permit
Inspection IJne. SO 4175 2 1001 �� � ue
� Else Read J PnQ 2 for
Internet www,ci Nodfied/Mmh IG ® Sae
Dplame
Cll. �/ aaml j q�n eUan
g t■ PLAN REVIEW
® New construction iT 1 no ecida)ttivim cement • Please check all that apply:
❑ Demolition 0 Other: ❑Service over225 amps, comet ❑Hazetdous locution
❑Service ova 320 amps —rating OBuildn overlo,00o it„
CATEGORY OF CONSTRUCTION g s9
_ of 1 -and 2 family dwellings 4 or more new residential
0 1 - and 2 family dwelling IS Commercial/industrial ❑ Accessory building ❑ System over 600 volts nominal emits in one structure
('Building over thine stories :Weeders, 400 amps or more
❑ Multi - family 0 Master builder ❑ Oar.
JOB SITE INFORMATION AND LOCATION ❑Occupant load over 99 persons ❑Manufactured structures or
❑Egress/lighting plan RV park
Job no.: 12335 Job site address: SW 72 AVE OHealth -cart facility ❑Other,
Submit 2 sets of plans with any of the above.
City /State/ZJP: — The above are not applicable to temporary construction service.
Suite/bldg./apt. no.: I Project name: FEE* SCHEDULE
_ naerl I Ory, J sue Tats I
Cross street/directions to job site: NEAR BONITA & 72 AVE New residential single or multi dwelling unit.
BETWEEN LANDMARK & BONITA ON 72' AVE — Includes attached garage.
1,000 sq. & or lei 145.15 4
Subdivision: I Lot no.: Pa. add'I 500 sq. R or portion 33.40 1
Tax map/parcel no.: � g /p j b D CO � Limited mrrgy, residential 75.00 2
DESCRIPTION OF WORK Limited energy, non-residential 75.00 2
Each manufactured or modular
POWER TO NEW CELL TOWER dwelling, service and/or (ceder 90.90 2
. Services or feeders installation, alteration, and/or relocation
200 amps or less ! 80.30 ID , 3
❑ PROPERTY OWNER I • ❑ TENANT 201 amps to 400 amps i06.85 2
Name: C 401 amps to 600 amps 160.60 2
11 01.4 • 46_ pear 1,,,, 601 amps to 1.000 amps 240.60 2
Address: / 4 to - /a - a 41 q t= Over 1,000 amps or volts 454.65 2
City/State/ZIP: h Reconnect only - 66.85 2
DI ri_A - ,Jb ea - Q7 a2 Temporary services or feeders installation, alteration, and /or
Phone: ( ) I Fax: ( ) relocation
less
Owner installation: This installation is being made on property that Town which is not 200 amps or 400 66.85 1
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 201 1 maps m 400 maps 100.30 2
401 amps to 600 amps 133,75 2
Owner signature; Date: Branch circuits -- new, alteration, or extension, per panel
❑ APPLICANT I ❑ CONTACT PERSON A. Fax for branch circuits with
Business name: service or feeder fee, each
6.65 2
branch circuit
Contact name: B. Fee for branch circuits
wirhogr service or feeder fee, 46.85 2
Address: cach branch circuit
Each add': branch circuit 6.65 2
City/State/Z1P: Miscellaneous (service or feeder not included)
Phonc: ( ) I Fax :: ( ) _ Pump or isieacon circle 53.40 2
E -mail: Sign or outline light 53.40 2
Signal circuit(s) or limited-
CONTRACTOR energy panel, alteration. or
Business name: Oregon Electric Group extension Describe: page 2 2
Address: 1010 SE 11th Ave Each additional inspection over allowable in any of the above
Per
City/State/ZIP: Portland, OR 9721d "011 62.50
•
lnvcstljation per hour (1 hr min) 62.50
Phone: (503) 234 -9900 1 Fax: (503)535 -2763 Industrial plant per hour 73.75
CCB Lie.: 203 ELECTRICAL PERMIT FEES'
Electrical Lic : 26-95C I Suprv. Lia: S Subtotal /`' . 3C)
Supry Electrician signature, required: Plan review (25 %ofp�it fee)
eft/
Print name: U 1 �' �� ' �. j R - State surcharge (8% of permit fee) / , , tE�
TOTAL PERMIT FEE g6,. 7 L
Authorized signature: ��`�� _ /; Tai permit appneidoo expires If a permit Is not chained within ISO
Print name: ' s �/ • � days
after It been accepted at complete
Li IIa , i� t : 01 /07 / • Fee methodology set byTri -Coonty 13uilding Industry Service Board
i �8ui •• Nu mber of inspections per punk allowed.
1dagwmnim�ELC. erinitAvedoc 17103 440461SIt10,02/COM/wEB
°IL t' issue f'�ot- t —�.�.— li 111.b( ® 4
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007 -00070
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/29/2007
Phone: (503) 639 -4171 �^q
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 5/21 /2007 TIME: 7:02AM PAGE: 36
SITE ADDRESS: 14020 SW 72ND AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: CLEARWIRE
DESCRIPTION: Electrical service for new collocation. Job No. 12335
OWNER: I S PROPERTIES LP, PHONE #:
CONTRACTOR: OREGON ELECTRIC GROUP PHONE #: 503234 -9900
Inspection Request Scheduled For: Date: 5/21/2007 Pour Time:
Code # Inspection Description - • • irm Contact # Message
199 Electrical final 04870301 503-8433291 ' Y
Corrections /Comments /Instructions: _ Q t b 9 16
I'
"%te 5'019 3W{- 329 I
M
X PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: V6 Date: 4 01 Phone #: (503) 718- 2440