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Permit w C ITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT DEVELOPMENT SERVICES PERMIT #: ELR2005 -00155 ..� AA I� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 6/20/2005 PARCEL: 2S113B0 -00600 SITE ADDRESS: 16060 SW 85TH AVE ZONING: I -P SUBDIVISION: SEWER TREATMENT PLANT LOT: JURISDICTION: TIG Project Description: Gas detection system replacement. A. RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: : HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: GAS DETECT X TOTAL # OF SYSTEMS: 1 Owner: Contractor: CLEAN WATER SERVICES CONDUIT ELECTRIC 2550 SW HILLSBORO HWY DBA DUIT LEVEL TOOL CO HILLSBORO, OR 97123 -9379 19461 SW 89TH AVE TUALATIN, OR 97062 Phone: 503- 681 -3600 Phone: 503- 692 -1428 Reg #: SUP 4501S LIC 109669 FEES ELE 26 -905C Description Date Amount REQUIRED ITEMS AND REPORTS [ELPRMT] ELR Permit 6/20/2005 $75.00 [ELPLCK] ELR Pln Rev 6/20/2005 $18.75 [TAX] 8% State Surcharl 6/20/2005 $6.00 Total $99.75 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 more than 180 days. ATTENTION: Oregon law requires you to f r s adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 throug OAR 952- 01 : i You may obtain copies of these rules or direct estions to OUNC at 03- 246 -6699. Issue B y: t Permittee Signatu 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'N 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. 2005 /JUN /14 /TUE 04:28 PM Conduit Electric FAX No, 5036923652 P. 002 ur(uzizuus ut:o4 rte ousDaolVOU c;1•lx ur 11iAxll tPJUUL q � I :on;orrJCE VS�c (» LY Elec '1 Permit `. e e _ t1 f l9t . ,- , R ece i ve d ` J 41 til L . J Dat E /7 , o f Perm!! No.: G 4 r- a ra1/ Clt 0 ' `riga <'1 Planning Approval Sign. JUN Date": , Permit No.: 13125 S W Sall Blvd. 2� Plan Review Other . . Tigard, Oregon 97223 CITY OF TIG ,RD Date/B • PeltslitNo.: . Phone: 503 -639 -4171 ];ax: 5 lrtul Lard Use �Cifi6C DI �' . «. 1 =i? ( DateJB : Casa No - lnternet_ ww tv,el,tigaxd.or.us j l Contact tti Sec Rage 2 for 24-hour Inspection Request: 503 -639 -4175 '- ` ,'"_ ' Name/Mt:ttnod; MI • • emvttal Information. IMESMEMMabh . • a, 0 E7rYi7 ' : �J�• 3• ?w4.:_gA �•��a"4�,�� y.'ia..-�.�:`w . :PL'A1�1'. • . �o1CaS�� l�.1�, , x�.Y���,' � :1?.:r..} New construction pi New ❑ Demolition ' ❑ Service over 225 amps- ❑ 1- lealth -care facility commercial MPI11.25rdoua location Ii Addt onfalteration replaC ❑ other: 0 Service over 320 amps-rating of ❑ Building over 10,000 square feet, I ' 1, ',.1.? .g1 ' s1fC 0WA LO.FICO t., 6 1 C (O IF.'. '-:C- ;]:.4.: a Ftfo,- 1 & 2 family dwellings four or mom residential units iii ID 1 & 2 -Famil dwelin • ■1. Commercial/Industrial • y D ' System over 600 volts nominal one structure Access() � uildin: Multi-Family Building over three stories Fecdcrc, 400 amps or more _ 0 Occapaat load over 99 persons 0 0 Manufactured structural l or RV park ■ Master Builder • Other: CI Egessilighting plea 0 Other J ,, -; ;:: Submit 7 sets of platter with any of the above l 7 y y A !� i- :ZiJ1" th1 Q 4 � I' n1 Ave- Ii,Tx,:�: 7Ati" ":`'•`. Vac above are not a icable to tem • era construction service Sob site address; 7 ' O e ,S'.(/ 85 A 4 7' .s r i' ii 44 , t � � 1a it s' -- • el oiaicN r :- . .. ..i, .i Suite #: Bld JA • t.#: . • .Number eh.. erdions • er - ermie allowed Pro 45 t re C7i0N .CY.f M A. /'LAafro 11eseri.tion . Qn' Fee(ea4 Toral 1111 i eetlDirections to job site: dwelling g unit Includes a or maid-Willy per Cross st dwellior emit Iadudes attached garage. • D uie- t4�" 1 l S Service Included: 1000 ea. ft. or leas 1 45_ Is Each additional 500 sq_ R or portion thereof 33.40 H Subdivision • Lot : - JJt:�a ens. residential . • 75.00 Limited ever _i non residential WM 75.00. / i EN `Z'EX Ina ► / • arael #: Etch meoufactuted home or modular dwelling i �© yT �i; ; �� n i :ow Qi 6117 4i 56 :. t l:+'a1•,j ` b ,'-y�i . �rviee andlor fir °" ,TP 'r services or lemma - l astallat i 90:90 oe, . alteration or relocation 80 30 200 em• or leas 201 amps to 400 atnvs 106.85 1=101 401 atn • z to 600 :.... 160:60. 1- .W.T1, 9 +r rs7' - �Tl L" I-E► l• . ".5114 ;;t - ;r{i .r 601 nmvsto 10002"3 - MI 240.60 � 1 ta l,lit:s ; `• , : Over I000 emus orvoht 454.65 © Name: C C-A--4-N litf f -re. 5. Cg-,E izecormect onl 66.85 — .Address: •16 0 S ' N X / p p T e m p o r a r y acr 4et5 or feeders - installation, (, 'alteration, or relocation: Cl /StatelZi •: 7 ' ' 0 ( /T 7 g 7 Z 200 , .. or less . 66.85 • Phone: Fax: • 201 amps 10 400 amps 100.30 -, �? � � 401 o 600 am• 133.75 e ,i•,• ,r., t ,_v1 - G �n.e�;an,'ir ?';'s 't:O i _�( �t . ``l e a l..I: - , I( $ranch circuits -!few, alteratinry or Name: • extension per panel; A,ddzesS: A. Fee for branch circuits with purchase of service or feeder fee, each branch circuit II 6.65 Cl /State /Zi ► : • - B. Fee for br rr.h circuits without purchase of • • service or feeder fee, first branch circuit Phone: Fax: Each additional branch circuit - - N Misc.(5ervtee or feeder not included" - E-mail: • 1 ,,, '',, y, _ Each or Lai rtioncircle 53,40 IN r P Y�� `►x11'+ . K .f u ytt e. !w': •-• Y ! ki eh.n_: �,.1�, s '�� � , „ � �i :7a '�.�._ �- � i' �'T.. �� sich sign or vatiioe lighting 111 53.40 Job No: - - . si circuit(s) or a limited energy paucl, t alterndou or extension P c - 2 Business Name: �Gl berg -t C nemrsi on: Address: ! 0 _C X! . 8 . ,, ` • Each additional ins . Mien over the allowable in MTV of the above: Cl /Statc/Zl • : • 1 / J TI /`/ ( 70 62 Per t. •• - :on • Thom- min. 1 hour Mil 62.50 - . Phone: 'S.0 3 6 2 — /V : • Fax: So 3 6 3 Z.— 3 . 2 [eves :..:. on fee; • t MI MN CCB Lie. 14: t9' 641411 �� r ' t r d o,d @ _ C:s ^C1 ] +'r' +��j T i� 'r rr. Supervising electrician • i • _ S S 1 - Oo Si: ► afore lead: - P ; � • Plan Review 25% of permit Fee $ 1 $ . 5 Printrlla e• C ��s ' / .'Jf Lie. #: State Surchar: e 8% of Permit Pee . 5 .., e 0 TOTAL MART FEE +T+`lMMIN Authorized Notice: This permit application =Ores if a permit is not obtained within Signature: Bate: 180 days alter It has been accepted as complete. *Fee methodology sot County Bofdtns Xndustty Service Board. ' (Please print name) - . ifDs1.0eimitFormi\EleFemv1App.doc 01/03 • • CITY OF TIGARD BUILDING DIVISION PERMIT #: ELR2005-00155 13125 SW Hall Blvd., Tigard, OR 97223. DATE ISSUED: 6/20/2005 Phone: (503) 639- 4171 µ ry 4i Itb Inspection Requests (24 Hrs.): (503) 639 -4175 4- 111 INSPECTION WORKSHEET FOR DATE: 6/13/2006 TIME: 7:22AM PAGE: 65 SITE ADDRESS: 16060 SW 85TH AVE CLASS OF WORK: SUBDIVISION: SEWER TREATMENT PLANT LOT #: TYPE OF USE: PROJECT NAME: CLEAN WATER SERVICES DESCRIPTION: Gas detection system replacement. OWNER: CLEAN WATER SERVICES, PHONE #: 503 - 681 - 3600 CONTRACTOR: C ONDUIT ELECTRIC - PHONE #: 503 - 692-1 Inspection Request Scheduled For: Date: 6113/2006 • Pour Time: Code # Inspection Description on 1 Contact # Message 199 Electrical final \ 031630 -01 555 -999 -3331 N Corrections /Comments /Instructions: • • �n1 9V $DASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS I FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED . Inspector: 1 L Date: 6I 13160 Phone #: (503) 7.18- 2-AlAk.