Permit A
CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2009-00438
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/03/2009
Parcel: 2S113B000600
Jurisdiction: Tigard
Site address: 16060 SW 85TH AVE
Subdivision: SEWER TREATMENT PLANT Lot: 0
Project: Clean Water Services
Project Description: Extend existing underground conduit approximately 2000' to existing Struvite Recovery factory.
Owner: FEES
CLEAN WATER SERVICES Quantity Description Date Amount
2550 SW HILLSBORO HWY
HILLSBORO, OR 97123 4 hr Hourly Electrical Rate 09/03/2009 $250.00
PHONE: 1 ea Hourly Electrical 12% 09/03/2009 $30.00
Surcharge
Contractor:
OREGON ELECTRIC CONSTRUCTION INC
1010 SE 11TH AVE
PORTLAND, OR 97124
PHONE: 503 - 234 -9900
FAX: 503 - 535 -2763
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $280.00
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 throue •AR • 001 0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246. r 1.800.332.2344.
4
Issued V: i � Permittee Signature:
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept In a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
• ti
A.VJ[8-09 09:30 FROM- Oregon Electric E rED +5032313587 T -708 P.002/002 F -475
' I v rOltoFt'1cEVS� • Electrical Permit A lication
Received ! Pernotxo. 1
City Of Tigard p 2 6 2009 Deceive 1 C2
74 - n 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review p Permit;
(F T IG A bateau : ® See Page 2 for
lnape 503 Line; 03 fax: 503.598.19�� p Re
inspection Line; 503.639.4175 (( i DIVISION P a te R e i d en+ad S'�NlCroen[al Information
TIGARD Intent= Wwwugas
BUILDING _ -
PLAN REVIEW. .. _
11T1E OT WORK
Please check all that apply (submit 2 seL. of plans w•
iiserrc checked below):
® New construction CI Addition/alteration /replacement ❑ Service or feeder 400 amps grim= ❑ Building over three stories.
where the available fault current El Marinas and boatyards.
❑ Demolition ID Other: exCCCd$ 1 0.000 amps oL 150 Vp1L< or CI Floacins bltildin�
CATEGORY OF' CANS 1 ItUC 1 ION is to ground. or exceeds 14.000 ❑ Cotnmercial•tUSC agricultural
❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps for all other hwtallatiorm. buildings
0 CI Fire pump. ❑ inRtallation of 75 KVA or
[� Multi- family ❑ Master builder ❑ c Ci Emergency system, larger separately derived system
' " ' O E INFORMATION AND LOCATION , ': : . O Addition of new motor load of ❑ "A ", "E ", "1 -2 - , -1.3 ",
. , JB ,SIT 100147 or more. occupancy.
❑ R ec reational vehicle parks.
Job no.: 14360 Job site address: 16060 SW 85 Ave q Six or or ma rxidcntiat cnia l voltage far more than
(] Health -care futilities. El SuPP Y
a Hazardous ovations. 600 volts a r
City /S[atc /ZIP: Tigard / OR / 97224 p Service or feeder e ns. 0 amps or more.
Suite/bldgJapt. no.: Project name: North Gravity Sewer FEE SCHEDULE . •
•
t)tsrr; don OEM. I 11110113. •
Cross street/directions directions to job site: Clean Water Services Site New residential single- or multi- family dwelling unit.
includes attached garage. 4
1,000 sq. ft. or less 145.1
Lot no.: 33.40 1
Subdivision: Ea. add'I 500 sq. ft. orporrion
Tax map /parcel no.: _ - Limited energy residential 75.00 2
with above . 4L
DESCIR1PT10N OF WORK ' Limited energy, multi - family 75.00
Extend existing underground conduit approximately 2000' existing St ttvtte • Services or feeders installation. alteration. and /or relocation
200 amps or less 80.30 2
Recovery Facility 106.85 2
❑ TENANT 201 amps to 400 amps
PROPERTY' OWNEIZ , . . 401 amps to 600 amps 160.60 r 2
Name: Clean Water Services - _601 amps to 1,000 amps 240.60 2
Address: 16060 SW 85 Ave f
Over 1,000 amps or volts 454.65
Temporary services or feeders installation, alteration, and/or
CitylState /ZiP: Tigard / OR / 97224 _ relocation 1
Phone: (503)681-3600 Fax : (503)681 -3603 200 amps or less 66'85 10030 2
201 amps to 4M amps
Owner installation: This installation is being made on property that I own which is not 401 GPs to 599 amps 133.75
intended for sale, /case, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits - new, alteration, or extension, per panel
Date: A. Fee for branch circuits with
Owner signature: T — above service or feeder fee, 6.65 2
® APPLICANT•, ❑ CONTACT pE 1tSON each braiichcir
13 Fcc for branch circuits
Business name: Oregon Electric Construction, Inc. without service or feeder fee, aG.85 2
first branch circuit
Contact name: Travis )Brinkman
Address: 1010 SE 11 Ave Each add"' branch circuit 6.65 _ 2
Miscellaneous (service or feeder not included).
Each manufactured or modular 90.90
- 2
City/State/ZIP: Portland / OR / 97234 dwelling, service and/or feeder G.85
_
2
Phone: (503) 535 -2616 Fax :: (503) 2 34 - 1001 Reconnect only 5 2
E-mail: t w.brinkman@oregon-electric.com Pump or irrigation citcl SiSign or outline lighting
c 53.40 ,4
2
CON I RA I =TOR, Signal circuit(s) or limited -
Business name: Oregon Electric Construction, Inc. energy panel, alteration, or 2
extension. Describe: Page 2
Address: 1010 SE 11th Ave
Each additional infection over allowable in any of the alwve
City/State/ZIP: Portland / OR /97214 - Per inspection 4 62.50 250.00
F (503) 234 -1001 --- Investigation per hour (1 hr min) (2.
Phonc:(503)535 - Z 61 G 73.75 _
G Suprv_ LiC. hotu .
Electrical l.ic.: A,-i5 P - b / .� - Industrial plantper hour ItICAI PERMIT - FEES .
/ /' /" • . (. r, Subtotal: 250.00
Suprv. Electrician signature, require. 411/ � ' � I� LFI s Plan review (25% of permit fee):
r' ' Date: `. State surcharge (12% o perm f ee ) : 30.00
Authorized signature:
• � ` _ � � b. Ili ._.. TOTALPERMiT 280.00
41 _,,, - �,� .iii This permit application expires ir permit Is not obtained within 'so
V .,, , L 1 r• Date: days after it has been accepted as complete.
Print name: - • Number of inspections allowed per permit.
I:d aap.461 sr(t tro5/CO
ewldinzwerrn ffiC- PumiWpp.doc Mr23106
J026-09 09:30 FROM- Oregon Electric +5032313587 T -708 P.001 /002 F -475
OREGON ELECTRIC GROUP
1010 S.E. 11TH AVENUE
PHONE: (503) 535 -2616
l ocsi m i te FAX: (503) 2341007
C ELL: (503) 572 -0737
To: City of Tigard Fax: _ 503 -598 -1960
From: Travis Brinkman Date: — August 26, 2009
Re: Building and Planning _ Page: 1 of 2 _
Job #: Cc: Lorraine
0 Urgent a For Review 0 Please Comment a Please Reply 0 Please Recycle
Notes /Comments:
Please Note: Electrical Permit application for Oregon Electric
Group. This installation involves installing conduit racewa only with
no conductors. Per phone conversation with Gary Nobel a charge of
4 inspections was agreed upon. ; e.l _ t Vb., Se
-
-{� _( . )01 , e ° . Q rP y iRc..t c,r_ ►' P � � . V t }- Vip -
0 '
Please call if you have any questions. . kJ
Thank You!! r ()RE! e,
ELE
Travis Brinkman
Project Manager