Permit CITY OF TIGARD ELECTRICAL PERMIT
e PERMIT #: ELC2005 -00418
DEVELOPMENT SERVICES DATE ISSUED: 6/16/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S113B0
SITE ADDRESS: 16580 SW 85TH AVE ZONING: I -P
SUBDIVISION: SEWER TREATMENT PLANT LOT : JURISDICTION: TIG
Project Description: Install (2) lights on crane.
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: 1 W /SERVICE OR FEEDER: 1 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:
CLEAN WATER SERVICES MILESTONE ELECTRIC
2550 SW HILLSBORO HWY 1800 NW 169TH PL. SUITE B700
HILLSBORO, OR 97123 -9379 BEAVERTON, OR 97006
Phone: 503 - 681 -3600 Phone: 503 - 645 -5323
FEES Reg #: ELE 34 - 618C
Description Date Amount LIC 153480
SUP 2113S
[ELPRMT] ELC Permit 6/16/2005 $86.95
[TAX] 8% State Surcharge 6/16/2005 $6.96 REQUIRED ITEMS AND REPORTS
Total $93.91
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 follow rules adopted by the Oregon Utility Notification Center. Those rules are set
forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699 or
1- 800 - 332 -2344.
Issued By: ,� Permittee Signature: •Z ate
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.
I
•
' ' Ilectrical Permit Application _
Received // ! n { �p ��cyl , g ,, �
Date/By: h 76 L-F— Permit No, :�3 (/ trO r
City of Tigard Nanning Approval Sign
13125 SW Hall Blvd. plan Review Other
Tigard, Oregon 97223 Date/By: Permit No.:
Phone: 503- 639 -4171 Fax: 503 -598 -1960 Post - Review Land Use
Internet: www.ci.tigard.or.us R Daff Case No -:
24 -hour Inspection Request: 503.639-4175 '4 . `f J" Contac t J 1u1 See Page 2 for
Natne/Method: T -U , Supplemental Information.
1 : r :1 :1: W:', ?M). �r 70 ,14'?'r4 , L'r ' 3' i :4.7. v` 3 k s, . >: 1' ; :P. "1L • /7..1'y 1 1� `. 1"� I s .4],4.,-.2,o! fI '41" t, �` � ' h . 1 r7.
1 - .1.1. oJ.{h.e1., 1' n -
ru New construction IN Demolition • Service over 225 amps- • Health -care facility
ddltion/aiterahon/re • laeement 111 Other commercial ID Hazardous location
ti , i I . r ..3 t :,'1: r ❑ Service over 320 amps.rating of ❑ Building over 10,000 square feet.
,i, : s a ,''` 1 i i - i r it t f � .� . 1.5' a.. ' I & 2 family dwellings four or more residential units in
II I & 2 -Famil dwellin 176 Commercial/Industrial 0 System over 600 volts nominal one structure
NI ACCBSSO Buildin_ 11, Multi -Famil ❑ Building over three stories l� Feeders, 400 amps or more
❑ Occupant load over 99 persons ❑ Manufactured structures or RV park
F Master Builder IN Other: ❑ E plan ❑ other.
tl.t1":'; r 4 ,- ' .4i alEfr:ERI'L .;I 4 ps is I I �' , s � � l.i `'+�^•' "� 'T''�', Submit _ sets of plans with any of the above.
.. ,: n
Job site address' 1� (4.) •
The ' Nr. ` The above are not a. disable to tern ore construction service.
Suite #: Bid! .1A MI �'' •� .� a ;,� ;t ; -'��..
t, #: • • , • Number ' Inspections per permit allowed
Pro'ect Name: .. Description Qty L Fee Cu.) Total I
Cross street/Directions to job site: New r
or tumid-family per j
dwelling malt. Includes attached garage.
Service included:
1004 sq, It or leas 145.15 4
Each additional S00 sq. R or portion thereof 33.40 1
Subdivision: Lot #: Limited energy, residential I 75.00 12
Limited energy, non residential '15.00 2
Tax ma • ■ arccl ?: Each manufactured home or modular dwelling
i ' 't I Y'* r t ir' r t 1 •` i ■ L "" i.; -, service and/or feeder 90,90 2
,• Services l a te tines s� lostallatiom,
*t' ; ta aiterathta o r atlour
200 amps or less / 80.30 3 2
201 am. - to 400 am. 106.85 2
401 amps to 600 amps _ 160.60 2
, 1 :1+, , i r ? t ' .; I t ` °`, '• ,f 601 amps to 1000 amps 240.60 2
Name: Over 1000 Amps or volts 454.65 2
Reconnect OJy 66.85 2
Address: Temporary services or feeders - iustallatlon,
Cl /St8te/Z • : alteration, or relocation:
200 amps or less 66.85 I
Phone: Fax 201 amps to 400 amps 100.30 2
r Name: c i r , 'l;, 4 401 to 600 amps 133.75 2
' Branch circuits - new, alteration, or
extension per panel:
Address: A. Fee for branch circuits with purchase of
service or feeder foe, each branch circuit / 6.65 tip 2
Ci /State /Zi • : B. Pee for branch circuits without purchase of
Phone: service or feeder fee, first branch circuit _ 46.85 2
Fax: Each additional branch circuit 6 -65 2
E-mail: Misa(Service or feeder not included):
c . i i :; ., 1 F ' e ' 1; < y v ✓ Each pump or irrigation clack 53.40 2
ob N O: 0 Each sign or outline lighting 53.40 2
Signal circuit(a) or a limited energy panel,
elteratio.,, exenaion
Business Namc: r yl, - 1 Page 2 2
Address: /. f►O , W 6, - y� ' - t Q TO i' Description!
Each additional Inspection over the allowable in any of the above:
Cut /State/Zi • : t A. 0 / O a' Per" cdon r hour min 1 hou
Phone:sTJ - — 23 Fax. .3- -, — ehr'4i3 investigation fee: G2.50
• ; . Other:
Supervising electrician c .
li r tt. . r.
A Subtotal S "x
si _ ature re. uired: !. P lan Review 25% of Permit Fee S
affillP State Surcharge (8% of Permit Fee) $
TOTAL PERMIT FEE 321..
A — ,
Authorized
attire: / / Notice: This permit application expires if a permit is not obtained within
6n , D ato: Co l f ' - OS 180 days after it has been aceepted as complete.
/ /j s '/ / 1 � GG /fr 'Fee methodology set by Tri County Building Industry Service Board.
.
(Please print name)
i : \Dsts \Permit Forms \EicPermitApp.doc 01/03
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CITY OF TIGARD _ r `
NI Y
BUILDING DIVISION PERMIT #: ELC2005-00410
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/1U2005
Phone: (503) 639 -4171 A401 � i l �
Inspection Requests (24 Hrs.): (503) 639 -4175 ...'
INSPECTION WORKSHEET FOR DATE: 6/23/2005 TIME: 7:10AM PAGE: 19
SITE ADDRESS: 16580 SW 85TH AVE CLASS OF WORK:
SUBDIVISION: SEWER TREATMENT PLANT LOT #: TYPE OF USE:
PROJECT NAME: DURHAM PLANT
DESCRIPTION: Install (2) lights on crane.
OWNER: CLEAN WATER SERVICES, PHONE #: 503- 681 -3600
CONTRACTOR: MILESTONE ELECTRIC PHONE #: 503 - 645.5323
Inspection Request Scheduled For: Date: 6/23/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 009998-01 503- 807 -3588 Y
Corrections /Comments /Instructions:
N se, c 103 - l° $7
6c---/
A PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED 1
Inspector: AVz —f--c,. _ Date: 4 ' —23 - `- 3 Phone #: (503) 718 -