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Permit
C ITY OF TIGARD . ELECTRICAL PERMIT I PERMIT #: ELC2005 -00755 DEVELOPMENT SERVICES DATE ISSUED: 10/6/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S 113 BO - 00600 SITE ADDRESS: 16580 SW 85TH AVE ZONING: I -P SUBDIVISION: SEWER TREATMENT PLANT LOT : JURISDICTION: TIG Project Description: (1) circuit for fire alarm panel for NW Fire. Job #88043. 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: 1 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 OREGON ELECTRIC CONST /GROUP 2550 SW HILLSBORO HWY 1010 SE 11TH AVE HILLSBORO, OR -9379 PORTLAND, OR 97214 Phone: 503 - 681 -3600 Phone: 503 - 234 - 9900 FEES Reg #: LIC 203 Description Date Amount SUP 4460S ELE 26 -95C [ELPRMT] ELC Permit 10/6/2005 $46.85 [TAX] 8% State Surcharge 10/6/2005 $3.75 REQUIRED ITEMS AND REPORTS Total $50.60 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: �" f r y _ Permittee Signature: OWNER INSTALLATION ONLY �( 6 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. OCT -05 -2005 12:01PM FROM -OR ELECTRIC SERVICE 5035352763 T -198 P.001 /002 F -550 f .......,...,.... .,. a. ... lea- + u..u.aim.' 1 j V j� • i.Ity of Tigard Received n - Dair/sy / )3 " �- Permit No.� / . 753 $ ) 13125 SW Hall Blvd-, Tigard, OR 97223 !` yl i �y OCT Plan Review Other Permit: Phone: 503,639.4171 Fax: 503.598.I960 C I l/ rl 001 "y`t 1 I �` Du n/ Inspection Line: 503- G39.4175 . ,.,! - .1_ Dote Ready/By! 0 See Page 2 for Internet: www.ci.tigard.or.us CITY OF TIGARD Notified/Method: ; Supplemental Information • 'IYPliI ' /ISIOi'V PLAN REVIEW ❑ New construction ® Addition/alteration/replacement Please check all that apply: 0 over 225 amps, comm'l ❑Hazardous location ❑ Demolition ❑ Other ❑Service over 320 amps - rating © Buildng over 10,000 sq, ft., CATEGORY OF CONSTRUCTION of I- and 2..faniily dwellings 4 or more new residential ❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building - ['System over 600 volts nominal units in one structure 0 Multi-family Master builder ❑ pThet; ❑Building over three stories ['Feeders, 400 amps or more ['Occupant load over 99 persons ❑Manufactured structures or JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park Job no.: 88043 Job site address: 16580 SW 85 Ave. ❑1icalth -care facility ['Other: Submit 2 sets of plans with any ofthe above. City /State/ZIP: Tigard, OR 97224 The above arc not applicable to temporary construction service. Suite/bldg./apt no.: Project name; Clean Water Services -, FEE SCHEDULE Umcrlplloa Qty- I no. 7 Torn] I " Cross street/directions to job site: New residential single- or multi- fiunily dwelling unit_ Includes attached garage. _ 1,000 sq. ft or less 145.15 4 Subdivision: Lot no,; Ea. add') 500 sq. ft, or portion 33.40 _ 1 TeX reap /parr el no.: Limited energy, residential 75.00 2 Limited energy, noel- residential 75.00 2 DESCRIPTION OF WORK Each manufactured or modular Add circuit for fire alarm panel for NW Fire. dwelling, service . tnai /or feeder 90.90 2 Services or feeders installation, alteration, and/or relocation 200 amps or less 80,30 2 ❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 Name: Clean Water Services 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 2 Reconnect only 66.85 2 City/State/ZIP: _ Temporary services or feeders installation, alteration, and /or Phone: ( ) Fax: ( ) relocation I 200 amps or less 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2 Owner Signature: , Date: Branch circuits - new, alteration, or extension, per panel ❑ APPLICANT r ❑ CONTACT PERSON A. Fee for brunch circuits with service or feeder fcc, each 6.65 2 Business name: branch circuit 13. Pee for branch circuits contact name. without service or feeder fee, e ach branch circuit I 46.85 l# �, 8S 2 Address: - Each add'l brunch circuit 6.65 2 City / State/ZIP: Miscellaneous (service or feeder not included) Phone: ( ) ( Fax:: ( ) Pump or irrigation circle 53.40 , 2 Sign or outline lighting 53A0 2 E -mail: Signal circuit(s) or limited- CONTRACTOR energy panel, alteration, or extension. Describe: Page 2 2 Business name: Oregon Electric Group Address: 1010 SE 11th Ave _ Each additional Inspection over allowable in any of the above - Per inspection 62.50 City / State/ZIP: Portland, OR 97214 I Investigation per hour (1 hr min) 62.50 - Phone: (503) 234 -9900 I Fax: (503) - 2763 Industrial plant per hour 73.75 CC13 Lie.: 203 I Electrical Lie.: 26-95C Su ELECTRICAL PERMIT FEES* p it_.: 4 46US Subtotal i s Suprv. Electrician signature, required: // Plan review (25% of permit the) State surchar (3% of p ermit feo) Print name: , , \ J a a te: 1Of5 /0� r S � TOTAL PERMIT FEE 50. le 0 Authorized signa 1 ' This permit appticvtian expires if a permit Is not obtained within 180 M - pc C , n N do sat after b It Had accepted as complete Print name: 1 / h Date: 10 /$/05 Fee mvtbudologv sal by hi- County Building industry Service Sanr4 •• Number of inspections per Octmit allowed, CITY OF TIGARD . BUILDING DIVISION PERMIT #: ELC2005.00755 1 13125 SW Hall Blvd., Tigard, OR 97223 , — DATE ISSUED: 10/6/2005 Phone: (503) 639 -4171 titol itili' 1 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 10/19/2005 TIME: 7:03AM PAGE: 76 SITE ADDRESS: 16580 SW 85TH AVE CLASS OF WORK: SUBDIVISION: SEWER TREATMENT PLANT LOT #: TYPE OF USE: PROJECT NAME: CLEAN WATER SERVICES DESCRIPTION: (1) circuit for fire alarm panel for NW Fire. Job #88043. OWNER: CLEAN WATER SERVICES, PHONE #: 503 -681 -3600 CONTRACTOR: OREGON ELECTRIC CONST /GROUP PHONE #: 503 -9900 I Inspection Request Scheduled For: Date: 10/19/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical fines 018655 -01 503- 644 -7720 Y Corrections /Comments /Instructions: 1 0 © PRai ►D'i. u RSA `' (- z�i`i 4 % " P4(%)._. © �v O 7s v Loc..k, • 6 N `� O'av i CI F a F iie , C, R. Lv 1 l 1 n PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS y p FAIL &CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: G N o (6 Date: 1 CAS c\\ Phone #: (503) 718- 2M01 CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC200&00755 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1W6/2005 Phone: (503) 639 -4171 �,,,up�,,,, i -' Inspection Requests (24 Hrs.): (503) 639 -4175 ' A .. INSPECTION WORKSHEET FOR DATE: 11/14/2005 TIME: 7 :12AM PAGE: 132 SITE ADDRESS: 16580 SW 85TH AVE CLASS OF WORK: SUBDIVISION: SEWER TREATMENT PLANT LOT #: TYPE OF USE: PROJECT NAME: LEAN WATER SERVICES DESCRIPTION: (1 : 'rcuit for fire alarm panel for NW Fire. Job #88043. OWNER: CLEAN t ATER SERVICES, PHONE #: 503 681 - 3600 CONTRACTOR: OREGON LECTRIC CONST /GROUP PHONE #: 503 -234 -9900 Inspection Request Scheduled For: Date: 11/14/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 021070 -01 503-81 N Corrections /Comments /Instructions: — '1'a► W DID 1V\IN i) PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: RA.)6 t.,) Le . Date: Oi L i ( Q Phone #: (503) 718- 2 -446 —