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Permit ELECTRICAL PERMIT , EFP CITY O TIGARD PERMIT #: ELC2006 -00674 COMMUNITY DEVELOPMENT DATE ISSUED: 11/27/2006 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S113B0 - 00600 SITE ADDRESS: 16580 SW 85TH AVE ZONING: I - SUBDIVISION: SEWER TREATMENT PLANT LOT : JURISDICTION: TIG Project Description: (1) feeder & (1) branch circuit for cell site. Job # 3254. 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 HEIL ELECTRIC CO 2550 SW HILLSBORO HWY 8425 SE STARK ST HILLSBORO, OR 97123 -9379 PORTLAND, OR 97216 Phone: 503 - 681 -3600 Contact #: FAX 503 - 255 -4139 PRI 503 - 255 -4074 FEES Description Date Amount Reg #: ELE 26 -66C [ELPRMT] ELC Permit 11/27/200( $86.95 LIC 387 [TAX] 8% State Surcharge 11/27/200( $6.96 SUP 810S Total $93.91 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 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: -� i 1 � Permittee Signature: � `P v 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. 11/27/2006 13:14 5032554139 HEIL ELECTRIC CO PAGE 01 t-Y t 1 I \t, :✓ v -'• - -e' `t. 0 • r — 4 w t-' 2—C' I v "c-ii3Y/(,, � Permit A�ppIcation FOR OFFICE USE ONLY City of Tigard Received �2 Perm No. i Cw Date/n . 7 - /, ld<�.. ide 'VOe ' 13125 SW 1 Blvd„ Tigard, OR 9 C kJ Plan Review Phone: 503.639.4171 Fare 503.598.1960 ' *�f °i ;�J '* Crde/By Other Permit: Inspection Line: 503.639.4175 I , v V 2 7 200 ,,., - ,.- i { DateP-ead run 13 Scc Page 2 for i Internet: www,ci.tigaid.or.us Notified/Method: Supplemental information F3 2 >:�'Sai :•; < :i• %'£ :;t.r,; ak) :rr : :; :3 :gi �,Fi• :,.; :':t, < : : y . x , F . ,.!w :sss > :. :. <,.. . :5 y!i #:'e'•. <•. • : F,... rs,f ; ,s,., ., a .,:• Y , Yr , ?ti �'�' i ?Fii :r' �F )� r '',,�+ !-riff k!r? �' r A is °i : °> � �i7° E k %�fi s r ...,..,.E i2`..... : � a: <.. k„ A: }. . EE:< :! : :;s� ��,,,, -�•• .asst :. >, :' t ,ts::2. L ..... .. .. s .,• : ¢.,r s ;,. ` lei :.Fi! ;i;..' �! .. •s >' iii ei' assns, >" ��,�k�l'ii :� - ' �',. ....s`.3...o-.....,.,...a :..a : :: >., •., �. 1st,.,_ ❑ New cortstructian > �, , ddition/altei ttion/replacemettt Please check all that apply: 0 Demolition 0 Other: ❑Service over 225 amps, conun'I ❑Ha2ardous location : i <.: n, ..�. r ['Service over 320 t;: �;i : : :iF :•.' : :ri ? : : : : %:f 'fY�� <.£��r'Fr'sss :; :< .:r:•):r;'; amps U� ,., i;t:.:. >.,..:,��-( srr:> ).;� p g ©$ ildn over ]0 000 sq. ft •'if x si x -s.. £iii` «rfi% '� :ii :> it �e :i!isi�... : s•. ''y. toss :! ... <.<.< >. >.... >.<..,... ,�� > �;; E: of 1 -and 2-family d wcllin e 'e >`... >....<,. .> ,s�trs;r�,. Y $ 4 or more new residential 0 1— and 2- farttily dwelling 1 Co rc i industrial ❑ Accessory building ['System ovcr600 volts nominal units in one struaurc ❑ Malli y ❑ Master builder ❑ Other. ['Building over three stories ❑Feeders, 400 amps or more b :2s ?r :•;;r,'.; <Y$ >.';., : : :,r :.ins :'sin :a :;: < : +: », <.,, > „•r ., r ['Occupant load over 99 persons ['Manufactured structures or '�t'•, :, 1... S.S. 2 f.: <.: ,S)•� :> ; : «sr, >�' 's : } ss!su >ii; £; 2)r i F5': p :i'.,; o;;t ! + :i'r, 'y pp•,;pp�ra�yy�rn .r aaCi : !fir ,.,.. p�!! :rl[ :Wi liC : l r� :i�,S x r J :. :� f I :: 7� y;�,y�y�rc ¢ K•£ iF! :L� + : :o- :�: ........ ,.�,.e. :l.Eii > : > : %�i },..,., > ?i,,.,�i'^i. .. i 7A` 7:7�i >;vf7�rs� "�iI `J��'`t y': �i :ii; :;;r!1,��� „�.��� :::..:.... ��.... :.,a :,:� :. 3.>.: ` %'i:�$ :, : : :3 : ;.st. » » »;YYYY rs: ❑Egressllightitlg RV park Job no.: Z 411. A Job site address:` , . — ©Health -core facility ['Other: a Submit 2 sets of plans with any of the above. City/State/ZIP: l ci 1v ci 4 t • The above are not applicable to temporary construction service. is �!! :sir!; }.<: i:o gi:ii.; }., : <7. I i >,: .;5i�f i` > >,:¢ +`kp %f^ rt „t.;: £s %. .r :dY: 9ulte/bld ./a t. no.. • eci name ,.. _...,...:a`s'i,.....<..> >' >r;'#���;Sf,.<., >�x,a� "� Y:c• •- z� : : ,x - -t .t. Deacrtpno I Qty. Fee. •.y. 'rata] efOSS strect/directions to job site; New residential single- or multi- family dwelling unit. Includes attached garage. 1,000 sq. R or less 145.15 4 Subdivision: Lot no.! Ea. add'l 500 sq. R or portion 33.40 1 Tax map /parcel no.: Limited energy, residential 75.00 2 NO a. .. —.eas e :_s icr :;a ?f? r . );r. :, :,..... , • •, Limited energy. non- residential 75.00 2 <, £. >: ,: , , f, , at. i:). r, r „ �.�� , «, <i 4. +:6' «ete.a'.i Y>?•re•;r :; •s. > : or +SiF :ii :i 'iis,.. g s;x•) v r' •�c+4ci.i�. 44•:yy,,,r�,,,, <t•�t�t .4, .h ei> ; >:b', ... < • : : >rr, ....,... s;ii + :; : : >: : :': :jQ.wK+f`i'l'�?!'`, • .L"1 ; .6? . , <. :. ; }i :4 :; { .b :< _. .. >.<•! 1•>.x....: ii Y : . ........... ..........� : :. . � :•'^,' :?'...t :i. S: t4:t!:i �� i . >:E: " ».:LS } > :4rr !!•!nit :Y� :Y�E : a 'a 4Y )i ::;: ; � " "` :•. ... .. : :: ;>r ' � � E ch manuftctur ... Y'� : - ed or modular • P 6,9-v \ N J {\ t R e v • 1111 ,. dwelling, service and/or feeder 90,90 2 Services or feeders installation, alteration, and /or relocation 200 amps or less ' 1 I 80.30 l e() .- 2 r�iF :' 'csi : :S;, y�; �`�?, <s . Q. :i� "� :: �:'� ::Q ' 201 acct t 4 ::t:': yy� s a 00 amps , s�t 106.85 ` �. 's; Name: r 401 amps to 600 amps 160.60 2 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 2 Ci /Stare/ZIP: Reconnect only t [ 66.85 2 Temporary services or feeders installation, alteration, and/or Phone: ( ) I relocation , 200 amps Or less 66,25 ,1 . Owner installation: This installation is being made on property that I own which is nOt 201 amps to 400 amps 100.30 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 snips 133,75 Owner signature: ;pate; <; } :, ��,,x 'sifirf•r: • <t: Branch circuits – new, alteration, or extension, per panel :r � > : :' iis: , <'i��£r'^ ��fF£ .t. tY +" A ):c �''.s? �'•� � c for bra nch .. ,.<.<, st+:i � ch circuit s with .r''. '.s: th :'till:: < - �Q : y,+�� ,� � ....... .........•. i %i t: i•: t i'��r, t�t�a y E�� , ''�> "s��V3r; % :: �`i•< :: ��ir£ :F �' ;• • ` i`i5 � � .... . < >•,•t :! :..e ,,.. t'a, ` fib,>. , .......,5<.:' :R;.�?i'.r. : •.... , . , ...;.o... , > :, >.r {�Y;...... Business name: service or feeder fee, each branch circuit 1 6.65 b 2 Contact name: B. Fee for branch circuits without service or feeder fee, 46.85 2 Address: first branch circuit Each add'! branch circuit 6.65 2 City /State/ZIP: lvliscellaneous (service or feeder not included) 1?lwne: Pump or i circle 53.40 I 2 ( ) — 1 Fax:: ( ) — Sign or outline ligjtting 53.40 2 E - mail: .,;•. >, :..,..,.,: ,<.YYi �- . : ,..... < : : :i: ' + :iF :f :.Y...... •xt,t•Y. Signal circuit (s) or �1Ft <S :t:F. • �i :RiSi 'ri :K >: yFS:': . . <. :S :i'ji :aSii�y: :i:2: < : : :: :x %ii :.�.�... ..:...:.d:`•:,. < . n . i,F, rig > " C•'�. :�s? > :Fi;'•� t,' en ergy pariol. .ilteratioq or Business nacre: �� st," extension. Describe: Paget 2 Address: a -- -, , Each additional inspection over allowable in any of the above 7 Per inspection 62.50 City /State/ZIP: 0 ,. : ` n4 �—�{ Investigation per hour (1 hr min) 62.50 EMENEREEKWAIIIMINIMIEIMO Industrial plant per hour 73.75 :, } : > • : ': JGJ. o� .,.'�' , <,',3+ :Wi i ?i: 7 l `3: ?' rrrv.' " >. Subtotal e a Electrical Lie. • .. .. ::; ?;ice: : :MVi..;; . ,.,: _ , _ .�..` jras' „ ) , k '' t : °:l, , Electrician signature, required: , 4 AXIIIIMMINI Plan review (25% of permit lee) • IP • Print nom (j j ” : .4 0 a 44_ I Date: 11 U( State surcharge (8% of permit fee) • r a ! i ? < ))wl '1111k TOTAL PERMIT FEE 1 ? `� l . t „ceo- e d signature: 0, i ] . j -! v v� ' This permit applicatieq expires ifs permit is not obtAlncd within 180 �yln Jt 1 1 ,n S I days atter it has been accepted AS tehipfete Print name; ] V t 1 /� J (� f j�a� f 2 ,..7 go o Feo m gy ethodolo set by Tri_Cotutty Building incrtrtry Service Board '" Number of inspections per permit allowed. i; lBuildvsg \pmuiralFil 12/03 v ( 440.46i5r(t0/0vcoM ,,55 CITY OF TIGARD BUILDING DIVISION %.. A ,\ PERMIT #: ELC2006- 00674 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639-4171 4,47, 4 0 0011i , i Inspection Requests (24 Hrs.): (503) 639-4175 A - 'IL INSPECTION WORKSHEET FOR DATE: 1/60007 TIME: 7 PAGE: 30 SITE ADDRESS: 16680 SW 86TH AVE CLASS OF WORK: SUBDIVISION: SEWER TREATMENT PLANT LOT #: TYPE OF USE: PROJECT NAME: CRICKET PDX-159-B DESCRIPTION: (1) feeder & (1) branch circuit for cell site. Job # 32M OWNER: CLEAN WATER SERVICES, PHONE #: 503-681-3600 CONTRACTOR: HEIL ELECTRIC CO %!NRY3kP\ PHONE #: 50.3..355 Inspection Request Scheduled For: Date: •6/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message '199 Electrica final 041824-01 503-265-4074 Y 5w) 2.5 ■ Corrections/Comments/Inst .ctions: — r be■CZRAs2A- 1 I k PASS Ei PARTIAL APPROVAL 0 CANCEL fl NO ACCESS I] FAIL El CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED Inspector: 1 N L -_. ' Date: 1 s-5- - 0'7 Phone #: (503) 718-1,*