Permit 1111 CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2007 -00077
COM DEVELOPMENT DATE ISSUED: 1/31/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 113 B0 -00600
SITE ADDRESS: 16580 SW 85TH AVE ZONING: I -
SUBDIVISION: SEWER TREATMENT PLANT LOT : JURISDICTION: TIG
Project Description: Electrical service for new collocation. Job No. 12354
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: 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 OREGON ELECTRIC GROUP
2550 SW HILLSBORO HWY 1010 SE 11TH AVE
HILLSBORO, OR 97123 -9379 PORTLAND, OR 97214
Phone: 503 - 681 - 3600 Contact #: FAX 503 - 535 - 2763
PRI 503 - 234 -9900
FEES
Description Date Amount Reg #: ELF 26 -95C
[ELPRMT] ELC Permit 1/31/2007 $80.30 LIC 203
[TAX] 8% State Surcharge 1/31/2007 $6.42 SUP 4460S
Total $86,72 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 = • • = han 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center.
Those rul s are set fo 'n OA: 952 - 001 -0010 through OAR 952 -001 -0100. You may obtain copi these rules or direct questions to OUNC at
503.246.•699 or 1.800.33 44.
Issued :y: I . / i_4 J /1 _i Permittee Signatu _ `0
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:
ONTRACTOR 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.
A
JAN -24 -2007 06:43PM FROM -OR ELECTRIC SVC 5035352763 T -891 P 003 /010 F -468
,r,tkviricat rermit i ppuial.Iuu,
iti - Received
City of Tigard ' , 1. >alte /B / � y�0 � %� Permit No.: EL 6 i ?- a bp 77
13125 SW Hall Blvd, Tigard, OR 97223 Plan Review
a
Phone: 503.639.4171 Fax: 503.598.1960 �►,,`` ak �lI QatctBK other Pcm
Inspection Line: 503.639,4 41,14 Date Ready /By ]aria ®Sec Paec for
Internet: www,ci_dgtreLor.us Notified/Methoth Supplementallnrormation
i
i.-
TYPE OF WORK_ /-1: 1. . PLAN REVIEW
® New construction ❑ Additionfalteiation /rep acement
Please check all that apply;
['Service over 225 amps, comm'l ❑ Hazardous location
Demolition ❑ Other:
- ❑ Service over 320 tamps - rating ❑IIuildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION al- and 2- family dwellings 4 or more new residential
❑ 1- and 2 family dwelling ® Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi - family ❑Master builder ❑Other: ❑ Building over three stories ❑Feeders, 400 amps or more
El Occupant Ioad over 99 persons ❑Manufi Ctured structures or
JOB SITE INFORMATION AND LOCATION 1 ❑ Egress/lighting plan RV park
Job no.: 12354 Job site address: 16580 SW 85 AVE ❑Health -care Rtcility ['Other.
Submit 2 sets of plans with any of the above.
City /State/ZIP: TIGARD, OR 97224 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: Project name: CLEARWIRE CELL TOWER Fes' SCHEDULE
_ Dcneiptloo I Qty_ Fro Toon --
Cross street/directions to job site: MIGHT BE SLIGHTLY ISOLATED New residential single -or multi - family dwelling unit.
- Includes attached garage. _
JUST NORTH OF BONITO RD ON SW 85 AVE 1,000 sq, ft or less 145.15 4
Subdivision: Lot no.: En. addl. 500 sq, It. or portion 33,40 1
Limited ascrgy, residential 75.00 2
Tax map /parcel n0
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
POWER TO NEW CELL TOWER dwelling, service and/or feeder 90,90 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
CI PROPERTY OWNER I ® TENANT 201 amps to 400 amps 1 06.85 2
401 amps to 600 amps 160.60 2
Name: CLEARWIRE COMMUNICATIONS 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
relocation
Phone: ( ) Fax: ( )
200 amps or less 66.85 I
Owner installation: This installation is being made on property that I own which is not 201 amps to 40D 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 I ❑ CONTACT PERSON A Fcc for branch circuits with
service or feeder fcc, each
6.65 2
Business name: branch circuit _
B. Fee for branch circuits
Contact name; without service or feeder fee, 46,E5 2
Address: each branch circuit
Fach add'I branch circuit 6.65 2
City/ State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) Lax:: ( ) _ Pump or irrigation circle 53,40 2
Sign or outline lighting 53,40 2
E -mail: Signal circuit(s) or limited-
- —
CONTRACTOR energy panel, alteration, or
extension_ Describe; Paget 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 c Investigation per hour (1 hr min) 62.50
Industrial plant per hour 73.75
Phone: (503) 234 -9900 I Fax; (503) 535 - 2763 _ _.
� - ELECTRICAL PERMIT FEES'
CCB Lie.: 203 I Electrical Lic.: 6 -9 C I Sup.. Lic.: 4460S Subtotal SO , 30
Suprv_ Electrician signature, required: / Plan review (25% of permit fee)
L.4 ■., _.� 4CI.r
Print name: M iU1L) j / / , a ate: 01/,', State surcharge (8% of permit fee) & ,
TOTAL PERMIT FIEF, 13& ,
Authorized signature: �/ _ This permit application expires I r a permit Is not obtained within 1t3o
i ' • �7 t trJ r /'T days atter It has been accepted us complete
Print name: �/ ' � 1 r • Fie methodology Set by Tri Building Industry Sere.. Board
• • Number of inspections per permit allowed.
i:\ BuildlnI \Pemtitn\PLC- PermitApp,dor 12103 - 441 - t 'JCO.M/WEB
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007- 00077
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/3112007
Phone: (503) 639 -4171 / �ra�� i �i�Vll�l��
Inspection Requests (24 Hrs.): (503) 639 - 4175±1
INSPECTION WORKSHEET FOR DATE: 7/12/2007 TIME: 7:04AM PAGE: 78
SITE ADDRESS: 16580 SW 85TH AVE CLASS OF WORK:
SUBDIVISION: SEWER TREATMENT PLANT LOT #: TYPE OF USE:
PROJECT NAME: CLEARWIRE
DESCRIPTION: Electrical service for new collocation. Job No. 12354
OWNER: CLEAN WATER SERVICES, PHONE #: 503 - 681.3600
CONTRACTOR: OREGON ELECTRIC GROUP PHONE #: 503 - 234 -9900
Inspection Request Scheduled For: / Date: 7/12/2007 Pour Time:
Code # Inspection Description Confirm Contact # Message
199 Electrical final 051791 -01 \ 503-849-3291 Y
I -I
Corrections /Comments /Instructions:
ASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
n FAIL _ CALL FOR INSPECTION [j] ADDITIONAL FEES ASSESSED
Inspector: cy 1 Date: 1 `It 01 Phone #: (503) 718- *lb IV