Permit C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00004
-�JII-h DE 5 SW Blvd., Tiga Tigard, 97223 DATE ISSUED: 1/4/2006
23 503- 639 -4171
PARCEL: 2 S 113 B0 -00600
SITE ADDRESS: 16580 SW 85TH AVE ZONING: I -P
SUBDIVISION: SEWER TREATMENT PLANT LOT : JURISDICTION: TIG
Project Description: Temporary service for temporary shower /washroom trailer.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: 1 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: 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 CONDUIT ELECTRIC
2550 SW HILLSBORO HWY DBA DU IT LEVEL TOOL CO
HILLSBORO, OR -9379 19461 SW 89TH AVE
TUALATIN, OR 97062
Phone: 503 - 681 -3600 Contact #: PRI 503 - 692 -1428
FAX 503 - 692 -3652
FEES
Description Date Amount Reg #: SUP 4501S
[ELPRMT] ELC Permit 1/4/2006 $66.85 LIC 109669
[TAX] 8% State Surcharge 1/4/2006 $5.34 ELE 26 -905C
Total $72.19 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 fa •• - = • -n 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules a = -t forth in OA -15 •1 -0. 0 through OAR 952 - 001 -0100. You may obtain copies of • - - rules •r direct questions to OUNC at
503- • 6-6699 or 1- 800 -3 2344.
Iss ed By: Permittee Sign Allift
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• :. i d�—� DATE: f 7
LICENSE NO: d 0
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.
2006 /JAN /03 /TUE 05. � t c ri FAX No. 5036923652 P. 001
•
Elect cal <'ermit AnplicatilDn ' bolt of FR - r I (m l.l
City of Tigard Received ' i Ar An Permit No.: (e 6, - woo A
13125 SW Hall Blvd, Tigard, Olt, 9 ,,,K.1_ Plan Review
Phew. 503.639.4171 Fax S .9 1 } • - ,� I Datedi . Odor Permit=
Inspection l ine; 503.639.41 T in TI'N ( Tr , i r 1 • Dale R ead y B y. Ed See Paget for
Internet www.cl.ligard,or.0 l 3 i. '•- - Noti5ed/Method: •
Sapplemeatal lnformstion
• -tr t ;7,7%7 j 't '' A . ,"�vP -11, �•'-r,,pu•f).P . j2rrr 1 t } � .. TIC T + t ' 7 5- � ' c.',7r =. _• `: :'7. 7�r� 7 7
; r ..tr r�..^w r.'!;Aii:.1 ���.�>L � sl.� li?S mm'sY�Sa��'Y.3}Y :+. i 1 L ..vi... _ �.w. .._._..... �..:2, . wS... S 5� ...:efi i;.:t z _»,.,:_..a‘.„o_...::�r"
0 New construction ❑ Addition/alteration/replacement Please check all that apply:
1:1 Demolition ❑ Other: DServiceover 225 amps; comni l 01 location
T,sDemr w 7 . h f •rt Service over 320 amps -rating OBUtidng over 10,000 sq. ft, ,
':.41,1,,,v----,...-: � v -;6',---,t.':_ 1 '' a9 ,t f . c p ' x'r: `ri'.r � �t �i t e .! �s`e •k1. -4 ;:a. •` +: -l;..^ :, of x - 4 or more new e
j_ ; � L y, a;� f and 2 . n residential
T �F��tJ�.� ^ �,(vs�: 1 ]._ .. d �Oh.. �iC•e+.r.:3 ?}!n•Ii.: :.
❑ I- and 2 - family dwelling /:1 Coix]merciaitndustrial ❑ .Accessory building ❑System over 600 volts nominal units in one structure
El Budding over three stories OFeeders, 400 amps or more
❑ Multi- family ■ Master builder 0 Other
3� -• „� >•��- .�,.• v -.a,7• -�• � ;, -.�„� a�;� �;•�- � ;:� , � ['Occupant load over 99 persona ❑Manufactured structures or
; 7 j�'t.i ' :? - ?•'1 c � F''4 i.,r -s *. 1 , � ' ' '"�'I� i'T .• , RV
``� 7:::: ` 1 1, 1� . ;; , r. - N r3 ,�° M W. i s, „ .,, ❑Egre ss/lightin plan
park
.':�:ui:2',�•s;:�;•:i:�:i,: ,_��a� _ �..� :�•:.+��. + : • i'!,Sr ,,v.�• i�x• 8 p
Job no.: Job site address: :,��: ] 4 OHetaltb -care facility . 0 Otber:
i • • r Submit 2 sets of plans with any of the above.
City/State/LIP: T 0/ J G''101 The above are not applicable to temporary construction service.
Suite/bldg,/apt. no.:. U Project name: i r � C.• :,l wr .5 ° . �
Deeviptien Orr- Fee. Total
Cross street/directions to job site: New residential single- or multi - family dwelling unit
Includes attached garage.
• 1,000 sq. ft. or less 145,15 4
Subdivision: - 1 Lot no.: Ba. add'l 500 aq. ft or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.: man -
,.':-„ m; , ,tee. .�' r. N. Limited energy,ioomresidential 75.00 2
. u , i( ' , r /,, ,a » 14 JS: 1,. I.. d y C . � ti ���. a . 4 '�. l .. Each ufacttri ed or modular
.�,.i,- >'. ,..!.�L.u.z,_�L.. -w•� • �r�Ms c- ;,.•.a,.. ��, e, t�•r.d. Eacc
ec,^,p/�� . /'� dwelling, service and/or feeder • 90.90 2
L R j n . T'C � e l 1a[ I �_.Q Services or feeders installation, alteration, and /or relocation
200 amps or less . 8030 2
. •� ,err7.* _.' i1 �+ 7 ,- .1," r 201 amps to 400 amps 106.85 2
f - t �.--, - -;,- . 4 ` a n� o '. ; 1 4 . ,.t E 4H ..2, ` ;
.t, "'�:.0 ^L 4 ,v *: hf s a. .1' .4. u :.[il�.,S.: L. i...:...� , . .ly. . , , v..i...T._"f E • _
401 amps to 600 amps 160,60 2
Name: . . 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: Temporaryaervices or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( )
I _ 200 amps or less I 66.85• U( I
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, leasc,'rent, or exchange, according to ORS 417, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature:. Date: Branch circuits - new, alteration, or extension, per panel
♦ n i� - '._'. 4,-'..‘--.., ,, r- r, ∎ �• 7 ";, .it � _ S ' -. A. Fee rot bmath CirtUita With *�.� r -..1V 7��4 v� -i t i : �i f
E� -' 7tw S.LS'r7: C -• , r =
i 3 ..:.:.,_ '....,. to.xr: ^?^.,�. 4
i3_aC..u: * s ti:3..cca��L�- z�.�� ��a�•,._�: service Or feeder f96, Caeb
Business name: • branch circuit
6.65 2
E. Fee for branch circuits '
Contact name: withou/ service or feeder fee,
each branch circuit 46.85 2
Address: Each adds branch 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 53.40 2
E - mail: • Signal circuit(s) or limited -
,,��.. _ .• ` .. , -,: r'g c:�k, 4 �t�•. '.. *i enetgy panel, alterati0A, or
.: ; 4 ��s4Vn:'7;Ir�"i,.. � ;fi EOhlt�. .7" 'C]t��c ='M , r"P�,�� e�y�iSvwzlitii
^t;r. • • ' ~ extension_ Describe: ion_ Dibe: Paget 2
Business name: Coach t a F 1 t _
. I ,� • )acs. additional inspection over allowable iu nn 'of the above
Address: g y 16 5� (1 ` C n ` J
/�
/� inspection 62.50
- City /State/ZIP: - a s ci � 1 r , Industrial plant per hoar 73.75
e `7 -7)( 0 a . _ luvestigation pm hour (1 hranin) 6250
Phone: (933) L xlc) [ Fax EON . (,p6 A a fM
^
CCB Lic.: j 5Z ( Electrical Lic.: ,Q(p S .rv. Lic.: <15()).3 Subtotal] t L -
fr .
Suprv. Electrician signature, required: ' / Plan review (25% o£pertliit fee) -
State surcharge (g% ofpe mi fe .
Print name:17) 0 d1 t �[i ri, r Date: gi J3/ TOTAL PERMIT FEE �
Authori,2ed signature: Ills permit application expires if a permit is not obtalged witbis x30
. - days afterit has bera accepted as complete
Print name: Date: • Fee methodology set by Tii- County Building Industry Service Boa
_• Nuceber of inspections per pemrit eUowed.
isBoildine \Pennki\..C.Pmmi1App.doc ]2/03 44O.estsr IOd6?/cQM/wm
1
CITY OF TIGARD ,
BUILDING DIVISION PERMIT #: I , °,,f,Xr t. tt;:l
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1i til l:
Phone: (503) 639 -4171 " A Nh��Np,q�,`i ; ll
Inspection Requests (24 Hrs.): (503) 639 -4175 •
INSPECTION WORKSHEET FOR DATE: 1/5/20OF TIME: 1 00AM PAGE: he
SITE ADDRESS: 16W0 SW flfJ1 H AVE. CLASS OF WORK:
SUBDIVISION: SEWER TREATMENT MENT PLAN T LOT #: TYPE OF USE:
PROJECT NAME: CLEAN WA t ER SERVICES
DESCRIPTION: Temporary service for temporary shower/washroom trailer.
OWNER: CLEAN WATER SFRVI CI' , PHONE #: x.;0 (.4 : t.;IA) I
CONTRACTOR: CONDUIT ELECTRIC PHONE #: I;O:i t;9 :) 1 %?. '
Inspection Request Scheduled For: Date: 11512306 Pour Time:
Code # Inspection Description Confirm # Contact # Message
110N . rernporary eier:tric r
a sevice 0:) 2/ -01 60 ;11 -516 21i0: N
1G /I
Corrections /Comments /Instructions:
C(
re
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector e'" i Date:frc.5 " 6 Phone #: (503) 718 - )V'(.6
L \ _______ _