Permit CITY OF TIGARD ELECTRICAL PERMIT
R PERMIT #: ELC2007 -00069
. COMMUNITY DEVELOPMENT DATE ISSUED: 1/29/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S134BC - 00600
SITE ADDRESS: 12390 SW SCHOLLS FERRY RD ZONING: C -
SUBDIVISION: PP1993 - 057 LOT : 002 JURISDICTION: TIG
Project Description: Electrical service for new collocation. Job No. 12348
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:
DENNIS THOMPSON OREGON ELECTRIC GROUP
9295 SW ELECTRIC ST 1010 SE 11TH AVE
TIGARD, OR 97223 PORTLAND, OR 97214
Phone: Contact #: FAX 503 - 535 -2763
PRI 503 - 234 -9900
FEES
Description Date Amount Reg #: ELE 26 -95C
[ELPRMT] ELC Permit 1/29/2007 $80.30 LIC 203
[TAX] 8% State Surcharge 1/29/2007 $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 for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center.
Those r es are orth in O: ' 952 - 001 -0010 through OAR 952 -001 -0100. You may obtain copies se rules or direct questions to OUNC at
503.2 .6699 or 1.80. 32 344. •
Issued ' 1 I it Permittee Signat . ,
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:
eONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: .0 —� 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.
JAN -24 -2007 06:42PM FROM -OR ELECTRIC SVC _ , 5035352763 T-891 P.001 F -468
i ,E±' ctricaI Permit Application- ' \. `, -3
City of Tiga `� : ,-- `� - per / / 0 7 » Permit No.: 1 o 7 f
13125 SW Hall Blvd., Tigmd, OR 97223 Plan Review �
Phone: 503.639.4171 Fax: 503.598.1960 pp t 201 A MIN,.'4 1 naIeJB OOmer Permit: H H�O� M -�7�
Inspection Line: 503.639.4175 JM 2 ` 1 .4. 14... '1 J.,, Date Ready/IIy. inn 1a See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method Supplemental Information
a l ■\�1 -
TVA _ li i if a'1.r 'V, )1' • • PLAN REVIEW
® New construction ❑ Addipd /01 ee`ratnbn'/repiacetnent Please chock all that apply:
, -i 1%. , 0 Service over 225 amps, comm'I ❑Hazardous location
❑ Demolition ❑ Other. ❑ Service over 320 amps - rating OBuildng over 10,000 sq. IL.
CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
-
❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building 0 System over 600 volts nominal units in one structure
❑ Multi - family 0 Masttz builder ❑ Other: ['Building over three stories ❑Feeders, 400 amps or more
❑ Occupant load over 99 persons ❑Manuffctured structures or
•
JOB SITE INFORMATION AND LOCATION ❑ Egress/lighting plan RV park
Job no.: 12348 Job site address: 12390 SW SCROLLS FERRY RD ❑Health -care facility ['Other:
Submit 2 sets of plans with any of the above.
City/State/ZIP: TIGARD, OR 97774 The above arc not applicable to temporary construction smite.
Suite/bldg. /Apt. no.: Project name: CLEARWIRE CELL TOWER
FEE' SCHEDULE
Destrlpticn I Qty- I Fea J Total I •'
Cross street/directions to job site: MIGHT BE SLIGHTLY ISOLATED New residential single- or multi- family dwelling unit.
Includes attached garage.
JUST EAST OF SW 125 AVE ON THE TIGARD SIDE OF SCROLLS FERRY 1.000 sq. R or less 145.15 4
Subdivision: I Lot no.: Ea. add') 500 sq. R or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.: - _ 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 Installadon, alteration, and/or relocation
200 amps or less I 80.30 2
' 0 PROPERTY OWNER I ® TENANT 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: S '< i "D fAJ/Jt S _ -
601 amps to 1,000 amps 240.60 2
Address:' a 9 5r c9to f L F C T,e r C.. .0.r ' Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State/ZIP'�a ,2_ )) e) 2 9 7 ,9,9 Temporary services or feeders iuslnllatlon, alteration, and/or
Phone: ( ) I Fax: ( ) relocation
200 amps or less 66.85 1
Owner installation: This installation is being made on property that 1 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
D APPLICANT _ 0 CONTACT PERSON A Fee for branch circuits with .
• service or feeder fee, each 6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee,
46'85 2
each branch circuit
ret
Address: Each add'l bnmch 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 ., 3
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 /Stare/ZIP: Portland, OR 97214 Investigation per hour (I hr min) 62.50
Phone: (503) 234-9900 I Fax: (503) S35 -2763 • Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lic.: 203 I Electrical Li . . 5 .- . . Lie.: 4460S Subtotal 80. 30
Suprv. Electrician signature, required: ' •. , Plan review (25%ofpermit fee)
Print name: // - State surcharge (8% of permit fee) t0 , 4 a
� .1 � I, � _ ...0, . I • : I TOTAL PERMIT FEE SO , 7
Authorized signature: ire, . 7hle aerate appGmdoe ecplros If a permit is eat obtained within 180
days otter It hag been accepted as complete
Print name: u .� I , / 4 , / � , a I. e: 01/24/ • Pee methodology sax by Tri U allowed.
nty Bui g Industry Service Bond
v I -• Number of inspections per permit
I: iaundingwe,mi,:ELC•Permitwpp 12/03 440 110W021COMNwm
0 k1 -t-u css(A -e. re r I lcto- ii.t`t. E l/i o1
CITY OF TIGARD
BUILDING DIVISION • PERMIT #: ELC2007 -000G9
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/29/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4/18/2007 TIME: 7:00AM PAGE: 27
SITE ADDRESS: 12390 SW SCHOLLS FERRY RD CLASS OF WORK:
SUBDIVISION: PP1993 - 057 LOT #: 002 TYPE OF USE:
PROJECT NAME: CLEARWIRE US LLC
DESCRIPTION: Electrical service for new collocation. Job No. 12348
OWNER: THOMPSON, DENNIS PHONE #:
CONTRACTOR: OREGON ELECTRIC GROUP PHONE #: 503 -234 -9900
Inspection Request Scheduled For: Date: 4/18/2007 Pour Time:
Code # Inspection Description Confir Contact # Message
199 Electrical final 1.6702 -01 503-849-3291 Y
(■ _
Corrections /Comments/ Instructions:
'1%1�-) 005)
•
glPASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1 `r d6 L_ Date: _ (fl Phone #: (503) 718-1ALN
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007.00069
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 112912007
Phone: (503) 639 -4171 A
Inspection Requests (24 Hrs.): (503) 639 -4175 �' 1J ..
INSPECTION WORKSHEET FOR DATE: 218 /2007 TIME: 7 :03AM PAGE: 11
SITE ADDRESS: 12390 SW SCHOLLS FERRY RD CLASS OF WORK:
SUBDIVISION: PP1993 -057 LOT #: 002 TYPE OF USE:
PROJECT NAME. CLEARWRE US LLC
DESCRIPTION: Electrical service for new collocation. Job No. 12348
OWNER: THOIMMPSON, DENNIS PHONE #:
CONTRACTOR: OREGON ELECTRIC GROUP PHONE #: 503-234 -9900
Inspection Request Scheduled For: Date: 2/8/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
115 Electrical service 0431330/ 503-843329/ Y
Corrections /Comments /Instructions:
fill& ` O i
4 I OMNI I
_:►_ _ .�':� �► ..c _ SIP
NIMEMIEM
N o t z 5 `"To Mt 4R- PAN -
■
%�_ DO PARTIAL APPROVA ❑ CANCEL ---44-440..AGeEt'S
►!
- OR INSPECTION ❑ADDITIONAL FEES ASSESSED
Inspector: G1 (■S Date: 1(6 Phone #: (503) 718 -M •