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Permit CITY OF TIGARD ELECTRICAL PERMIT s COMMUNITY DEVELOPMENT Permit#: ELC2015-00394 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/02/2015 Parcel: 2S113B000600 Jurisdiction: Tigard Site address: 16060 SW 85TH AVE Project: Clean Water Services Subdivision: ROSEWOOD ACRE TRACTS Lot: D Project Description: (2)branch circuits for washer compactors in the compactor room. Contractor: OWNER Owner: BURLINGTON NORTHERN INC CLEAN WATER SERVICES PROPERTY TAX DEPT 16060 SW 85TH AVE PO BOX 961089 TIGARD, OR 97224 FORT WORTH,TX 76161 PHONE: 503-547-8185 PHONE: FAX: FEES Quantity Description Date Amount 2 crt Branch Circuits wo/Purchase 06/02/2015 $63.60 Specifics: Service or Feeder 1 ea 12%State Surcharge- 06/02/2015 $7.63 Type of Use: COM Electrical Class of Work: ALT 1 ea Plan Review Electricial 06/02/2015 $15.90 Type of Const: Occupancy Grp: Total $87.13 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable law. All work will be done cordance ' - approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ENTION: Oregon I-• re• 'as you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 95 01-0010 throu.h OAR 952-00090. Y.• may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: .6 � Permittee Signature: / �- OWNER INSTALLATION ONLY tl 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' Date: 6,/.346— LICENSE NO. 799 Call 503.639.4175 by 7:00 a.m.for the next available inspection date. 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. Electrical Permit Application FOR OFFICE USE ONLY Received City of Tigard k..teB : �� Permit No.: [S- y rrill " 13125 SW Hall Blvd.,Tigard,OR 97223 V Si Received 'Ian Revie / Phone: 503.718.2439 Fax: 503.598.1960 r�,V Datc/B : �, Other Permit: V � TIGARD Inspection Line: 503.639.4175 ce , Date Rea.y : /�/ ' m ® See Page 2 for Internet: www.tigard-or.gov � ( cW1 Notified/Method: ( Supplemental Information TYPE OF WORK 1`0 �,t��0 l L' VAI l(�/VLi© PLAN REVIEW ❑New construction ® Addition/alteration/rep r etc 1\ v\c j\I , Please chick all that apply(submit 2 sets of plans w/items checked below) �.a1 , - p1 ❑Service or feeder 400 amps or more ❑Building over three stories. ❑ Demolition ❑ Other: c,, +\, Q\� where the available fault current ❑Marinas and boatyards. CATEGORY OF CONSTRUMON exceeds 10,000 amps at 150 volts or ❑Floating buildings. less to ground,or exceeds 14,000 ❑Commercial-use agricultural ❑ 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building amps for all other installations. buildings. ❑ Multi-family El Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system. ❑Addition of new motor load of ❑"A","E","1-2","1-3", Job no.: Job site address: 16060 SW 85th Ave IOOHP or more. occupancy. ❑Six or more residential units. ❑Recreational vehicle parks. City/State/ZIP:97224 ❑Health-care facilities. ❑Supply voltage for more than El Hazardous locations. 600 volts nominal. Suite/bldg./apt.no.: Project name:Clean Water Services ❑Service or feeder 600 amps or more. — FEE SCHEDULE Cross street/directions to job site: Description I Qty. I Fee. I Total I New residential single-or multi-family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq.ft.or less 168.54 4 Ea.add'I 500 sq.ft.or portion 33.92 1 Tax map/parcel no.: Limited energy,residential DESCRIPTION OF WORK (with above sq.ft.) 75.00 2 Limited energy,multi-family 75.00 2 install recpt on compactor washer in Class I Div II residential(with above sq.ft.) Renewable Energy ❑ See Page 2 Services or feeders installation,alteration,and/or relocation ® PROPERTY OWNER I ❑ TENANT 200 amps or less 100.70 2 201 amps to 400 amps 133.56 2 Name:Clean Water Services 401 amps to 600 amps 200.34 2 Address: 16060 SW 856 Ave 601 amps to 1,000 amps 301.04 2 Over 1,000 amps or volts 552.26 2 City/State/ZIP:97224 Temporary services or feeders installation,alteration,and/or Phone:(503)547-8185 Fax:(503)547-8196 relocation 200 amps or less 59.36 1 Owner installation:This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 2 OW,ncr signature: Date: Branch circuits—new,alteration,or extension,per panel ® APPLICANT ❑ CONTACT PERSON ,: A.Fee for branch circuits with above service or feeder fee, 7.42 2 Business name:Clean Water Services each branch circuit B.Fee for branch circuits without Contact name:Mario Zigoy service or feeder fee,first branch circuit 56.18 ,j'� 2 Address: 16060 SW 85th Ave Each add'I branch circuit i 7.42 7.NA 1 2 Miscellaneous(service or feeder not included) City/State/ZIP:97224 Each manufactured or modular 67.84 2 Phone:(503)547-8185 Fax: :(503)547-8196 dwelling,service and/or feeder Reconnect only 67.84 2 E-mail:zigoym @cleanwaterservices.org Pump or irrigation circle 67.84 2 CONTRACTOR Sign or outline lighting 67.84 2 Business name: CD(../ N�E� Signal circuit(s)or limited-energy See I panel,alteration,or extension. Page 2 2 Address: Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr City/State/ZIP: Investigation(I hr min) 66.25/hr Phone:( ) Fax:( ) Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lie.: AO- Electrical Lie.: Suprv. c.: 4799S specifically listed(1/4 hr min) //;(0 ELECTRICAL PERMIT FEES Suprv.Electrician signature,required:�j,/ _/ Subtotal: . 0 Print name: /114/2,f J 7/4e/ Date: 5/14/2015 Plan review(25%of permit fee): ih q e JJ State surcharge(12%of permit fee): 47•ke 3 Authorized signature:` TOTAL PERMIT FEE: 7 Print name: /� Date: 5/14/2015 This permit application expires if a permit is not abta within 180 /V 4.2..,v Z/GO days after it has been accepted as complete. 1-6 Number of inspections allowed per permit. I I:\Building\Permits\ELC_PennitApp_ELR_ERE.doc Rev 05/21/2013 440-4615T(11/05/COM/WEB Po ' Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 16060 SW 85TH AVE, TIGARD, OR, 97224 Commercial - Electrical 199 Electrical ﬁnal PASS - No C of O ELC2015-00394 Jeff Grove Violation Summary: Inspector Contractor