Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
Permit #: ELR2010 -00083
g l� COMMUNITY DEVELOPMENT Date Issued: 05/14/2010
tGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S 114AA00100
Jurisdiction: Tigard
Site address: 9000 SW DURHAM RD
Subdivision: Lot: 0
Project: Tigard High School
Project Description: Installing (1) video system in security office.
FEES
Owner:
TIGARD - TUALATIN SCHOOL Description Date Amount
DISTRICT #23J, 6960 SW SANDBURG ST Restricted Energy Permit 05/14/2010 $67.84
TIGARD, OR 97223 12% State Surcharge - Electrical 05/14/2010 $8.14
PHONE:
Contractor:
ALLIED FIRE & SECURITY
530 NE COUCH ST
PORTLAND, OR 97232
PHONE: 503 - 231 -9550
FAX: 503- 231 -9551
Type of Use: COM
Class of Work: ALT
Total Number of Systems:
Audio & Stereo: N Boiler Controls: N
CCTV: N Clock Systems: N
Data & Telecommunications: N Fire Alarm: N
HVAC: N Instrumentation: N Total $75.98
Intercom /Paging: N Landscape /Irrigation: N
Required Items and Reports (Conditions)
Landscape Lighting: N Medical: N
Nurse Calls: N Protective Signal: N
Security Alarm: N Other: Y
Other Desc:
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 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 the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through • e ' 952 - 001 -0100. You may obtain a co y_of_the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued B . / Permittee Signature:
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' 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.
05-13-10 08:03 FROM- T-864 P000110003 F-490
Electrical Permit Application FOR OFFICE USE. (.7: •
City of Tigard Received
patella : MIN= :, V"
•7 , . 13125 SW Hall El lvd., Tigard, OR 9RE, CEIVED Plan Review Permit N°.: EL 10 - o e
' s • Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit!
T 1 G A Ft D Inspection Line: 503.639.4175 MAY 1 3 2 010 Date Ready/By; lurk: 0 See Page 2 for
Internet: www.tigard-or.gov Notified/Method: 1:71-02 Supplemental Information
: •: ; : ; -•;:iK.;,.: ' ' 1 ..■ . t: . • ..:''' .., f';..7;•: .: .•' :;i.‘... .i.. • ...40..Wv•,.
D New construction E Addition/A., Oft, c , • ,,./• MI; i . Please cheek NI that apply (submit 2 sets of plans wilierns checked below):
0 Service or feeder 400 amps or more CI Building over three stories.
El Demolition D Other: where the available fault current p Marinas and boatyards.
-''-'7-""-"'-''-----'---, .,:!,.(.','i••c.#,Q .
. .'.77•;.•'.:;.:)''::;-.i. exceeds 10,000 amps at 150 volts or Ll Floating buildings .
less to ground, or exceeds 14,000 0 c agricultural
ill 1- and 2-family dwelling r Commercial/industrial D Accessory building amps for all other installations. buildings.
0 Multi-family Ei Master builder 0 Other: 0 Fire pump. 0 Installation of 75 KVA or
• , . . . , „ . , ., .. ., ..,, , . .,,., ,„...„ ;., , ., 0 Emergency system. larger separately derived system
‘.• 0 Addition of new motor load of
100HP or more. occupancy.
Job no.: 1°°51 t r Job site address: 'JO 5(.3 1),AlkkA Pizi D Six or more residential units. 0 Recreational vehicle parks.
City/State/ZIP: -r' .0 o g, 4 /103 Ll 0 Health-care facilities, 0 Supply voltage for more than _
0 Hazardous locations. 600 volts nominal.
Suite/bldg./apt. no.: 1 Project name: , 4_ s 4ukto si ckei,,, D Service or feeder 600 amps or more.
TYR ''''';',:•,'‘if'.'`' '..; ',.;:";;•',.
Cross street/directions (0 cLQ.ko cut 9„. --\ 0 pc_fr) lion Qtr. Fcc, Total *
New residential single- or multi-family dwelling unit.
"*60 7:Dtb-r 9-;11 c;(11:)y•-r1/4.AckAN Includes attached garage.
Subdivision: I 1..ot no.: 1,000 sq. ft. or less 168.54 4
Ea. add, 500 sq. ft, or portion 33.92 1
Tax map/parcel no , . Limited energy, residential
67.84 2
'e:.: :/. ij,R ".- 1 q,j O :* :,;.." A,',' :::;':::. (with above sq. B.)
' 4. •“\,\,,k 5u9.to S\U (it I
IC
Limited energy, multi-family
residential (with above sq. fl.) 67.84
Services or feeders installation, alteration, and/or relocAtion 2
L, tett, 4 OW 4 11../*(1 i''''t Om. at 200 amps or less 100.70 2
'' , '''" 4 .•'''''' '...' ''''' O - ' ' " " ' • • • ' ' I .. - -n 1 1640 ,, : , .;: , ,,. ,,, 201 amp to 400 amps 133,56 2
401 amps to 600 amps 200.34 2
Name; ,1 ,' s
. ,., --
DOI amps to 1,000 amps
301.04
2
Address; 9 000 s --N 1)„,u fk: Over 1,000 amps or volts 552.26
2
- ...
Temporary services or feeders installation, alteration, and/or
.City/State/ZIP: /1 , I /11 # • S q relocation
4 •
200 amps or less 59.36 l
Phone: (50/ ) , Chi , Lig Pax: (V"; ) - ut 1 ,„ 614
- 201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not -
.54
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168 2
Branch circuits new, alteration, or extension, i er panel
. Owner signature: Date: A. Fee for branch circuits with
' • ' " ' • ' ' "' ' - ."- . . .'" ' ',:■•:; above service or feeder fee,
: :,,4• . 'i; i : ;4•.;'••:.;,;!.g , ,0 tt.):•'.;','; „'i*?.:) each branch circuit 742 2
Business name: L. tt, fi ge 4, st-toe.rvY B. Fee for branch circuits without
service or feeder fee, first 56.18
, 2
Contact name: 1 . i _ IV i A ilia _branch circuit
Each add'IbranCh circuit 7.42 ,.._
2
Address: '0 kft Onoojk 51" Miscellaneous (service or feeder not included)
Each manufactured or modular
City/State/ZIP: . - Fi3c1D, 0 K. '` SZ. dwellin • , service and/or feeder 67.84 2
/
Reconnect only 67.84 2
Phone: ( ) - 0 72_,. - um, Pax! : (511i ) 731 .1 5 /
Pump or irrigation circle 67.84 2
E-mail; / 1 dA. e . v / - .ie. . . clop . Sign or outline lighting 67.84 2
.; :::::•'.f.•:U''':::.;;•.•::'•.'..;:: Signal circuit(s) or limited-energy I Of .Zq 2
Business narnc: Awe, rt A e - . - 5E - 60? : •,vri Op 5 44/ k
of
- L • et, Aeration, Or extension. 1 Page 2
i ., • eh additional inspection ovei: atiolvable in any the above
Address: 599 )..,fe ()AA •S'Y . • dditional inspection (1 hr min) 66.25/ hr
Investigation (I hr min) 66.25/ hr
City/State/ZIP: TONIMb c V 2-32-
.. Industrial piant (t hr min) 78.18/hr
. _
Phone: (6Z) - Pax: (502 ) 23 1 - q5 Inspections for which no fee is
90.00/ hr
- s. cificall listed (1/2 hr min)
CCS Lie.: t, Li q (. 5 ) Electrical Lic.! 26_ g (e3 0 supry • Lc.: ...:. f CI.CAVITIOlit.FE '..",'Z'
Suprv, Elegc i - igtei 7 rili 92,
kquired: ,26// - 7 , /r
ia t
Subtotal: ( ry
Plan review (25% of permit fee):
, - .
Print name: /1 CE/0- Date; 05-03/(0 State surcharge (12% of permit fee): Z - / Li ----
_
Authorized signature: /. /// , , //gbt..---- TOTAL PERMIT FEB: - 75
This permit application
.-.
expires if a permit is not obtained within 180
/'
days after it has been accepted as compiete.
Print name: / /a. 44 gort Date: 40'2/7/ ("0 4 Number of inspections allowed per permit.
I: VauildinelPermitAELC.PerrnitApp.dee 10/01709 440
05- 13 -'10 08:03 FROM- T -864 P0002/0003 F -490
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
AJ�r,r •.,�Y, n .,a uA.L 1 _ a.F a 9.' WWS �1�LL171W
Fee for all residential systems combined ... $67.84
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
[❑ Other:
�►,, 1 n� � _ , t "� r � ^ „ k � �� ��' k' y i ? a � .fi ^,�a�v
F� Ih �.. .e�m ; r x.., ran n .� ,.u.; +� ui �. a,}” Fan ..� .}uw. b.�� w'�✓" =7
Fee for each commercial $67.84
system
(SEE OAR 918 -309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
"Other V 0
Total number of commercial systems: I
*No licenses are required. Licenses are required
for all other installations
1: 1111uildingTermitaLC •PertnitADD,doc 10/01/09