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Permit • CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT `� - COMMUNITY DEVELOPMENT Permit #: ELR2010 -00283 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/21/2010 Parcel: 2S114AA00100 Jurisdiction: Tigard Site address: 9000 SW DURHAM RD Project: Tigard High School Subdivision: Lot: 0 Project Description: CCTV system in main office. Contractor: HECKTEC TECHNICAL LLC Owner: TIGARD - TUALATIN SCHOOL 3484 HILLSIDE CT DISTRICT #23J HUBBARD, OR 97032 6960 SW SANDBURG ST TIGARD, OR 97223 PHONE: 503 - 572 -1938 PHONE: FAX: 503 - 982 -4823 FEES Description Date Amount Specifics: Restricted Energy Permit 12/21/2010 $75.00 12% State Surcharge - Electrical 12/21/2010 $9.00 Type of Use: COM Class of Work: ALT Total Number of Systems: 1 Audio & Stereo: N Boiler Controls: N CCTV: Y Clock Systems: N Data & Telecommunications: N Fire Alarm: N HVAC: N Instrumentation: N Intercom /Paging: N Landscape /Irrigation: N Landscape Lighting: N Medical: N Nurse Calls: N Protective Signal: N Security Alarm: N Other: N Total $84.00 Other Desc: 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 in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is .uspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification C -nter. Those :re / orth in 952- 001 -0010 through OAR 952 - 001 -0090. You may obta cow of the r or direct questions to OUNC by calling 503. • .1987 or 1.800. • • Issued By: v� 0 0 .0% Permittee Signature: I `� �'� tf OWN 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. CaII 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. Elect Permit A l icat i on ,) .. , . . . .„ F ,. OR OFFICE USE ONLY City of Tigard Received 13125 SW flail Blvd., Tigard, 072 o d DataB / a � ( • � Permit \'o.; Phone' 50 3.718.2439 Fax: 503.59 i � , , tan Review . ' �. *. 1... .tr• ! TIGARD [nspection Line: 503.639.4175 w r�� " Date Date;Re Other Permit. Internet: www.tigard or.gov 0 ♦ Noti fied/Method: 4ed/Me d: ` r :� ofietho See Page 2 for � Mr Supplemental Information • TYPE. OF'Wt7Rh.'' ❑ Nev construction lion :/ ldditioltlalterattot�/r cement PLAN e t c ofp)a Ple a se check all that apply (submit?. sets of plans W rICIDS checked 6CIU W): ❑ Service or feeder 400 amps or more ❑Buildin over three stories. ❑ Demolition ❑Other; CATEGORY where the available fault current ❑ Naming and boatyards. OF 'CONSTRUC'TION exceeds 10,000 amps at 150 volts er • ❑ Master builder ❑ Other: ❑ 1- and 2- family dwelling Commerciallindtlstrial less o ground, e r exceeds (4,000 ❑ Floating buildings. t ❑ Accessory - building ❑ Commercial -use agricultural ❑ Multi-family amps i2u all other installations- buitclings. ❑ F ire pump. JOB" SITE INhORMATION .AND LOCATION ❑ Installation of 75 KV.4 or Emergency system. larger separately derived system., kb no.: Job ❑ Addition of o „, molar load of Sob site address: r 1 ? 1 �/� ❑ .. \" "E ._ "1 2' • "1 3 ", 1�1 1I l 1 rt 1001P or more. occupancy. CICy /state /GIp: � �` j\ 1 � � a a � � ❑ Sir or more residential units. ` V ❑ supply a[io voltage vehicle ore than El 1 - leash -care facilities, ❑ Suppl voltage for more than Suite/bldg./apt. 1dg, /apt. 110.: ` l + �� � ❑ Hazardous locations" 600 volts nominal. Project name: t1�li- t ❑ Service or feeder 600 amps or more. . 'FEE SCHEDULE Cross street/directions to job site: • • ' Desert Won Qh. Frc New residential single- or multi - fancily dwelling unit. Tout I Subdivision: Includes attached garage. Lot no.: 1,000 sq. IL or less fax map /parse[ no.: Ea. add'1501) sq. 11. or portion .DESCRIPTION 'WORK. ' Limited energy', residential Q � —�� !witltal>oves .Il.) Ili 75.0D • l= L Limited energy. multi- Etmily residential (with above s , (1") Ill 75.O0 2 Services or feeders installation, alteration, and /or relocation • • 'Tl' �� 200 amps or less 100.70 Min ❑ PROPER O 'NCR ' TENANT , 201 7 amps to 40(1 amps - 133,56 Ell 401 amps to 600 amps 200.34 �© Address: 601 amps to 1.000 amps l 30104 2 Cher 1,000 amps or volts City/State/ZIP: !� Temporary services or feeders installation, alteration, and /or Phone: ( relocation Fax: ( ) 200 amps or Tess 59.;6 Owner installation: This installation is being made on property that I own which is not intended for sale, lease, rent or exchange, according to ORS 447, 449, 670, and 70/. 201 amps to 599 amp 125 .08 —� 401 amps r 168.54 � Ot +ilea Si Blanch circuits — new, alteration, or extension, er and Date: A. lee for branch circuits with '� ❑ CONTACT PERSON above service orfeederfec, Business name: I O I �t �r n each branch circuit 2 • T� e � 1 B. Fee for branch circuits without Contact name: or feeder fee. first Sr A 1 branch circuit 56.13 NM Address: ( f I Ea add branch circuit ll l 7.42 M. 2 Miscellaneous (service or feeder not included W - • J (1'70, ^ Each manufactured or modular Ci1y /S111e /Z Phone: ^-' 7 Fat:: ( IFa J dec o Reconnect onlne, service and/or feeder 67.34 � � _95 G ecn F; mail: f Z p L s1 s1� cc W l l J R 67.31 �® Pump or irrigation circle CONTRACTOR Sign or outline lighting ��® • Business name: p - Signal circuit(s) or limited-energy C ( ' 1 anel. alteration, or extension. OS A II ddress: Each additional inspection over allowable in any of the above Additional inspection (1 hr min) IN 66.25x' lu' City /State/ZIP: investigation - 66.25 /i _ cation (I hr min) v OM Phona: (�v 5/07 I Fax: Go) 9u-951e Industrial plant (1 hr min) 111111 78,113! CCB tic.: + 7 l Inspections for which nu fee is • ill I ectriCa1 L 1C,: f q/. I u p L specifi alit' listed (5 hr nun) 90.00 / hr ( r S ry Lic.: j L I 7 Suprv. Clectricit i signature, required: • ; . ■ f J suhto� • Print name: Plan review (25% 0 r permit fee): Date: (2-;0_1(,) State surcharge (12% of permit fee): Authorized signature: � C YIl� � J •TOTAL PERMIT I 190 This permit application expires if a permit is not obtained within 180 Date. r _ �l� Y/ / ,, days alter it has been accepted as complete. l ^�Rt tdutR t'l'amit d L./ ' Number of inspection:, allowed per permit. GLC-PtemntAppeee, 17;61)10 140- 46S SCQ t(CScn j't £B 2' d 8L Oi86E0S Ieo>uyoal oa �oaH e 6S�1T 01 0 �aU PPP f L W O L,ERxT o Check c "Ipntiar � vCrp N . yAe of wo rk fAVOIYed; co b,ne d.. S7i ,aA U -Aud and. Jtereo .)j >s renas Burgl . uarrn • ❑ Garage Door Opener* ❑ 1-1 coting, Ventilation and Air Conditioning 1'aa,t unSystem s * b System* • ❑ ❑ Other: C OMMERCi.AL tXiORK ONL Fee for each coxnmercia! Y: > ystem..... $75.00 (SEE OAR 918- 309 -0000) :heck Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ] Clock Systems ] Data Telecommunication Installation ] Fire Alarm Installation FIVAC Instrumentation ] Intercom and Paging Systems ] Landscape Irrigation Control* ] Medical ] Nurse Calls Outdoor Landscape Lighting* Protective Signaling Other C C • 'oral number of commercial systems: I fo licenses are required. Licenses are required ,r all other installations Zing Pem aisle LC- Acrmit4pp.doc 0 "01!10 E'd 8Gb0I86E0S Ieotuyoal oal.1° H e6S =II OI OZ 'tI