Permit CITY OF TIGARD
i , ' ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00282
T IGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/10/2007
PARCEL: 1 S 133RD -02200
SITE ADDRESS: 10730 SW 130TH AVE MULTI - PURPOSE ZONING: R - 7
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: WESTGATE BAPTIST CHURCH
Project Description: Low voltage for fire alarm add on.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: X OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: :
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
• WESTGATE BAPTIST CHURCH ADVANCED SECURITY & FIRE
12930 SW SCHOLLS FERRY RD 2218 NE SUNRISE LN
TIGARD, OR 97223 HILLSBORO, OR 97124
Phone: Contact #: PRI 503 - 519 - 4550
FAX 503- 640 -8311
FEES Reg #: ELE CLE8
LIC 166176
Description Date Amount SUP 611LEA
[ELPRMT] ELR Permit 7/10/2007 $75.00
[TAX] 8% State Surcha 7/10/2007 $6.00 REQUIRED ITEMS AND REPORTS
Total $81.00
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 rules are set forth in OAR 952 -001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By:c ,ti�j'Lw /c�z�c P e rmittee Signature: x
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'N: 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.
Electrical Permit Ap' =tin rot) FOR OFFICE USE ONLY .
L. n
City of Tigard i csa DaDate/By: O / Q�
Permit N . / 0 .0
V 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.5 8 +960 0 200 Date/By: Other Permit -
Inspection Line: 503.639.4175 Jul- Date Ready /By: lur ® See Page 2 for
TIGARD
• - Internet: www.tigard- or.gov a Notified/Method Supplemental Information
.� �'�� �Ia"i: ' t ' l R
T ®WORK r PLAN REVIEW , ,
❑ New construction Ws. .'�o/Jtl nlx e ple e 'a me°tirt' g l °j Please check all that apply (submit 2 sets of plans w /items checked below).
1
(3 Service or feeder 400 amps or more ❑Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial - use agricultural
❑ I- and 2- family dwelling ,Commercial /industrial ❑ Accessory building amps for all other Installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
❑ Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ", • •
Job no.: Job site address: L� 100HP or more. occupancy.
/pL / . - �/ �C-fJ �d Q! IS /L hl'y d❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: f� /� (J (� '� ✓ El Health -care facilities ❑ Supply voltage for more than
T/ Cf r c 1 (/ /( G ❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: J Project name: Z es -i A l e 6 .. 5 f ( ,..„,) ❑ 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 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
DESCRIPTION OF WORK - (with above sq. ft.)
r / Limited energy, multi - family
�
On / n n ,51 j �e rn - residential (with above sq. ft.)
75.00 2
/// Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name: a> 6 7 A� - f 1 S -- f GA a re l) 401 amps to 600 amps 160.60 2
n l ,, 601 amps to 1,000 amps 240.60 2
Address: / o i 36 s4/ SC - 0 /(,5 }--e J . / s t Rd Over 1,000 amps or volts . 454.65 2
City/State /ZIP: 1
/ Temporary services or feeders installation, alteration, and/or
�� I oR % relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
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, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Owner signature: Date: Branch circuits— new, alteration, or extension, per panel
g A. Fee for branch circuits with
❑ APPLICANT • ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
first branch circuit
Address: Each add'l branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular
dwelling, service and /or feeder 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E - mail: Pump or irrigation circle 53.40 2
' CONTRACTOR Sign or outline lighting 53.40 2
Business name: Signal circuit(s) or limited -
�p� ` !7 C a st ?° C l�f f` 1 �t/ r�
energy panel, Desclnbation, or / Page 2 d v 2
Address: ,2 ! 0 / E S-( s- 1.-;_. 2,-). extension.
/ ( s
City/State /ZIP: /Y' //S hare J!( q 7 /32I Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (So3) .576? _ 4556 Fax: (S63 >110_ Q p J 1 ( Investigation per hour (I lu min) 62.50
CCB Lic.: /6 6 / 2 . Electrical Lic.: CL E. - q' Suprv. Lie.: i /)._ E /9 Industrial plant per hour 73.75
. ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal:
e2 n r9 v .; k D Plan review (25% of permit fee):
Print name:
Vl d 71 7 _ �� 0 State surcharge (8% of permit fee): Co*
Authorized signature: �� ('� TOTAL PERMIT FEE: ' 0.-- ((( ��� �� This permit application expires if a permit is not obtained within 180
Print name: Day y id 7r) O 0/9 vi k Date: 7 _ J67- .) days after it has been accepted as complete.
* Number of inspections allowed per permit.
I: \Building \Permits\ELC - PermitApp doe 05/23/06 440- 4615T(1 I /05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information,
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
n Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
n Vacuum Systems*
n Other:
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918 - 260 - 260)
Check Type of Work Involved:
I Audio and Stereo Systems
n Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
RI Fire Alarm Installation
❑ HVAC
n I • nstrumentation
n Intercom and Paging Systems
n Landscape Irrigation Control*
n Medical
❑ N urse Calls
n Outdoor Landscape Lighting*
n P • rotective Signaling
n Other
Total number of commercial systems' 1
*No licenses are required. Licenses are required
for all other installations
I \ Building \Permits\ELC- PermitApp.doc 03/23/06
CITY/OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007- 00202
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7110/2007
Phone: (503) 639-4171 1110 ��� 1
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 9/7 /2007 TIME: 7:00A PAGE: 10
SITE ADDRESS: 10730 SW 130TH AVE MULTI - PURPOSE CLASS OF WORK:
SUBDIVISION: STGATE BAPTIST CHURCH LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION: Sanctuary - Low voltage for fire alarm add on.
OWNER: WEST GATE BAPTIST CHURCH, PHONE #:
CONTRACTOR: ADVANCED SECURITY & FIRE PHONE #: 503 - 519 -4550
Inspection Request Scheduled For: Date: 9/7/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
• 199 Electrical final 055342 -03 503. 572 -7392 N
Corrections /Comments /Instructions:
1A i 5 5 i 41'"etM \AM PeeT '- ilD 0
4.�v� Z %QII -1 , �- .
. .
-NN.
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, „..\\.. .\,-\\\ ,
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, ,
PASS n PARTIAL APPROVAL CANCEL I I NO ACCESS
I FAIL I I CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: G ( 3 45 Date: i f o") Phone #: (503) 718- 2- 446
' CITY OF TIGARD
BUILDING DIVISION : i ...,
PERMIT #: ELR2007-00292
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/1012007
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639 -4175 JA N 7��
INSPECTION WORKSHEET FOR DATE: 916/2007 TIME: 7.00AM PAGE: 10
SITE ADDRESS: 10730 SW 130TH AVE MULTI- PURPOSE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: WESTGATE BAPTIST CHURCH
DESCRIPTION: Sanctuary - Low voltage for fire alarm add on. .
OWNER:, WESTGATE BAPTIST CHURCH, PHONE #:
CONTRACTOR: ADVANCED SECURITY & FIRE PHONE #: 503-619-4550
Inspection Request Scheduled For: Date: 9/6/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 056264 -01 503- 572 -7392 \ Y
Corrections /Comments /Instructions:
1P Ra 4, ts:,-E RED co L4(L G R, L v 11 %a-zoo --
C . N.e. V.L .vr Pfx NI CL.
\\ VA- P 2OON 10 Yvn.) 1) rV e.pOct RO .
e
PASS XPARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
I I FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 5. I v rU l.- Date: 4 01 Phone #: (503) 718- 410
CITY OF TIGARD F.
BUILDING PERMIT #: ELR2007 -002I2
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/10/2007
Phone: (503).639 -4171 40,41 1t
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7/19/2007 TIME: 7 :03AM PAGE: 2f
SITE ADDRESS: 10730 SW 130TH AVE MULTI - PURPOSE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: WESTGATE BAPTIST CHURCH
DESCRIPTION: Low voltage for fire alarm add on.
OWNER; WESTGATE BAPTIST CHURCH, PHONE #:
CONTRACTOR: -ADVANCED SECURITY & FIRE PHONE #: 503.519 4550
Inspection Request Scheduled For: Date: 7/19/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage Co-re-r 0523613-01 503-519-4550 Y
Corrections /Comments /Instructions:
>4ASS I I PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
I FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Date: -(9-7 Phone #: (503) 718-