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Permit CITY OF TIGARD ELECTRICAL ENER - RESTRICTED ENERGY F P u:1 l, DEVELOPMENT SERVICES PERMIT #: ELR2002 -00177 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/30/02 SITE ADDRESS: 14650 SW 97TH AVE PARCEL: 2S111AC -02700 SUBDIVISION: TIGARDVILLE HEIGHTS ZONING: R -4.5 BLOCK: LOT: 037 JURISDICTION: TIG Project Description: Installation of fiber, telephone and data systems for modular classroom. Job No. 61274. A. RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATAITELE COMM: X NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: : HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: FIBER X TOTAL # OF SYSTEMS: 3 Owner: Contractor: TIGARD TUALATIN SCHOOL DIST 23 FRAHLER ELECTRIC CO 6960 SW SANDBURG RD 11860 SW GREENBURG RD TIGARD, OR 97223 TIGARD, OR 97223 Phone: Phone: 639 - 4627 Reg #: LIC 37410 SUP 1816S ELE 34 -13C FEES Required Inspections Type By Date Amount Receipt Low Voltage Inspection PRMT CTR 8/30/02 $225.00 2720020000 Elect'I Final 5PCT CTR 8/30/02 $18.00 2720020000 Total $243.00 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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -1987. Issued by t� - Permittee Signature /f-,%>'� /(i} -j j0/i 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 639 -4175 by 7:00 P.M. for an inspection needed the next business day I A Electrical Permit Application . . Date received: , 5d 02, Permit no.: E142_2007 ,, , Q i 7 7 � j1j-r : �� j . City of Tilg • III �� Project/appl. no Expire date: City of Tigard Address: Add 13125 SW H. r ': id, igard, OR 97223 By: Receipt no.: D ate issued: B Y � . Recei P Phone: (503) 639 -4171 2002 • Fax: (503) 598 -1960 AUG 3 0 Case file no.: Payment type: Land use approval: CU. Y Ulf I I 0. ', t a ,I, ;b l iu ' • TYPE OF PERMIT . ❑ 1 8i: 2 family dwelling or accessory ❑ Commercial/industrial 0 Multi - family ❑ Tenant improvement ❑ New construction EI Addition/alteration /replacement ❑ Other. ❑ Partial • JOB SITE INFORMATION Job address: 14650 SW 97th AVENUE Bldg. no.: Suite no.: Tax map /tax lot/account no.: Lot: 'Block: 'Subdivision: Project name: TWALITY MIDDLE SCHCIaliescription and location of work on premises: FIBER, TELEPHONE AND DATA Estimated date of completion/inspection: . FOR MODULAR CLASSROOM CONTR AP -PLJ.C,4T1Oy,_ T u _ FEE,.SCHEDULE Job no: 61274 Fee Max Business name: FRAfII. ER ELECTRIC COMPANY Description Qty. (ea.) Total no. htsp Address: 11860 SW GREENBURG ROAD New residential dwell -singleorr ch e dg a ar a ge. r hrg unit. Inciades ached garage. City: TIGARD I State: OR I ZIP: 97223 Service included: Phone: 639 -4627 I Fax: 639 -4673 IE -mail: 1000 sq. ft. or less 4 _ 374 I 34 -13C Each additional 500 sq. ft. or portion thereof C CB no.: Elec. bus. l ic. no: Limited energy, residential 2 City /metro lic. p..: Limited energy, non- residential 2 0828 O2 Each manufactured home or modular dwelling Signature of supervising electrician .. uired) Date Service and/or feeder 2 Sup. elect. name (print): MIKE WAGNER License no: 2334S Services or feeders — installation, alteration or relocation: PROPERTY OWNER 200 amps or less 2 Name (print): 201 amps to 400 amps 2 401 amps to 600 amps 2 Mailing address: 601 amps to 1000 amps 2 City: 'State: 'ZIP: Over 1000 amps or volts 2 Phone : I Fax: 1E-mail: Reconnect only 1 Owner installation: The installation is being made on property I own Temporary services or feeders - which is not intended for sale, lease, rent, or exchange according to installation, alteration • 200 amps or less 2 ORS 447, 455, 479, 670, 701. 201 amps to 400 snips 2 • Owner's signature: Date: 401 to 600 amps . 2 ENGLNEER Branch circuits - new, alteration, . or extension per panel: 1 Name: A. Fee for branch circuits with purchase of Address: service or feeder fee, each branch circuit 2 • City: 'State: - I ZIP: B. Fee for branch circuits without purchase of service or feeder fee, first branch circuit: 2 Phone: Fax: E-mail: Each additional branch circuit PLAN REVIEW (Please check all that apply) misc. (Service or feeder not included): • ❑ Service over 225 amps-commercial ❑ Health -care facility Each pump or irrigation circle 2 ❑ Service over 320 amps - rating of 1&2 ❑ Hazardous location Each sign or outline lighting _ 2 family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, ❑ System over 600 volts nominal more residential units in one structure alteration, or extension* - 3 225.00 2 ❑ Building over three stories ❑ Feeders, 400 amps or more *Description: FIBER, 'TELEPHONE AND DATA ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above: ❑ Egress/lightingplan ❑ Other. Per inspection Submit _ sets of plans with any of the above. Investigation fee The above are not applicable to temporary . construction service. Other Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ 225.00 • ❑ Visa ID MasterCard expires if a permit is not obtained Plan review (at %) $ Credit card number: I / within 180 days after it has been State surcharge (8 %) .... $ 18.00 Expires accepted as complete. TOTAL $ 243.00 Name of cardholder as shown on credit card $ Cardholder signature Amount 440 -4615 (6/00 /COM) Electrical Permit Fees: Limited Energy Fees: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY Complete Fee Schedule Below: Restricted Energy Fee $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total st, cneck of Work Involved: Residential - per unit 1000 sq. ft. or less $145.15 4 ❑ Audio and Stereo Systems Each additional 500 sq. fL or portion thereof $33.40 1 . ❑ Burglar Alarm Limited Energy $75.00 Each Manuf'd Home or Modular n Garage Door Opener Dwelling Service or Feeder $90.90 2 Services or Feeders D Heating, Ventilation and Air Conditioning System' Installation, alteration, or relocation 200 amps or less $80.30 2 Vacuum Systems 201 amps to 400 amps $106.85 2 401 amps to 600 amps $160.60 2 601 amps to 1000 amps _ $240.60 2 i I Over 1000 amps or volts $454.65 2 Reconnect only„;,__., <; '� . $66.85 2 Temporary Services or Feeders �. TYPE OF WORK INVOLVED - COMMERCIAL ONLY. Installation, alteration, or relocation Fee for each system $75.00 ■ 200 amps or less _ $66.85 2 (SEE OAR 918 - 260 -260) 201 amps to 400 amps $100.30 2 401 amps to 600 amps - $133.75 _ 2 Check Type of Work Involved: Over 600 amps to 1000 volts, see "b" above. 7 Audio and Stereo Systems Branch Circuits ❑ Boiler Controls New, alteration or extension per panel a) The fee for branch circuits with purchase of service or n Clock Systems feeder fee. Each branch circuit $6.65 2 n Data Telecommunication Installation b) The fee for branch circuits without purchase of service n Fire Alarm Installation or feeder fee. First branch circuit $46.85 - HVAC Each additional branch circuit $6.65 Miscellaneous n Instrumentation.: (Service or feeder not included) Each pump or irrigation circle $53.40 f �I m Intercom and Paging Systes Each signor outline lighting $53.40 I ' ;r . , Signal circuit(s) or a limited energy panel, alteration or extension $75.00 ri Landscape Irrigation Control Minor Labels (10) $125.00 El Medical Each additional inspection over the allowable in any of the above Calls Per inspection $62.50 Per hour $62.50 ❑ In Plant $73.75 • Outdoor Landscape Lighting Fees: ❑ Protective Signaling Enter total of above fees $ n Other 8% State Surcharge $ Number of Systems 25% Plan Review Fee No licenses are required. Licenses are required for all other installations See "Plan Review" section on $ front of application. Fees: Total Balance Due $ Enter total of above fees $ ❑ Tnust Account # 8% State Surcharge $ Total Balance Due $ i:\dsts\forms\elc- fees.doc 10/09/00 • CITY OF TIGAAD _ 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested V/ AM PM BUP Location ` L( 4° Suite MEC Contact Person -!� � Ph ( ) '" 3 ' - - PLM Contractor Ph ( 5D ) 1 SWR l BUILDING Tenant/Owner ELC �/ `) Footing CELC — d b 37 0 Foundation Access: ( ' 00 ( - Ftg Drain Crawl Drain Slab Inspection Notes: Post & Beam - (20 (7 g Shear Anchors Ext Sheath/Shear g,A149 Int Sheath/Shear Framing Drywall ywal Dywall Nailing Firewall Fire Sprinkler Fire Alarm -\ - -� Susp'd Ceiling Roof U 51'6 - r= A 5 �� Other: 1 ��y� • Final l 'e a-- °CQ '1,5k4D - PASS PART FAIL PLUMBING Post & Beam I 7 Under Slab Rough-In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage ire lar ina Reinspection fee of $ required before next inspection. Pay at City Hail, 13125 SW Hall Blvd. A PART FAIL SITE ❑ Please call for reinspection RE: Unable to inspect - no access Fire Supply Line ADA Approach/Sidewalk Date 2///e � Inspecto y « � f Ext Approach/Sidewalk Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL