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Permit
, CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2003 -00742 . I DEVELOPMENT SERVICES DATE ISSUED: 7/1/2004 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 25111 AC -02700 SITE ADDRESS: 14650 SW 97TH AVE SUBDIVISION: TIGARDVILLE HEIGHTS ZONING: R-4.5 BLOCK: LOT : 037 JURISDICTION: TIG Project Description: Addition of new multi - use student commons & kitchen remodel. RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION: 1 EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: 7 MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10): SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: 2 W /SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 3 1st W/O SRVC OR FDR: PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 75 IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: TIGARD TUALATIN SCHOOL DISTRICT ATLAS ELECTRICAL CONTRACTORS 6960 SW SANDBURG ST 4403 SE ROETH E RD TIGARD, OR 97223 MILWAUKIE, OR 97267 Phone: Phone: F - 659 - 4944 Reg #: "9 -2212 2581S LIC 1532 FEES ELE 3 -2C Description Date Amount Required Inspections [ELPRMT] ELC Permit 7/1/2004 $1,558.30 [ELPLCK] ELC Pln Rev 7/1/2004 $389.58 Ceiling Cover [TAX] 8% State Surcharge 7/1/2004 $124.66 Wall Cover Underground Cover Total $2,072.54 Elect'I Service Rough -in Elect'l Final 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. 411111 41 Issued By: ,1- if P Permit Signature: cf. 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 7:00pm for an inspection the next business day Electrical Permit Application FOR OFFICE USE ONLY -, . Received • Electrical g Date /By: ilk o9 / /D �� Permit No.: Et -d4, City of Tigard ti O Planning A pr val Si F9 Date /By Permit No.: 13125 SW Hall Bl t Plan Revie , Q gard, Oregon 9- 2o� lAcil Date/By: t/j / /tj Jlj Permit No.: /49 e - GYM 70/ hone: 503- 639 -4171 �c: S,( 5'9'8 -1 60 Post- Review Land Use Internet: w.ci.t g P Date /By: 0 off of �( sb Case No.: MI`I��03 -600 /7 Int: ww.ci.ti ard. . s 24-hour ernet Ins a I+ g G 9 14. . Ali Contact VA/ `, ,• ® See Page 2 for p wh `a ""'- / }S" Y N ame /Meth 44,:..,, / I Co Supplemental Information. v .rr,QMO /mil :: ... , , . ;','' ...e *._ ^'=`.TYPES "OF,:W t ° . • . " "' i;`:a;;<.;;�c -: " , :: ,: .. . -,, ,_ " - "-p. •,�;,. ORIC° ` �r�``:° ` :�"r_�' = "`• x,, Pleasecti p '° . •s° • , , �� LAN= RE�'IEW� ( tck�allthatap I" �:'�' vn ❑ New construction ❑ Demolition Service over 225 amps- ❑ Health -care facility Addition/alteration/replacement ❑Other: commercial ❑ Hazardous location , A r,s- �•n.i ,,. ❑ Service over 320 amps- rating of Li Building over 10,000 square feet, t CATEGORY'OFECONSTRUCTION'1' a�. • ••' ;`.,.; , `:� _ I & 2 family dwellings four or more residential units in ❑ 1 & 2- Family dwelling ®.Commercial/Industrial El System over 600 volts nominal one structure ❑ Accessory Building Et Multi- Family ❑ Building over three stories •I=1. Feeders, 400 amps or more (.Occupant load over 99 persons ❑ Manufactured structures or RV park ❑ Master Builder ❑ Other: s, Egress/lighting plan ❑ Other: '.'. - LZJ ill,OB.`SITEINE.ORMA =TIOWiiiit ;Q;CATION' Submit sets of plans with any of the above. Job site to address: ��6SD 5c-.) �'� � The above are not applicable to temporary construction service. Suite .1 _�,f ',H ."', v _ " ._,.> . , ' FEE *;iSCHEDULE.' >tze�� .�. =tf `; „+ ..a �_ ; v v,z-� r: (J/ Bldg./Apt.#: PA �,� Number of inspections per permit allowed Project Name: Tl,JpeLLT -? NS AI 0 t - i 3 - 1 Ettsiutxt, Description Qty Fee (ea.) Total Cross street/Directions to job site: New residential - single or multi - family per 1 dwelling unit. Includes attached garage. NI' ALL 1 LV Q . T>, St M. G I-70b vuo Service included: N. C k�DIJ� -Co q VI- 1000 sq. ft. or less 145.15 4 6, Av t Each additional 500 sq. ft. or portion thereof 33.40 I Subdivision: Lot #: 27DD Limited energy, residential 75.00 2 Limited energy, non residential 75.00 2 Tax map /parcel #: 2. 5 1 `I is, C. Each manufactured home or modular dwelling .., ,. 4,,tk ." 1 ` DESCRIPTIONNOF'•WORK': ;_ ,.." ".,i'Viita`'";° service and/or feeder 90.90 , • 2 t"Ct DIJ.J O tN MOLT{ -(sc Services or feeders - installation, �C�C alteration or relocation: TO E GSM. MnKi letTe-t-�W 1 K-1. LO10t 4- 200 amps to 400 amps 106.85 less 2 80.30 . 2 - 2 201 amps to 7y 3� 2 401 amps to 600 amps 160.60 2 3PROP OWN ,? s . :; : :l' ❑-TENANT-'sr:t ' : : :T "' 601 amps to 1000 amps 2 40.60 2 :..,'�:�'• ;� � sba'< >'.w `�,'�:. P Name: - Tt&�YZb --To A o ver 1000 amps or volts 454.65 2 L��N �C.� at t. vIS121CT Reconnect only 66.85 2 Address: ,91,0 54) SA1.3%9%60124. Net, Temporary services or feeders - installation, C lt /State /ZI alteration, or relocation: y p I L &- 2 .\7 9-7 Z. .3 200 amps or less 66.85 . I Phone: S 03 - 431- 4o0o Fax: 431 -= 404-7 201 amps to 400 amps 100.30 2 . 40I to 600 amps 133.75 2 ®'-AP,PEICANT;`` :- : -,, -'. = ';;_' " ":?;;` ^.21.CONT 'OT-P.ERSON =° ;"'3: Branch circuits - new, alteration, or Name: 4,\113, c5 & t.4 tt4 - pV (.L OLSO(...) lAultES extension per panel: Address: A. Fee for branch circuits with purchase of 31 r'l 4,L,) L )Pe S+kl N (,TO 0 ST -. Z OO service or feeder fee, each branch circuit 6.65 416X 2 City /State /Zip: 1 4 a en .., 16 4) i -1-to 4 B. Fee for branch circuits without purchase of service or feeder fee, first branch circuit 46.85 2 Phone: 224 - 6 15D Fax: Z73 - 51 5-z. Each additional branch circuit 6.65 2 E- mail: { ,;44, 6 L1 d W a • Gb Misc.(Service or feeder not incl ded) �,t� 'r,. 'r a , v ,, . ' £' :'; ,,cnGQ TRACTOR'_ 4 „ , t' , :t :t .. 7. Each pump or,irrigation circle eStA1AP PUNp) I 53.40 2 Each sign or outline lighting 53.40 2 Job No: Signal circuit(s) or a limited energy panel, e , W ' 92 % X Business Name: -r - Le tt , 21i - ,e4L ►(- Q, a lteration or extension 7 Page 2 • 2 �j Address: . (�„L /- Description: City /State /Zip: h l �t,J,r}� I OR, /7;47 Each additional inspection over the allowable in any of the above: Per inspection per hour (min. I hour) 62.50 Phone: 1p6q gar 2-- Fax: Investigation fee: - CCB Lic. #: /6-3a Lic. #: 3 02,C other: Supervising electrician ,y '' " ";f,,, -: • - §-- tlecfrical! Permit § Fees *' 8,14. - 'n ,;+. -T. .: Subtotal > $ /5 , '' signature required: Plan Review (25% of Permit Fee) $ 35j . 'nt Name: Lic. #: 0 251 /S State Surchar e 8% of Permit Fee $ ( / O3 TOTAL PERMIT FEE S i ,Authorized �/ , / � / Notice: This permit application expires if a permit is not obt S withtn , Signature: � � 1 *AC, ate: 180 days after it has been accepted as complete. •� •� *Fee methodology set by Tri- County Building Industry Service Board. r J■Z±I! 4 4 -- - _01. 0 4 (Please print name) r ' A "f,.t W n is \Dsts\Permit Forms \ElcPemiitApp.doc 01/03 Electrical Permit Application - City of Tigard i 1` Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: - RESIDENTIAL WORK ONLY: Fee for all systems • $75.00 ' • Check Type of Work Involved: n Audio and Stereo Systems n Burglar Alarm n Garage Door Opener Heating, Ventilation and Air Conditioning System El Vacuum Systems Fl Other COMMERCIAL WORK ONLY: Fee for each system ... $75.00 (SEE OAR 918- 260 -260) Check Type of Work Involved: E Audio and Stereo Systems Boiler Controls - " Clock Systems I I Data Telecommunication Installation © Fire Alarm Installation HVAC Instrumentation IT Intercom and Paging Systems n Landscape Irrigation Control n Medical .Nurse Calls n ,,Outdoor Landscape Lighting n Protective Signaling • n Other , Number of Systems * No licenses are required. Licenses are required for all • other installations \Dsts \Permit Forms \ElcPermitAppPg2.doc 01/03 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (5031,639 -4135 INSPECTION DIVISION Business Line: (503)639 -4171 MST BUP Received Date Requested / 7 AM PM BUP Location f /2 c l 7 Suite MEC Contact Person , - C Ph ( ) � /— 93,37 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner Y ELC .gD03 06 7e-A-Q-- Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains f 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 Fire Alarm ��" Reinspection fee of $ - required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PART FAIL SIT ❑ Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line - ADA � � Approach /Sidewalk Date 701// 2 Inspector L Ext Other: Final DO NOT REMOVE this inspection record rom th ob site. PASS PART FAIL CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE ATLAS ELECTRICAL CONTRACTORS 4403 SE ROETHE RD MILWAUKIE, OR 97267 Electrical Signature Form Permit #: ELC2003 -00742 Date Issued: 7/1/2004 Parcel: 2S111AC -02700 Site Address: 14650 SW 97TH AVE Subdivision: TIGARDVILLE HEIGHTS Block: Lot: 037 Jurisdiction: TIG Zoning: R -4.5 Remarks: Addition of new multi -use student commons & kitchen remodel. Your company has been indicated as the electrical contractor for the permit indicated above. In order for the electrical permit to be valid, the signature of the supervising electrician is required. Please have the appropriate individual from your company sign below and return this Electrical Signature Form prior to the start of the work to the address above, ATTN: Building Division. No electrical inspections will be authorized until this completed form is received OWNER: ELECTRICAL CONTRACTOR: TIGARD TUALATIN SCHOOL DISTRICT ATLAS ELECTRICAL CONTRACTORS 6960 SW SANDBURG ST 4403 SE ROETHE RD TIGARD, OR 97223 MILWAUKIE, OR 97267 Phone #: Phone #: F- 659 -4944 659 -2212 Reg #: MET 00002432 SUP 2581S LIC 1532 ELE 3 -2C AN INK SIGNATURE IS REQUIRED ON THIS FORM X 014,4,129.— a� Signature of Supervising Electrician If you have any questions, please call 503.718.2433.