Permit CITY TIGARD A RD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00052
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/12/2008
PARCEL: 2S 114AA -00100
SITE ADDRESS: 09000 SW DURHAM RD ZONING: R -4.5
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: TIGARD HIGH SCHOOL
Project Description: Installing (1) low voltage system.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA /TELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
TIGARD - TUALATIN SCHOOL DISTRICT 23J AZIMUTH COMMUNICATIONS INC
6960 SW SANDBURG ST P 0 BOX 508
TIGARD, OR 97223 WILSONVILLE, OR 97070
Phone: Contact #: PRI 503
FAX 503- 639 -0115
FEES Reg #: ELE 36 -94CLE
LIC 145828
Description Date Amount SUP 2312LEA
[ELPRMT] ELR Permit 3/12/2008 $75.00
[TAX] 12% State Surch 3/12/2008 $9 00 REQUIRED ITEMS AND REPORTS
Total $84.00
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 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC at 503 246 6699 or 1 800.332.2344 1
Issued By _" � i Permittee Signature: 0 V
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 Application ,FOR oFFICE.LSE ONLY '
City of Tigard Date /Bea r A- ' Permit No.. F,400 F-+. S
.13125 SW,E-Iall Blvd., Tigard, OR 97223 +y Plan Review
Phone: 503.639 4171 Fax: 503.598. 1 ' . i'f /I�uil5IJii' Date /By Other Permit. e(�� _ ..
Inspection Line 503.639.4175 Date Ready/By Juris' ® See Page 2 for
Internet: www.ci.tigard.or us 1 .4 q 6 Notified/Method Supplemental Information
• TYPE n PLAN REVIEW .
❑ New construction IN Additi2 Cti alit Please check all that apply:
❑ Othe0u a ❑Service over 225 amps, comm'l ❑Hazardous location
❑ Demolition ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of 1 -and 2- family dwellings 4 or more new residential
❑ 1 - and 2 family dwelling Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi - family �� ❑ ° °° Master builder ❑Other: ❑Building over three stories ❑Feeders, 400 amps or more
❑Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION DEgress/lighting plan RV park
vd S (� " b''tf - 26 40 ❑He 2 -care facility
f p ay ❑Othee.
Job no.: Job site address: ?d,06 f� - c1�' 1 Submit il 2 sets of plans with any of the above.
City /State/ZIP: 77 440 The above are not applicable to temporary construction service.
'' FEE *',SCHEDULE ' .
Suite/bldg. /apt. no.: Project name: 7764 y, S '
Description I Qty. I Fee. I Total
Cross street/directions to job site: New residential single - or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.:
Limited energy, non - residential 75 00 2
DESCRIPTION OF WORK Each manufactured or modular
V t CE: �� dwelling, service and/or feeder 90.90 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
401 amps to 600 amps 160.60 2
Name: 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
' City /State /ZIP: Temporary services or feeders installation, alteration, and /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 600 amps 133.75 ' 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
❑ APPLICANT. 4 CONTACT PERSON A Fee for branch circuits with
service or feeder fee, each
Business name: 4'2/ "wry et� bzt ct,tj i C,g7 7U.1.'S branch circuit 6.65 2
B. Fee for branch circuits
Contact name: cOf)3 Lt (12-y-:--46 without service or feeder fee, 46.85 2
Address: 7 D 6O V 5 )c '
each branch branch it
Each add'I branch circwt 6.65 2
. City /State/ZIP: Co I LSo JL LL l� d. 97670 Miscellaneous (service or feeder not included)
Phone: (53) 7Q 3 -. 2$' 19 Fax„ (563) 6 34' _ G , l Pump or irrigation circle 53 40 2
Sign or outline lighting 53 40 2
E - mail: Signal circuit(s) or limited-
- CONTRACTOR ,, energy panel, alteration, or
extension. Describe: Page 2 2
Business name: 142 edn1i11uti/f imbe f
Address: PO - &) J( 5 Each additional inspection over allowable in any of the above
Per inspection 62 50
City /State/ZIP: id / (, CO,t ,A, L L 92/ 0 Investigation per hour (1 hr mm) 62.50
6 q o i D �U 3) 4 34 -dill" Industrial p lant per hour 73.75
Phone: (50 5) Fax: . ELECTRICAL PERMIT FEES* '
CCB Lic.: ( cis - g'Zg Electrical Lic.: 3h _y��C(� Suprv. Lic.: 2 -? a Lqr Subtotal ,
Suprv. Electrician signature, required: �✓ ���/ Plan review (25% of permit fee)
I ` - � State surcharg 4 of permit fee) 1 t OD
i Print name: ��Z% aa� Date: 3 If z
TOTAL ERMIT FEE g'`t.c/6
Authorized signature: This permit application expires if a permit is not obtained within 180
- days after it has been accepted as complete
Print name: Date: • Fee methodology set by Tn- County Building Industry Service Board
- •• Number of inspections per permit allowed.
i \ Budding \ Permits \ELC- PermitApp doc 12/03 440 -4615T(10 /02/COM /WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
e x
LIMITED ENERGY PERMIT FEES:
Fee for all residential systems combined .. $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning
System*
❑ Vacuum Systems*
•
❑ Other:
r COMMERCIAL WORK ONLY:
Fee for each commercial system $75.00
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
El Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
O . Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
El Outdoor Landscape Lighting*
❑ Protective Signaling !
El Other
Total number of commercial systems: /
*No licenses are required. Licenses are required
for all other installations
i \Bwldmg\Perm,ts\ELC- PennitApp doc 04/03
CITY ��o����N����&����
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BUILDING DIVISION p ' PERMIT #: ELR2008'0U052
13125SVV Hall Blvd.. Tigard, ORS7223 DATE ISSUED: 3/131Z008
Phone: (503) 639-4171
Inspection Requests (24Hm.):(SU3)03Q'417G „4,4 AJL
INSPECTION WORKSHEET FOR DATE: 3/1912808 TIME: 7:01AKH PAGE: 30
SITE ADDRESS: 09000 SW DURHAM RD CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: 11GARD HIGH SCHOOL
DESCRIPTION: Installing (1) low vo|tmDmsvuiem.
OWNER: TlGAR[>TUALAT|N SCHOOL DISTRICT 23J. PHONE #:
CONTRACTOR: AZIMUTH COMMUNCATIONS INC PHONE #: 503 0110
Inspection Request Scheduled For: Date: 3/19/2008 Pour Time:
Code # Inspection Description Confirm • Contact # Message
199 Electrical final 066934-01 503-793-2906 N
Corrections/Comments/Instructions:
N
N
fr
';11 PASS 111 PARTIAL APPROVAL CANCEL [I] NO ACCESS
| I FAIL I I CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: 08^ ~� Date: 3 -I c'01 Phone #: (503) 718- 2 4i
` `
CITY OF TIGARD u, ,
BUILDING DIVISION - PERMIT #: EL,R2008.00052
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/12/2.008
Phone: (503) 639-4171 . i
lit
Inspection Requests (24 Hrs.): (503) 639-4175 ;
INSPECTION WORKSHEET FOR DATE: 3/13/2008 TIME: 7:02AM PAGE: 3
SITE ADDRESS: 09000 SW DURHAM RD CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: TIGARD HIGH SCHOOL
DESCRIPTION: Installing (1) low voltage system.
OWNER: 'FIG ARD-TUALATI N SCHOOL DISTRICT 23J, PHONE #:
CONTRACTOR: AZIMUTH COMMUNICATIONS INC PHONE #: 503
Inspection Request Scheduled For: Date: 3/13/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 066667-02 503-793-2906 N
•
Corrections /Comments / Instructions:
) .0\i
(i)/ (kcItz7 A Lk. cAe LA 'ai 1 1()A)
CAI) 4 1 liav - F4 9 ., 6...
... ,-,-L-iNst, Rvz_
yokm. ut(Na4( 0 oil 1 C
0 PASS El PARTIAL APPROVAL El CANCEL r7 NO ACCESS
FAIL ' CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED
Inspector: a) utt Date: 2 . i 311$ Phone #: (503) 718- 2-IK
CITY ���������������
�*w m x OF TIGARD
BUILDING DIVISION ~ ' PERMIT #: ELIR2008-00052
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/12/2000
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 3/13/2008 TIME: 7:03AM PAGE: 4
SITE ADDRESS: 09000 SW DURHAM RD CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: fiGARO HIGH SCHOOL
DESCRIPTION: Installing (1) low voltage system.
OWNER: TIGARDIUALATIN SCHOOL DISTRICT 23J PHONE #:
CONTRACTOR: AZIMUTH CO&4K4UM|CAJl0NSINC PHONE #: 5054339-0110
Inspection Request Scheduled For: Date: 3/13k2000 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 086667-01 503'793-3906 yV
Corrections/Comments/Instructions:
XPASS �� CANCEL �� NO ACCESS
APPROVAL
FA|L I I CALL FOR INSPECTION ri ADDITIONAL FEES ASSESSED
' \�^ �� « °�� °� m�
Inspector: ~��~- � �J�� �� K-�� Date: Phone#� (503) 718- ���~t6