Permit C ITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY DEVELOPMENT SERVICES PERMIT #: ELR2004 -00280
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/2/2004
SITE ADDRESS: 09000 SW DURHAM RD PARCEL: 2S114AA 00100
SUBDIVISION: ZONING: R -4.5
BLOCK: LOT: JURISDICTION: TIG
Project Description: Limited energy for security system - school only, excludes out buildings, ie: auditorium, swim center,
gym.
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: OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL: X
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
SCHOOL DISTRICT 23J ELECTRIX LLC
13137 SW PACIFIC HWY 115 V STREET
TIGARD, OR 97223 VANCOUVER, WA 98661
Phone: Phone: 360 - 694 - 5094
Reg #: LIC 148685
ELE 37 -930C
SUP 4398S
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 9/2/2004 $75.00 Elect'I Final
[TAX] 8% State Surcharl 9/2/2004 $6.00
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.
Issued by / Permittee Signature 3 p, \,
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
08/31/2004 22:27 3606950670 ELECTRIX PAGE 01
h1112 ( ?h�hl['I; USE ONLY
Electrical Permit A iicalti
City of Tigard
Received S — /(� [ / _ `L
oauB
13125 SW Hall Blvd., Tigard, OR 97 �' E��E® . A !� P Ra vicw Other Permit:
Phone 503 639.4171 Fax: 503.9 4 -
A 1 Date Reed lementnl information
inspection www . ig rd, r.us SEP 0 1 2004 Notifed/Mcthn Sinn
Internet: wWw Ci,tigafdAr.l13 S�1 r rI�1 x . i roc,iin r 1 • e' fGtf, " r'''
a� mi . 1 i 1 . t l l � f)� } Il RI p {f ll ��� l n4 {zii}d � 1 tf 'r lr I • l y;,k,U ,
�+,^ p ` ! ^, a!!+1 {Rllli � (' lki'i'C"' (, ' ' 1411{;! '6 1 PSI r f ll• • � m . 1 p i„ t! ii11 ;�} 1c I Mf) r s� „
:? 1 : I 13th , , a, k ,,:qd . r�ti iii i .t.. , ... . 11 1 11 1 1, ' f Please check all that apply:
❑ New construction 211.81 �itl`Zc G {ei��t. )replacement
,, �I s};; NG DIVISION ❑S check
over 225 amps, etrmm'1 ❑Hazardous location
[] Demolition LJ`� OServicc over 320 amps - racing o Buildn over 10,000 sq, ft..
I ill kP1P , ,T r iV."I 1 { rte• hits "a "� , a c cylmsl41ie� t l� / g s 4 or more new residential
S 11+,4, I , i .. ��` j� structure
i'' ,,1�r.J dit, .,�..+:lfrt.,i „it';�n!mhtnhcAU a'bn,�li`a• ��r> r�,ittr +t n.. �af�l',I�ti1��l.lf�l'�FI� 114' � "tr,• .,. of 1- and 2- family dwelling ❑System over 600 volts nominal units in one st
❑ 1- and 2- family dwelling (:33 Commercial /industrial ❑ Accessory building
['Building over three stories ❑Feeders, 400 amps or more
c
Master builder ❑ Other: DO load over 99 persons 9Manufactured structures or
Multi -family ❑ park
t'r ` s d s I 1 v I f i ,` { 1{ I I e f (' ❑Fgress/lightingplan R V ark
i ): :iqq",' .i. - i d1. l 1. ;' 4 R! . l':. ttr 4 a sirliilr Pc, ii m ans ,11 # i �i/ / l4 1 „ , r, pother: II Submit -care ofp
Job no.: Job site address. ' Submit sets fa plans with any of the above,
The above are not applicable to temporary construction service.
City /State /7.14: � � I . lie u r" 1; #j1iU l' ,y ;,:,40,1, Ili' Ill'1 '!li'i'' li' P” .i I; IC;I L; ° l;''
II' .1 „•„ d •
4, 1 Ili i01 li I C, I ! , ,. M I�1.�fl3iti +.,,,,ljJ �, j r, r „I3t „ac
Suite/bldg. /apt. no.: Project name: Tigard Security Phase 2 DataeipUun Qty. Fee. Tntnl I ”"
New residential single- or multi - family dwelling unit.
Cross streeddi____ ns to job site: Includes attached garage. _
1,000 sq. tt. or less 145.15 4
J Lot no,: Ea. add'l 500 sq. 'ft, or portion 33.40 1
— — Subdivision: Limited energy, residential 75.00 2
Tax map/parcel no.: Limited energy_ non - residential 75,00 2
r
, I , „ q� r 'in 'l P I I' I 'i; I IiII, ' y t 4 1 . 1g Each manufactured or modular
ir ' lI R;,i,�lit`,(INI Ji $;;'! y i '�ti'i a' � +' MOO m7 ji � , ':U,1rl' f t, >.
'' i', >,.5 •, '..� .s�,rt�; , , ll =.. ,, n: r! as�ia sn7�,._. IQ' Ilartr :!I 90.90 2
+ dwelling, service and /or feeder
_ Services or feeders installation, alteration, and /or relocation
200 amps or less 80 30 2
r{ w,w (�' � T t ! I10 201 amps to 400 amps 106.85 2
l(y` j ° af , {i(, ' ? , t ' �"�r1ri �7Y1, i o ; Y, 1 11 :Ill llllfl? >�i�afi�l� ll11t`Il HiI u' ri i1 . i; ` �llf� #Ii11111�1 fyJ . 401 amps to 600 amps 160.60 2
Name: TTSD 601 amps to 1,000 amps 240 60 2
. Over 1,000 amps or volts M 454,65 2
Address: 6960 SW Sanbur$ Street - Reconnect only 66,85 2
City/State /ZiP: Tigard, OR 9'722.3 Temporary services or feeders Installation, alteration, and /or
relocation
Phone: (503)431 -4000 I . Fax: ( ) 200 amps or Tess 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
mmmll u 3(l . �, �.tlea +. I A. Fee for branch circuits wfth
+•' � d. Sri rn�aSC:hl'yo., �rl , "r,t i !° 4 l �;} 1 gi�f i 0 1 ! 1' n "A , b 1. E
1' ,I .,rii d i Itd,I ,. t e 1 . If Iii i l qi i Jl{Jl f7f' {tt „ It n�n �t Mh I kY. service or feeder fee, each 6.65 2
Business name: ELECTRIX, LLC branch circuit
B, Fee for branch circuits
Contact name: JEFF MARSH. willow service or feeder fcc, 46 85 2
each branch circuit
Address: 115 V STREET Each ridd'I branch circuit 6.65 2 _
City /State /ZIP: VANCOUVER, WA 98661 Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 I 2
Phone: (360) 694 -5094 Fax:: (360) 695 -0670 Sign or outline lighting 53.40 2
E-mail: LIZC @ELECTRUX.BIZ
" �^ N ry ( j� �� {j{$ y j } jr��� . Signal circuit(s) or limited-
' 1( Ir }I a" a 1 I ' 7r . " ' ,�fr �+k, 1 1Y1 I r R "� ENIN +aYW{dld 1 } A iit1fV11/i(. ,i energy panel, alteration, or
^ e lw ?r !1; C S �l' , !`I.I, uxi r Jlareha alit li1r t till t e „, extension, Describe: Paget 2
Business name: ELECTRIX, LLC
Each additional inspection over allowable in any of the above
Address: 115 V STREET Per inspection 62 50 i
City /State /ZIP: VANCOUVER, WA 98661 Investigation per hour (1 hr min) 62,50 i
6 5-0670 Industrial plant per hour 73.75
Phone, (360) G94 5094 Fax (360) 9 `'I r i (I {' 0 w ... I M,I SFAI, alit 7�`,,.''1 . 'i '
tM'4 `F � � l r lU ; . ,
CCB Lie. 148685 Electrical 1_•ic.: 37 -9300 Suprv. Lie.: 3161S S ubtotal qt.,
Suprv. Electrician signature, required: Plan review (25% of permit fee)
State surcharge (8% of permit fee) YJ
Print name: Sthtliii.M.61.4/6 Date; 9!1!04
TOTAL PERMIT FEE 1
Authorized signature: This !mantic application expires if a permit in not ohtainc within 180
days after It has been accepted as complete
Print name: Date. • Foe methodology set by Tri- County Building industry Service Board
Number of inspections per permit allowed,
i.\ a1IIAing \Permttt \FJ_C•Permi1AVP,dec 14/03 440 - 4d 15T(10 /071COM/W58
CITY OF TIGARD 24 -Hour `
BUILDING Inspection Lira:" (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
•
Received Date Requested �� _, AM PM BUP
Location l o00 ®V\ `k Suite / MEC
Contact Person \yam Ph (c3 ) 3 \cl `o 9 � PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation
Ftg Drain Access: ELR D.00 �� d`�►
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: 7
Final
PASS PART FAIL
C
PLUMBING : "> .
Post & Beam
Under Slab
Rough -In
)1 1
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
CTRLC� _
Service
Rough -In
4t1t4
Fire Alarm
+Y di 1►
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SITE Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach /Sidewalk Dat ° Inspector /1 .� O LA � � E
Other:
Final DO NOT REMOVE this inspection record fro the job site
PASS PART FAIL