Permit 1 CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00309
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 8/22/2007
PARCEL: 2S 103DC -01000
SITE ADDRESS: 11265 SW GAARDE ST ZONING: R -3.5
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: TIGARD ASSEMBLY OF GOD
Project Description: Low voltage for Fire Alarm. (Christian School)
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:
Owner: Contractor:
TIGARD ASSEMBLY OF GOD FIRE PROTECTION SERVICES
11385 SW FAIRHAVEN ST 5573 SW ARTIC DR
TIGARD, OR 97223 BEAVERTON, OR 97005
Phone: Contact #: PRI 503 -590 -3732
FAX 503- 628 -6214
FEES Reg #: ELE 34- 488CLE
LIC 154333
Description Date Amount SUP 4120LEA
[ELPRMT] ELR Permit 8/22/2007 $75.00
[TAX] 8% State Surcha 8/22/2007 $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 N. a ion - • er. Th. e rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules 5r direct question t. •U C :t 503.246.6699 or 1.800.332.2344. _
Is ued By: i / A_ / ■/ / ' Permittee Signature:
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.
Illpi
a
Electri. ;W ermit Application -.----;., - ---, .. ,'--- FOR OFFICE ONLY
" City ce g rd -
OR ,A
7- CEW ED Receive.
Date/By:" /OM Permit No.: .... a
13125 SW Hall Blvd., Tigard, -- Plan Revii v
Phone: 503.639.4171 Fax: 503.518. ‘1
4 *.4111$111' . Date/By: Other Permit:
Inspection Line: 503.639.4175 AUG '7 '(u I ...-4- 41
a , Date Ready/By: 1uri; El See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
: T itak`
, - 4 ,- ' ','-,'' . '.4"-- ,,e'A':: - ',v .,W' .,, ,---:.;,‘ ' ',' ,.
•','ql , , - '..4!' I ei . 1 ' '-''% :"'" ' ' . 4ill'i: " ''' 4. *. :'''','''' '-' ''''!'
0 New construction OW / r; a teration/replacement Please check all that apply:
Demolition Other:
0Service over 225 amps, commll 0 Hazardous location
I=1 0
, , ['Service over 320 amps - rating 0Buildng over 10,000 sq. ft.,
.. ,‘ P F ccoN§Tj3
'.'" . ' .•'' , ..',
CATEGORY Q' '- ‘, ',-_ ' i of I- and 2-family dwellings 4 or more new residential
El 1 - and 2 dwelling [E] Commercial/industrial E Accessory building ['System over 600 volts nominal units in one structure
0Building over three stories s Feeders, 400 amps or more
El Multi-famil El Master builder 0 Other:
00ccupant load over 99 persons 0Manufactured structures or
l A.w ''''''''''' RV park
„,k''g, ., ; , ""t' ' jii ' El Egress/lighting plan
Job no.: 2472 Job site address: 11265 SW Gaarde St. OHealth-care facility 00ther:
Submit 2 sets of plans with any of the above.
City/State/ZIP: Tigard, OR 97224 The above are not applicable to temporary construction service.
Suite/bldg./apt. no.: Project name: Gaarde Christian School ,' , ' ' .'' - FEE,. ISCHED,HILE,:, , ,,,':
Description Qty. Fee. Total **
Cross street/directions to job site: Gaarde St. / 115th New residential single or multi dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. addll 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
,, -,, -':' ''';, ,;:ct Each manufactured or modular
Instalation of new Fire Alarm system dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
;;:"'„';l,':i :l, 0E10V64j4i7;4 : Isj;,,,,,,,,v -, 201 amps to 400 amps 106.85 2
''' ' ' l '''''''' 401 amps to 600 amps 160.60 2
Name: Same 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 I
Owner installation: This installation is being made on property that I own which is not 201 amps 10 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps 10 600 amps 133.75 2
Owner signature: Date: Branch circuits- new, alteration, or extension, per panel
'","' fs
4;ipfp
lialcrikl - ;;APP:"'":":::7 - A. Fee for branch circuits with
OiKt 411q P:.- ,,,, --,,,,,::,,'' Y: ; ' '., ''Age0 -, :. ':.."-.4L.;1.„ - ,,,..Z,„. - -4441'7,...d:
service or feeder fee, each
6.65 2
Business name: FIRE PROTECTION SERVICES, INC. branch circuit
B. Fee for branch circuits
Contact name: DAVID M. PHIPPS without service or feeder fee,
46.85 2
each branch circuit
Address: 5573 SW ARCTIC DRIVE
Each addll branch circuit 6.65 2
City/State/ZIP: BEAVERTON, OR 97005 Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: (503) 590 Fax: : (503) 628
Sign or outline lighting 53.40 2
E phipps@fpsnw.com Signal circuit(s) or limited-
. ltOSITICA'CTOR
, I energy panel, alteration, or
,
1. OC)
extension. Describe: i Page 2 • 5. 2
Business name: FIRE PROTECTION SERVICES, INC.
Address: 5573 SW ARCTIC DRIVE Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State/ZIP: BEAVERTON, OR 97008 Investigation per hour (1 hr min) 62.50
73.75
Phone: (503) 590-3732 Fax: (503) 628-6214 Industrial plant per hour
- ogokyou,ii.ovoyloss:..,''':,
CCB Lie.: 15433 Electrical Lie.: 34-488CLE Suprv. Lie.: 4120LEA Subtotal 74
Suprv. Electrician signature, required: Plan review (25% of permit fee) .4 ---
, State surcharge (8% of permit fee) 6.bo
Print name: b ab1/4 . 0 , 1 1 iv\ i t, oc , Date: 8/06/07
TOTAL PERMIT FEE , 1.00
.
Authorized signature:
.";,,&:7 This permit application expires if a permit is not obtained within 180
44
days after it has been accepted as complete
Print name: b.0; A m if , s Date: 08/06/07
I I V I, 1.Ar * Fee methodology set by 'Fri-County Building Industry Service Board
** Number of inspections per permit allowed.
C3Building \ Permits \ ELC-PenyntApp.doc 12/03 440-4615T(10/02/COM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007 -00309
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/22/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/28/2007 TIME: 7:00AM PAGE: 400
SITE ADDRESS: 11265 SW GAARDE ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: TIGARD ASSEMBLY OF GOD
DESCRIPTION: Low voltage for Fire Alarm. (Christian School)
OWNER: TIGARD ASSEMBLY OF GOD, PHONE #:
CONTRACTOR: FIRE PROTECTION SERVICES PHONE #: 503-590-3732
Inspection Request Scheduled For: sate: 8/28/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 064742 -01 60:3 -5590 -3732 N
• i
Corrections /Comments / Instructions:
•
PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
I I FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
• Inspector: V '' N bet Date: bill/O Phone #: (503) 718 -
CITY OF + ^-
�°w u n n�"n TIGARD
BUILDING DIVISION PERMIT #: BR20070030
/ 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/22/2007
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 839'4175 � t
INSPECTION WORKSHEET FOR DATE: 8/24/2007 TIME: 7:00A|W PAGE: 60
SITE ADDRESS: 11265 SW GAARDE ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: TI CARD ASSEMBLY OF GOD
DESCRIPTION: Low voltage for Fire Alarm (Christian School)
OWNER: TIGARD ASSEMBLY OF GOD, PHONE #:
CONTRACTOR: FIRE PROTECTION SERVICES PHONE #: 503-590-3732
Inspection Request Scheduled For: Date: EK24/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 054587'01 503-590-3792 Y
Corrections/Comments/Instructions:
0 4 (-eel � ~ �� ' � , � � r;e ' te CivF h7 l)
(Di ^ - � ~ -^ 04.
PASS | | PARTIAL APPROVAL CANCEL | NO ACCESS
��7FA|L | | CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector,: �� ^~ S-1,- � Date: � Phone #: (503) 718-
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