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Permit CITY OF TIGARD ELECTRICAL PERMIT I COMMUNITY DEVELOPMENT Permit #: ELC2012 -00002 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/05/2012 Parcel: 1 S134CC01700 Jurisdiction: Tigard Site address: 12325 SW KATHERINE ST Project: Mary Woodward Elementary Subdivision: MERESTONE Lot: 13 Project Description: Power for new boiler system. Contractor: RELIANT ELECTRIC OF OREGON LLC Owner: TIGARD - TUALATIN SCHOOL 20200 SE OLDENBURG LN DISTRICT 23J SANDY, OR 97055 6960 SW SANDBURG ST TIGARD, OR 97223 PHONE: 503 - 701 -4562 PHONE: FAX: 503 - 668 -4190 FEES Quantity Description Date Amount 1 ea Services or Feeders - 200 01/05/2012 $100.70 Specifics: amps or less 2 crt Branch Circuits w /Purchase 01/05/2012 $14.84 Type of Use: COM Service or Feeder Class of Work: ALT 1 ea 12% State Surcharge - 01/05/2012 $13.86 Electrical Type of Const: Occupancy Grp: • Total $129.40 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952- 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. / Issued By. /_ = s� ����.— Eermittee 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' Date: LICENSE NO. Call 503.639.4175 by 7:00 a.m. for the next available inspection date. 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. E . • , lectrical Permit A )plicath) 1 , Ir I u I 1 ,,I t,., , City of Tigard 503.598.1960 Rweivod " 13125 SW Hall B1 4., Tigard, pit 07223 e� ,„ � Permit No.; i� - .a,: ' Phone: 503,7182439 Fax 503.598.1960 0 4 20 12 D ow �� Other Pe�;t 'Inspection Line: 503.639,4175 y! f ■ , �. 1 1 t 1��t Date Ready/By; 6i! SK NA86 2 for Internet: www CITY OF TIGAF D Nai; l & upplem Infor TYPE OF Vf+4T,i f I i - ..._ PLAN REVIEW 0 New conshvction & ddilion/alteration/r•eplaccment Fl h ail that apply (submit a sets of pleas w/ito a cneoked below) :' C] Demolition Other: ❑ Service or feeder 400 amps or more ❑ Building over three stories, where the available fhult current ❑ Matinee and boatyards, CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 1 so volts or ❑ Floating buildings, o I •and 2- family dwelling ] Commercial/industrial 0 Accessory buildin less to gmtmd, or exceeds 14.000 0 Commercial -use agricultural El Multi- 1)tmil r T g amps for all other inytallationa. lwiIdingE, 0 Master builder Q Other: , ❑ Fire pump. El Installation of 75 KVA or ❑ Emergency system, larger separately derived ayste, JOB Sl1 E INFORMATION AND LOCATION Job no.: Jo 13 Addition fno motor load of El ", "g "t -2 ", "1 -3 ", Site address: 113 5 I4..) ,0 e;� e. ' lc or occupancy. City /Stste/ZIF: D © Six or more residential units, q Recreational vehicle parks. 1 22 ❑ Ilealth -care facilities, ❑ Supply voltage for more than Suite/bldg./apt. no.: ❑ Hasardous locations. 600 volta nominal. Pr oject name: ij r , . 0 iy W❑ Service or feeder 600 amps or more, iimin Cross street/directions to Job site: ' - L e . IrEE SCHEDULE nNtt i Qty. I Fee. Tet{it New residential single- or multi - family dwelling unit. Subdivision: Includes attached garage. Lot no.: l .000 sq. ft. or less 168.54 4 Tax map /parcel no.: Ea. add'I 500 sq. it or portion 33 1 DESCRIPTION OF WORK Limited energy, residential (with above sq, fl.) 75.00 2 truer Limited energy, multi - family residential (wills above sq. it) l 75.00 2 S e rvi ces or s installation, alteration and/or relocation 20 amps or l�s 1.0 0.70 2 ❑ PROPER'X•Y OWNER 0 TENANT t amps to 400 feeder amp 13356 2 401 amps to 600 amps 200,34 2 Address: 601 Snips to 1,000 amps 301.04 2 Over 1,000 amps or volts 552.26 2 City/State/DP: Temporary services or feeders Installation, alteration, and/or relocation Phone: ( ) 200 amps or leas 59.36 Owner installation: This installation is being made on property 201 amps m 400 umpa 1 intended for sale, lease, rent, or exchange, according to ORS 447t449, 670, and 7011 — 125.08 2 401 amps to 599 amps 168,54 2 Owner signature; Date: Branch circuits= new alteration or extension ■ r . anal A. Fee for branch circuits with ❑ APPLICANT ❑ CONTACT PERSON above service or feeder the 1 ' ■ p /t_ � astir branch circuit 7.42 f,.4 ` 2 1\ L.1 ' C fr ([' r re. _4 B. Pee for branch circuits within& Contact Warne ' r't service or feeder fee, first r ... Yl branch circuit 56.18 2 Address: �� Each add'l branch circuit 7.42 2 4/ Miscellaneous (service or feeder not included) +(� t 1 Each manufactured or modular r C✓ I dwelling, service and/or feeder 67.84 Phone: ( 7 pit !- ^ s Q F ax: : co t t g "" if _ ! r`�, O Reconnect only 67,84 0 r . it >� / y /..: Q 0 1 Pump or irrigation ci 67.84 e • CTO Sign to outline lighting 67.84 El Signal cieruit(s) or rlimited- ttelgy el alteration oroxtenalon, P 2 IN Address: Each additional inspection over allowable in any of the above Additional inspection (1 hr min) 66,25/ hr ril��ir<rE / � 1n�osYlgatirm (1 hr min) 66.25/ hr li>ir 4 . Phone: ( Ar I! ,, , Inspectio ns for which no fee is plant (I hr min) ' 78.18/ hr hr , Inspections 90.00/ hr Inii �L ii z�i Electrical * I,iC. S u r „ � — sp _llis ; ture, required: � � r • Suprv, Electrician - i p ", PERMIT FEES ELECTRICAL PER�`f: ����� Subtotal: .�:,... Print name A n Plan review (25% of permit fee); . it tt l/, S / v to Q./' Date: 1—.3._q___ Stare Surcharge (12% of permit tee): JW3 5"(i Authorized signature: 0 _A—....-4 / TOTAL PERMIT PEE 01.2."-- i t4 , This permit app1cadon expires if a permit la not Mailed within 180 IZMIEMMXIMPIAMEMMEURI dsya after It bee beau accepted is complete. • bomber of inspections allowed par perm 1:lnuildipg Perm tcl[+a,(;.Pmmp , 07/t1/10 440- 4615TO itusieowwer Z /Z 3DVd 06117899E09 obaa° ]o oz.zgoaTa quETTag ]aid EZ :ZO ZTOZ'b0' uet