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Permit CITY OF TIGARD ELECTRICAL PERMIT c• PERMIT #: ELC2006 -00307 . DEVELOPMENT SERVICES DATE ISSUED: 5/31/2006 I ` = 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S134CC -01700 SITE ADDRESS: 12325 SW KATHERINE ST ZONING: R -4.5 SUBDIVISION: MARY WOODARD SCHOOL LOT : JURISDICTION: TIG Project Description: (1) signal circuit. Job # 954074. RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL /PANEL: 1 MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10): SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 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: WACO SCHOOL DISTRICT 23J CHERRY CITY ELECTRIC 6960 SW SANDBURG ST 8100 NE ST JOHNS ROAD D -104 TIGARD, OR 97223 VANCOUVER, WA 98665 Phone: Contact #: PRI 360- 571 -4411 FAX 360 -571 -4410 FEES Description Date Amount Reg #: ELE 37 -620C [ELPRMT] ELC Permit 5/31/2006 $75.00 LIC 91668 [TAX] 8% State Surcharge 5/31/2006 $6.00 SUP 3486S Total $81.00 REQUIRED ITEMS AND REPORTS 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. Issued By: - 77 - Qr,�� Permittee Signature: 0,e 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 - 41.7-5- 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. MRY- 31- 2006(WE0) 10:36 P. 002/002 Elect rieai Permit Applicat• • 1 1R OFFICE USE ONLY r . - , -- 4 11, City of Tigard Rec , . � P ■ Na.: 13125 SW Ball Blvd., Tigard, OR 97223 Date/3 • 3 !� 1 1 y a 0 Plan Review phone: 501639,4171 Fax: 503.51 ,{ '� ElVED ; t, Mil tawny: Other Permit Inspection Line: 503.639.4175 ��Js1; 6 21:, DateReady/By: 1 Internet: www- ci.tigard -or•us Notified/Method: f k1 See Page i rut I I e J pplcmentat lutormauon It'".y. .a dy. w Caw '+k�' r '" 1 ,� 1 1 e' - : • , z . a l � J , V r.' fi • — • i .. • .,i:, r a . , r , � H pt mu, , 1 , ,, - > , `" i s i : t, . . '[l er >c'S�. � _ aa .nt} +x`I� .ae.lr ..i -.: , "S `p�:' , ."IV.ek:2 ^s +6''"�tl('. :: �. ❑ New construction i>lit lit .. ti L. acement Please check all that apply: ' ❑ Demolition CottijepING DWI • DSc/vice over 225 amps, comm'l ['Hazardous location 6 ;> x •, [ ' - � r a . e ,: _ ❑Service over 320 amps — rating ❑$uildng over 10,000 sq. R, t µ '� .4t .P,! ,.» W , -,-f.� .a • pe C '' t ° • . _ . ' . .. , : t,n , ' 1 $ { 1 : ); I0-1■ ;� i;y} ;; of 1 -and 2- family dwelli 4 or more new residential Q 1— and 2 family dwelling Comtnercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure ❑Building over three stories ❑Feeders, 400 amps or more a:0 A a (] Multi - family © Master builder 0 other n • ! 7 "�' ! a Occupant load over 99 persons °Manufactured structures or tip -, r m, "W`o iw[a rlir+ ['Egress/lighting plan RV park Job nef fi p i i Job site address: ; 1 1 M� /„ Q Health cart facility ❑Other: Submit 2 secs of plans with any of the ¢bave- City/State/ZIP: /1 i. r / e ■ The above are not applicable to temporary construcrion service. Suite/bldg. /apt. no. Project name, Ma A ill IMT ",' '47 ;`1ri 1154 W Ir ialiS Oils t,AQ I ' W ' 'i'f`I ,',_i'r. .. Peacdptlnn Qty. Pee. Tafel Cross street/directions to job site: 4 Now residential single- or multi family dwelling unit. Includes attached garage. 1,000 sq. ft. or less 14515 4 Subdivision: Lot no.: Ea. add`1500 sq. ft. or portion 33.40 1 Limited enemy, residential 75.00 2 Tax trap /parcel no.: Limited energy, non - residential 75.00 2 M a!a: an g'8a.'a �1'ahn m.:!M' r i3OMMI` i l galn'�it i Bath manufactured c rmodular -- - i ', �' � dwelling, service and /or feeder 90.90 2 Services or feeders Installation, alteration, and/or relocation �. ' ,�I(h cry qtr 200 amps or less 80.30 • 2 201 amps to 400 ii fr _`i n K � ' {G ` • 3mW i C� " ab" :xCi1 r rra M � I l;� .: 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 /StatcJZlP: Temporary services or feeders Installation, niteratiun, and/or I. relocation Phone: ( ) I r ) ( 200 amps or less 66.85 i Owner installation: This installation is being made an property that I own which is not 201 amps to 400 amps 1 00.30 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 g „ w' li y"Vk"I" i I � �' � +�; >.trtr, W Y 1 1 - r ,, � �i 1 �i � • t 1. li ' .r,a legtriM � � A - F for branch circuits whit 'i: 9 acs . s � i t ? Ti�.. ;�r + �!$e, ;t . I ' 1.4 service or feeder fee, each Business name: branch circuit 6.65 2 — 13. Fcc for branch circuits Contact name: without service or feeder fee, 2 Address: each branch circuit 46.85 Each add') branch circuit 1 6.65 _ 2 City/State/ZIP: Miscellaneous (service or feeder not included) — Phone: ( ) Fax:: ( ) Pump or irrigation circle 1 53,40 ( 2 Sign or outline lighting 53.40 2 E.-mail: r��t'��.�� y l• y , ,-..fir � v i � ,� , ,�� i , r �,,�,g�• r��„�� ,^,,�? Signal circuit(s) or limited- , ^:�l:a� ; :1� d a large . Ed: YpetO �i �1 ��" tdth::gtil §1•t ' '..:if l� ei+er panel, alteration. or ��, extension. Describe: Page 2 l) Business name: II ' IAt 1∎ ' ei t i r Each additional inspection over allowable in an of the above Address: /gall I1 `t ■ , 4 �� ` P Y �' =�' Per inspection ME 62.50 City/ State/ZIP: Y MI1; 1 � mil; Investigation per hour (i hr min) 62.50 . Phnne- I �1 ��„�IM E >,1 � III 73,75 CCB Lie. � r/ �' � t . VIE �� 1N, ''0 . ri!,' ! : M. - :I / 1 i !i� Suprv. Lie. sly �.+� Subtotal d 1 , Suprv. Electrician signature, required: r _ Plan review (25% of permit fec) I �] v State surcharge (8n% of permit fee) p • 0,....., J Print name: J - t - - - a 1 ('v-1 - ey 4..1 / - b Date: — TOTAL PirRMIT FEL Authorized signature: g...., 1'hls permit avocation expires if a permit is not obtained within 180 days after It has been accepted as complete t Print name: Date: • Pcc methodology act byTri- County Building industry service Board •" Number of inspections per permit allowed. i :Muilding\PenritelELC- Permititpp .doe 17103 440.4,lIT(IoroyCOPNwEB CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2006 -00307 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/31/2006 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 6/19/2006 TIME: 7:05A4 PAGE: 51 SITE ADDRESS: 12325 SW KATHERINE ST CLASS OF WORK: SUBDIVISION: MARY WOODARD SCHOOL LOT #: TYPE OF USE: PROJECT NAME: MARY WOODWARD SCHOOL DESCRIPTION: (1) signal circuit. Job # 954074. OWNER: WACO SCHOOL DISTRICT 23,. PHONE #: CONTRACTOR: CHERRY CITY ELECTRIC ` ' ° \ PHONE #: 360- 571 -4411 Inspection Request Scheduled For: Date: 6/19/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 03189901 111 - 111 -1111 N • Corrections /Comments /Instructions: 'rcL R 002- CWE(k.k.I Cif \I - kZ•S IS.4200f6 • 001 7 3 60- ‘0 - 1•5 1 4,2. ; PASS PARTIAL _APPROVAL ___ ❑._ CANCEL . _ ❑_ N.O_ ACCESS ___ FAIL ❑ CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED Inspector: N Date: • 19 ' d6 Phone #: (503) 718- 2.446