Permit •
•
,,CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00532
DEVELOPMENT SERVICES DATE ISSUED: 7/27/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1 S134CC 01700
SITE ADDRESS: 12325 SW KATHERINE ST ZONING: R - 4.5
SUBDIVISION: MARY WOODARD SCHOOL LOT : JURISDICTION: TIG
Project Description: (5) branch circuits for VFD replacement. Job No. 954072
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:
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: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 4 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
•
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Phone: Phone: 360 571 -4411
FEES Reg #: ELE 37 -620C
LIC 91668
Description Date Amount SUP 3486S
[ELPRMT] ELC Permit 7/27/2005 $73.45
[TAX] 8% State Surcharge 7/27/2005 $5.88 REQUIRED ITEMS AND REPORTS
Total $79.33
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 • - an 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules a - set forth in OA' 152 -00 -00 0 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to •— a.
503 -2 , 6 -6699 or 1- 800 -332 44 _
—
Issu; d By: - % � - Permittee Signature: , /�✓
AP
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 INS ' L I NLY
SIGNATURE OF SUPR. ELEC'N: / DATE:
LICENSE NO: 65
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 Applicar R o _. USE ONLY' •
Cl of Tigard Received
Date/By: j_
Permit No.: C l� e p`�` � M „c 5j ^�
I-
13125 SW Hall Blvd., Tigard, OR 97223
Phone: 503.639.4171 Fax: 503.598.1960 a". `J g Re 5 j Plan Review
�� t� DateB Other Permit: Inspection Line: 503.639.4175 °.J.. Date Ready/By: �Jurs /1 El See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: ''.7 ' v Supplemental Information
f'"`Y' =7� "";�.�: e ;:s?.�.`:: �- ?r�;i^f�: =,? -.;�& „ _s_: axe °ate u,�.' .� »: _- - h;�;., ---
?�•,. .. a_ *: tea. .;?:�,. ;SIa - E'= _ .. ''..� ..:xx = -
'!° '' � %�� . ins - . �-� . a ..��. - -:A'.. . e `, a �:
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❑ New construction Addition /alteration/replacement Please check all that apply:
❑ Demolition El Other: ❑Service over 225 amps, comm'l ❑ Hazardous location
i - s� � _ , „ , , , ,•.,;.,,." _ _ , ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
j 3P- 71 V - If: : Y el � § Ci re it ST R tti ` `n'zwAz . . of 1- and 2- family dwellings 4 or more new residential
❑ 1 - and 2 family dwelling - Commercial/industrial ❑ Accessory building ESystem over 600 volts nominal units in one structure
❑Building over three stories ❑Feeders, 400 amps or more
❑ Multi - family ❑ Master builder 1=1 Other:
['Occupant load over 99 persons ['Manufactured structures or
44qq ��k- ,. = cf sx-r�t• . .. P P
A 4, :v,7 rJ ,4 , ,y P 1 0 - -'4 01 � P ," C A , , ; ,, , -- .m :2, ❑Egress /lighting plan RV park
Job no.:9(! a j L Job site address: IA ,G V .4 8 ['Health-care facility ['Other: '" loll �1� �� Submit 2 sets of plans with any of the above.
m
City /State /ZIP:T; ( --Z 61� 2 l � 2 The above are not applicable to temporary construction service.
11 t c � r n °`J,f » r
Suite/bldg./apt. no.: Project name `; VI W D0`��+rr�rot •te, . it >_. it *:S iftli IiE An:- :' _ **
D Qty. Fee. 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'l 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.: Each manufa -
o- ay �.., . ' =;; * ^^ _, fl ..ra s ..: a ::.P ,. `.ter? ys u* °,:t Limited energy, non - residential 75.00 2
?; .'-' t�, t,,a; .x;.: ' +.:at„.::r: < S.: > V;: QF� �?F c * Z < r " f? • t „
�, ��- _- ,..�� &y =�x -,�., ��� = w'�;� c tured or modula r
J - 1 / i i r p p j dwelling, service and /or feeder 90.90 2
V 1' / X� ( Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
' `x i > ; "-x :s a N�. 1, , ; F s,F i °f . >. ` ,> ...: �:, . , ,w -. .� .4:4 201 amps to 400 amps �,�. �. _ �.�4 ;- O ER1� Q�`�*T ��`�,. -;� . ,�,�.: �� .. '� �., x�� .., ,;�,�,• . ,�,:,,�� mP P 106.85 2
�•�� ;, ,.,1 .; a's.,z EV �, a f `.; «.,» 0, .. ltOl lAtirrnWitA:._,j. # ,N T." .,> •a . . z 401 amps to 600 amps 160.60 2
Name: 601 amps to 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
Phone: ( ) I Fax: ( ) relocation
I 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
,� ,�. -� a� was ,��«..�... I ps = ;,.; „ "_ ��; � f :. m . � ra �- rxx�»�- =. ':a�es:�_.:. •�:g��:�� �:'�,•,„ -.
�� "�j, - l am i �' A. F ee f o r b ran ch c w
� �.; ° � � ��_,. �.d'`"" ' ' s "� � � ".xis . ".� "'°" �' ��� service or feeder fee, each
Business name: branch circuit 6.65 2
B. Fee for branch circuits
Contact name: without service or feeder fee,
each branch circuit l 46.85 2
Address: Each add'l branch circuit L. ff 6.65 Z. (PO 2
City/State /ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) I Fax: : ( )
Sign or outline lighting 53.40 . 2
t.'" E -mail: Signal circuit(s) or limited -
-: �'MI i3` '+=' R; :? r te: ": :;.,.; -6 ., �.« , ar �, u yan� , ;,,i &,,.. a . k, s ae.
- %:`�=t1" 0 0.1 ""c „vsf.
.tw L .,..,,,- t a� ,r:. � 4, 4), 4 : x
4 $,. ya c energy Panel, alteration, or
fxtrr,,. .,�' �� �„� � s (a?C+1 � T13A �TpR ,�.,.
j �� f jj V` ' 1_ ± extension. Describe: Page 2 2
Business name: � l� t ` C �l
Address: sl up y C - 11 m Each additional inspection over allowable in any of the above
"�'
Per inspection 62.50
1' 'n (n/In
City/State /ZIP: Y o, t Gm�/tir, W'T a Y IJLI.e J _ Investigation per hour (I hr min) 62.50
Phone ( ) Fax: ( ) Industrial plant per hour 73.75
CCB Lic.: q /4262g , �(G Q Ele al Lic.:%%? trio Suprv. Lic... I A �l
v Subtotal 73g�
Suprv. Electrician signature, required: Plan review (25% of permit fee)
Print name: J
`
.671. v j'o Dat e: �� � State surcharge (8% of permit fee)
• TOTAL PERMIT FEE 7‘1'21--
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 Tri- County Building Industry Service Board
** Number of inspections per permit allowed.
is \Building\Pcrmits\ELC- PermitApp doc 12/03 440- 4615T(10/02/COM/wEB
Electrical Permit Application -' of Tigard . -
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
,�r- ,�s1i':ciV"s'+m47 7 . 'F>' �e a v+."' .:r".�l µ 4.t"- a . � S.;'1'#s` °`i
Fee for all residential systems combined $75.00
Check Type of Work Involved:
n Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
n H eating, Ventilation and Air Conditioning
System*
n V acuum Systems*
n Other:
rica agile
Fee for each commercial system $75.00
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
n Intercom and Paging Systems
n Landscape Irrigation Control*
❑ Medical
n Nurse Calls
n Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other •
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
is\ Building \Permits\ELC- PernutApp.doc 04/03
CITY-20F TIGARD. .
BUILDING DIVISION , - PERMIT #: ELC2005-00532
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/27/2005
Phone: (503) 639-4171 , ;:iimihttilil -
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 9/8/2005 TIME: 7:09AM PAGE: 86
SITE ADDRESS: .325 SW KATHERINE ST CLASS OF WORK:
SUBDIVISION: M ' wY WOODARD SCHOOL LOT #: TYPE OF USE:
PROJECT NAME: MAR WOODWARD ELEMENTARY
DESCRIPTION: (5) branc- circuits for VFD replacement. Job No. 954072
• OWNER: WACO SCHO DISTRICT 23J, PHONE #:
CONTRACTOR: CHERRY CITY ' ECTRIC PHONE #: 360-571-4411
Inspection Request Scheduled For: Date: 902005 Pour Time:
Code # 4111111 Description Confirm # Contact # Message
199 Electrical final c2-5I 971-563-6106 N
Corrections/C..4 ents/Instructio -:
---------- PASS 1 0 CANCEL 171_NO_ACCESS__
FAIL 0 CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: G N GE!, L1 Date: 1 1 eic ----- Phone #: (503) 718- 2N (5.
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