Permit CITY TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00490
. 4� & DEVELOPMENT S8RVICES DATE ISSUED: 7/11/2005
A. c�' 11 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S13400-01700
SITE ADDRESS: 12325 SW KATHERINE ST ZONING: R -4.5
SUBDIVISION: MARY WOODARD SCHOOL LOT : JURISDICTION: TIG
Project Description: Lighting retrofit, (8) branch circuits. Job No. 86704
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: 7 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:
TIGARD- TUALAI1N SCHOOL DISTRICT OREGON ELECTRIC CONST /GROUP
6960 SW SANDBURG ST 1010 SE 11TH AVE
TIGARD, OR 97223 PORTLAND, OR 97214
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Phone: 503 - 431 -4000 Phone: 503 - 234 -9900
FEES Reg #: LIC 203
SUP 4460S
Description Date Amount ELE 26 - 95C
[ELPRMT] ELC Permit 7/11/2005 $93.40
[TAX] 8% State Surcharge 7/11/2005 $7.48 REQUIRED ITEMS AND REPORTS
Total $100.88
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 f. •- _ - than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules are -t forth in • R 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these r es or direct questions to OUNC at
503 -2 -6699 or 1 -800 - -2
Issu d By: k ��� . _ � Permittee Signa' • . / /of .
• 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:
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CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO: 4 c
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.
JUL -08 -2005 11:12AM FROM -OR ELECTRIC SERVICE 5035352763 T -433 P.001 /004 F -262
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VI- - City of Tigard u R Dat. eca �/Bv eJ 05 1 P ernut N 6449e:95'.. 0041510
13125 SW Hall Blvd., Tigard, OR 97223 jl i � oOr t P ht' n l B1' ' F Other pernut.
Phone: 503.639,4171 Fax: 503.598.1960 V 8 w"� f t` 17 +
Inspection Line: 503.639.4175 '' 1 Date Rea4y/tty. )uq VI Se., Pogo 2 for
Internet: www_ci53.639r.us CITY OF TIGAr- NotinaRvieIwd: / ((t Supplemental Information
nNtit reinice. nn••�• -∎ • /
TYPE OF
• WOR
aO ,I: I v ruI\ -IIV PL REVIEW
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❑ New construction ® Addition/alteration/replacement Please check all that apply: •
❑Service over 225 Iimpc, comm'l ❑ Hazardous location
❑ Demolition ❑ Other: ['Service over 320 amps — rating 0 13uildng over 10,000 sq. R.,
CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
['System over 600 volts nominal units in one structure
❑ 1- and 2- family dwelling ®Cotmr3erciaUindllstrittl ❑Accessory building ❑Building over three stories ❑feeder+, 400 amps or more
❑ Multi - family ❑ Master builder ❑ Other: ❑ Occupant load over 99 persons ❑Matnttuctured stnictur'es or
JOB SITE INFORMATION AND LOCATION ❑EgreesJlighting plan 1W park
❑Health -cure facility ❑Other
Job no.: 86704 Job site address: 12325 SW Katherine St. Submit 2 sets of plans with any of the above.
City /State/VP: Tigard, OR The above are not applicable to temporary construction service.
FEE" SCILEDULE
Suite/bldg. /apt, no.: I Project name: Mary Woodward Elementary Description I Qty. Fee, I rmat I ""
Cross street/directions to job site: New residential single- or multi - family dwelling unit
_ - Includes attached garage.
1,000 sq. IL or less 145.15 4
Subdivision: Lot no.: Ea_ add'' 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
DESCRIPTION OF WORK Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Lighting Retrofit - Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
- 201 amps to 400 amps 106.85 2
El PROPERTY OWNER ❑ TENANT
>~N 1NT 401 s p a to 600 amps 1G0 -60 2
Name: Mary Woodward Elementary School _ 601 amps to 1,000 amps 240.60 2
Address: 12325 SW Katherine Street Over 1.000 amps or volts 454.65 2
Reconnect only 66.85 2
City /State /ZIP: Tigard, OR Temporary services or feeders installation, alters flan, and/or
relocation
Phone: ( ) 1 Fax: ( ) 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 10030 — 2
intended for sale, lease_ rent. or exchange- according. to ORS 447. 44), 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: _ Date; Branch circuits – new, alteration, or extension, per panel
0 APPLICANT I ❑ CONTACT PERSON A Pee for branch circuits rifle
service or feeder foe, each 6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: wiiout service or feeder fee, i 46_85 4 q . 2 5 2
each branch circuit
Address: _ _ Each add'1 branch circuit 1 6.65 u,C 5 2
City/State/ZIP; Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) 1_ Fax: : ( ) Sign or outline lighting 53 -40 2 —
E - mail: Signal cirouil(s) or limited-
CONTRACTOR energy panel, alteration, or
- extension. Describe; Page 2 2
Business name; Oregon Electric Group
Address: 1010 SE 11th Ave Each additional lns�lecdon over allowable in any of the above
Per inspection 62.50
City/State/ZIP: Portland, OR 97214 Investigation per hour 0 hr min) 62.50
Phone: (503) 234 -9900 l Fax: (503) 535 -2763 Industrial plant per,hour 73.75 i
ELECTRICAL PERMIT FEES*
CCB Lie.: 203 11ectric -9 ' spry. Lic.: 4460S Subtotal Ora q0 _
� -rte' 1
Suprv. Electrician signature, requited: Plan review (25% of perm fee)
Print mane:
V State surcharge (8% of permit fee) ', ,
Mark Date: / i •: TOTAL PERMLT_FET_ `00 , $S
Authorized signature: "so.r.i.gr- ' „ This permit applioatinn expires ir permit is out eblaiaed within 1130
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days alter it has been accepted as complete
Print name: a 3. ' 1, �, , ate: 117/08/05 • Pee methodology set by Tri Building Indust ry ServiceBeotd
■• Number of inspections nee oermit allowed.
CITY OF TIGARD
BUILDING DIVISION • PERMIT #: ELC200500490
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/1 WW1
Phone: (503) 639-4171 hapho„,
Inspection Requests (24 Hrs.): (503) 639-4175 14191.
INSPECTION WORKSHEET FOR DATE: 1/9/2006 TIME: 7:01AM PAGE:
SITE ADDRESS: 12326 SW KATHERINE ST CLASS OF WORK:
SUBDIVISION: MARY WOODARD SCHOOL LOT #: TYPE OF USE:
PROJECT NAME: MAR'I'VODWARD ELEMENTARY
DESCRIPTION: Lightingr44„fit, (8). branch circuits. Job No. 86704
OWNER: TIGARD-TUALk" \I SCHOOL DISTRICT, PHONE #: 503431-4008
CONTRACTOR: OREGON ELECT CONSTIGROUP PHONE #: 603-234-9900
Inspection Request Scheduled For: \ Date: 1/9/2006 Pour Time:
Code # • - cription \ Confirm # Contact # Message
199 Electrical final . 124579-02 503-793-5706
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- .1" - - •• '• - a Jr . • s:
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0 PASS 0 PARTIAL APPROVAL CANCEL 0 _NO. ACCESS
" 7--- FAIL CALL FOR IN PECTION El ADDITIONAL FEES ASSESSED
Inspector: Date: 1 — 9-06 Phone #: (503) 718-