Permit CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
r IA DEVELOPMENT SERVICES PERMIT #: ELR2001 -00276
, �I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/5/01
SITE ADDRESS: 12325 SW KATHERINE ST PARCEL: 1S134CC-01700
SUBDIVISION: MARY WOODARD SCHOOL ZONING: R-4.5
BLOCK: LOT: JURISDICTION: TIG
Project Description: Security System located in the main building at the PS panel
Job No.5387 -241
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: OUTDOOR LANDSC LITE:
OTHER: • HVAC: PROTECTIVE SIGNAL: X
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
SCHOOL DISTRICT #23 JT SOUND SECURITY, INC.
13137 SW PACIFIC HWY 1975 SW 6TH AVE
TIGARD, OR 97223 PORTLAND, OR 97201
Phone: Phone: 223 -5822
Reg #: LAC 53535
ELE 26- 370CLE
FEES Required Inspections
Type By Date Amount Receipt Ceiling Cover
PRMT CTR 11/5/01 $75.00 2720010000 Wall Cover
Elect'I Final
5PCT CTR 11/5/01 $6.00 2720010000
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 Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
Issued by ����yy� & . Permittee Signature
J% 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 639 -4175 by 7:00 P.M. for an inspection needed the next business day
et
imommimilin
Electrical Permit Appiication
Date received: /l _ _ Perm no. L2 ; ,
s :.',111'!' City of Tigard Project/appl.no.: , Lxblredete: . i ,2
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 9722 Date issued: l y: I Receiptno.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval:
!1 j ' , C• 1;.. ,i,,
❑ I & 2 family dwelling or acce§sory )(Commercial/industrial ❑ Multi- family ❑ tenant improvement . ' i
❑ New construction Addition/alteration/replacement ❑ Other: ❑ Partial j
Job address: 1 3 a 55 S1,3 y -- -k.yi s, Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: Block: ISubdivision: f --
Project name: - (11t! (lk b,pcdo/l Description and location of Work on premises: 06144t _ ,
Estimated date of completion/inspection: t � • ,_ ,� t)
Job no: 5 3g D1-1 Fee Max
Business name: Sound Security Description Qty. (ea) Total no. insp
Address: 1975 SW 6th Avenue New residential - single ormuhl- family per
dwelling unit Includes attached garage.
City: Portland I State: OR I ZIP: 97201 Service included
Phone: 223 -5822 [Fax: 223 - 0604E -mail: 1000 sq. ft. or less 4
CCB no.: 53535 IElec. bus. 1k. no: 26- 37OCLE Each additional 500 sq. ft. or portion thereof
Limited energy, residential 2
City /m ic. no.: n(' Limited energy, non- residential 2
t�(J •'Z2 •-o( Each manufactured home or modular dwelling
S a of supervising electrician (required) Da et , Service and/or feeder, 2
Sup. elect. name (print): 1 �,c;),, l ,C License no35 Services or Feeders— installation,
alteration or relocation:
I'IlOPI:R7' %' OWNER 200 amps or less 2
Name (print): 201 amps to 400 amps 2
Mailing address: 401 amps to 600 amps 2
601 amps to 1000 amps 2
City: I State: [ZIP: Over 1000 amps or volts 2
Phone: I Fax: I E -mail: Reconnect only I
Owner installation: The installation is being made on property I own Temporary services or feeders - .
which is not intended for sale, lease, rent, or exchange according to installation, alteration, or relocation:
ORS 447, 455, 479, 670, 701. 200 amps or less 2 • 201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 am s 2
Branch circuits - new, alteration,
Name: or extension per panel:
A. Fee for branch circuits with purchase of
Address: , . i service or feeder fee, each branch circuit 2
City: I State: • I ZIP: B. Fee for branch circuits without purchase
Phone: Fax: E -mail: of service or feeder fee, first branch circuit: 2
Each additional branch circuit:
PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included):
O Service over 225 amps- commercial O Health -care facility Each pump or irrigation circle 2
O Service over 320 amps - rating of 1&2 0 Hazardous location Each sign or outline lighting 2
family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
I 5 �
O System over 600 volts nominal more residential units in one structure alteration, or extension* 2
O Building over three stories O Feeders, 400 amps or more , "Description:
O Occupant load over 99 persons 0 Manufactured structures or ttV park Each additional inspection over the allowable in any of the above:
O Egress/lightingplan O Other.
Per inspection I I I
Submit sets of plans with any of the above. Investigation fee 1
The above are not applicable to temporary construction service. 1 Other
Not all jurisdictions accept credit cards, please can jurisdiction for more information. Notice: This permit application Permit fee $ `'i`5 + CJL;
0 Visa O MasterCard • expires if a permit is not obtained Plan review (at _ %) $
Credit card number: I / within 180 days after it has been State surcharge (8%) .... $ t DO
Expires accepted as complete. TOTAL $
Name of cardholder as shown on credit card
•
Cardholder signature Amount
440-4615 (6/00/COM)
h
" Electrical Permit Fees: Limited Energy Fees:
Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
p Restricted Energy Fee $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total s
Check Type of Work Involved:
Residential - per unit
1000 sq. ft. or less $145.15 4 n A udio and Stereo Systems
Each additional 500 sq. ft. or
portion thereof $33.40 1
Limited Energy $75.00 El Burglar Alarm
Each Manufd Home or Modular
Dwelling Service or Feeder $90.90 2 n Garage Door Opener*
Services or Feeders El Heating, Ventilation and Air Conditioning System*
Installation, alteration, or relocation
200 amps or less $80.30 2
201 amps to 400 amps $106.85 2 V acuum Systems
401 amps to 600 amps $160.60 2
601 amps to 1000 amps $240.60 2 n O ther
Over 1000 amps or volts $454.65 2
Reconnect only $66.85 2
Temporary' Services or Feeders' , TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Installation, alteration, or relocation Fee f each systehi $75.00
200 amps or less $66.85 2 (SEE OAR 918 - 260 -260)
201 amps to 400 amps $100.30 2
401 amps to 600 amps $133.75 2 Check Type of Work Involved:
Over 600 amps to 1000 volts,
see "b" above. n Audio and Stereo Systems
Branch Circuits
New, alteration or extension per panel ri Boiler Controls
a) The fee for branch circuits
with purchase of service or n Clock Systems
feeder fee.
Each branch circuit $6.65 2 n Data Telecommunication Installation
b) The fee for branch circuits ,
without purchase of service ❑ : Fire Alarm Installation
or feeder fee.
First branch circuit $46.85 '
Each additional branch circuit $6.65 n HVAC
Miscellaneous n Instrumentation
(Service or feeder not included)
Each pump or irrigation circle $53.40 ❑ Intercom and Paging Systems
Each sign or outline lighting $53.40
Signal circuit(s) or a limited energy ,
panel, alteration or extension ` $75.00 ❑ Landscape Irrigation Control
Minor Labels (10) $125.00
Each additional inspection over ❑ Medical
the allowable in any of the above
Per inspection $62.50 El NurSe 0115
Per hour $62.50
In Plant $73.75 n Outdoor Landscape Lighting*
Fees: ❑ Protective Signaling
Enter total of above fees $ r 0 % J ; n Other
8% State Surcharge $ 6 '‘' 60
Number of Systems
25% Plan Review Fee * No licenses are required.' Licenses are required for all other installations
See "Plan Review" section on $ - � q
front of application.
Fees:
Total Balance Due $ al
,, t Enter total of above fees $
El Trust Account # "4' 1 '' ' 8% State Surcharge s " $
Total Balance Due $
1:\dsts \forms\elc- fees.doc 10/09/00
CITY OF TIGARD BUILDING INSPECTION DIVISION f , Ao
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
r Date Requested / — / e i AM PM BLD
Location 1 � d∎ ,3..S
, Ka* ,0/I./ r e, Suite MEC
Contact Person 7& 1 -1 5ec c) J-hc.. Ph . PLM
Contractor 1t�X r Ph 7 3 S8 SWR
if
BUILDING , - Tenant/Owner ,a i /_, , ,„„,„,2 i i ELC
/
Retaining Wall ( ELR c: III" — /1
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam t
Ext Sheath /Shear _
Int Sheath /Shear
Framing
Insulation ,--
Drywall Nailing ...:::V",";_',. ifs k.3 gJ oci:271a /✓t Te
Firewall C ,. i /
Fire Sprinkler i'i CI j, /W , !f j✓ 44 PS p •
Fire Alarm L ('4, LA2(7
Susp'd Ceiling
Roof - .
Misc: '
•
Final
PASS PART FAIL �'
Pos & Beam c. coi C 5 -b- ��► - 4 S i/Jr., 1515 "PLC
Under Slab � Z / l itc- )/‘ ("V P/ 1 ss 1 c
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL `
MECHANICAL
Post & Beam
(
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
„`ow Volta.
F�ir
,,' PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk D J
Other / -- /7 0 L Inspector / Z9(. �/ r'7 Ext
Final �J
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.