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Permit n CITY OF TIGARD ELECTRICAL PERMIT B. 111 COMMUNITY DEVELOPMENT Permit #: ELC2012 00111 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/12/2012 Parcel: 1 S 134CC01700 Jurisdiction: Tigard Site address: 12325 SW KATHERINE ST Project: Mary Woodward Elementary Subdivision: MERESTONE Lot: 13 Project Description: Electrical for replacing existing cooler and freezer and revising exterior classroom. Contractor: PARKIN ELECTRIC INC Owner: TIGARD - TUALATIN SCHOOL 14001 FIR STREET DISTRICT 23J OREGON CITY, OR 97045 6960 SW SANDBURG ST TIGARD, OR 97223 PHONE: 503 - 657 -4958 PHONE: FAX: 503 - 557 -1059 FEES Quantity Description Date Amount 5 cR Branch Circuits wo /Purchase 07/09/2012 $85.86 Specifics: Service or Feeder 1 ea Plan Review Electricial 07/09/2012 $21.47 Type of Use: COM 2 ea Info Process /Archiving - Lg 07/09/2012 $4.00 Class of Work: ALT $2.00 (over 11x17) 1 ea 12% State Surcharge - 07/09/2012 $10.30 Type of Const: Electrical Occupancy Grp: Total $121.63 Required Items and Reports (Conditions) This permit i ' e. s t to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done '- accordance with —proved 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. TENTION: Oregon l • i'- - you to follow the rules adopted by the Oregon Utility Notif • , ter. Those rules are set forth in OAR 952-00 - 0010th 'ugh OAR 952% 11 -009. Y.0 may obtain a copy of the rules : direct questions to OUNC b �. a .1987 or 1.800.332.23 • . .. i Issued By: /1 / Permittee Sig J � ., fi�� �� � 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' s Date: 7/ 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. From: 07/09/2012 14:41 #519 P.002/003 07/09/2012 13:43 5835981968 REGE1116 PAGE 02/02 C 0 JUL 09 2012 Electri , . Permit A' . : -" . Current - P111:11 . A WohingtoN , - -Ft. N. V' Ay, Suite 350, G 11 elY eST46#0124, App rOwa 7.4'2:110 f al - • • • Phone:. t . : , Mist: '1 - . • 3993, • 1 a [MN Project # , , - --: on .., .. • estu 503-846-3699 ... ,T,..s, Au: • ' •., itiAl "'""' 4 , ,r1s4 ,....VN.S, ,:..:• ...,...: ,..;.:. • .:.., ...,,,• TYPE OFWDIPL • . , • • • ^ • " New construction It Addition/alteration/replacement rat(fv>..., i ,.,rt . Pkasc 606 all that apply: Scrim or Ikeda 400 imps 0 liozordem locations or mare vinerc tbo aysilablc0 Soviet or feeder600 arrrormore , ,. ......,;, . .. .... emsfootp 4)1r . q0uSTRUCT11:001 . t.NRc ±:_a' .e., si gitkla o ultchwent 0 Building ova three storms uuu =Pe at ISO vot" er 0 Marinas and boatyards 1- smd 2...family dwelling I/1 Commercial/industrial t:1 Accessed,' bu ltl[0„ 1 $:\ ' in;s to id, or eseecds 0 F wating b 0 Multi-family 0 Master builder 0 Other: 6 „. 14.°11° Commercial-use agricultural . ' ' • - ! '.: • JOB CM INVO'RlaktIOPr *1113 .1-.0CATION• cs,\) V.' ••• - : installatIons, buildings 0 Fire pump ' Job no.: 11087 I Job address: 12326 SW Katherine St. 0 ErnagelICY RYStan 0 of 150 KVA or larger &lived system El AddStion of new motor "A. " "" City/State/ZIP: Tualatin, OR 97062 load of 100 1-3occupancy 91P armors 0 it= vehicle pada Suite/bldg./apt. no.: { Project name: Woodward ES Cool ., ' 0 s 0 supoy voltage for MOM ThOO 0 HtwIth-cam facilities . 600 volts nominal Cross street/directions to job aim: .. : ',.c. ' ....;::•Is ,..;REE1BOHBEISILE !... .. . .. • • Description I qty. I Fee 1 Total I Subdivision: Lot no,: Reslianthd 41.41.8- ertmil .. • - ...%" Isielidielf" Tax map/parcel no.: • 1.000 .it. or leas . 159911 4 ...... 1 : : ...t,.::/ ':.. .. *.;.• IllifICRIPT1014 41If .IVORSC::. - . : • ' • .• • - ' : Ea. add'I SOO sq. fl. or portion 44.7$ Limited maw. residanle 63.50 Replace existing cooler and freezer and revise existing exterior clgo odith Lima t4. ft.) 2 s Limited energy, multi-fimuly 69.7S 2 t issidentiol (with above ad, 0) p DmiE=.771 . s....-., :. .„, • ELIENANT i • :, .... F ;:••,' :stiervtees **den installatititafiteratIgn, atiMbr relocation, ..t: 200 amps OT ICTS 95.75 2 Name: Tigard-Tualatin School District 201 amps to 400 amps ,.. 117.00 2 I P Address: 6960 Sandburg St. , 4.01 amps to 600 amps 191.00 2 601 amps to 1,0130 amps ' 15400 2 City/statcarP: Tigard, OR 97223 Over 1,000 ....... . volts 335.00 2 Phone: ( 503 )431-4000 I Fax: ( ) L= 9.f.t "P ff°11 ' di . . g motanadom This insmitraiati is being mode on nosideraial or firm pommly owned by me or a member of 200 alma or less CM 1 my immediate faintly. This property is am intended fer sale. exchange or rent. (ORS 479.54001 and 479.560(1). 201 to 400 sotps 114.5* 2 Owner signature: to • Date: 401 amps . 599 amps 0 2 : . t,..,....... Efit •,, ::. .... .. 1 . ... '4'.... ts Amp= pERsopy : • . • oritiletilrgati ,4 eIviidriffrlitiek 6 umb0055ftWOrTille A. Fee for branch circuits wish Business name: DOWA above service or feeder fce, 9.00 each branch circuit 2 Contact name:Bill Conboy B. Fee for bromeh circuits . othhOlit SETViOO OT feeder 1 61 63.50 Address: 907 SW Stark a (he, firm branch cheek 2 - City/State/VP: Portland, OR 97205 Eta slid, branch circuit 4 9.no unn Itheedli(itiougraiiedorikillerWeElingluthil) ... '• . ' • ' ', Phone: ( 603)26-6960 I Fax: ( ) Erich manufactured or modular 108.00 2 dwelGt. service. E-Mail: bill.conboy@dowa-ibigroup.com and/or feeder • Reconnect only 82.75 1 : . . .'. Pump er irrigation circle 63.50 2 . . . . -• - Business name: f Kr,..., P le 7..,..0 Sip or outline Speen i0.50 2 Sipal circuit(s) or limited- Address: f vp / F i f . S .- H7.e.e., energy panel, alteration. or 63.50 . • atcardon. Describe: City/State/ZIP: 0 fzele).., ( al , 012 q7eq.6. • , 2 em•f—i--.. ' Phcmc (03 ) r ,g7... f Fax: (50? ) 515 7 •• /05' 9' . Sifiliceddittondlimpiallon over stiowebtele lister theaboie Per inspection 105.rto . . E i , CCB He. no.: 3 /f . lavestigation fca Mca coraolhood - Electrical lie. no.: 3q-if C.,. City or metro tic.: Other: - superviRing electrician/ .' at tiEktur*EEs •,.- ....' ,... ' eel,. signature, required: Subtotal . P rint name: PAU - PA/20/A-) r Date: Plats review ( 25% of permit fee) Auttiorimrd / i I /- State surcharge (12% of permit fee) signature; , . - I....._.„ TOTAL PERMIT PEE This permit appriesdna expires Ira permit is net obtained Print name: kVjlrdVtrMIIIIIN IIIII Date: /ffRal widget 130 days after It has beets accepted as complete •Nurribcent lam:warn allowed yet monk It Mato) &II • �� �.t -� ' ' Electri .1 Permit A • Current Plannin , 3 ° t Washington o a.- - •. 5 N. 1` AV,' Suite 350, MS 12, Hillsboro, OR 97124, Approval VZ2 V. G L.N OREco Phone: 50 . -3470, Fax: I 3993, Project # 0:"...C..,;.0 1,2-0p I f ction Requests: 503 - 846 -3699, w w.co.washinoton.or /2 ,,pR . ) IX tkk )3.1, TYPE OF WORK 6 P REVIEW ❑ New construction Q Y Addition/alteration/replacement ❑Tk O ,'� P lease check all that apply: � p I, ❑ Service or feeder 400 amps ❑ Hazardous locations I' „AN or more where the available ❑ Service or feeder 600 amps or more CATEGORY OF CONSTRUCTION � l c I l fault current exceeds ❑ Building over three stories ❑ 1 and 2 family dwelling © CommerciaUindustrial ❑ Accessory buil t�&� ,NS 10,000 amps at 150 volts or Marinas and boatyards G� less to ground, or exceeds 0 Floating buildings ❑ Multi- family ❑ Master builder ❑ Other: 1 `� 14,000 amps for all other JOB SITE INFORMATION AND LOCATION OA >' installations. ❑ _ bu Idtn ercial -use agricultural gs ❑ Fire pump Job no.: 11087 I Job address: 12325 SW Katherine St. ❑ Instal lion of 150 KVA or larger • ❑ Emergency system derived system ❑ Addition of new motor City/State /ZIP: Tualatin, OR 97062 °A,' `E," 1- 2, ""1 -3 °occupancy load of 100HP or more 0 Suite/bldg. /apt. no.: Project name: Woodward ES Cool ❑ Six or more residential units Recrea zonal vehicle parks ❑ Supply voltage for more than ❑ Health -care facilities 600 volts nominal Cross street/directions to job sito: FEE SCHEDULE Description I Qty. I Fee I Total I* b Subdivision: I Lot no.: Residential single- or multi- family dwelling unit. -� Includes attached garage. Tax map /parcel no.: 1,000 sq. ft. or less 159.00 4 DESCRIPTION OF WORK Ea. add'l 500 sq. ft. or portion 44.75 Limited energy, residential 63.50 2 Replace existing cooler and freezer and revise existing exterior clf (with above sq. ft.) Limited energy, multi - family residential (with above sq. ft.) 69.75 2 .. t ® PROPERTY OWNER I ❑ TENANT Services or feeders installation, alteration, and/or reloca 200 amps or less 95.75 2 {� Name: Tigard- Tualatin School District 201 amps to 400 amps 127.00 2 1 �•' Address: 6960 Sandburg St. 401 amps to 600 amps 191.00 2 601 amps to 1,000 amps 286.00 2 City/State/ZIP: Tigard, OR 97223 Over 1,000 amps or volts 535.00 2 Phone: ( 503) 431 -4000 • I Fax: ( ) Temporary services or feeders installation, alteration, and/or relocation Owner installation: This installation is being made on residential or farm property owned by me or a member of 200 amps or less 82.75 2 my immediate family. This property is not intended for sale, exchange or rent. (ORS 479.540(1) and 479.560(1). 201 amps to 400 amps 1 14.50 2 Owner signature: Date: 401 amps to 599 amps 159.00 2 ❑ APPLICANT I i CONTACT PERSON Branch circuits - new, alteration, or extension, per panel A. Fee for branch circuits wills Business name: DOWA above service or feeder fee, 9.00 • . each branch circuit 2 Contact name: Bill Conboy B. Fee for branch circuits Address: 907 SW Stark St. without service or feeder '� 63.50 63.50 fee, first branch circuit 2 Each add'I branch circuit 4 9 36.00 City /State /ZIP: Portland, OR 97205 . Phone: ( 503) 26 -6950 I Fax: Miscellaneous (service or feeder not included) ( ) Each manufactured or modular 108.00 2 dwelling, service, and/or feeder E - mail: bill.conboy @dowa- ibigroup.com Reconnect only 82.75 1 CONTRACTOR Pump or irrigation circle 63.50 2 Business name: - Sign or outline lighting 63.50 2 Signal circuit(s) or limited - Address: \ energy panel, alteration, or 63.50 • extension. Describe: City/State/ZIP: ✓ 2 • Phone: ( ) eta � Fax: ( ) Each additional inspection over allowable in any of the above / `• f Per inspection 105.00 E -mail: t/ t/dt ti‘ • 0.( CCB lie. no.: Investigation fee (see compliance) Electrical lic. o.: 000 City or metro lie.: Other Supervising electrician ELECTRICAL PERMIT FEES signature, required: Subtotal Print name: I Date: Plan review ( 25% of permit fee) Authorized / State surcharge (12% of permit fee) signature: y - / '`' V //1 e TOTAL PERMIT FEE / ,qr, ( e ' � T his permit application expires if a permit is not obtained Print name: 6L 60A 2 2 Date: j within 180 days after it has been accepted as complete • Number of inspections allowed per permit. Revision 6/11 •