Permit CITY OF TIGARD ELECTRICAL PERMIT
• a _ COMMUNITY DEVELOPMENT Permit #: ELC2012 -00508
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/28/2012
Parcel: 2S 114AA00100
Jurisdiction: Tigard
Site address: 9000 SW DURHAM RD
Project: Tigard High School Subdivision: 1993 -078 PARTITION PLAT Lot: 2
Project Description: 11) branch circuit to disconnect and reconnect boiler
Contractor: CASCADE ELECTRICAL LLC Owner: TIGARD - TUALATIN SCHOOL DISTRICT
PO BOX 160 6960 SW SANDBURG ST
BRUSH PRAIRIE, WA 98606 TIGARD, OR 97223
PHONE: 360 - 518 -0905 PHONE:
FAX: 360- 666 -0135
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo /Purchase 08/28/2012 $56.18
Specifics: Service or Feeder
1 ea 12% State Surcharge - 08/28/2012 $6.74
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $62.92
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through OAR 9 -401 -0090. You may • btain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: `�a�a. , '(!I (� Permittee Signature: BO, r r 0477 V kl
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' Date:
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.
Aug. 27. 2012 4:08PM 360 - 666 -0135 No, 4749 P. 2/3
Electrical Permit Application 2 o % 3 Full; OFFICE USE ONLY
City of Tigard Received Perm;lNo.: �iL�� l , -iDs� •
' 13125 SW Hall Iilvd., Tigard. OR 97223 P1antRevi
. ew
i h
n Phone; 503.718.2439 Far: 503.598.1960 Date/B plherPermtl.
rtc;nliu Inspection Line: 503.639,4175 Dale Ready/By: El See Page 2 for
Internet: www.tigard- or.gov Notified/Method Supplemental Information
.....,,::: .:, :::: ,:::._ ....,.., ._.._ .,.......TI'PE... F WORK. r ,... s_._ ...,.. •+.. +• ,,4 : 4 , . 1.,. . -- ...................... .. .... .. ,
• ❑ New construction IM Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w/items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
Q Demolition D Other: where the available fault cement ❑ Marinas and boatyards.
:... ............................... ............_.......... . .- :.,,,.....,.,,._,.,...,,,,: :: v: ; isa: rsi :::_�_:e:::::::.= :..:c'::::. tin buildings.
....... ......................... ... exceeds 10,000 am at 150 ooh or 0 Floating but dub
._ ...... ................::.:..:.... ... ::':CA'I7:CrORY:;'.OF��CO , ., r � . : � : ::: Ds 8 H s.
1
3 , ,. � :r . z and exceeds 14000 C
......................:: �.,.,...:::::::•::.:.:.:::-.-,::::,:,:::::::-::::::::_ .:.._,...:.•....:•......, ; :,, ,. ;, .,.,._ , .,......,.• ,;,.: .,. -:r' esstol or Commercial-use agricultural
❑ chin - use '
❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
El Multi - family ❑ Master builder ❑ Other: 0 Fire pump. D Installation of 75 KVA or
, •��.,. .,, N. ,�{,,. _ Emergency syst larger separately derived system.
'iVI:'"•: i i , " J 'B: s . R �x . N -' D LOCATI:Oi�I = ' i :.:_ ; = -: „ u „ „ „
::; -!:I f! �_::.,:::::: �:::_:; :_0,....:: -.,�, : O,,: t` t!' ��.:: ��:, 1: � ...::::::::::::::.::.: ::::::........_............... ................. ❑ Addition of new motor loaQ of CI u A , " . I.2 . 13 ,
• Job no.: C702 I Job site address: 9000 SW Durham Rd, iOOlsP ormore. occupancy.
•
❑ Sis or mom residential units. 0 Recreational vehicle parks.
City/State/ZlP: 97224 ❑ Health - cure Steilities. ❑ Supply voltage for more than
❑Haaardous locations. 600 volts nominal,
Suite/bldg./apt. no.: I Project name: TwalitylTigard Boilers ❑ Servieeor feeder 600 empsorMOM.
Cross street/directions to job site: East of SW 92 °a Ave. on SW Durham Road t .i .0 I
o i Q. I I'm _ 1 Told •
New residential single- or multi - family dwelling unit.
_ Includes attached garage.
^
Subdivision: I Lot no.: 1.000 sq. ft. or less 168.54 4
Tax map/parcel no.: Ea. a Limited 500 sq. ft, or portion 3192 1
imited energy, residential
....,.. . ....... .............::�....:;, -... ,,••.,..,. „''s�:i , :.; 5::- I!'�':'= ".t:::;�= t:�: . 75.00 2
..._ .................. ..... : . t� I ,._,,f;
:...,;. -$
:, (withabove
Limited energy, multifamily 75,00 2
Disconnect and reconnect Boiler residential (with above sq. (L)
Services or feeders Installation alteration, and/or relocation
200 amps or less 100.70 2
..t.; `:.`;;tr'::::t:; "ri .`:`:: ;:,.,..4... r';:'• a,,::;,:'�' „�� 201 to 400 am s 133.56 2
-
................. PJaOR , QIVVNEA.,......._...:.:__ ..:• ........ � • . , '�, .1.• ? :';1 1y
EYiT'Y ... ...r..°..: ,;!;,
t rd sops
401 amps to 600 amps 200.34 2
Name: 601 amps to 1,000 amps 301.04 2
Address: over 1,000 amps or volts 552.26 2
City/State/ZIP: /Stale /ZIP: - Temporary services or feeders installation, alteration, and/or
ry relocation
Phone: ( ) I Fax: ( ) 200 amps or less 59.36 1 I
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
,: r is ; ,. :. . ,, . .. ....... . .. :r: - :=:.: !:;._;],:: : :: •' - ,: ,s.li `
'. b i
',;i aove service or feeder fee,
.............. 7.42 2 .. .
, - �Y� .)< . - d ''• C QXPA;( � T F EI�SOF! X : dl ai : ,�;
...........•..., � �v ..t. .., ,.:.;.:.•...,,. •., „::.: ....... .::. . ...... : :.:::::::: -:::• . Z each branch circuit
Business name: B. Pee for branch circuits without
service or feeder fee, fuse 1 56.18 56.18 2
Contact name: branch circuit
• Each add'! branch circuit 7.42 2
Address: ,,Ilscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular 67 84 2
�' dwelling, service and/or feeder
Phone: ( ) I Fax :: ( ) Reconnect only 67.84 _ 2
Pump or irrigation circle 67.84 2
E -mail:
.,:;:;:.r .. ::. . ,. t . . ,:' .. t •, _ - - - -- 67.84 2
,,.,......" ...... .. ............ "., :..:.... Si circuit(s) or (unclad -energy
Business name: Cascade Electrical, LLC panel, alteration, or extension. Page 2 2
Each additional inspection over allowable In any of the above
Address: PO Box 160 . Additional inspection (1 hr min) 66.25/ hr
City /State/ZIP: Investigation (1 hr min) • 6625/br
Industrial plant (I hr min) 78.18/hr
Phone: (360) 518 -0905 I Fax: (360) 666 -0135 Inspections Ibr which no fee is
90.00/ hr
specifically listed (4 hr min)
CCB Lie.: 158047 Electrical Lic.: 37 -1027C Suprv. Lie,: 4730S . .... - _) ,;1,- 417.° .. ' niel
............. -
Subtotal: 56.18
Suprv. Electrician signature, required: Plan review (25% of permit fee):
Print name: Dan Lindberg . Date: 08/27/2012 State surcharge (12% of permit fee): 6.74
TOTAL PERMIT PEE: 62.92
Authori2ed signature: ` - / - This permit application expires If a permit is not obtained within 180
days after It has been accepted as complete.
Print name: Dan Lindberg Date: 08/27/2012 s Number of inspections allowed per permit.
1:03ufdleg\Penole ELC- PermiWpp.doe 07/01n0 44046%5T(I VOS /COMtwea
CITY OF TIGARD ELECTRICAL PERMIT
• a _ COMMUNITY DEVELOPMENT Permit #: ELC2012 -00508
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/28/2012
Parcel: 2S 114AA00100
Jurisdiction: Tigard
Site address: 9000 SW DURHAM RD
Project: Tigard High School Subdivision: 1993 -078 PARTITION PLAT Lot: 2
Project Description: 11) branch circuit to disconnect and reconnect boiler
Contractor: CASCADE ELECTRICAL LLC Owner: TIGARD - TUALATIN SCHOOL DISTRICT
PO BOX 160 6960 SW SANDBURG ST
BRUSH PRAIRIE, WA 98606 TIGARD, OR 97223
PHONE: 360 - 518 -0905 PHONE:
FAX: 360- 666 -0135
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo /Purchase 08/28/2012 $56.18
Specifics: Service or Feeder
1 ea 12% State Surcharge - 08/28/2012 $6.74
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $62.92
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through OAR 9 -401 -0090. You may • btain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: `�a�a. , '(!I (� Permittee Signature: BO, r r 0477 V kl
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' Date:
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.