Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
IN n Permit #: ELR2012 00225
a • COMMUNITY DEVELOPMENT
TIGAR0 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/27/2012
Parcel: 2S114AA00100
Jurisdiction: Tigard
Site address: 9000 SW DURHAM RD
Project: Tigard High School Subdivision: 1993 -078 PARTITION PLAT Lot: 2
Project Description: (1) low voltage for boiler controls
Contractor: AZIMUTH COMMUNICATIONS INC Owner: TIGARD - TUALATIN SCHOOL DISTRICT
PO BOX 508 6960 SW SANDBURG ST
WILSONVILLE, OR 97070 TIGARD, OR 97223
PHONE: 503 - 639 -0110 PHONE:
FAX: 503- 639 -0115
FEES
Description Date Amount
Specifics: Restricted Energy Permit 09/27/2012 $75.00
12% State Surcharge - Electrical 09/27/2012 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio & Stereo: N Boiler Controls: Y
CCTV: N Clock Systems: N
Data & Telecommunications: N Fire Alarm: N
HVAC: N Instrumentation: N
Intercom/Paging: N Landscape /Irrigation: N
Landscape Lighting: N Medical: N
Nurse Calls: N Protective Signal: N
Security Alarm: N Other: N Total $84.00
Other Desc: 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 952 - 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: ( j�2
_,2%/V*LALthet,_________
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.
To: 5035981960 From: Lindsey Cartwright 9-27-12 8:27am p. 4 of 4
Electrical Permit Application F
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..„ ,..-. City of Tigard SEP 2 7 2012 Received
Datem . al 4 i 2.. 5.4- Permit No.,6 ' . 0 j..000 •
, , ° 13125 SW Hall Blvd. Tigard, OR 97223
I Plan Review
: - a Phone: 503.718.2439 Fax: 503.598.196tiTy cli fic _: DatelB : Other Permit:
G
Inspection Line: .503.639.4175 ■., , i. .
, t , Date ReadyIty: .1tt.4 , 0 See Page 2 for
'T I A:RD
Internet: www.tigard-orgov 3utiDiN!cinfko ,olitied/Method: 1 / 4 0 0 Supplemental Information
„A' ?: 0t;' • ;' ,...'' ,:. .,.. ,..,,:: :- .-.-' ' --, ::„..-;•:'1'"':''IPIN. REVIEW:,:,,:1
0 New construction 'Addition/alteration/replacement Please check all that apply (submit / sets of plane re/items checked below):
0 Service or feeder400 amps or more 0 Building over three stories.
0 Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
: .'' ' , ' ' • ' • ' .-.':'• Vrti)NSTRUCTIO14
'CATEC 3 y io --7 ID - 7. , ..7 .' 7 . • '.: ' ... "":: ,•
il exceeds 10.000 amps at 150 volts or Floating buildings.
less to ground, or exceeds 14,000 0 Commereial-use agricultural
0 1- and 2-family dwelling Commercial/industrial 0 Accessory building amps for all other installations. buildings.
El Multi-family 0 Master builder 0 Other: El Fire pump. 0 Installation of 7S KVA or .
larger separately derived systein.
• • • .. -- :JOBy SITE 4NFORMAT1ON 'L'OCATIONt• - 'd•• • ,'.' ,- - - , , ,
Job no:: , Job site address: 10 SI,k) DVINAlyl. 10011P or more. occupancy.
0 Six or more residential units. 0 Recreational vehicle parks.
City/State/ZIP: 1i ..
lard Oft. li 0 Health-care facilities. 0 Supply voltage for more than
0 Hazardous locations. 600 volts nominal.
SSuite/bldg./apt. no.: Project name: ' f f5 S 1 , .) 0 Service feeder 600 amps orniOre.
,kt.e. Witlaitt-,•.;:::,.
Cross street/directions to job site: Description I Qty. I Fec. j Total I •
• New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision: I Lot lid.: 1,000 sq. ft. or less 168.54 4
Ea. add'I 500 sq. ft or portion 33.92 ' 1
Tax map/parcel no.:
. ..: Limited energy, residential
75.00 2
,v.. itt .....:',1 1 1ESkIt.i . 0141 4- ).Y74 1 -0 11 1( .. ''..:' ,;:,:, .. : ::''.:1:- T '.; (with above sq. ft)
Limited energy, multi-family
NI 0 .._Crej) - - - 1 / 1/4. e((edi ro.Airbls Li residential (with above sq. ft.) 75.00 2
' ...--,.----
Services or feeders installation,,alteration, and/or relocation
200 amps or less 100.70 2
. .. .. , . . .._. ,
11 ) 141 0ER'ikr 1 ;i*k*.: :;::: :..._.t.' i L'. r 13 ..T0f*Iii;,. . 201 amps 10 400 amps 133.56 2
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' Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 I
201 amps to 400 amps 125.08 2
Ow installation: This installation is being made on property that 1 own which is not
2
i nded for sale, lease, or exchange, according to ORS 447,449,670, and 701. 401 amps to 599 amps 168.54
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
0 'hijki&tilit. .: . .:" ,':.1 ' f: ' i. 0 ' :‘,- above service or feeder fee,
742 2
each branch eircuit
Business name: Azimuth Communications B. Fee for branch circuits without
service or feeder fee, first
56.18 2
Contact name: Octnyl pezirmyk branch circuit
- Each add'I branch circuit 7.42 _ 2
Address: 9540 SW Tuala - Sherwood Rd. Miscellaneous (service or feeder not included)
Each manufactured or modular
City/State/ZIP: Tualatin, OR 97062 dwelling, service and/or feeder 67.84 2
Phone: (503) 639 Fax: (503) 639 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E lindsey®azimuthcommunications.com
. .. ..,.._, Sign or outline lighting 67.84 2
" :‘:'. ' ,.. '..:',..,1 ,,, ' '__:::_',,, . • g2,.. 77 :- - 27 .. Signal eircuit(s) or limited-energy
panel, alteration, or extension. I Page 2 _ 2
Business name: Azimuth Communications
Each additional inspection over allowable in any of the above
Address: 9540 SW Tualatin Rd. Additional inspection (I hr min) 6625/ hr
Investigation (1 hr min) 66.25/ hr
City/State/ZIP: Tualatin, OR 97062
Industrial plant (1 hr min) 78.18/ hr
Phone: (503) 639 Fax: (503) 639 Inspections for which no fee is
90.00/ hr
specifically listed CA hr min)
CCB Lic.: 145828 Electrical Lic.: 36-94CLE Suprv. Lic.: 23I2LEA 71;
Suprv. Electrician signature, required: Subtotal:
red: . N9- ' . '-------------.
Plan review (25% of permit fee):
Print name: Brett Ulberg Date: O 21_1 z 1 State surcharge (12% of permit fee):
___— TOTAL PERMIT FEE:
Authorized signature: c - 2----‘ ". This permit application expires if a permit is not obtained within 180
Print name: Brett Ulberg Date: r 2 I 12_ days after it has been accepted as complete.
Number of inspections allowed per permit.
L'Iltiildint \ Perm its‘ELC-PerrnitAPp.doc 07,01110 440-46157(11/05/COM. WEB
To: 5035981960 From: Lindsey Cartwright 9 -27 -12 8:27am p. 3 of 4
Electrical Permit Application - City of Tigard
Page 2 - Supplemental. Information
LIMITED ENERGY PERMIT FEES:
[RRESIDENT ALV:da it Ne -
Fee for all residential systems combined .. $75.00
Check Type of Work Involved:
❑ Audio.a Stereo-Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
.❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
I COM_M.ERCI'ALVO_RK''OIVL - -�^
Fee for each commercial $75.00
system
(SEE OAR 918 -309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
5 4 Boiler Controls
❑ Clock Systems
❑ Data Telecoinrriunication Installation
❑ Fire Alarm Installation
:0 HVAC
❑ .Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
,❑ Medical
.❑ Nurse
❑ Outdoor Landscape Lighting*•
❑ Protective.Signaling
❑ Other
Total number of commercial systems:
*No licenses are'required. Licenses are required
.for all other installations
VBuild 'mF•Pc1milslELC- PermiaApp.doc 07.01,10
To: 5035981960 From: Lindsey Cartwright 9 -27 -12 8:27am p. 1 of 4
Fax
FACSIMILE
Date: 9/27/2012
To: 5035981960
From: Lindsey Cartwright
Subject: FW: Message from KMBT_C360
Lindsey Schmitt I Administrative Assistant I Azimuth Communications, Inc.
Physical Address: 9540 SW Tualatin - Sherwood Rd. Tualatin, OR 97062
Mailing Address: PO Box 508 Wilsonville, OR 97070 I Ph: 503 - 639 -0110 I Fax: 503 - 639 -0110
From: konica @azimuthcommunications.com [ mailto: konica 0azimuthcommunications.com]
Sent: Thursday, September 27, 2012 9:23 AM
To: Lindsey Cartwright
Subject: Message from KMBT_C360
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1