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Permit
rI rte w CITY OF TIGARD ELECTRICAL PERMIT - RESTRICTED ENERGY tii DEVELOPMENT H P I MEN Tigard, SO R9 ACES 639 -4171 DATE ISSUED: 2/26/04 ELR2004-00048 SITE ADDRESS: 10865 SW WALNUT ST PARCEL: 2S103AA 00101 SUBDIVISION: ZONING: R -4.5 BLOCK: LOT: JURISDICTION: TIG Proiect Description: Low voltage for fire alarm install. 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: X OUTDOOR LANDSC LITE: OTHER: • HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL # OF SYSTEMS: 1 Owner: Contractor: SCHOOL DISTRICT NO 23 J SHAW WEST COMPANY 13137 SW PACIFIC HWY PO BOX 1427 TIGARD, OR 97223 TUALATIN, OR 97062 Phone: Phone: 682 3723FAX Reg #: SUR- 393921s LIC 63142 ELE 34 -70c FEES Required Inspections Description Date Amount Low Voltage Inspection [ELPRMT] ELR Permit 2/26/04 $75.00 Elect'I Final [TAX] 8% State 2/26/04 $6.00 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 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699. Issued by AO /./ /i Permittee Signature - 7 • / /� . 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. ELECN: DATE: LICENSE NO: Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day FEB -25 -2004 08:51 SHAW WEST 503 682 3723 P.02/04 Electrical Permit AprittoE 1 1110 ()Fhl(:'I: t !il; (il�'I.1 r - diy of Tigard R eceived A , i , l3lia SW Hall Blvd., Tigard, OR 97223 Date/By: /A �' Permit No ���7> //d Phone. 503.639.4 171 Fax • 503.598.1960 FEB 2 5 2004 A D a Pa te a / By. �/�Q Inspection Line: 503.639.4175 s�� ' Re 503.639.4175 Other Permit Internet: Line: 5 39. its CI - Date adyBy: funs I ® OF TIGARD Notified/Method v, � i } Supplementa Page l lnformation for El ; ;,'. :,ilia' o` ?`'i ;' ; (tl i New construction ® Addition /alteration /replacement Please check all that apply ['Service over 225 amps, comm'l ❑Hazardous location ID Demolition ❑ Other: I " . -' - }, i 'i . z ,, , _ ❑Service over 320 amps - rating ❑Bulking over 10,000 sq ft , , } -,9 *§ 14 1 tt va);I, ; „, ;,,, i ,;, , : ; : :i r;; ; , , , of I- and 2- family dwellings 4 or more new residential ❑ I - and 2- family dwelling ® Commercial /industrial ❑ Accessory building ['System over 600 volts nominal units in one structure [-_] Multi- family ❑ Master builder ❑ Other: ❑Building over three stories ❑Feeders, 400 amps or more JQ<_$ rpm” ';t;a ❑Occupant load over 99 persons ❑Manufactured structures or . , ;� _ �, "�.,,�•, • ''•. ii ; - - ;: ', `! ; ❑Egress /lighting plan RV park Job no.: 0337 Job site address. 10865 SW Walnut ❑Health care facility ❑Other: Submit j.. sets of plans with any of the above. - C :ity /Slate /ZIP: Tigard, OR 97223 The above are not applicable to temporary construction service Suite /bldg. /apt. no.: Project name: Fowler Middle School/FA upgrade ' It, ?` ;s :FE'iiG)ipUliE ; Duenption I Qty. I Ice. I Total I " Cross street/directions to job site: Walnut Street to Tiedeman Ave. New residential single - or multi - family dwelling unit. Includes attached garage. 1,000 sq. R. or less 145.15 4 _Subdivision: I Lot no.: Ea. add', 500 sq. ft. or portion 33.40 1 Wax map /parcel no Limited energy, residential 75.00 2 Limited energy, 2 DES It1RIM47{ (llt'•�'1'4 ;' ; ;, .t i, gY, 7 ' - ' "v" ''11 Each manufactured or modular Replace existing Fire Alarm system dwelling, service and /or feeder 90 90 2 Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 . 4 ®'.ii,itUQ1F j0# i /E43' � _ ; ' ei i il ' r,= .N • 201 amps to 400 amps 106.85 2 Name: Tigard Tualatin School District 401 amps to 600 amps 160.60 2 601 amps to 1,000 amps 240.60 2 Address: 6960 SW Sand burg St. Over 1,000 amps or volts 454.65 2 City /State /ZIP: Tigard, OR 97223 Reconnect only 66.85 2 Temporary services or feeders installation, alteration, and /or relocation Phone: (503)431 -4000 J Fax: (503)431 - 4047 ps Owner installation: This installation is being made on property that I own which is not ^ 20 amps to or less 0G 80 1 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 201 amps to 400 amps 100.30 2 401 amps to 600 amps 133 75 2 Owner signature: Date: Branch circuits - new, alteration, or extension, per panel _ ' ❑`:,ApP1. cAlL17", ' r,. :', l ..0 00 l .' 14 A. Fee for branch circuits with Business name: Cornerstone Construction Management service or feeder fee, each branch circuit 6.65 2 Contact name: John Abel B. Fee for branch circuits withoui service or feeder fee, Address: 5410 SW Macadam, Suite 250 each branch circuit 46.85 2 Each add'I branch circuit 6.65 2 Cite /State /ZIP: Portland, OR 97239 Miscellaneous (service or feeder not included) Phone (503) 295 -0108 Fax: • (503) 295 -1896 Pump or irrigation circle 53 40 2 E-mail: john @cornerstonemgi.cont Sign or outline lighting 53.40 2 Signal circuit(s) or limited- - - • , ,... _ ; : -:•.s - =: C©NJi 4 4 :,,i -. :, ;!:-, ;, :,''_ :.,, • : .,;;js :. • ; ,: - 1•;-;.: 4 - ,;,, energy panel, alteration, or Business name: Shaw West Co. extension. Describe: Fire alarm Page 2 75.0D 2 upgrade Address: PO Box 1427 Each additional inspection over allowable In any of the above City/State/ZIP: Tualatin, OR 97062 Per inspection 62.50 Investigation per hour (I hr min) 62.50 Phone. (503) 682 - 3939 I Fax: (503) 682 - 3723 Industrial plant per hour 73 75 t'C'13 Lie.: 63142 Electrical Lic.: 34 -70C I Supt/ ic.: 221 S EfaFr,'G'Al PERMIIEIrS� Subtotal 75.00 Supt v. Electrician signature, required: / i . j �` Plan review (25% of permit fee) — State name: e � 412 4 / yj „ � A o , A ! S Date: 02/24/04 tate surcharge (8% of permit fee) /II 1 V 6.00 Authorized signature: TOTAL PERMIT FEE 181.00 This permit application expires if a permit Is not obtained within 160 Pi int flame: days after it has been accepted as complete Date: * Fee methodology set by Tri- Cqunty Building Industry Service Board `" Number of inspections per permit allowed , lnuddmgm.mnlsTLC- permitnpp doe I2/03 440-46151( I0 /02/COM/WFR CITY OF TIGARD 24 -Hour BUILDING Inspection Lin =} 503) 639 -4175 . INSPECTION DIVISION Business : (503) 639 -4171 MST BUP Y Received a� Date Requesd �' �' AM PM BUP Location / ?lS SGCJ Suite MEC Contact Person e - — Ph ( ) 59— 5 5 . PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR ;t., -D X- 00e Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Fi rewal I Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains • Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL 4. MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final P T FAIL • LECTRICA Service Rough -In UG /Slab Low Voltage PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. . ASS SIT Please call for reinspection RE: El Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date - 1- 0 Inspector �Q NJ Ufa Ext Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL