Permit p CITY OF TIGARD ELECTRICAL PERMIT
- s • COMMUNITY DEVELOPMENT Permit #: ELC2012 -00739
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/31/2012
Parcel: 2S114AA00100
Jurisdiction: Tigard
Site address: 9000 SW DURHAM RD
Project: Tigard High School Subdivision: 1993 -078 PARTITION PLAT Lot: 2
Project Description: (2) branch circuits for gate
Contractor: WEST SIDE ELECTRIC CO INC Owner: TIGARD - TUALATIN SCHOOL DISTRICT
1834 SE 8TH AVE 6960 SW SANDBURG ST
PORTLAND, OR 97214 TIGARD, OR 97223
PHONE: 503 - 231 -1548 PHONE:
FAX: 503 - 736 -0677
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 12/31/2012 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 12/31/2012 $7.63
Type of Use: COM Electrical
Class of Work: ALT
•
Type of Const:
Occupancy Grp:
Total $71.23
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 O 52 -00 0090, You ay obtain copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1,800.332.2
Issued By: W �C C Permittee Signature: OL r I PL'C' ` 34 (lO 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 503.839.4175 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.
I
()--/?,(11,-"CA E. a0 6 1 0 f d, 00 '
RECEIVED .
' I ' iihone: 563:71814 Fax: 5°1598W DEC 3 1 2012 .19 D -
ZIID my: .
Inspection Line; 503.639.4175 Date Rendy/By! iint ,,_ ID Scc Page 2 foTh . - ----- 1
"I'lCARD Notified/Method: — ymai Supplemental Information
Internet: vvww.tigard-Or.gov
• • '1 -*' ' '"' 7! , T 1 (, ; ,•9 . ,,,,ETICIA,,,,,102 4 ,2: .•,:;.- 1 7:;:g , :'W6;.a:•;:i;:::Z.',';,"i•n.''.0[•Aigj!REvIEviri ,,,, .•' , .
7 Florio check all that apply (submit Z sets of plans Witems checked below):
F ---- New construction ------ Addition/alteratio Pate
,_, 0 Service or feeder 400 amps or more 17 Building over three stories.
0 Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
. . —
'.7. ."':'•7'':'''':'S.:'.:!.;...:.0!,:..i,''eATEGORV"Or..,C+IA'iSTIRVCTIQ.Tiii:,.''''.7:t tt':, exceeds 10,000 amps at ISO volts or 12 Floating buildings .
less to ground. or exceeds 14.000 0 Commercial-use agricultural
0 1- and 2-ftunily dwelling Wommercial/industrial 0 Accessory building amps for all other installations. buildings.
0
Multi-family .....1) Q Other: 0 Fire pump. 0 Installation of 75 KVA or
,„,,..„ .... , , ....,..., 1 . : „... : „,,.,„,,, , El Emergency system. larger separately derived system.
o f 20R.:SrfEillNVORMA1101•1900!:;.,ocA.vo.p_ .;:i: • ; ...2:-...• '::!•...-, 0 Addition of new motor load o
100HP or more. occupancy.
Job no.: 1 • ove Job site address:43mo 5 it le- 2-0, osix Or more residential units. 0 Recreational vehicle parks,
0 Health facilities. 0 Supply voitage for more than
City/State/ZIP: 't 0.)00,- _ri_ Ci - 12,7_9 - 600 volts nominal.
El Hazardous locations.
____,.
1:1 Service or feeder 60 amps or more.
Suite/bldg./apt no.: Project name:1 4 , t # 1 . VI, iv 1 -.- .., ,,, ,:,, FEE, s DuLE.
— .. • - •.., .
Cross street/directions to job site: ascription 1 0 ' Fret,
-----------
----- New residential single- or multi-family dwelling unit.
_ Includes attached garage.
. r
Subdivision: I Lot no.: 1,000 sq. ft, or less 111 168.54 11111
,— . ----- Ea. add', 500 sq, ft. or portion 53,92
Tax map/parcel no.: _. Limited energy, residential
- . 75.00 II
4p*';;;SFIV with above ,, . ft.
7 ;' , .1'.;'•-.:-.' , .•.-,;.0 .. .i';':?::•, - ;••::1' , !::'..'''1 , '' .;;,l' . liE l ''''' ..9 S 9 ':''''''''''""• • . Li energy, multi-family 2
a ' 75.00
• • r esidential above sq, I)
. ---- Services or feeders installation, alteration, and/or relocation
200 amps or Icss M 100.70 1111 2 1
• :Y.i:ri' 1:17PROPEritVOVIVER... P;Vi'i:!* AVilf.'„,..1f:•.ti;.;i,.;+.•,';.,;i,:;,1‘,51ayl.;rin.p.1.1.47...,.•;....:■h;),,,,z751, 201 amps to 400 amps
133.56 2 1
1--.'u• .• ••.',. 401 amps to 600 amps MI 200 111=111
Name: — „
_ 601 amps to 1,000 amps 1. 301,04 2 '
Address: Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and/or
City/Statc/ZIP: ___. relocation _
-------- 200 amps or less 59.36 I
Phone: ( ) Fax: ( ) . — 201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is 401 amps to 599 amps 168.54 2 not
intended for sale, lease, rent, or exchange, according to O 7o
RS 447, 449, 670, and .
Branch circuits - new alteration, or extension, pcirjmnel
Owner signature: ____...— Date; A. Fee for branch circuits with
. ;, ; „ • • . • , i -.:,.:.•: 1 ‘: ' ,-: ; Q t
litiNtAtt c'e tk olq
- . • r ' '' l ' Cr 1114' 11C ANT 2 I ;.':::!:: cl; 4; :.,:: A.,: :. s•-%.' ,;', . • I-■ , • . . ' , ' '. • - - above serve or feeder fcc, 7.42 2
each branch . circuit - .
13, Fee for branch circuits without
Business name: _____----_ service or feeder fee, first I 56.18 dD (41/5 2 ;
— branch circuit
Contact name;
---- Each add'I branch circuit - 1 ---- 7. 4 77 .'. 2_ 2
Address: miscellaneous (service or feeder not included)_
,_ ,--- Each manufactured or modular
City/State/ZIP; 67.84 2
L------------------------- . --- dwelling .,2a and/or feeder
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
— Pump or irrigation circle 67.84 2
E Sign or outline lighting 67.84 2
. Signal circuit(s) or limited energy
panel, alteration, or extension. Page 2 2
Business name: West Side Electric Co., Inc. Each additional inspection over al In any or thcabov
----
Address: 1834 SE g Ave. Additional inspection (1 hr min) 66.25/ hr
— Investigation (1 hr min) 66.25/ hr
City/State/ZIP: Portland/OR/97214 Industrial plant (1 hr min) 78.18/hr
Phone: (503) 231 Fax: (503) 736 Inspections for which no fee is 90.00/ hr
specicaIl ,, liste
CCB Lit.: 13306 Electrical Lic.: 26-)35C Suprv, Lie.: 4654-S i':. ,ELLE . :,.pE FEES . •
Subtotal: l_O ' • *
Suprv. Electrician signature, require • ,,, ._, , . .,..... , _41.„,._, Plan review (25% of permit fee): 7,1 0
Print name: Randall F Roberts Date: i 'L 1 1_, State sureharge (12% of permit fee): _
TOTAL PERMIT FEE: —71.'2-3
Authorized signature: This permit application expires if a permit is not obtained within 180
------- —
days after it tans been accepted as Complete.
Print name: Date: * Number of inspections allowed per permit,
---- •
. _.
- - , . . . /011//a• AO A 440-46 I 5T( I 1/051C0MAVEB
/ I. # L866 EEO 0961,869E0S: 0! 40913 9 1 0 !S lsetIA:wo-id! 9t :LI, fl,--87-