Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
II • COMMUNITY DEVELOPMENT Permit#: ELR2013-00233
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/18/2013
Parcel: 1 S 136CC00100
Jurisdiction: TIGARD
Site address: 8200 SW PFAFFLE ST
Project: Westside Christian High School Subdivision: 2006-016 PARTITION PLAT Lot: 3
Project Description: Data telecommunications sytem.
Contractor: AZIMUTH COMMUNICATIONS INC Owner: WESTSIDE CHRISTIAN HIGH SCHOOL
PO BOX 508 4565 CARMEN DRIVE
WILSONVILLE,OR 97070 LAKE OSWEGO,OR 97035
PHONE: 503-639-0110 PHONE: 503-697-4711
FAX: 503-639-0115
FEES
Description Date Amount
Specifics: Restricted Energy Permit 09/18/2013 $75 00
12%State Surcharge-Electrical 09/18/2013 $9 00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 11
Audio&Stereo: 0 Boiler Controls: 0
CCTV. 0 Clock Systems' 0
Data&Telecommunications' 1 Fire Alarm 0
HVAC 0 Instrumentation" 0
Intercom/Paging: 0 Landscape/Irrigation: 0
Landscape Lighting- 0 Medical: 0
Nurse Calls 0 Protective Signal: 0
Security Alarm 0 Other: 0 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 503 232.1987 or 1 800.332.2344.
/ I
Issued By.■00.11.11. Permittee Signature:
W'
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 Schmitt 9-16-13 3:46pm p. 3 of 4
Electrical Permit Application #111111—.%'" roR()r•ricl;usi:ONi
City of Tigard ,cit. Received _
•iil 13125 SW Hall Blvd.,Tigard,OR 97223 9� �� �t`B • M �fi 0 �4 'E e
Phone: 503.718.2439 Fax: 503.598. t •
Other Permit: `t ( ,
L
TI( A R 1 r Inspection Line: 503.639.4175 (A r. :�'�Z
Internet: www.tigard-or.gov �� ��
..- ;r3,1?y 0`F'Lp!p c: Qf j`11 :'.,.,,•;_ .PLAN REVIEW a J
. Please cheek all that apply(submit 2 sets of plans w/items checked below):
❑New construction- ®Addition/alteradon/repla,17'.1,4,s
Other: ❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑Other:
v where the available fault current ❑Marinas and boatyards.
';.' CAPF.CORYs:O IO, RI9CT1O i , - - • exceeds 10,000 amps at ISO volts or ❑Floating buildings
- _ - less to ground,or exceeds 14,000 ❑Commercial-use agricultural
❑ 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building amps for another installations. buildings.
❑Multi-family ❑Master builder ❑Other. ❑Fire pump. ❑Installation of 75 KVA or
- ` ,:JOB;SITE INFO A1NND1'1IOCATION- ❑ r 'oy system larger separately derived system.
'� ' ` - - ° `_.. - ❑Addition of thew motor Mad of
Job no.: I Job site address:8200 Pfaffle St IOOHP Of more. occupancy
['Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP:Tigard,OR ❑Health-care facilities. ❑Supply voltage for more than
❑Hazardous locations. 600 volts nominaL
Suite/bldgJapt.no.: I Project name:Westslde Christian ❑Service or feeder 600 amps or more. - -
Cross street/directions to job site: FEE,SCHEDULE'
] Description I Qty. I Fee. I Totat I
New residential single-or multl-family dwelling unit.
Includes atteched garage.
Subdivision: Lot no.: 1,000 sq.ft.or less 168.54 4
Ea.add'1500 sq.ft.or portion 33.92 1
Tax map/parcel no.: Limited energy,residential 75.00 2
' -5.1.D_ESCRIPTION OF\VO12K . - . - - .. _ (with above sq.ft)
Limited energy,mtilti•family 75.00 2
Voice/Data residential(with above sq.-ft.)
Services or feeders Installation,alteration,and/or relocation
200 amps or less 100.70 2
,PROPERTY ON ER, _ , �, EA7 - 201 amps to 400 amps 13356 2
Name: 401 amps to 600 amps 200.34 2
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
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
above service or feeder fee,
;APPCANiP. <, ':=-' •CONT�SC� PERSQN' 7.42 2
each branch circuit
Business name:Azimuth Communications B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Contact name:Jerry branch circuit
Each add'l branch circuit 7.42 2
Address:9500 SW Tualatin-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)639-0110 Fax::(503)639-0110 Reconnect only 67.84 2
Pump ar imgation circle 67.84 2
E-mail:lindsey @azimuthcommunications.com Sign or outline lighting 67.84 2•_, CONTRfC.1 OR' ! Signal ctrcuit(s)or limited energy
Business name:Azimuth Communications panel,alteration,or extension. Page 2 7- r'- 2
Each additional inspection over allowable In any of the above
Address:9500 SW Tualatin-Sherwood Rd. Additional inspection(1 hr min) 66.25/hr
City/State/ZIP:Tualatin,OR 97062 Investigation(I hr min) 66/5/hr
Industrial plant(1 hr min) 78.18/hr
Phone:(503)639-0110 /Electri I Fax:(503)639115 Inspections for which no fee is
I specifically listed(%s hr min) 90.00/hr
CCB Lic.: 145828 cal Lie.: 36=94CLE ✓ Suprv.Lic.: 2312LEA ELECTRICAL,PERMIT FEES
Subtotal: 9 lin,'
Suprv.•Eleetrician signature,requiredi� l Plan review(25%of permit fee):
Print name: Brett Ulberg Date: 09/16/2013 State surcharge(12%of permit fee):
TOTAL PERMIT FEE: #8f l`!' 1„/r
Authorized signature: ,,,,e_14 (/ ..--' This permit application expires If a permit Is not obtained within 190
Print name: Brett Ulberg Date: 09/16/2013 • days after It has been accepted as complete.
$ Number of inspections allowed per permit.
l:1BuitdiastPermns+E1.C•PermitApp.doe 07/01;10 440W6151(11/OS'COMAVE9
To: 5035981960 From:'Lindsey Schmitt 9-16-13 3:46pm, O. 4 ' of 4
•
Electrical Permit Application- City of Tigard
Page 2--Supplemental Information
,LIMITED ENERGY PERMIT FEES:
•
•,_.1tE._SI�E;�I°IAL�,Wh�__ O � �, :.: ��• ���:1.:� ,.
Fee for all residential systems combined .. $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating,Ventilation and Air Ccindiiioning.System*
❑ Vacuum Systems*
— - -0 Other. -' -—
'NCO-7:._aoo ° ..d».,rittl�r.'? ,._ ?�1=cta X-;`.t,�,v,`-oji
O�0,1.. �•�.i�f�'a;.1;.a�.'.'®_:L_'�-i.3i�;:.°T.'�.''r� /
Fee for each commercial $75.00
system
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ yick Systems
Data Telecommunication Installation
❑ Fire Alarm Installation.
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
.0 Nurse Calls
.0 Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems: j_
*No licenses are-required. Licenses are requited
for all other installations
I:Building'PermswELGPermibApp.doc 07101,10' - — _—
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
8200 SW PFAFFLE ST, TIGARD, OR, 97223
Commercial - Electricial Limited Energy
135 Low voltage
2013-12-10 00:00:00
ELR2013-00233
PASS
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
8200 SW PFAFFLE ST, TIGARD, OR, 97223
Commercial - Electricial Limited Energy
199 Electrical final
2013-12-24 00:00:00
ELR2013-00233
PASS - No C of O
Violation Summary:
Inspector Contractor