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Permit s p CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT rF1 " COMMUNITY DEVELOPMENT Permit#: ELR2014-00099 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 ' Date Issued: 04/23/2014 �9 /5- Parcel: 2S114AA00100 Jurisdiction: Tigard Site address: 9000 SW DURHAM RD Project: Tigard Tualatin School District Subdivision: 1993-078 PARTITION PLAT Lot: 2 Project Description: Low voltage for CCTV. 4/9/15,REPRINTED to correct address from 6960 SW Sandburg St to 9000 SW Durham Rd. Contractor: A&E SECURITY& ELECTRONICS SOLUTIONS Owner: TIGARD-TUALATIN SCHOOL PO BOX 179 DISTRICT 23J MCMINNVILLE, OR 97128-0179 6960 SW SANDBURG ST TIGARD, OR 97223 PHONE: 503-883-4139 PHONE: FAX: 503-883-7664 FEES Description Date Amount Specifics: Restricted Energy Permit 04/23/2014 $75.00 12%State Surcharge-Electrical 04/23/2014 $9.00 Type of Use: COM Class of Work: ALT Total Number of Systems: 1 Audio&Stereo: 0 Boiler Controls: 0 CCTV: 1 Clock Systems: 0 Data&Telecommunications: 0 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: I 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. ATTENT : Orego law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-001 hrough OAR 95•. . -1190. You may obtain a copy of the rules or direct questions to OUNC by call'.• -; . 32.1987 or 1.800.332.2344. Issued B . ` Permittee Signatutte` • c 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. CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT IIII a COMMUNITY DEVELOPMENT Permit#: ELR2014-00099 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/23/2014 Parcel: 25101 DD00701 Jurisdiction: Tigard Site address: 6960 SW SANDBURG ST Project: Tigard Tualatin School District Subdivision: SALEM FREEWAY SUBDIVISION Lot: 4 Project Description: Low voltage for CCTV Contractor: A& E SECURITY&ELECTRONICS SOLUTIONS Owner: TIGARD-TUALATIN SCHOOL PO BOX 179 DISTRICT 23J MCMINNVILLE, OR 97128-0179 6960 SW SANDBURG ST TIGARD, OR 97223 PHONE: 503-883-4139 PHONE: FAX: 503-883-7664 FEES Description Date Amount Specifics: Restricted Energy Permit 04/23/2014 $75.00 12%State Surcharge-Electrical 04/23/2014 $9.00 Type of Use: COM Class of Work: ALT Total Number of Systems: 1 Audio&Stereo: 0 Boiler Controls: 0 CCTV: 1 Clock Systems: 0 Data&Telecommunications: 0 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 $84.00 Other Desc: Required Items and Reports(Conditions) This permit is_issued-subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done accordance with “proved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. TTENTION: Oregon la r-• res you to follow the rules adopted by the Oregon Utility Notificat• Center. Those rules are set forth in OAR 952- 01-0010 through OAR 952-a -0090L _ 4L41 u may obtain a copy of the rules or direct questions to OUNC by - •—r 987 or 1.800.332.2344 I ued By: Permittee Signatur=. / r /Cr�'">r eL�`—�`� OWNER INSTALLATION ONLY ' The installation is being made on property I own which is not intended for sale,lease or rent. OWNER'S SIGNATURE: Date: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR.ELEC' Date: LICENSE NO. Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Electrical Permit ApplicationAECE$VF City of Tigard [[ Date By �/ n� �/J Permit No.:Et 6, _0,099 . Date/BY: 7 0� 7 Ili13125 SW Hall Blvd.,Tigard,OR 97223 q Plan Review Phone: 503.718.2439 Fax: 503.59R.1960APR 2 3 2014 Date By: Other Permit: Inspection Line: 503.639.4175 Date Ready By: Ions: ® See Page 2 for TIGARD Internet: www.tigard-or.gov CITYOF fIGARD Notified/Method: Supplemental Information TYPE OF vaisawnwisioni PLAN REVIEW Please check all that apply(submit 2 sets of plans w/items checked below): ID New construction Addition/alteration/replacement ❑Service or feeder 400 amps or more ❑Building over three stories. ❑ Demolition ❑Other: where the available fault current ❑Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 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 all other installations. buildings. ❑Fire pump. ❑Installation of 150 KVA or El Multi-family ❑ Master builder ❑Other: ❑Emergency system. larger separately derived system. JOB SITE INFORMATION AND LOCATION ❑Addition of new motor load of ❑'A"."E"."I-2"."I-3". I00HP or more. occupancy. Job no.: Job site address: ❑Six or more residential units. ❑Recreational vehicle parks. �C- �v ' j— _ ...-t}� ❑Health-care facilities. ❑Supply voltage for more than City/State/ZIP: C fl v '� r 4��M(L �SrJ' ❑Hazardous locations. 600 volts nominal. ❑Service or feeder 600 amps or more. Suite/bldg./apt.no.: Project name:" 7,� _"� 1, t,_ FEE SCHEDULE Cross street/directions to job site: Description a . Fee. Total • New residential single-or multi-family dwelling unit. Includes attached garage. 1,000 sq.0.or less 168.54 4 Subdivision: Lot no.: Ea.add'1 500 sq.ft.or portion 33.92 I Tax map/parcel no.: Limited energy,residential 7500 2 DESCRIPTION OF WORK (with above sq.ft.) Limited energy,multi-family 75.00 2 i _ CLA-s residential(with above sq.ft.) Renewable Energy ❑ See Page 2 Services or feeders installation,alteration,and/or relocation ❑ PROPERTY OWNER ❑ TENANT 200 amps or less 1 00.70 2 201 amps to 400 amps 133.56 Name: 401 amps to 600 amps 200.34 2 Address: 601 amps to 1,000 amps 301.04 2 Over I,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 Owner signature: Date: Branch circuits-new,alteration,or extension,per panel q APPLICANT 50 CONTACT PERSON A.Fee for branch circuits with above service or feeder fee, 7.42 2 Business name: dr-V L u Y t each branch circuit B.Fee for b ranch circuits without Contact name: E s e..A.,4 A ',5 ba.4 ,!t service or feeder fee,first 56.18 2 (vJ `I �j branch circuit Address: e,0 '` t ri C + tt-f e. t-1 t rJ1JV//i p o2 ` 7fa ' Each add'l branch circuit 7 47 i 2 SO li (-)//f Miscellaneous(service or feeder not included) City/StatelZiP: NI 'Each manufactured or modular 67 84 2 •1 1 Fax: : _ ) 2 —� l dwelling,service and/or feeder 2 Phone: ) 7j_1`1`7jA Reconnect only 67.84 E-mail: Pump or irrigation circle 67.84 2 CONTRACTOR Sign or outline lighting 67.84 2 Business name: ' .46 v &L t e-r-12'NtCz7 —`k L L.77e —S Signal circuit(s)or limited-energy See 5� 2 tam {s panel,alteration,or extension. I Page 2 po Address: e `� V(C 1--�r n)Nth t'.� U 2 y'7/A--7. Each additional inspection over allowable in any of the above + Additional inspection(I hr min) 66.25/hr 66.25/hr City/State/Z1P: o c�jy �!7 Investigation(1 hr min) 78 18/hr Phone: ) �—y ` 1 Fax:(5t3)W 3—��p� Industrial plant(1 hr min) Inspections for which no fee is 90.00/hr CCB Lic.: w,r{Oy �I Fxlectrical Lic• Suprv.Lie.: 181 yq� specifically listed(;4 hr min) .3IC tb ELECTRICAL PERMIT FEES Suprv. Electrician signature,required: �� ry m/,46" • Subtotal: 'i c,-`� Date: L ` Plan review(25%of permit fee): rI Print name: + 15f y ) a►1 y State surcharge(12%of permit fee): —Yf—gOU Authorized signature: TOTAL PERMIT FEE: ,-l{ • This permit application expires if a permit is not obtained within 180 Print name: L,,-Z Fv Date: ` I al I 1,1 days after it has been accepted as complete.?I/ A Q • Number of inspections allowed per permit. _7f----- I I:\Building\Perm us`ELC Permit App_ELR_ERE.doe Rev OS/21/201y 440-46151-(II'05'COMiWF.B .0''