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Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT "''1 I COMMUNITY DEVELOPMENT Permit#: ELR2014-00282 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/09/2014 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: Low voltage for access control. Contractor: FIRST RESPONSE SYSTEMS INC Owner: WESTSIDE CHRISTIAN HIGH SCHOOL 4970 SW GRIFFITH DR#100 4565 CARMEN DRIVE BEAVERTON, OR 97005 LAKE OSWEGO, OR 97035 PHONE: 503-207-5300 PHONE: 503-697-4711 FAX: 503-207-5301 FEES Description Date Amount Specifics: Restricted Energy Permit 12/09/2014 $75.00 12%State Surcharge-Electrical 12/09/2014 $9.00 Type of Use: Class of Work: Total Number of Systems: 0 Audio&Stereo: 0 Boiler Controls: 0 CCTV: 0 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 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 stet forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: Permittee Signature: — 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. Dec. 9. 2414 11 : 17AM No. 6981 P. 2 Electrical Permit Application HOR(.)I FIUI 1:sf:°N I.' Received City of Tigard - Daiell3 : 1 ® /M� _ .2 III I , u 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Phone: 503.718.2439 Fax: 503.598.1 Dale/B : Other Permit p; f 3_ `y -114 _4 I �5 0 q�j e - I l t i A,K ll 1nSpcClion Line: 503,639.4175 A {�/-■ Dale Ready By: See Page 2 for Internet: www,ligard-OLgov 1 , 1 i NoliledlMelhod Supplemental information .� ;r g1,ia. �n,Y. .. 1 A'r46 :4 r, �. �, 1:.' W r .x.R�.,.,"..k yxry717 T ..r5._=... _ e x ❑New construction 1; Addition/alterationhepl4e n I ' Plesse check all that apply(submit 2 sets of plans whtems checked below) ❑Service or feeder 400 amps or more ❑Puilding over three stones. ❑Demolition ❑Other: '1;i t where the available fault current D Marinas and boatyards. h °;s k n Y exceeds 10,000 amps at 150 volts or []Floating buildings. ,.4li;-1= i'?.';'' `' `' °' `. 7tbrt '.1470I,11.,- . . ' -- 1.-_:., ,i- less is ground or exceeds 11,000 ❑Commercial-use agricultural ❑ I-and 2-family dwelling VComtnercial/induslrial ❑Accessory building amps for all other installations. buildings. ❑Multi family ❑Master builder ❑Other: CI Fire pump, ❑installation of 150 KVA or - --- ----w--^ D Emergency system. larger separately derived system. a' f iiilk ii15 1 g; 1�� 1 410 -t/]OI -...,nom ..1_.._� .ii,._ , ', ' ❑Addilionofnewmolorlpadnp ❑,.A.,..L, ..1_2„.,1_3., Job no.; Job site address:'' 2OO.AJR-��9.I e . ,1-,rte} 1rx or ioo,,resi / Raueation. ❑Six or more residential units. 0 Recreational vehicle parks. City/State/ZIP: 4 5 a,�a 0 Y� (' cf—7223 ❑Hazard curl facilities O Supply is nomr for a'ore than � 600 volts nominal ❑Hazardous Ivcaltons Stli(e/bldg./apt no Project name: Cj 1 tc..eiln,r ` 1AO Li Service rvtc.,or feeder 600amps or y Cross street/directions to job site: ieterwllon Qty. Pro. Told • Ncw residential single-or multi-family dwelling unit, belittles attached garage, 1,000 sq.ft.or less I I 168.54 14 Subdivision: Lot no.: � Ea.add'I 500 sq.R.or portion 33.92 1 Tax map/parcel no,: Limited energy,residential . ,i ,• I '�r u I �r •. Y '-s (with above sq.R.) 75.00 2 y� 1 1` o On a Liaised energy,i(with above sq 75.00 2 residential(with above sq.R.) , Renewable Energy CJ Ste Page 2 n ttp,la Services or feeders Installation,alteration,and/or relocation r i x "� eJ "'� � SyEQr� r.i{`,�, > �., 200 amps or less 100.10 2 l 7 I q � ,,.[ _ 14 , s , .: ?pea!t.`s. r:..'.>.,=f! �:s�.: ,s �;4e..i 201 Daps to 400 maps 133.56 2 Name: 401 amps to 600 amps 200.34 2 Address: 601 amps to 1,000 amps 301.04 _2 Over 1,000 amps or volts 552.26 2 City/State/ZIP: Temporary services or feeders Installation,alteration.and/or Phone:( ) IFax:( ) relocation 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 163.54 2 Owner signature: Date: Branch circuits-new,alteratiot,or e>*tens Ion,per panel t rr',., @il'101, "0 i e• 1 ti r1.,, A.Fee for branch circuits lefth .=• i�1 �ft�a� Fay above service or feeder fee, 7,42 2 Business name: each branch circuit S.Fee for branch circuits,,)hour Contact name: service or feeder fee;first 56.18 2 branch circuit Address: Each add'I branch circuit 7.42 2 City/State/ZIP: Miscellaneous(service or feeder not included) Y Each manufactured or modular Phone:( ) ` Pax: :( ) dwelling,service ond/or feeder 67.84 2 Reconnect only 67.84 2 E-mail: Pump or irrigation circle 67.84 2 .r "Z c ''' CdNTRACTOR% y As- 1;0..1:'. - Sign or outline lighting 67.84 2 Business name: 1.—�/�/- 71r� Yi Signal circuit(s)or limited-energy \/ See r r 1 l l 1� �] r 1 _ panel,alteration,or extension, X Page 2 �.;.),iJ 2 Address: q 7 c- 3(,t )(.- 5-/.4-)24.1,.) Dr i ec. 9. 2014 11 : 17AM No. 6981 P. 3 Electrical Permit Application•-City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees; 3 1 ffil AlatlA,_ r \;01:1:`(0h1L' f_4S�z . ,°_.y L ft)t1.10I)ti Fee for all residential systems combined,.....,, $75.00 ■ daNMENSo Renewable electrical energy systems: Check Type of Work Involved: $kva or less - 100.70 _© 5.01 to 15 kva 1111 133.56 _ 111 Audio and Stereo Systems* 15.01 to 25 kva r 200.34 _© Wind:eneradon s stems In excess of 25 kva: Burglar Alarm 25.01 1.050 kve 301.04 -© n Garage Door Opener* 50.01 to 100 kva - 552.26 _© >100 kva(fcc in accordance with ■ _® OAR 918-309-0040) 552.26 n Heating,Ventilation and Air Conditioning System* Solar generation systems in excess of25 kva: Each additional kva over 25 7.42 _© n Vacuum Systems* >100 kva—no additional charge - 0.0 _© Each additional ins.cction over allowable in an of the above: n Other: Each additional inspection is the _ed et an hour' 1 hr min 1.1 66.25J hr Inspections for which no fee is s (deal listed i4 hr min II 90.00/hr iCtii. 4l..!t IDl(tC1F/,J \nI0)t1 (Ortal1 V•,_. :_.. __ I )..i t1{rIIl11!.r_1t'ili9;IIII)i1 Fee for each commercial system $75.00 Subtotal: (SEE OAR.918-309-0000) Plan review,if required(25%of permit fee): State surcharge(12%of permit fee); Check Type of Work Involved: TOTAL PERMIT FEE: This permit application expires Ira permit Is not obtained within 180 ❑ Audio and Stereo Systems days after 11 has been accepted as complete. Number of inspections allowed per pennil. ❑ Boiler Controls ❑ Clock Systems n Data Telecommunication Installation ❑ Fire Alarm Installation n HVAC n Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* n Protective Signaling I . Other Total number of commercial systems. *No licenses are required. Licenses are required for all other installations LLL1uddingWermiicELC)ceniApp_ELR ERE.doc Rev 05/21/2013