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Permit a y q CITY OF TIGARD �� ELECTRICAL PERMIT I ' COMMUNITY DEVELOPMENT 7 °fig«'h' Permit#: ELC2015-00500 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/30/2015 Parcel: 2S101AD02400 Jurisdiction: TIGARD Site address: 12753 SW 68TH AVE Project: George Fox University Subdivision: WEST PORTLAND HEIGHTS Lot: 9 Project Description: (8)branch circuits for TI:(3)new offices in the library,(1)ADA restroom adjacent to the library.&lighting retro fit. 7/28/15,reprinted to low voltage for fire alarm panel and data cabling. Contractor: OWNER Owner: GEORGE FOX UNIVERSITY GEORGE FOX UNIVERSITY ATTN: FINANCIAL AFFAIRS 414 N MERIDIAN 414 N MERIDIAN NEWBERG, OR 97132 NEWBERG, OR 97132 PHONE: 503-554-2010 PHONE: FAX: FEES Quantity Description Date Amount 8 crt Branch Circuits wo/Purchase 06/30/2015 $108.12 Specifics: Service or Feeder 1 ea 12%State Surcharge- 06/30/2015 $12.97 Type of Use: COM Electrical Class of Work: ALT 1 ea Signal circuit or Limited 07/28/2015 $75.00 Energy Panel Type of Const: 9 12%State Surcharge- 07/28/2015 $9.00 Occupancy Grp: Electrical(manual) 45 Misc Administration Fee 07/28/2015 $45.00 1 ea Signal circuit or Limited 07/28/2015 $75.00 Energy Panel 9 12%State Surcharge- 07/28/2015 $9.00 Electrical(manual) Total $334.09 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 Banc- 'h 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. AT NTION: Oregon =w requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001 010 throu• OAR 952-••1-•••0. Y• ay obtain a copy of the rules or direct questions to OUNC by calling 503 `2.1987 or 1.800.332.2344. Issue By: `/ �� AIL .. Permittee Signat A .� r 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' 7)7r c1 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. 111 CITY OF TIGARD ELECTRICAL PERMIT �' COMMUNITY DEVELOPMENT Permit#: ELC2015-00500 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/30/2015 T t t.•r\tZ D 9 Parcel: 2S 101 AD02400 Jurisdiction: TIGARD Site address: 12753 SW 68TH AVE Project: George Fox University Subdivision: WEST PORTLAND HEIGHTS Lot: 9 Project Description: (8)branch circuits for TI:(3)new offices in the library,(1)ADA restroom adjacent to the library.&lighting retro fit. Contractor: OWNER Owner: GEORGE FOX UNIVERSITY GEORGE FOX UNIVERSITY ATTN: FINANCIAL AFFAIRS 414 N MERIDIAN 414 N MERIDIAN NEWBERG, OR 97132 NEWBERG, OR 97132 PHONE: 503-554-2010 PHONE: FAX: FEES Quantity Description Date Amount 8 crt Branch Circuits wo/Purchase 06/30/2015 $108.12 Specifics: Service or Feeder 1 ea 12%State Surcharge- 06/30/2015 $12.97 Type of Use: Electrical Class of Work: Type of Const: Occupancy Grp: Total $121.09 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 e 180 days. AT ' •': • egon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set f i OAR 952-001 ■010 through OA' 752-• -••9 You may obtain a copy of the rules or direct questions to OUNC by calling 503.23 1. 32.2344. \ Issue 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' 4 011 ��` 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. L Electrical Permit Applicati CFJIVFjP FOR OFFICE USE ONLY ReceiNed ,s p Permit#: £ /J '�`3 D 0 City o f Tigard Date;B : 111 . • 13125 SW Hall Blvd.,Tigard,OR 972 2 9 20'15 Plan Review , ��/,I A Phone: 503.718.2439 Fax: 503.598. 2 Date/B : Related Permit#: i .� 'iv TIGARI� Inspection Line: 503.639.4175 YYY Ready Date/By: Juris: ® See Page 2 for Internet: www.tigard-or.gov CITY UN 11(1A11� Notified/Method: Supplemental Information TYPE OF'SV(•1k1 '`. "" PLAN REVIEW ❑ New construction ❑Addition/alteration/replacement Please check all that apply(submit I sets of plans w%items checked): ❑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. ❑ I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground.or exceeds 14,000 ❑Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family ❑ Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived / �/ ,�1 i ❑Addition of new motor load of system. Job#: Job site address:fei 4 5'(r) 4S/ f t t 10011P or more. ❑"A".°E","t-2^,"t-3", City/State/ZIP: 77647246 <77 2-,- 3 ❑Six or more residential units. occupancy. ❑Health-care facilities. ❑Recreational vehicle parks. Suite/bldg./apt.#: I Project name: 1...18ieRf2.-/ ❑Hazardous locations. ❑Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE Description I Qt). I Each I Total I • New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add'I 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential /MOVE e. -T'/•iJ� d/e.cvi . — 4-44 (with above sq.ft.) 75.00 2 Limited energy,multi-family 75.00 2 ,ce- Te //v eof ee9 L//C.;1k7�S residential(with above sq.ft.) / Renewable Energy ❑ See Page 2 ❑ PROPERTY OWNER I ❑ TENANT Services or feeders installation,alteration,and/or relocation Name: 6-40aC fel r (/ rjl/'-r 200 amps or less 100.70 2 Address: V/5/ A, 0(/J��j�� 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP: /(i QQ1Z 601 amps to 1,000 amps 301.04 2 Phone:(503) 5,/-- Z08-O I Fax:('SO) ,53Y-- ZG2�j Over 1,000 amps or volts 552.26 . 2 Temporary services or feeders installation,alteration,and/or Email: relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 I intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 _ 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 APPLICANT Branch circuits—new,alteration,or extension,per panel ❑ I 0 PERSON A.Fee for branch circuits with Business name: above service or feeder fee, 7.42 • each branch circuit Contact name: B.Fee for branch circuits without Address: service or feeder fee,first 56.18 �p,i 2 branch circuit City/State/ZIP: Each add'I branch circuit 7 7.42 _51.99 2 Miscellaneous(service or feeder not included) Phone:( ) Fax: :( ) Each manufactured or modular dwelling,service and/or feeder 67.84 2 Email: Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: O Gt )i0 Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy ❑ SeePa e 2 2 Address: panel,alteration,or extension. g City/State/ZIP: Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:( ) Fax:( ) Investigation(1 hr min) 90.00/hr Email: Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lie.: Electrical Lim Su!rv.Ae 97, specifically listed(%hr min) ' ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: �. r 1�/,7�� Subtotal: /'D 5'-/ Print name:P,9.JL eejRee7r.�e..4 oll C_ 1 ate: /, z7./, ❑Plan Review Required(25%of pennit fee): r---- State surcharge(12%of permit fee): / .` •? 7 Authorized si Ina:, This PERMIT FEE: /a-/.e 9 This permit application expires if a permit is not obtained within 180 Print name: / Date: (,—Z ,— /s1 days after it has been accepted as complete. • Number of inspections allowed per permit. 1:Building.Permits,ELC_PennitApp_ELR_ERE.doc Rev 06/1712015 440-46151-(11/05/COM/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Fee for all residential systems Renewable combined: $75.00 Ren Qm 1 Each l Total � electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 2 5.01 to 15 kva 133.56 2 Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: Burglar Alarm 25.01 to 50 kva 301.04 2 50.01 to 100 kva 552.26 2 Garage Door Opener* >100 kva(fee in accordance with OAR 918-309-0040) 552.26 U Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 Vacuum Systems* >100 kva—no additional charge 0.0 3 Each additional inspection over allowable in any of the above: Other: Each additional inspection is 66.25/hr 1 charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed('_hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Fee for each commercial system: $75.00 Subtotal(Enter on Page I): (SEE OAR 918-309-0000) * Number of inspections allowed per permit. Check Type of Work Involved: n Audio and Stereo Systems Boiler Controls Clock Systems Data Telecommunication Installation I I Fire Alarm Installation n HVAC Instrumentation ❑ Intercom and Paging Systems n Landscape Irrigation Control* n Medical Nurse Calls I Outdoor Landscape Lighting* Protective Signaling ❑ Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations 1:\Building`Permits\ELC_PennitApp_ELR_ERE.doc Rev 06/17/2015 Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 12753 SW 68TH AVE, TIGARD, OR, 97223 Commercial - Electrical 130 Ceiling cover PASS ELC2015-00500 Herb Stabenow Violation Summary: Inspector Contractor