Permit (40) CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2018-00256
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/09/2018
T I t A l=.t 9 Parcel: 2S114AA00100
Jurisdiction: Tigard
Site address: 9000 SW DURHAM RD
Project: Tigard High School Subdivision: None Lot: None
Project Description: Electrical for MDF room.
Contractor: PRAIRIE ELECTRIC INC Owner: TIGARD-TUALATIN SCHOOL DISTRICT
6000 NE 88TH ST 6960 SW SANDBURG ST
VANCOUVER,WA 98665 TIGARD, OR 97223
PHONE: 360-573-2750 PHONE:
FAX: 503-576-7422
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 05/09/2018 $100.70
Specifics: amps or less
1 ea Services or Feeders-201 to 05/09/2018 $133.56
Type of Use: COM 400 amps
Class of Work: ALT 16 crt Branch Circuits w/Purchase 05/09/2018 $118.72
Service or Feeder
Type of Const: 1 ea Plan Review Electricial 05/09/2018 $88.25
Occupancy Grp: 1 ea 12%State Surcharge- 05/09/2018 $42.36
Electrical
Total $483.59
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 suspe.•- •r more the 180
days. ATTENTION: Oregon law requires y.. to follow the rules adopted by the Oregon Utility Notification Center. Those -s are -t forth in OAR
952-001-0010 through OAR '01-00•0 Yo =y obtain - opy of the r. -s or direct questions to OUNC by calling 503.232.1987 or .80# -. .2344.
Issued By: fr/,ir 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.
Electrical Permit Application FOR OFFICE USE ONLY
City°W Tigard g CEDE t eceived ` �' C /4C//8''�
aateBy: < 'ermit#:i�
'413125 SW Hall Blvd.,Ti ard,OR 97223 Plan Review
S Phone: 503.718.2439 Fax: 503.598.1960
Date/By: S / Il Related Permit#:6 L(/ /p/SO`D 8`
TIGARD
Inspection Line: 503.639.4175 4'2� p Ready Dat (C 2 5.( I `//'�► I Supplemental Information
TYPE OF WOR1 i1'. PLAN
❑New construction ® �TIGARD REVIEW
Addition/alteratio a(� Please check all that apply(submit 2 sets of plans w/items checked):
0 Demolition 0 Other: to /JOG DIVISION ❑Service or feeder 400 amps or more 0 Building over three stories.
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or
0 Floating buildings.
❑ 1-and 2-family dwelling ®Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
❑Multi-familyamps for all other installations. buildings.
0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
Job#:200319.03 Job site address:2 WSIV DURHAM ROAD 0 Addition of new motor load of system.
100HP or more.
City/State/ZIP:TIGARD,OR 97224 ❑Six or more residential units. ccupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name:TIGARD HIGH SCHOOL 0 Hazardous locations. 0 Supply voltage for more than
Cross street/directions to job site:
0 Service or feeder 600 amps or more. 600 volts nominal.
FEE SCHEDULE
Description I Qty. I Each I Total I *
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
Tax map/parcel#: 1,000,$q.ft.or less 168.54 4
DESCRIPTION_OF WORK .t Ea.idd;L5000 sq.ft.or portion 33.92 1
t Limittof lergy,residential 75.00 2
ELECTRICAL TI EFFORTS FOR MDF ROOM RELOCATION '?r ':(with above sq.ft.)
Limited energy,multi-family
1 residential(with above sq.ft.)
75.00 2
' El PROPERTY OWNER ❑ TENANT Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
! Name: ' 100.1V 2
200 amps or less 100.70
Address: 201 amps to 400 amps I 133.56 I 33 i cipt 2
City/State/ZIP: 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
I Phone:( ) Fax:( ) Over 1,000 amps or volts 552.26 2
Email: Temporary services or feeders installation,alteration,and/or
relocationOwner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1
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
Branch circuits—new,alteration,or extension,per i anel
❑ APPLICANT Cl. CONTACT PERSON
A.Fee for branch circuits with
4 i +
Business name:PRAIRIE ELECTRIC,INC. above service or feeder fee, _ /
Contact name:ANITA PASO each branch circuit /
B.Fee for branch circuits without
Address:6000 NE 88TH STREET service or feeder fee,first 2
branch circuit t
City/State/ZIP:VANCOUVER,WA 98665 Each add'l branch circuit ,_? _——i.42 C4.40.2%
Phone: Miscellaneous(service or feeder not included)
( )503.286.9209 Fax: :( ) Each manufactured or modular
Email:ANITAP@PRAIRIELCTRIC.COM dwelling,service and/or feeder 67.84 2
Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:PRAIRIE ELECTRIC,INC. Sign or outline lighting 67.84 2
Address:6000 NE 88TH STREET Signal circuit(s)or limited-energy
panel,alteration,or extension. 0 See Page 2 2
City/State/ZIP:VANCOUVER,WA 98665 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:( )503.286.9209 Fax:
( ) Investigation(I hr min) 90.00/hr
Email:ANITAP@PRAIRIELECTRIC.COM Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
CCB Lic.: 60178 Electrical Lic.: 37-491C Suprv.Lic.: 3562S specifically listed ehhr mm) 90.00/hr
Suprv.Electrician signature,r fed"* -, Subtotal:
3s�
ELECTRICAL PERMIT FEES
c 0'
Print name: BILL HALBERh � I Date .24.18 0 Plan Review Required(25%of permit fee):
t ,
State surcharge(12%of permit fee): - ��
Authorized sign , TOTAL PERMIT FEE:- a
litigi-
This permit application expires if a permit is not obtain•. • ,'n 180
Print name:ArinIFW
_ Date: •
�= days after it has been accepted as c :1.ete.
��� * Number of inspections allowed per permit. * ti t-3 . i
s
I.\BuildingiPer iii" `'PermitApp_EL'_ERE..• 'ev 06/17/2015 440-4615T01/05/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 combined: $75.00 Description I Qty. I Each Total I
Renewable 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
❑ Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva(fee in accordance
with OAR 918-309-0040) 552.26 2
❑ Heating,Ventilation and Air Conditioning
System* Solar generation systems in excess of 25 kva:
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 mm)
Inspections for which no fee is
specifically listed(%hr mm) 90.00/hr
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):
(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
n Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
n Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doe Rev 06/17/2015