Permit (210) CITY OF TIGARD ELECTRICAL PERMIT
Ill ■ COMMUNITY DEVELOPMENT Permit#: ELC2018-00375
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/23/2018
T t r;,,r.n g Parcel: 2S111ACO2901
Jurisdiction: Tigard
Site address: 9500 SW MURDOCK ST
Project: Templeton Elementary School Subdivision: None Lot: None
Project Description: Power for new condenser units,and replacing cafeteria and gym lighting.
Contractor: NIXON ELECTRIC CORP Owner: TIGARD-TUALATIN SCHOOL
PO BOX 68569 DISTRICT 23J
PORTLAND, OR 97268 6960 SW SANDBURG ST
TIGARD, OR 97223
PHONE: 503-654-8841 PHONE:
FAX: 503-345-3403 _ _
FEES
Quantity Description Date Amount
17 crt Branch Circuits wo/Purchase 07/23/2018 $174.90
Specifics: Service or Feeder
1 ea Signal circuit or Limited 07/23/2018 $75.00
Type of Use: COM Energy Panel
Class of Work: ALT 1 ea Plan Review Electricial 07/23/2018 $62.48
1 ea 12%State Surcharge- 07/23/2018 $29.99
Type of Const: Electrical
Occupancy Grp:
Total $342.37
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 m, •stain a c•* •r direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.�
Issued By: rL,, __.•., • _ _ __ Permittee Signature: <�� - y�/ . ' j
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 [ISE ONLY-
City of Tigard Received _h __
111
u 13125 SW Hall Blvd.,Tigard,OR 97223
RECEIVE� 1DateB . f•Avv r
I. Plan Review �_�_®� ), :-
Phone: 503.718.2439 Fax: 503.598.1960 I Related Permit#: " -;e
: i
Inspection Line: 503.639.4175 MAY 2 4 2 018 ReadyBI See Page 2 for
l'IGAKpDate : A Juris: o
Internet: www.tigard-or.gov Notified/Method:', I7T j y- Supplemental
TYPE OF W r.' _TY Ofgig--:t,t ce:t M 'd-r PLAN REVIEW
i IL !NC fvfSIO +
❑New construction ®Addition/alteration/rep acemen Please check all that apply(submit 2 sets of plans w/items checked):
0 Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition ❑Other:
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-famtl amps for all other installations. buildings.
Y ❑Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
Job#: Job site address:9500 SW Murdock Street ❑Addition of new motor load of ystetn.
100HP or more.
City/State/ZIP:Tigard,OR 97224 0 Six or more residential units. cupancy.
01ealth-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Templeton Elementary Scho 0 Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site:96th&Murdock 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#:2S111ACO2901 1,000 sq.ft.or less 0 168.54 0 4
Ea.add']500 sq.ft.or portion 0 33.92 0 1
DESCRIPTION OF WORK Limited energy,residential 0 75.00 0 2
Partial lighting retro of existing school. (with above sq.ft.)
Limited energy,multi-family 0 75.00 0 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2 0
0 PROPERTY OWNER 0 TENANT
Services or feeders installation,alteration,and/or relocation
Name:Tigard Tualatin School District 200 amps or less 100.70 2
Address:6960 SW Sandburg Road 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Tigard,OR 97224 601 amps to 1,000 amps 301.04 2
Phone:(971)727-4168 Fax:( ) Over 1,000 amps or volts 552.26 2
Email: Temporary services or feeders installation,alteration,and/or
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
Branch circuits—new,alteration,or extension, •er panel
® APPLICANT ❑ CONTACT PERSON
A.Fee for branch circuits with
Business name:DayCPM above service or feeder fee,
each branch circuit 7.42 2
Contact name:Shawn Christensen B.Fee for branch circuits without
Address:6960 SW Sandburg Road service or feeder fee,first 1 56.18 56.18 2
branch circuit
City/State/ZIP:Tigard,OR 97224 Each add'l branch circuit 16 7.42 118.72 2
Phone:(971)727.4168 Fax:: Miscellaneous(service or feeder not included)
( ) Each manufactured or modular 6284 2
Email:schristensen@daycpm.com dwelling,service and/or feeder
Reconnect only 67.84 2
CONTRACTOR Putnp or irrigation circle 67.84 2
Business name:Nixon Electric Sign or outline lighting 67.84 2
Address:2542 SE 13th Ave Signal circuit(s)or limited energy
panel,alteration,or extension. ® See Page 2 75 2
City/State/ZIP:Canby OR 97013 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(503)6548841 Fax:( ) Investigation(1 hr min) 90.00/hr
Email:travis@nixonelectric.net Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
CCB Lic.: 191508 $1ti/te Electrical Lic.: 655 Supr ic.: 3185S specifically listed('/:hr min) 90.00/hr
Suprv.Electrician signature,required: ^ ELECTRICAL PERMIT FEES
Subtotal: 249.90
Print name: Craig Robison Date: 5/23/18 0 Plan Review Required(25%of permit fee): �(i
fj?�- D/
State surcharge(12%of permit fee): 29.99
Authorized signature: ` E TOTAL PERMIT FEE: � /) 37
This permit application expires if a permit is not obtained within 18
Print name: 4.- d , C l 6_1. 1.s ezY� Date: 5/23/18 days after it has been accepted as complete.
r1 " Number of inspections allowed per pennit.
1:\Building\Permits\ELC_PermitApp_ELR_ERE.doe Rev 06/17/2015 440.46151(11/05/COMAVEn
Electrical Permit —
ApplicationCity 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 Qty. Each I Total
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
n 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 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:
C Other: Each additional inspection is 66.251 hr 1
charged at an hourly(I hr min)
Inspections for which no fee is 90.00/hr
specifically listed(Y2 hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system:. $75.Q0 Subtotal(Enter on Page 1):
*
(SEE OAR 918-309-0000) Nwnber of inspections allowed per permit.
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
n Data Telecommunication Installation
® Fire Alarm Installation
❑ HVAC
n Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems: 8
*No licenses are required. Licenses are required for all
other installations
I:\Building\Permits\ELC_Permi1App_ELR_ERE.doc Rev 06/17/2015
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9500 SW MURDOCK ST, TIGARD, OR, 97224
Record Type: Record ID:
Commercial - Electrical ELC2018-00375
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor