Permit (143) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit#: ELR2017-00075
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/01/2017
Parcel: 2S113B000300
Jurisdiction: Tigard
Site address: 7980 SW DURHAM RD
Project: Durham Elementary School Subdivision: None Lot: None
Project Description: Low voltage for fire alarm
Contractor: PERFORMANCE SYSTEMS INTEGRATION LLC Owner: TIGARD-TUALATIN SCHOOL DISTRICT
7324 SW DURHAM RD 6960 SW SANDBURG ST
PORTLAND, OR 97224 TIGARD,OR 97223
PHONE: 503-641-2222 PHONE:
FAX:
FEES
Description Date Amount
•
Specifics: r Restricted Energy Permit 05/01/2017 $75.00
12%State Surcharge-Electrical 05/01/2017 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio&Stereo: 0 Boiler Controls: 0
CCTV: 0 Clock Systems: 0
Data&Telecommunications: 0 Fire Alarm: 1
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 set forth in OAR
952-001-0010 through OAR 952-001-0090 You may obtain a copy of the rules or direct questions to OUNC by calling 503.232,1 7 or 1,800.332.2344.
Er
Issued By: i✓i �--, . 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.
INCITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit#: ELR2017 00075
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/01/2017
T tom' f"L? 9 Parcel: 2S1138000300
Jurisdiction: Tigard
Site address: 7980 SW DURHAM RD
Project: Durham Elementary School Subdivision: None Lot: None
Project Description: Low voltage for fire alarm
Contractor: PERFORMANCE SYSTEMS INTEGRATION LLC Owner: TIGARD-TUALATIN SCHOOL DISTRICT
7324 SW DURHAM RD 6960 SW SANDBURG ST
PORTLAND, OR 97224 TIGARD, OR 97223
PHONE: 503-641-2222 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Restricted Energy Permit 05/01/2017 $75.00
12%State Surcharge-Electrical 05/01/2017 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio&Stereo: 0 Boiler Controls: 0
CCTV: 0 Clock Systems: 0
Data&Telecommunications: 0 Fire Alarm: 1
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 set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1 7 or 1.800.332.2344.
Issued By: 41—i.41e.J m Permittee Signature: A---- t X.
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.
RE
C ! „ ; ..
Electrical Permit Application FOR OFFICE USE ONE)
City of Tigard I. ' 1 ) ;?'!:117 Received _
- Date/B ���'�''II Permit#: e� , 0 7-60676--
,
Ill13125 SW Hall Blvd.,Tigard,OR }''� + I� Plan Review
Phone: 503.718.2439 Fax: 50 ,5�� !IGARD DateB : Related Permit#:
Inspection Line: 503.639.417 it Ready Date/By: Juris H See Page 2 for
TI G A R(7 Internet: www.tigard-or.gov �Jd �� G SIO Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
❑New construction ®Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
❑Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition ['Other: where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
0 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: 0 Fireum .
p p 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: 107844AES Job site,address: SW Durham Rd. 1001-IP or more. ❑"A","E","t-2","t-3",
City/State/ZIP:Tigard,Oregon 97224 79 gO ❑Six or more residential units. occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Durham Elem AES El Hazardous locations. 0 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 Qty. I Each I Total
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
with above s ft. 75.00 2
Installation of AES Radio ( q )
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
0 PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation
Name: 200 amps or less 100.70 2
Address: 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: 601 amps to 1,000 amps 301.04 2
Phone:( ) Fax:( ) 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 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
0 APPLICANT 0 CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name:Performance Systems Integration LLC above service or feeder fee, 7 42 2
each branch circuit
Contact name:Dan Schelhaas B.Fee for branch circuits without
service or feeder fee,first
Address:7324 SW Durham Rd. branch circuit 56.18 2
City/State/ZIP:Portland,Oregon 97224 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(503)641-2222 Fax: :(503)641-1464 Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email:dan@psintegrated.com Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:Performance Systems Integration LLC Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
Address:7324 SW Durham Rd. panel,alteration,or extension. El See Page 2 7.5-,0 2
City/State/ZIP:Portland,Oregon 97224 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(503)641-2222 Fax:(503)641-1464 Investigation(1 hr min) 90.00/hr
Email:dan@psintegrated.com Industrial plant(1 hr min) 78.18/hr
2 Inspections for which no fee is 90.00/hr
CCB Lic.: 205924 Electrical Lic.: Suprv.Lic.: 3/7 V'.G� specifically listed(/�hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal:
Print name: William Driver III Date: 4/10/17 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): Cj.60
Authorized signature: TOTAL PERMIT FEE: gL�,00
This permit application expires if a permit is not obtained within 180
Print name: Dan Schelhaas Date: 4/10/17 days after it has been accepted as complete.
* Number of inspections allowed per permit.
1\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(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
DescFee for all residential systems combined: $75.00 Ren won Qty. Each 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
Fl A• udio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
n B• urglar 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 2
❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System*
Each additional kva over 25 7.42 3
n 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
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed(9z hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Subtotal(Enter on Page 1):
Fee for each commercial system: $75.00
* Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
N Fire Alarm Installation
❑ HVAC
n Instrumentation
n Intercom and Paging Systems
n Landscape Irrigation Control*
n M• edical
❑ Nurse Calls
n Outdoor Landscape Lighting*
n Protective Signaling
n Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
7980 SW DURHAM RD, TIGARD, OR, 97224
Record Type: Record ID:
Commercial - Electrical Limited Energy ELR2017-00075
Inspection Type: Inspector:
198 Low voltage final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor