Permit (15) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
III '� Permit#: ELR2019-00006
• COMMUNITY DEVELOPMENT
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/09/2019
T I C''E h Cr g Parcel: 2S113B000300
Jurisdiction: Tigard
Site address: 8040 SW DURHAM RD
Project: Durham Education Center Subdivision: None Lot: None
Project Description: Limited energy for audio visual systems installation.
Contractor: DELTA SYSTEMS INTEGRATION INC Owner: TIGARD-TUALATIN SCHOOL DISTRICT
2450 NW ELEVEN MILE AVENUE 6960 SW SANDBURG ST
GRESHAM, OR 97030 TIGARD, OR 97223
PHONE: 503-907-0137 PHONE:
FAX: 503-786-3803
FEES
Description Date Amount
Specifics: Restricted Energy Permit 01/09/2019 $75.00
12%State Surcharge-Electrical 01/09/2019 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 0
Audio&Stereo: 1 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 set forth in OAR
952-001-0010 through OAR 952-001-0090. You m-y obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
i
Issued By: ..s...--‘. i„--el Permittee Signature: t '/
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.
REOFThIP
Electrical Permit Application `
FO120! l'R'I: tSI: ON L\
City of Tigard JAN 3 2019 Received A �
13125 SW Hall Blvd.,Tigard,OR 97223 Date/B : , la. P r �•, _1(.47-- . .6.
S Plan Review
Phone: 503.718.2439 Fax: 503.598.1 '; .) pateB : "_ t 40" 4
Inspection Line: 503.639.4175 6 :,„..1; 1,D .:t'\ Ready Date/By: ® See Psge 2 i
1 l t"�h(� Internet: www.tigard-or.gov Notified/Method: Supplemental Information
®New construction 0 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.
❑Demolition 0 Other: 0 Marinas and boatyards.
where the available fault current
+ .
- „ .t + i s ,+' o_,,,:01.)I,'‘;,."- ,�',, . 2e 4', ;' exceeds 10,000 amps at 150 volts or ❑Floating buildings.
❑ I-and 2-family dwelling ®Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
0 Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
w.,. -:',.iiiaillzttlitik),* ,Atoo n,t ,77:::,:C., ❑Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: 18-0034 Job site address:8040 SW Durham Road 100HP or more. ❑"A","E","1-2 , 1-1 ,
City/StateJZIP:97224
0 Six or more residential units. occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Durham Education Center 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:Between SW Carol Ann Ct and SW 79th Ave ''; ";:44` . ; ' ii it ' "" "
Desedption Qty. Each 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'l 500
r4 kr sq.ft.or portion 33.92 1
.Mk ..; . ,, , . P ORti . I ;,® t.a ' iAfhU ,., §, !., . ' Limited energy,residential 75.00 2
Limited energy audiovisual systems installation (with above sq.ft.)
Limited energy,multi-family
75.00 2
residential(with above sq.ft.)
RiR7 " Renewable Energy 0 See Page 2❑'POPEY O R , S., ;;414‘` w ❑,. E,P. " .
' Services or feeders installationzalteration,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 1 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
1E1',004.0*,*: Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name:Delta AV above service or feeder fee,
7.42 2
each branch circuit
Contact name:Mickey Bartle B.Fee for branch circuits without
service or feeder fee,first
Address:2450 NW Eleven Mile Avenue branch circuit 56.18 2
City/State/ZIP:Gresham,OR 97030 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(503)907-0152 Fax: :(503)907-0065 Each manufactured or modular
67.84
dwelling,service and/or feeder
Email:pmadmin@deltaay.com Reconnect only 67.84 2
rI-; „','"':'-=., CONTRACTOR , Pump or irrigation circle 67.84 2
Business name:Delta AV Sign or outline lighting 67.84 2
Signal circuits)or limited-energy
Address:2450 NW Eleven Mile Avenue panel,alteration,or extension. ICI See Page 2 2
City/State/ZIP:Gresham,OR 97030 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(503)907-0137 Fax:(503)907-0065 Investigation(I hr min) 90.00/hr
Email: madmin deltaay.com / / 7 L Industrial plant(1 hr min) 78.18/hr
p @ 7/, `�v L1 3 4 L'L 6 Inspections for which no fee is 90.1 D/hr
CCB Lie.: 1132131 Electrical Lie.: 26923CLE Suprv.Lic.: -436L-EB" specifically listed(%hr min)
}
ELECTRICAL.PERMIT`FEES
SSuprv.Electrician signature,required: e:::7,
Subtotal: 75.00
Print name: SCOTT ULRICH Dat . - 7-19 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
' Number of inspections allowed per permit.
1'.iBuildinglrermits\ELC..PermitAppp_ELR_ERE.doe Rev 06/17/2015 440-4615T(I1MS/COM/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
2 . ,�: EN ORJ O Y r
. .t�_ :3 ,« ,.>: .a».'$a..� Deacdptbn Qt7. EaeM l Total e
Fee for all residential systems combined: $75.00 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
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
❑ 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 6625/hr 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed %s hr min)
OMKERC �¢.® � °.±ONLY: ,
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:
Audio and Stereo Systems
El Boiler Controls
❑ Clock Systems
El Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
El Instrumentation
El Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
El Other:
Total number of commercial systems: I
*No licenses are required. Licenses are required for all
other installations
I:\Ruildi,5\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:
8040 SW DURHAM RD, TIGARD, OR, 97224
Record Type: Record ID:
Commercial - Electrical Limited Energy ELR2019-00006
Inspection Type: Inspector:
198 Low voltage final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor