Permit (242) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit#: ELR2019-00151
T I(1 r\R 0 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/20/2019
Parcel: 2S111ACO2901
Jurisdiction: Tigard
Site address: 9500 SW MURDOCK ST
Project: Templeton Elementary School Subdivision: None Lot: None
Project Description: Limited energy for class room projectors,gym sound system,café video/audio system.
Contractor: ONE DIVERSIFIED Owner: TIGARD-TUALATIN SCHOOL
37 MARKET ST DISTRICT 23J
KENILWORTH, NJ 07033 6960 SW SANDBURG ST
TIGARD, OR 97223
PHONE: 908-245-4833 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Restricted Energy Permit 08/20/2019 $75.00
12%State Surcharge-Electrical 08/20/2019 $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 y. to follow the rules adopted by the Oregon Utility Notification Center. T se le -re s- orth in OAR
952-001-0010 through OA; •52-001-0090. You• ay obtain a co;-.f the rul- or direct questions to OUNC by calling 503.232.19 ��. 3 . '44.
Issued By: .( Air". Permittee Signature: y
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 t SE ONLY
City Of Tigard Date/BReceie•d ' ��1J �'` Lig'__ '•/ r
'13125 SW Hall Blvd.,Tigard,OR 97223 A I I r� Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 v'i r'-.''- Date/ Related Permit#:
Inspection Line: 503.639.4175 Ready Date/By: Juris: VI See Page 2 for
TIGARD Internet: www.tigard-or.govNotified/Method: Supplemental Information
Pi A W
®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 ❑Building over three stones.
❑Demolition ❑Other: where the available fault current 0 Marinas and boatyards.
AT t ORY fid' CON TR11CTION 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 ❑Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: 0 Fire pump, 0 Installation of 150 KVA or
kinillriiIIIIIMiliIIIIIIIIIi:VSINIMI; IIMMOTAAQN:ANAIWcalM-4.,:.,i,,,Rii,;•::,f,,:• :,:::,,,•
❑Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: Job site address:9500 SW Murdock St 100HP or more. ❑"A "E","1-2","1-3",
❑Six or more residential units. occupancy.
City/State/ZIP:Tigard,OR 97224 ❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name:JamesTempleton Elemen ❑Hazardous locations. 0 Supply voltage for more than
roJ p
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: 'FEIN SCHEDUL+E :'
Description I Qty. I Each I Total
New residential single-or multi-family dwelling unit.
Subdivision: I Lot#: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: _Ea.add'l 500 sq.ft.or portion 33.92 1
a r
13 = tt�'iII �,it... 1 1I :'r ! , F ,;- _ ...- Limited energy,residential 75.00 2
Class Room Projectors,Gym sound system,Café Video/Audio system (with above sq.ft.)
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
anositilialincinOrip*NW!!*,44::!--4::,,,,,,, ,,,f,,,,,,,,,,,::,,,,,:,,,,tarurogsm,,,,,,,,,,,,,,,,,,,,,,,':-,,,,, 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: amps168.54 2
- ew,alt tion,or extension,per panel
401 to 599amp
f Dgg Branch circuits n era
A.Fee for branch circui with
Business name: t r W Sr ati above service or feeder fee, 7.42 2
J each branch circuit
Contact name: B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Address: branch circuit
City/State/ZIP: Each add'I branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:( ) I Fax: :( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Email: Reconnect only 67.84 2
®a Pum or irri ation circle 67.84 2
fa �i<. �- tom-: • .,..: .. , .. >..ti._° • �, . ...: . P g
` Business name:One Diversified - ' 1 Sign or outline lighting _ - -_-61f.94-_ -___.,.._.4-___-__--
Signal circuit(s)or limited-energy ® See Page 2 75.00 2
Address: 10035 SW Arcitc Dr panel,alteration,or extension.
City/State/ZIP:Beaverton,OR 97005 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(503)601-5523 Fax:( ) Investigation(1 hr min) 90.00/hr
Email:sanderson@diversifiedus.com 7/2 /` �Aindustrial plant(1 hr min) 78.18/hr
664-4, Inspections for which no fee is 90.00/hr
CCB Lic.: 213697 Electrical Lic.: C E527 Suprv.Lic.: 171LEA specifically listed(%hr mm)
Suprv.Electrician signature,required: - Subtotal: 75.00
Print name: Scott Anderson Date: 08/20/2019 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): 9.00
Authorized signature: TOTAL PERMIT FEE: 84.00
This permit application expires if a permit is not obtained within 180
Print name: / �h.41,/ �j•1�.y Date: q7,-,2,072a ydays after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Building\Permits\ELCPermitApp_ELR_ERE.doe 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:
FEE Gh3IEI3
I 1 , ,
ID -1
Description � Qty. I Each ITotal
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
552.26 2
with OAR 918-309-0040)
❑ 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(%z hr min)
Q ER ORK7.
SubtotalEnteron 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
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems: 1
*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
Tel: 503.718.2439
Location: Inspection Date:
9500 SW MURDOCK ST, TIGARD, OR, 97224
Record Type: Record ID:
Commercial - Electrical Limited Energy ELR2019-00151
Inspection Type: Inspector:
198 Low voltage final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor