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Permit I. CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT -1 Permit#: ELR2019-00153 COMMUNITY DEVELOPMENT Date Issued: 08/21/2019 T-1 c,A R T3 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S111ACO2700 Jurisdiction: Tigard Site address: 14650 SW 97TH AVE Project: Twatity Middle School Subdivision: None Lot: None Project Description: Limited energy for data telecommunication installation. Contractor: IES COMMUNICATIONS Owner: UNION HIGH SCHOOL DISTRICT 5433 WESTHEIMER STE 500 NO. 3 JT HOUSTON,TX 77056 00000 PHONE: 713-860-1561 PHONE: FAX: FEES Description Date Amount Specifics: Restricted Energy Permit 08/21/2019 $75.00 12%State Surcharge-Electrical 08/21/2019 $9.00 Type of Use: Class of Work: Total Number of Systems: 0 Audio&Stereo: 0 Boiler Controls: 0 CCTV: 0 Clock Systems: 0 Data&Telecommunications: 1 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) Tbehis permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All workthe180will 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 days. ATTENTION: Oregon law requires you to f low the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 95 .. 0090. Yo may ob in a copy of rules or direct questions to OUNC by calling 503 232.1987 or 1.800.332.2344. oir _._...f Issued By: "00,- ✓ fit Permittee Signature: i 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,Peemit Application—City of Tigard Page 2-Y Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: -DescrFee for all residential systems combined: $75.00 � in Each Total ( •1 3' Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 2 5.01 to 15 kva 133.56 2 O 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 t s ificall listed '/hr min 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 Systems Clock S ❑ y ® Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems O Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls • Outdoor Landscape Lighting* E Protective Signaling ❑ Other: Total number of commercial systems: _ *No licenses are required. Licenses are required for all other installations I:\Building\Permits\ELC_PennitApp ELR ERE doe Rev 06/17/2015