Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00112
:TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/9/2008
PARCEL: 2S1 11 AC -02700
SITE ADDRESS: 14650 SW 97TH AVE ZONING: R -4.5
SUBDIVISION: TIGARDVILLE HEIGHTS LOT: 037 JURISDICTION: TIG
PROJECT: TWALITY MIDDLE SCHOOL
Project Description: Installing (1) low voltage intercom system.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: X
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: • HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
TIGARD - TUALATIN SCHOOL DISTRICT PRAIRIE ELECTRIC INC
6960 SW SANDBURG ST 6000 NE 88TH STREET
TIGARD, OR 97223 VANCOUVER, WA 98665
Phone: 503 -431 -4000 Contact #: PRI 360 -816 -0484 •
FAX 360- 816 -0482
FEES Reg #: ELE 37-491C
LIC 60178
Description Date Amount SUP 3562S
[ELPRMT] ELR Permit 5/9/2008 $75.00
[TAX] 12% State Surch 5/9/2008 $9.00 REQUIRED ITEMS AND REPORTS
Total $84.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: i Permittee Signature: Gz7.
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'N: DATE:
LICENSE NO:
Cali 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
05/08/2008 THU 8:31 FAX 3608160482 GB Manchester 0 001 /003
Electrical Permit Application
r �c �� � 5 4QS s • �+ ?�QR�fmd. "+�ftp�13D' e,. "1. °,�'�,•4
LV & ki! Permit No.: -� ' • — 1 I O�
�; ��° ° 13125 SW Hall Blvd., Tigard, O�t9 23 "=' - iL
. . 1 Plan Review
' : Phone: 503.639.4171 Fax: 503.8. 1960 J � �-`. '' Date /By: Other Permit:
7 [ GiAvR[3' Inspection Line: 503.639.4175 t t P\ °� . - i Date Ready /By: Juris El See Page 2 for
h x r eua Internee www.tiganl -ocgov ` - t ( e + No[ified/Method: Supplemental lnformation
Win♦' .a "T�r �. �•'•_ - - - :carte efi..,,i' Y� t — ��'�..,= �'r�+: --''Ar rEresi - c
❑ New construction n Addition% lteralran/rePlticement
Please check all that apply (submit 2 sets of plans w/ttems checked below).
` ❑ Service or feeder 400 amps or more [1 Building over three stories.
❑ Demolition ❑ Other:
where the available fault current ❑ Marinas and boatyards.
.xw�e > vas>w .gym+:• r m •. - mx a.-x
-- - r. °: �' v i ® N ��- •'��'�` � exceeds 10,000 amps at 150 volts or ❑ Floatin buildin
g 65.
1- and 2-fami dwelli Commercial ndustrial less to groun a exceeds 14,000 ❑Commercial -use agricultural
❑ y g C
�-- b ❑Accessory building amps for all other installations. buildings.
❑ Multi family Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75
KVA or
t h emu.. . •. M . z ❑ Emergency system• larger separately derived system.
i, .. t 1 A a . p e s tom; F
r�ts .•xur�:3:u'`.tis:'SL....f?�tfin :t 3 _e� ° s�- «.,.'' •- -� t � - . ,,.mu1 �� • u,rr ❑ Addition of new motor toad of ❑ "A" "E" "1 -2" "1-3"
Job no.: 33'I Job site address: J LJ ( 5 D Sw 97 / /C I x or zno rest occupancy.
❑ Six or more residential units. ❑ Recreauonttl vehicle parks.
City /State/ZIP: / C 9 ��� 9 j� ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations 600 volts nominal.
Suite/bldg. /apt. no.: I Project name: 7 7 ❑ Service or feeder 600 amps or more.
Cross street/directions to job site: /7 f'k n � ED. 1 �a• 1
J �w _r ��; tJJl;l.1� �� .Id Descdptiaa �Qry. � � Fee. l Total 1
New residential single- or multi - family dwelling unit.
SW AVE Includes attaehed garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no. Limited energy, residential
,
r 75.00 2
=`�'� t �-r.. • i k9t `.�t�' �J�b ! ...."x ���.��ss,. . `..'tti .. _ s ,,,�r� , ' , " . F. (with above sq, f 1)
Limited energy, multi - family
Tt�R � �rrt f _j ji 7? Lf residential (with above sq. R) 75.00 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
R ar t z ts. �' lr s i • `�i H{ % -: 201 amps 00 400 amps 106.85 2
,r.. -..... - a5matmmmr• .i.... i....t...: ....�w.:�:4
Name: 401 arnps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City /State/Z1P: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) I Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: - A. Fee for branch circuits with
above service or feeder fec
_>s->- __ .`»a' �. W.,xw..rt w�..�.t8.:a�,.L."za•,.h r..'«1...�au�y,u �a- �.�r�- 6.65 2
Business name: each branch circuit
r' felt � �jTi`2 b 3..�, let€ t7,ECi72iG B. Fce for branch cimuits
without service or feeder fee,
Contact name: 5coil E c.Ksnj first branch circuit 46.85 2
Address: (, / a'° 5r T Each add'l branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City /State/ZIP: Each manufactured or modular
fl^�i =� VL''2 t.�(� 90.90 2 c { '(eC� J�
r dwelling, service and/or feeder
Phone: (..3o) Fax:: (Q) �'1� , o-1 - Reconnectonly 66.85 2
E -mail: Pump or irrigation cucle 53.40 2
r` J s l yy �i O 6i -*' Signor outline lighting 5340 2
j s `l �� e _1G a1, sk s .
•iL� .. ...... �.x u5e..- tse9ilt]?•stie.la s - '-'•e.:...�J err`•» •.
Biness name: ��++� t I �� q �� Signal circuit(s) or limited -
us l ss� ihJCCftSI Lr_tLE� �2t� energypanel, alteration, of
Address: lc '1- S r i extension. Describe: I Page 2 -u 2
City /State/ZIP: Y �t -Ov /t L 1 x1 a Ech additional inspection over allowable in any of the above
1 Per inspection 62.50
Phone: 3o) O2// I Fax: (? ) ) (G, , q- lnvestigation per hour (1 hr min) 1 62.50
CCB Lic.: COl - j Elce .� Lic.:�3 7_ 4/9/ Suprv. Lic.: 35�a3 Industrial plant per hour 73.75
Suprv. Electrician signature, requ ed: Subtotal: 75. O
-
r Plan review (25% of pennit fee):
Print name: ,// , Date: State surcharge (12% ofpermit fee): 9
Authorized signatu = i/ TOTAL PERMIT FEE: C�
This permit apptication expires if a permit is not obtained within 180
Print name: Z2 - - $ Date: 7.-4j' days after it has been accepted as complete.
• Numbcr of inspections allowed per permit
/:' auildiug \Permits\ELC- PermilApp.doc 05/23/06 440.4613T(It /05 /COMIWEB
1 _�
CITY OF TIGARD { +
BUILDING DIVISION PERMIT #: FLR2008- 00112
13125 SW Hall Blvd., Tigard, OR 97223 DATE'ISSUED: 5/9/2000
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639 -4175
•y
Y'•
INSPECTION WORKSHEET FOR DATE: 5/17J2008 TIME: 7:01AM PAGE: 19
SITE ADDRESS: 1'1650 SW 97TH AVE CLASS OF WORK:
SUBDIVISION: TIGARDVILLE HEIGHTS LOT #: 037 TYPE OF USE:
PROJECT NAME: 1WALITY MIDDLE SCHOOL
DESCRIPTION: Installing (1) low voltage intercom system.
OWNER: TIGARD-1 UALATIN SCHOOL DISTRICT, PHONE #: 503-431 -4000
CONTRACTOR: PRAIRIE ELECTRIC INC PHONE #: 360 - 816 - 0484
Inspection Request Scheduled For: Date: 5/12/2008 Pour Time:
Code # Inspection Description j Confirm # Contact # Message
199 Electrical final \\ 069729-01 ��� 360 - 0160484 N
Corrections /Comments /Instructions: '
No ibtrkm\ �p j citalki
I �
V PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: (y'. 006t-6" Date: 81/74<rt Phone #: (503) 718- 'l 1