Permit ' ELECTRICAL PERMIT
CITY O F TIGARD -
RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT #: ELR2005 -00004
?=--' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/4/2005
SITE ADDRESS: 14650 SW 97TH AVE PARCEL: 2S111AC 02700
SUBDIVISION: TIGARDVILLE HEIGHTS ZONING: R -4.5
BLOCK: LOT: 037 JURISDICTION: TIG
Project Description: Installation of audio equipment.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: X INTERCOM & PAGING:
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:
WACO SCHOOL DIST 23J BROWNELL SOUND + HI -Fl
6960 SW SANDBURG ST 12115 SE 82ND AVE
TIGARD, OR 97223 PORTLAND, OR 97266
Phone: Phone: 503 - 652 - 2160
Reg #: LIC 73876
ELE 26- 789CLE
SUP 412LEB
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 1/4/2005 $75.00 Elect'I Final
[TAX] 8% State Surchart 1/4/2005 $6.00
Total $81.00
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.
Issued by ,�. �LLI Permittee Signature _ -� o)
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:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
': •
Application, Elect ' D F OR OFFICE USE Electrical Permit Q � �jj �/�
Q � ® Received ,/ I S) Permit No.; 6-4..i. !N 5 2Ud
City of 'Tigard �" n eceiv : `� a
13125 SW Hall Blvd ", Tigard, OR 972 Plan Review Ocher Permit:
Phone: 503.639,4171 Fax; 503.598.1960 0 4 200 ■ b "� ° oi ; DatB/B
�� °
" ..- I Date Ready /By: El See Page 2 for
Inspection Line: 503.639,4175 ' " Notified/Method; Supplemental information
Internet: www.ci,tigard.or,us , - Notified/Method;
;,„ , .tae^
m:
'••': • : ,-• ,..:.,.:... _ -- a . � , ', ` ^}h' :in _ ::ti;' .Mail ''i7 1'•ii'li 1, *Z.dV7.W`V;' :`t +tp t• ∎ :.V1.''.i'!''' di '
e:- i�;�t.
+ ,.�.,r^ i ::,
_, y� " n , �c•.`f:`i'r'1;r `;%li"�, •�i: •�'`,� "i'i"' `1'F �:- :�, "if .C:�,ti .;::rk....,. .;,
.. };S''L ti? f ]d,t; 74'.ix;;;+.'...yl . i Jl s . 4, �T. 2l G .L.1w:i.i:~
" r'. 'sF,..f.�:.':,"'„- �%��1 "•' .. ,E t t l i ........:... _ Please check all that apply:
❑ New construction ®Additf�llr tton/replaccment []Service over 225 amps, comm'l ❑Hazardous location
❑ Demolition ❑ Other: ❑Service over 320 amps - rating ❑Bulldog over 10,000 sq• ft,,
w p� ^wT" dwellin 4or more new residential
V t + '^ * ! of 1- and 2- family
:.� ,.. ,s i.;., A .- ? �a . OF /,CON, ..".. ON' ,r ,, .a, ;. ! >1';�`'•.4' 'e' ; 9 in one - "�� 6:%' -` =r �'W ��?.:,��.'".�`.�xe rir., Y . y ,' �, �.^, �' ,�G''�r,���t'� 'wa,��!....e.s.�b w'L�: .� .,. - e l.: :S, r�' � v . , structure
, , ...,s:.}•:^ ,, � � ❑System over 600 volts nominal units 1- and 2.-family dwelling ®Commercial /industrial CI Accessory building DBuilding over three stories ❑Feeders, 400 amps or more
0 :
O ther t load over 99 persons DManufactured structures or
Multi- family 0 Master builder ❑ � } :'may ['Occupant p RV park
;R. '' •''' •:'N `° I ' r L ID OCi1TIO "" e ta " t i"'a' DEgress /lighting p
�pyri;•, °tFt , J.OD STI m....,. �. i�3 + .. !r ❑Ocher:
"�Iy M,.p • '•,;!:,. t... -�• y r. �. �w �Healtll'CFIrC facility •
Sob no.: Job site address: 14650 SW 97 Avenue
Submit ? sets of plans with any of the above. ; -.
City /StatcIZIP: Tigard, Oregon 97224
The above are not app to temporary construction service.'
iw ;: . , i . :; Ik+ti "`i F lfi"E �"-- SCA:.... �`,_''. ' : ,t;,• /• r ` d � #• . .
t � t.. � ,� TD[fJ'..'F!` r ,i " ti'r�'.;. ^ ' rer_':t::rAi: . iu.)
Project name: Twality Middle School ' i "r " "' I
Suitc/bldg. /apt. no.; y Description I Qty. I Fee. I Tani 1 "
New residential single- or multi- family dwelling unit.
Cross street/directions to job site: - Includes attached garage.
1,000 sq, ft. or less 145.15 4
Subdivision; !Lot no.:
Ea. add'! 500 sq. ft, or portion 33.40 1
Limited energy, residential 75,00 2
eel no.: Limited energy, nonresidential 75.00 2
Tax map /par _ —_ , ,w� , . ,, ,,l r ,, ,:
...:54 , "'"��� """" "4 �. +i � Ilw, �' manufactured or modular
g.. 7.4 ...,'. - :,: N ,-...... ,.,- ,� TIUI UT Q FI �: �. �, r,., ?y4-�� Each ma 90 r 2
':`: : ; *k M?a. , :� ° : D.E9G� _, C..,;;.:',•` ?. service and /or feeder 90
�• •...: = r.... " ,6 s:. •�::,�:._ ` ., ..., dwelling, s ,
Installation of Electronic Audio Equipment Services or f eeders installation, alteration, and/ar relocation
200 amps or less 50.30 2
201 amps to 400 amps 106.85 2
2
r.W I a :#:; - Q .'s �FA �v ?fit s 160.60
l'..''@.-:+,1:i10. , P,ROF>✓R''1? Iii ., ,l}.;; „� ::".m,° �., " ifat l.;. w. 401 amps to 600 amp •
601 amps to 1,000 amps 240.60 _ 2
Name: — Over 1,000 amps or volts 454.65 2 _
Address: Reconnect only 66.85 2
City /State /ZIP: Temporary services or feeders installation, alteration, and /or
relocation 1
Phone: ( ) Fax: ( ) 200 amps or less 66.85
Owner installation: This installation is being made on property that 1 own which is not 2 01 amps to 400 amps 100,30 22
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701- 401 amps to 600 amps 133.75
Date: Branch circuits - new, alteration, or extension, per panel
Owner signature: • L 7�, ' • ,tr-.. �: A. Pee for branch circuits with
; :Wi ; : , :, 1 � i ., -.: :!' ' .i * .1 �;p` ...d ,V., :a;l ,),, xtl -04-I .,',0- :'c't4it'.::.`: .., feeder fee each 2
i {a[{, P � ICrti lY T;;r ='a ,. x ' , , i, service or 6,65
si ^:r: n ar . branch circuit
Business name: - B. Fee for branch circuits
Contact name: - without service or feeder fee, 46.85 2
each branch circuit
Address: — Each add'! branch circuit 6,65 2
_Miscellaneous (service or feeder not included)
City /State /Z1P: Pump or irrigation circle 53.40 2
Phone: ( ) l Fax: ; ( -) Sign or outline lighting .- 53.40 2
Signal circuits) or limited -
E-mail; ,. alteration, or
„� r* ',.1 y ;,, eMa,�j�p t e nergy panel, a lters
.,,,... •, ,g ,..f,.! ,M 0.;r. :I' `S,•it'O�∎n..:,R...L R' ` :. ' "i:5 "',4 ''i''''' , :•... .:, '''''' '':`r•,:4' .. ' exte e2 2
� .i : - .:t: , : !' .t. ., . <. ..�. +. _ ti::...h.- nsion. Describe; Page
Business name: Brownell Sound, Inc
Each additional inspection over allowable in any of the above
Address; 12115 SE 82nd Avenue Per inspection 62.50
City /State /ZIP: Portland, OR 97266 Investigation per hour (1 hr min) - 62.50
Industrial plant per how 73.75 L -
Phone: 652-2160 Fax: (503) 652 -2764 ' ''^• : i; �� 0 ItM, ,[Ty TES'' x _i -i' : �`•` 'f f
(503) 652 -21 t, /iivr�:itvtralJ C> >~.r..'..
CCS Lic.: 73876 Electrical Lie.: 26-789CLE Suprv. Lie.: 2375LEB
Subtotal 76 00
Plan review (25% of permit fee)
'
Suprv. Electrician signature, requite.. +, State surcharge (8% of permit fee)
` , 1 1 � 0` �
TO PERMIT FEE
name; J . u_ .L— Date:
This permit application aspires if a permit is not obtained within 180,
Authorized signature: _ days after it has been accepted as complete
Print name; I
Date: • S ee m ethodology set by Tri County Building Industry Service Board
- °* Number of inspections per permit allowed.
440 4615TO oi02/C O Mla5B
iABuildin�s�Permil :'\F.1.C•PcntyltApp.dac 12!03 '
Z0 39Vd QNfOS ii3Nmoela b9LZZ59E09 ZE :9T 9OOZ /bO /TO
1( CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2005 -00004
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/4/2005
Phone: (503) 639 -4171 Ins pection Requests (24 Hrs.): (503) 639 -4175 Ja
__..
INSPECTION WORKSHEET FOR DATE: 5 TIME: 7 :10AM PAGE: 91
SITE ADDRESS: 14650 SW 97TH AVE CLASS OF WORK:
SUBDIVISION: TIGARDVILLE HEIGHTS LOT #: 037 TYPE OF USE:
PROJECT NAME: TWALITY MIDDLE SCHOOL
DESCRIPTION: Installation of audio equipment.
OWNER: WACO SCHOOL DIST 23J, PHONE #:
CONTRACTOR: BROWNELL SOUND + HI -Fl PHONE #: 503- 652-2160
Inspection Request Scheduled For: Date: 6/9/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 006315-01 503-260-8293 Y
Corrections /Comments / Instructions:
6 L 0,4 /1,/0/) : / kg x150 .
7
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL _ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1 /'j'L l Date: Phone #: (503) 718-