Permit CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
^ll ®Ev W H BM E Nq rd S 03) 639 -4171 DATE ISSUED: ED: 9/32 004 00281
13125 SITE ADDRESS: 09000 SW DURHAM RD PARCEL: 2S114AA 00100
SUBDIVISION: ZONING: R -4.5
BLOCK: LOT: JURISDICTION: TIG
Proiect Description: (4) portables, Reconnect only of data tele., Fire alarm. Intercom & paging.
Job # 9026
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: X
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA /TELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: X OUTDOOR LANDSC LITE:
OTHER: • HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 3
Owner: Contractor:
SCHOOL DISTRICT 23J TEAM ELECTRIC CO
13137 SW PACIFIC HWY 9400 SE CLACKAMAS RD
TIGARD, OR 97223 CLACKAMAS, OR 97015
Phone: Phone: 557 - 7180
Reg #: LIC 47336
SUP 4416S
ELE 3 -225C
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 9/3/2004 $225.00 Elect'l Final
[TAX] 8% State Surchart 9/3/2004 $18.00
Total $243.00
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 Permittee Signature
OWNER INSTALLATION ONLY ;( 0
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
SEP. 2. 20134 4 :45PM TEAM ELECTRIC NO.552 P.2
' Electrical Permit Application • I'OR OFFICE USE ONLY • - • ,
City of Tigard : n Receives . — -
D,vds ' try IPM Permit No ;,`,�1 ^. $4
13125 SW Hall Blvd,, Tigard, OR 97223 Plan Review J
Phone, 503.639,417l Fax; 503,598,1960 ."ti� :8 i :x\ D ate/By. nu
Other Fern 6 L. �y - ,/ 1 f
Lyspecuon Line: 503 639.4175 ._; . 1 11 DateReady/Sy; ' )ant. $i See Page 2 ror
m
Lzteet: www ci.rigard,or.us Noti5ed/Mettwd: 1 'Cj Supplemental Intermiuon
-,�- rc•�n,��. .F`i;35 'r. ` k'_1 f , • }�• ': sl .C a ���a '� �� r{'� � r1 4 ,y r �'��: rF''JT( i. , !U j^ } " �e �>;-tS'�yp�e• • 'r > "- -
:r L r,. X � � S1. d i,lr4 1 $itrl ,� 5•T , r r;� ' .,w . _ T�� �l M " ��Il x;•�'PT�'d
:c r„•a+..•. L IIL. ' rieet..::x;,r.2::c 1 0b. iii 11; .;1 a. , . ,.., 'T x '-, t. . k ., ;
❑ New construction • Addition/alteration/replacement Please check all that apply;
[Service over 225 amps, comm'l ❑Hazardous Iocauon
❑ Demolition ❑ Other
� 1 a t+]e� t1T , w ar a ❑service over 320 amps - rarmg CBu: kin g over 10,000 sq ft ,
�� i 1�!1��{ `+� ' 4 t lj• e ' N:A rry i }: r o] Mils 1 116G J �i�Ja9;r 5 c ., ;�,�p , of 1- and 2- farruly dwellings 4 or more new residential
fc,.�. r.:nF3r�r,u�t�..,:. Ii._�3��t..
I E] I - and 2- family dwelling r4 Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
I: Muln family El Master builder Other:
Building over three stories ❑Focdera, 400 amps Or more
fr v rr , e 1 y f °� 1 r •' ❑Occupant load over 99 persons ❑Manufactured structures or
F. r ,,..7,1 �df-IM n 9 { i;iit�aR� l;t iltt(e, � =� j' ae' Ii -i'O' E� x4 01 4 f Pik r j t 1 ;; I ❑ ligh
Egress/ring plan RY park
..t .. s I.. ...t. ,. '. .. L-_. . 1 r.._... _., r.._,,_1�..1„ L
Job no . ?() % (r7 Job site address: ..57 � �/ 2 ,, e ❑me,alth -cart facility ❑Other
Submit 2 sets of plans with any of the above.
C■ty /State /ZIP; / i', V t 9 7Z Z e The above are not applicable to temporary construction service,
suite/bld /apt. noY Project name: 11 ': _ ;1', G1 l...A ,.` "4 _ -, ? f+ s,. i "
Description Qtr. Ncc. renal •"
Cross street/directions co job site: New residential single- or multi- family dwelling unit.
Includes attached garage.
1,000 Sq. ft. or leas 145,15 4
Subdivision: Lot no.: Ea. add'l 500 sq. ft. or porn on 33 40 1
- Limited energy, residential 75.00 2
Tax map/parcel no.:
1j +• =r �: - tF:.••J AC a a t rtx }y z t , i nl -
Limited energy, non - residential 75.00
c?C'¢�'• 1 ui�` t; r'l >! c T fi c '`ixt a rien 7f �� l r ,,�i � " r,? �' r ' > I` Each manufactured or modular
v_ia��r_ `?.? s^�, �`F�"t. r.� ...a,.i a.:.i ..C.�:_�_ H _t.. 1�'1�..... �F,
77941-a- J /� { C ` t _ _ t — dwel]ins, service and/or feeder 90.90 2
1--� • J`L eki / % l.� - Services or feeders installation, alteration, and/or relocation
?tie •
200 amps or less 80.30 2
.s, ,t V-ritil ty�'�� it'1 k r . I t4xU{ a 1 � t:}e
fR/ t- } ,'r15 X711 201 amps to 400 amps 106 35 2
- ..r.
- f. r Ca a7? rtw,•'? �? `' . �i 1.v. ? Y
' ".
I - -`1t r i<<. '1'ii's"' f a lir -
401 amps w 600 amps 160 60 2
l ama 501 amps to 1,000 amps 240.60 2
Address; Over 1,000 amps or volts 454 65 2
Reconnect only 66 85 2
City /StateJzlp' Temporary services or feeders installation, alteration, and/or
Phone: ( ) Fax: ( relocation -
200 amps or l ess 66 .85 1
Owner installation; This installation is being made on property that I Own Which iS not 201 amps to 400 amps _ 100,50 2
attended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701, 401 amps to 600 amps 133.75 2
Owner signelure: rr Date_ - Branch circuits •- new, alteration, or extension, per panel
,�tT. �' N.:.`r ".7 1 V ' f I t f 1' i Y 1- { 1'l P ',',,i,.4;
i=n 2l1 ,� t _ _
/, (of z c l: : - i ;t r e?, .. .. t o .'7.-.1:,k r }l , a . i s : y l L �i it :%, ,.. - I 1; A. Fee for brunch rfee, each 6,65 2
rs with
r' , service or feeder fee,
Business name;�� ,� -�-� (tL C ' • - 1 ,.,G, btsn circuit
� ^ Br Fee for branch circuits
Contact name, 9 1 7 4 J i� 1,��' re-) without service or feeder fee,
46.85 2
/ 00 S 6 . _ -C // y each branch circuit
address' �f- Lp�1'{^ �c t!/' L� Each add'I branch circuit 6 65 2
Cl tviState/ZIP: Ci1—r'j .a t '7 o/5 Miscellaneous (service or feeder not inclu
Phone: (51 - ) Sc 7 - 7 i d5 O Fax :: c5o3) S5 7 -gZ 0 f Putttp or irrigation circle 53.40 2
Sift or outline lighting e 53.40
6-mail: Signal circuit(s or limited-
.. : , ae , J c I ;2 ; T ll'3,3 • A I L' . a e alteration or
▪ `; 4 • , - . , � : . : "•• i / , , . L I r
:r '�i � �..r,. ni - J ' : •' , . 1 4, f . i r ! fi ?� ' ,. 1 1 - ?? , L r Yd,2:,� A's" .li,1 4 ' energy P rl ( I On e
extension Describe; 3 Page 2 22.5 2
Business name: S / C Q A v‹ .
—
4daress' L Each additional Inspection over allowable In any of the above
Per inspection 62.50 -
City /State/ZIP Investigati per hour (i lv min) ' 62-50
L Phone. ( ) Fax: ( ) Industrial plant per hour F 73.75
l : i +a 1 l LD51j',LI::�'�, ' �J ir4- ?-65 4 4 i � ; •rr
CCS Lic. +7 3'3 4 Electrical Lic.:7 25 G Suprv. Lte.;ijr f�� ' s _
Subtotal ��
I S uprv, Electrician signature, required: f ‘ Plan review (25% of permit fee)
nn 9/, State surcharge (8% of permit fee) t 8"
?rim name, I C1 �S 1 bate_ ei .Z zf,
TOTAL PERMIT FEE 24'3000
Authorized Stgztantre: , , Thla permit application expires If a permit le not obtained within 190
days after It has been accepted as complete
Print name: Date: • Fee methodology set by ni -County Building industry SaMOe Board
Number of inspections per permit allowed.
3u: kilo of e- reareLC.Permuwppdec t3JOS 4 5.4 51 Sr(LO/edico ntma
CITY OF TIGARD 24 -Hour
BUILDING Inspecti 2 LriE (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested 7 AM PM BUP
Location C f .0U D (.! A_ ,A /Tr Suite MEC
Contact Person I't- Ph ( ) 9 7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Ftg Drain Access: ELR d d0
Crawl Drain � � I Z �/
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath /Shear
Int Sheath/Shear
Framing
Insulation t .�, - / V 5 4 - � Q � /�
Drywall Nailing !i`-' f'`� / i t 6
Firewall
A �'
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other: I !
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fi - Alarm
Reinspection fee of $ - required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
Please call for reinspection RE: f(� El Unable ( t � o inspect — no access
Fire Supply Line — l `°vI L 64
ADA -- 0 Approach /Sidewalk Date Inspector C Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL