Permit - CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2004 -00570
DEVELOPMENT SERVICES DATE ISSUED: 9/8/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S114AA -00100
SITE ADDRESS: 09000 SW DURHAM RD
ZONING: R - 4.5
SUBDIVISION:
BLOCK: LOT : JURISDICTION: TIG
Project Description: Replace low voltage cable w/ 110v feed at speed sign.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL /PANEL:
MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
SCHOOL DISTRICT 23J OREGON ELECTRIC CONST /GROUP
13137 SW PACIFIC HWY 1010 SE 11TH AVE
TIGARD, OR 97223 PORTLAND, OR 97214
Phone: Phone: 503 - 234 - 9900
Reg #: L1C 203
SUP 4460S
FEES ELE 26 -95C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 9/8/2004 $46.85
[TAX] 8% State Surcharge 9/8/2004 $3.75 Rough -in
Elect'I Final
Total $50.60
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: Permit Signature: S Pr1�Q
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 7:00pm for an inspection the next business day
SEP - 07 - 04 12:25PM FROM - Oregon Electric Estimating 5032313587 T -329 P 001/002 F -322
I;ecIlr1Cdi ui
reru. a ltim v • •
�., nitc
Of Tigard
7/ J / II /� Received
Cl �/ l n
tl� ll r� D,,u!Ry: � 4/ 6 ?et� No eL e.J aa��a / 0
13125 SW Hall Blvd., Tigard, OR 97223 C Plan Rcvicw
Phone: 503.639.4171 Fax: 503.59S.1960 - /r * i lr' I O ther Permi
SEP �d rii Datc/BY: _
inspection Line: 503.639.4175 Datc Reay/Byt SC r p 0 / tUU „` d /
Internet: www.ci.tigard,or.us P 0 Notified/Method:. / (f El see Page 2 tar
supplemental IniOrma[iOn
• T /M:rOrr∎ PLAN REVIEW
III New construction ® Addihpn/alter eat Please check all that apply:
wt./ILL/114V I.JI l.Dl
❑Service over 225 amps, comet'l ❑Hazardous location
El Demolition ID Other:
['Service over 320 amps — rating ❑ Buildng over 10,000 sq, ft.,
; CATEGORY OF CONSTRUCTION • ' ' . of 1 - and 2- family dwellings 4 or more new residential
❑ 1 - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑Building over three stones ❑Feeders, 400 amps or more
❑ Multi- family ❑ Mastcr builder El Other:
E1Occupant load over 99 persons ❑Manufacwred structures or
JOB; SITE INFORMATION AND LOCATION ❑tigress /iighting RV park
Job no.: 80473 -101 Job site address: 9000 SW Durham Rd. 01ealth - caie facility C]Otl,er:
Submit 2 sets of plans with any of the above.
City /State /ZIP: Tigard, OR 97224 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: Project name: Tigard High School FEE' SCHEDULE
Description Qty. Fee. TOtad I ,*
Cross street/directions to job site: New residential single- or multi- family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.; Ea. add'I 500 sq. ft or portion 33.40 1
— Limited energy, residential 75.00 2
Tax map /parcel no.: _ . Limited energy, non 75.00 2
A18SCRJF 140N 07N WORK . . Each manufactu or modu
Replace low - voltage cable with 110v feed at speed sign. dwelling, service and/or feeder 90.90 2
. - - . Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
� , • 201 amps to 400 amps 106 85 _ 2
B rROPERTY" OWNER ❑. TENANT 401 amps to 600 amps 1 60.60 2
Name: 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
c � Reconnect only 66.85 2
City /State/ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) 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 l0 600 amps 133.75 _ 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
' ❑ A'PLICANT..• ' ' I. ::, ' j. . ;'❑.: CONTACT PERSON, : •' , • A. Fcc for branch circuits wrlh
service or feeder fee, each 6.65 2
Business name: branch circuit
— B. Pee for branch circuits
Contact name: without service or feeder fee, 7 46.85 y6- . 2
Address: each branch circuit _
Each add'l branch circuit 6.05 2
City /State /ZIP: Miscellaneous (service or feeder not included) _
Pump or irrigation circle 53.40 2
Phone: ( ) Fax: ( ) Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited-
CONTRACTOR ' energy panel, alteration, or
extension. Describe; Page 2 2
Business name: Oregon Electric Group
Address: 1010 SE 11th Ave
Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State/ZIP: Portland, OR 97214 Investigation per hour (1 hi' min) 62.50
Phone: (503) 535 -2652 Fax: (503) 2311 -3587 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES'
CCB Lie.: 203 Electrical Lie.: 2 95 . t Su 44605 Subtotal mfg g,, ---e'
Electrician signature, required: / / e Plan review (25% of permit fcc)
L. State surcharge (8% of permit fee } S
Print name: �f� � �.� , D r ��� /
,/ � � TOTAL PERMIT FEE ) U
Authorized signatu 9:7 e Jn This permit application expires if a permit is not obtained with � l BO
t�G ,/ G /`/ / days after it has been accepted as complctr
me:
Print na JT /;��� / � / • Fee methodology set by Tri- County Building Industry Service Board
f !! •' Number of inspections per pert•N[ al1Owed.
i eu ,IdanglPem,issi.LC- PnmitApp.doc 12/03 440- 4615T(10 /02 /COM/WEB
CITY OF TIGARD 24 -Hour
BUILDING Inspection fine: X503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested Cr-- I b AM PM BUP
Location � � -I`P� Suite MEC
Contact Person A1/ Ph ( ) _ gq7 1 65. 2 — PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC1 °f` Co 570
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT -
Post & Beam --`u" CovL 50PCM 9(6
/AM.
Shear Anchors r
Ext Sheath/Shear _
�L j�
Int Sheath /Shear i
Framing
Insulation T � Y 1 GE W F //1/
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
(i.
Roof
Other:
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
ICAL
ou i -In
UG /Slab
Low Voltage
F' - Alarm
AS PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
• S Please call for reinspection RE: 111 Unable to inspect — no access
Fire Supply Line 16tAitAIN-a5624-Ext
ADA I f ( 0 0 Inspector J
Approach /Sidewalk Date
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL