Permit C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2004 -00088
DEVELOPMENT SERVICES DATE ISSUED: 2/25/04
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2 S 114A0 -00100
SITE ADDRESS: 09000 SW DURHAM RD
ZONING: R - 4.5
SUBDIVISION:
BLOCK: LOT : JURISDICTION: TIG
Project Description: Connect (2) modular classrooms from main building until new service is established. Installation of
limited energy for fire alarm in each building.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: 3 PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL /PANEL: 2
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: 3 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 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 PORTLAND ELECTRICAL CONST INC
13137 SW PACIFIC HWY PO BOX 586
TIGARD, OR 97223 OREGON CITY, OR 97045
Phone: Phone: 655 - 2281
Reg #: L1C 51764
SUP 3461S
FEES ELE 3 -246C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 2/25/04 $370.50
[TAX] 8% State Surcharge 2/25/04 $29.64 Low Voltage Inspection
Elect'I Service
Total $400.14 Rough -in
Elect'I Final
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 ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set
forth,, 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. Ar
( dI sued By: l /� �'._ `
Permit Signature: ` f 1AL
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: c - e( gp / Lem DATE:
LICENSE NO: , * : / 61
Call 639 -4175 by 7:00pm for an inspection the next business day
, L .
Electrical Permit Application .::':4:0 FOR OFFICE USE
", City of Tigard Received
Date/By rffMall Permit No 444,S._ g
b "13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 i : 0.. Date/By: Other Permit i
Inspection Line: 503.639.4175 --i3O 1 ,- I Date Ready/By. Juns 11 Q 1 6 *CVO /y 7-
El See Page 2 for
Internet: www ci.tigard or us I Notified/Method: Supplemental Information
tffi rorW'O t',..:MS,IeWffAV'ikOEiAir -gliilliii•MThi:
1 .,/,..' ,,...', '* "- ---, 4:, - -,' ,, ,w..46,, A,„,, • ,,,, , „ 41,h, . r.,-,%„,,, ,,,,,,.,- .. , - & - ,,,
El New construction Addition/alteration/replacement Please check all that apply:
['Service over 225 amps, comm'l DHazardous location
0 Demolition Other: ,,,,„„ EjService over 320 amps - rating DBuildng over 10,000 sq ft.,
V's ''3 '-'kit6divizif,f61` 4 *-- of 1- and 2-family dwellings 4 or more new residential
::Cii :.:,-,7,,,' ..,,,,,,..,. -' -0, ,-,--
111 1 and 2 dwelling A Comidustrial Accessory building OSystem over 600 volts nominal units in one structure
['Building over three stories ['Feeders, 400 amps or more
El Multi . 0 Master builder 0 Other: ['Occupant load over 99 persons ['Manufactured structures or
' Vii44'-%:',<21:6Vg.,0447(50kI:,14):KA#117,-.41:031'7,..rIWF: 0 E,soli plan RV park
DHealth-care facility ['Other:
Job no.: Job site address: ,410 sh bi ira
Subnut 2 sets of plans with any of the above.
City/State/ZIP: -7-; 4 , r .A 0 a le . „. 972 2. / The above are not applicable to temporary construction service.
A P10,3411:
Suite/bldg./apt. no.: (7. Project name: 77/4 th Sa 6440;E :,3
c
Description Qty. I Fee. I Total I `*
Cross street/directions to job site: a ,1,, 0 Az ;tree 5 New residential single- or multi-family dwelling unit.
Includes attached garage.
, 1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. addi 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map/parcel no.: _,,,„ ,, , Limited energy, non-residential 75.00 2
411001%;''A:A;A0*,004,01*!-Og,40 41f::1,4P1.110.6tAISL,1 Each manufactured or modular
dwelling, service and/or feeder - 90.90 2
,,O)//2e Z iNt9atedefr bWili:) " 'Prom Services or feeders installation, alteration, and/or relocation
154 c 200 amps or less 80.30 2
1 b*. it nex) ..serfArte /3 e-/-4 , i .:# ,
i ir*N - i 473:04 , , „, 114: Titi i .-, , , , m x „op 201 amps to 400 amps 106.85 2 ,
1 ' " '"'''''' '` 401 amps to 600 amps 160.60 2
Name: 7 ea 5i.hool P/s71r;c.,/- 601 amps to 1,000 amps 240.60 2 ...
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
Phone: ( ) Fax: ( )
200 amps or less V
3 OSS I
Owner installation: This installation is being made 66.85 ZO 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 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
ASWEVW,WeitASitt-NZ,Isiti4-;9 ":4 A. Fee for branch circuits with
service or feeder fee, each
Business name: branch circuit 6.65 g y'S 2
B. Fee for branch circuits
Contact name: without service or feeder fee,
-
each branch circuit 46.85 2
Address: Each addi branch circuit - 6.65 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 Signal circuit(s) or limited-
ecisifitxtfo-,:.Nioi,,,i,Nf;4rti,;r :1V energy alteration, or
extension. Descnb , Page 2 2
-:"
Business name: Portland Electrical Construction, Inc. ‘7re. A tier y 1. ratgi, .P. 2. /5.0. ..
Each additiona inspeC fiver allowable in any of the above ,
Address: 1019 7 Street Per inspection 62.50
City/State/ZIP: Oregon City, OR 97045 Investigation per hour (1 hr min) 62.50
Industrial plant per hour 73.75
Phone: (503) 655-2281 Fax: (503) 655-5033
'Aii;i110:6:Z§44ECtRICikia„POMIri W„5:,,t'W-42,j,..:,t:::?P,,A
CCB Lie.: 51764 Electrical Lie.: 3-246c S v. Lic.: 3461S Subtotal 370, 52,
Suprv. Electrician signature, required: , . Plan review (25% of permit fee) --r
State surcharge (8% of permit fee) 2,q. 6 it
Print name: , ,. A , ae c p e). , e , Date: .1',2;.a2:,v 0 ti
TOTAL PERMIT FEE WOO ,
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
.. .,... (,)
Print name: e t e a 6 tm ) je; ) 04 Oh ki C__ Dat 2 • 2 ,
0 . Fee methodology set by Tri-County Building Industry Service Board ,
** Number of inspections per permit allowed.
i \Building\l'ermits\ELC-PermitApp doc 12/03 440-4615T(10/02/COM/WEB
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
/ p BUP
Received4 7 y ' 3 � Date Re ested 3 — / 1 0
�*, AM PM BUP
Location 7 ,0() (4 GG?i!/f Suite MEC
Contact Person � Ph ( )f 7l ' ��7.� — b 2 Z i
Contractor Ph ( ) SWR
BUILDING Tenant/Owner av f4--S 4 ? 00i) g7
Footing
ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: � � Yn ( 'd �GZ44 SIT
Post & Beam Gt/L.
Shear Anchors 0- (-- J ,
Ext Sheath /Shear G�/�
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Fire wall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling t
Roof V
Other:
Final
l
PASS PART FAIL
PLUMBING ` r
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
51ECTRICAL
ervice
Roug -In
UG /Slab
Low Voltage
Fir- _ arm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
S PART FAIL
SITE V V ° - ❑ Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line
ADA _ - 6
Approach/Sidewalk Date Inspe r • Ext
Other:
Final DO NOT REMOVE this inspection recor from the j site.
PASS PART FAIL