Permit CITY OF T I G A R D ELECTRICAL PERMIT -
RESTRICTED ENERGY
Y
"alit DEVELOPMENT SERVICES PERMIT #: ELR2004 -00332
13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/22/2004
SITE ADDRESS: 10350 SW LINCOLN ST PARCEL: 1S135AB -00100
SUBDIVISION: TOWN OF METZGER ZONING: R -4.5
BLOCK: LOT: 005 JURISDICTION: TIG
Project Description: Sound system in gymnasium & commons.
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:
WASHINGTON CLACKAMAS CO BROWNELL SOUND + HI -Fl
SCHOOL DIST 23J 12115 SE 82ND AVE
6960 SW SANDBURG STREET PORTLAND, OR 97266
TIGARD, OR 97223
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 10/22/2004 $75.00 Elect Final
[TAX] 8% State Surchart 10/22/2004 $6.00
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and
all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not
started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires
you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010
through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699.
Issued by 2Ei Permittee Signature 5' p,
OWNER INSTALLATION ONLY V 4
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR.. ELEC'N _ _ _ _ DATE:
LICENSE NO:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
Electric l herm A loca tion
FOR Qf FIC:£ USE ONLY
City of$':aard EA DA. / �', / d Permit No.:LL a Z7o - y /
13125 SW Hall Blvd., Tigard, OR 97':_4_I Plan Review
Phone: 503.639.4171 Fax: 503.598j9;. x ■ ` ' ti a ' � l �` Date /13 . Other Permit;
Inspection Line: 503.639.4175 _���j. ' __ y Date Ready/By: ES See Page 2 for
Internet; www.ci,tigard.or - • ', - Notified /Method: Supplemental Information
_ ..
. .4ijt. avr i2-' :` :'•< ii :lt .. O 1� 4;" : .., > .y,• 0 '�• ' `!K` '' VA r'.i?r *V '
❑ New construction ® Addi- t eat . Please check all that apply:
El Demolition p Othc, El Service over 225 amps, comm'l ❑Hazardous location
x ,' � = 'r' >C�ITEGU �O I TJ OlV^ y 3, ; , ; :r •,- ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ti,
•: } '.Su..'k:�. ... .,v, ,. .v... .,r..ti.o.T,.. ? ?, .3 ✓. ^. --'� 3 '::tii : :µ`'' ,, r i: of I- and 2-family dwellings 4 or more n residential
❑ 1- and 2- family dwelling � ® Commercial/industrial ❑ Accessory building pSystem over 600 volts nominal units in one structure
❑Building over three stories OFeeders, 400 amps or more
❑ Multi- family ❑ Master builder 0 Other:
yY:; •,� . "
. ,.; ", r ❑Occupant load over 99 persons ❑Manufactured structures Or
.. ',.4 JOB S1�FT D th :
. -....t ..:..xs:•... „ A�.OIRMitx .,,.,.... C.4,'i'IOl�F ;;• a : " ❑ $gross /lighting plan RV park
Job no.: I Job site address: 10350 SW Lincoln St ❑Health -care facility ['Other:
Submit/ sets of plans with any of the above.
City/ Statc/Z1P: Tigard, OR 97223 The above are not applicable to temporary construction service,
Suite/bldg. /apt, no.: Project name: Metzger Elementry $ = >'{,d+i:. ; °`'- sz:' ;1 SCE7IEDLRiE:f
Description 1 qty., f Pm I Total ±:"
CroSS Street/directions to job site: Locust New residential single - or multi- family dwelling unit.
Inclodcs attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no„ Ea. add'l 500 sq. ft_ or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
Limited en non - residential 75.00 2
r'
.:;`,+:n . � . •c'. -'1 v •� � �` � . y . „ _ ...d -..:. .ir. -• CJ 1
: .' = �t:.a;�! ; :' I. R�`: ,� -4= >�,_ ::�"::,'f'. �.`',c,.. Each manufactured rm
0 modular
Sound system in gymnasium & commons, low voltage electronics. dwelling service and /or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
ir•'- r1• ' r r -, ...i 'i � 201 am s to 4
ti:s .I, .s ' . OE.ER I'_YO.WN�R`” ,. !: :. ,et L �.� i ka , •::. _ P 00 amps 106.85 2
'" �.
`: rrt"t'' 401 amps to 600 amps 160.60 2
Name: G , ) p s J ),1.0 (D) , -S C .L' 601 amps to 1,000 amps 240.60 2
Address: C d ` - V q ? J Over 1,000 amps or volts 454,65 2
j c� _ Reconnect only 66.85 2
City /State/ZIP: 1"-\ ‘Q , r�� Temporary services or feeders Installation, alteration, and/or
Phone: 0— a7j ' — c 0 3 Fax; ( ) relocation
_ 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 600 amps 133.75 2
Owner signature: Date:
f Branch circuits - new, alteration, or extension, per panel
.....7,.. - : '!.: ® ,.APPL7Cixts -. M' . � _ ;)`. [J p A g p }� . .. A. Fee for branch circuits with
service or feeder fcc, each
Business name: branch circuit 6.65 2
m
Contact name: 8, Fce for branch circuits
without service or feeder fee, 46.85 2
Address: each branch circuit —
Each add'l branch circuit 6.65 2
City /State /ZIP; Miscellaneous (service or feeder not Included)
Phone: ( ) Fax:: ( ) Pump or irrigation circle 53.40 2
E -mail:
Sign or outline lighting 53.40 2
Signal circuit(s) or limited -
' �. . ... .... Q10 . .. •. ,.... ; ;•1a•: ;.I,; >8.Ar.,..I> °j<;: energy panel, alteration, or ++
Business name: Brownell Sound, Inc extension. Describe: f Page 2 2
Address: 12I15 SE 82" Avenue Each additional inspection over allowable In any of the above_
Per inspection 62.50
City/ State/ZIP; Portland, OR 97266 Investigation per hour (1 hr rain) 62,50
Phone: (503) 652.2160 1- _ 0 a Fax: (503.) 652.2764 Industrial plant per hour 73.75
A rd ` ' cot':'gfartCROOX aERNAUXETS:o? .. *,a ,
..
CCB Lie.: 73876 Electrical Lie.: 26- 789CLE Suprv, Lie.: 2375LEB _ Subtotal � UP
Suprv. Electrician signature, required: Plan review (25% of permit fee) •
Print name: ,��� m `f'� , // Date 10/22/2004 State surcharge (8% of permit fee) 6 00
TOTAL PERMIT FEE W, d o
Authorized Signature: This permit application expires if a permit is not obtained within 180
Print name: days after it has been accepted as complete
Date: • Fee methodology set by TI i-County Building Industry Service Board
'• Number of inspections per permit allowed.
; u 1 d:ng‘Pcrmiulrit.GPermitnpp,dec 12/03 44 0.46I /pycoMlwff
TO 39 CNfOS 113NMOi•I2 b9LZZ59£05 9b :0T b00Z /ZZ /0T
/CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR -00332
13125 SW Hall Blvd., Tigard, OR 97223 �E IS - SUED
Phone: (503) 639 -4171 i
� 1012 2004
Inspection Requests (24 Hrs.): (503) 639 -4175 AJI.
INSPECTION WORKSHEET FOR DATE: PAGE:
5/11/2005 TIME: 7:12AM 75
SITE ADDRESS: CLASS OF WORK:
SUBDIVISION: 10350 SW LINCOLN ST LOT #: TYPE OF USE:
PROJECT NAME: TOWN OF METZGER 005
DESCRIPTION: METZGER ELEMENTARY
Sound system in gymnasium & commons.
OWNER: PHONE #:
CONTRACTOR: BROWNELL SOUND + HI -Fl PHONE #: 503- 652 -2160
Inspection Request Scheduled For: Date: 5/11 /2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 006637 -01 603-260.8293 Y
Corrections /Comments /Instructions:
f., L t/V/91/ a fiW 1/0
PASS ❑_PARTIAL- AP-P-ROVAL 0- CANCEL ❑_NO_ACCESS _
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 6 KLOy5. Date: Phone #: (503) 718-
—d-g-4(--