Permit CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
44 40 DEVELOPMENT SERVICES PERMIT #: ELR2003 -00174
13125 SW Hall Blvd., Tigard. OR 97223 (503) 639 -4171 DATE ISSUED: 6/23/03
SITE ADDRESS: 08048 SW SHAFFER LN NEW DURHAM PARCEL: 2S113B0 -00300
SUBDIVISION: BORQtlA/ ELEMENTARY SCHOOL ZONING: R -12
BLOCK: LOT: JURISDICTION: TIG
Protect Description: JOB 75332 -101
Retrofit lighting
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: 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: X
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 2
Owner: Contractor:
SCHOOL DISTRICT NO 23J OREGON ELECTRIC CONST /GROUP
13137 SW PACIFIC HWY 1010 SE 11TH AVE
TIGARD, OR 97123 PORTLAND, OR 97214
Phone: Phone: 503 234 - 1001
Reg #: L1133-234M00
SUP 4460S
ELE 26 -95C
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 6/23/03 $150.00 Elect'I Final
[TAX] 8% State Tax 6/23/03 $12.00
Total $162.00
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 throuc
Issued by Permittee Signature J /� _
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
. 9-03 10:44 FROM- T -201 P.003/004 F -688
I (Electrical Permit Application
. OFFICE USE ONLY
City of Tigard Date received: Permit no.: E../142403 -Pa /741
,, 13125 SW Hall Blvd ProjecVappl. no.: Expire date:
,? Phone: (503)639-4171, FAX; (503) 598 -1960 Date issued: By: Receipt no.:
Internet address: www.ci.tlgard.or.ue Case file no.: Payment type:
24 -Hour Ins • ection R- • uest 503-639-4175
• 182 family dwelling or accessory o CommerdaVindustriai ❑ Multi- family ❑ Tenant improvement
❑ New construction O addition/alterationlreplacement ❑ Omer. . ❑ Partial
JOB SITE INFORMATION
Job Address: 8048 SWShaffer LA Bid • . No.: Suite no.: U Tax ma ./tax lot/account no.:
Lot Block: Subdivision
Project Name: Durham Elementary School Description and location of work on premises: Lighting Retrofit
Estimated Date of corn • letion/ns • action:
Will • u calffor Ins. - ction within 24.hours? Yes • No 0 Project Contact Shawn Hetnl • - (503) 535.2673 Phone
CONTRACTOR APPLICATION 1 5E SCHEDULE
no.
Job No.: 75332 - 101 Desaip con Qty Foo (ea.) Total Ipso
ow resraor•naGamgre or
multi family per dwelling unit.
Business name: Oregon Electric Group Includes coached garage.
- Service Included:
Address: 1010 SE 11th Ave. 1000:4 f1. or less $ 145.00 $ - 4
Ci : Portland State: OR Z.: 97214 Ea Addl 500 SF Or PONon S 33.40 $ -
Phone: 1503) 234.9900 Fax: (503) 234 -1001 E -mail: united Energy. 1 8 2 Family $ 75.00 $ - 2
CCB no.: 203 Elec. b rs. lic. no.: 2 &95C uneed energy. muni -Fancy S 75.00 $ - 2
Cl /m - :.• .'v ' 0.' Each manufactured home or
�� � modular dwelling. Service
c ., ,. o ai. Ibiad,A • 6119/2003 and/or feeder. $ 90.90 $ - 2
Service or Feeders •
Su • . Elect. Name _ ��� License no: 4460$ Installation, Alteration Of
Relocation:
PROPERTY OWNER 200 •a or less S oo.ao $ - 2
Name (print): 201am. , - 400arnps $ 106.55 $ a
Mailing Address: 4olames 600amp$ $ 160.60 $ - 2
,City State: IZp: _ 64/lamps 1000Onips $ 240.80 , $ - 2
Phone: Fax: 1E-mail Over 1000A or Volts $ 454.05 $ - 2
Owner Installation: The installation is being made on property I own which is T ins or $ 66.85 $ - +
not intended for sale, lease, rent, or exchange aCCOrdtng to ORS 447, 455, Feeders - Installation,
479, 570. 701. Alteration or Relocation:
Owner's s' nature: Date: 200 am or loss $ 68,85 $ - 2
c 201ampa.400amps $ 100.30 $ - 2
Name: Over 401amps- 600amp$ $ 133.75 $ - 2
ranc rouge - ' ew,
Address: Alteration or extension Per
Panel: A. Fee for branch
City: State: Zip: dreula with purchase of service
or treader foe, each branch
Phone: Fax: E-mail: circuit 5 5.85 $ - 2
B. Foc for branch circuits W /Out
Purchase or service or Feeder.
PLAN REVIEW 1$1 Branch Ckt $ 16.85 $ - 2
❑ Service over 225 amps -comet ❑ Health -care faculty Each additional branch circuit 5 8.65 $ -
❑ Service over 920 amps -rating of 0 Hazardous location Miscellaneous • (service or
feeder not Included)
1&2 family dwelings ❑ Building over 10,000 square feet four or Each pump orimnzsen circle S 53.40 $ - z
❑ System over 600 volts nominal more residential units in one structure Each Sign or Outline lighting $ 5340 $ - 2
❑ Building over three stories 0 Feeders, 400 amps or more Signal Cirwit(s)orumlme Energy
panat Alteration Or Extension'
El Occupant load over 99 persons O Manufactured structures or RV park 2 $ 75.00 $ 150.00 2
O Egress/lighting plan 0 Other: 'Cesalptton: .
Each Additional Inspection over
the Allowable In any of the
Above. Per inspection
S 62.50 $ -
Submit 2 sots of plans with any of the above. Investigation foe:
The above are not applicable to temporar C onstruction service. clef_
Permit Fee $150.00
Notice: This permitapplicaBOn Plan review 25% $0.00
expires v ° permit r = ^ °r State Surcharge 8% $12.00 7
obtained wirrin 180 days after it $1 f2.00
has been accepted as complete. Total
CITY OF TIGARD 24 -Hour
BUILDING ! Inspection Line: (503) 639 -4175
INSPECTION / DIVISION Business Line: (503) 639 -4171 MST
/ BUP
( Z-100 0
Received 21 ' aD tea Requested / 2J / 7 I o 33AM PM BUP
Location 0 5? 0 2 S -fit c-- -Suite MEC
�� v -z 3
Contact Person �h ( ,�� � � � C � `7 ELM
Contractor V /E-P /� Ph ( ) /j SWR
BUILDING Tenant/Owner ,t J(�V? /�� -& trr� ELC
Footing
Foundation ELC
Ftg Drain Access: -3 7SZ
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling 1
Roof t,Jc h e
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
ELECTRICAL
Service
Rough -In
UG/Slab -
Low Voltage
Final El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SITE LI Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA l � l
Approach/Sidewalk Date F C � Inspector 1- � d � �- � Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL