Permit ELECTRICAL PERMIT
� CITY OF TIGARD
PERMIT #: AIR, DEVELOPMENT SERVICES DATE ISSUED: 11/3/00
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S103AA -00101
SITE ADDRESS: 10865 SW WALNUT ST
' SUBDIVISION: ZONING: R -4.5 •
BLOCK: LOT : JURISDICTION: TIG
Project Description: Inspection of retrofitting for 2,344 lighting fixtures.
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: PER HOUR: 1
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 NO 23 J AMTECH LIGHTING SERVICES, INC.
13137 SW PACIFIC HWY 2202 NW ROOSEVELT ST
TIGARD, OR 97223 PORTLAND, OR 97210
Phone: Phone: 503 - 224 -7636
Reg #: LIC 127455
ELE 26 -1074C
SUP 4567S
FEES Required Inspections
Type By Date Amount Receipt Elect'I Final •
PRMT CTR 11/3/00 $62.50 2720000000(
5PCT CTR 11/3/00 $5.00 2720000000( EXPIRED
Total $67.50
This Permit is issued subject to the regulations contained in the Tigard Munidpal 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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATU I / ' / , I I it I ISSUED BY:
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:
NT RAC + j ST • / TION ONLY
SIGNATURE OF SUPR. ELEC' . = • /
DATE: `F 3 - aOO 0
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
t.
Ab Electrical Permit Application •
Date received: //3 07) Permit no.: EZe 7070 -606/9
# ti 4 - . 1 h■ L ' City of Tigard Project/appl.no.: Expire date:
CityofTigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: By: Receiptno.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval:
TYPE OF PERMIT
tilv.Fi n
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi -fami - c --u Tenant improvement
❑ New construction ❑ Addition /alteration/replacement `l�Other: i i ❑ Partial
• JOB SITE INFORMATION
Job address: /084,5 ! MEL ST Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: Block: Subdivision:
Project name: f p 1,¢4- 04., -A S .00h I Description and location of work on premises: & (\.(5.,4 1w15 c .O, �,\
Estimated date of completion/inspection: ' T l: ' y Sor-e, Hera iv es - i-o c .14, ota ,
CONTRACTOR APPLICATION - FEE SCII
Job no: Fee Max
Business name: 'P \TEC1 \,.. cewitAS `G1L Description Qty. (en.) Total no.insp
�] New residential - single or multi- family per
Address: �t . A)62) Rt e_VQ.� - `j T, dwelling unit. Includes attached garage.
City: S( {N I State: O. I ZIP:77910 Service included:
Phone: S63 i.( -1636 I Fax: ' 4 - L-7376 I E -mail: 79-rieri ` t4 r. 1000 sq. ft. or less 4
CCB no.: /a 7y5 rj I Elec. bus. lic. no: .. 7y Each additional 500 sq. ft. or portion thereof
Limited energy, residential 2
City /met o lie. no.: a //7/O a_- 4 /o /O/ Limited energy, non- residential 2
V N ay , I ` '/ to /3 /dd Each manufactured home or modular dwelling
.Signat e f Arvisi (required) Date i % Service and/or feeder 2
Sup. elect. name (print): License no: y56 S /Services orfeeders installation,
alteration or relocation:
• - • - - - ,.. . PROPERTY OWNER -. - - .. - - -. - - - - ... p
200 amps or less 2
Name (print): ~ To i\ O I ti 201 amps to 400 amps 2
401 amps to 600 amps 2
Mailing address: 601 amps to 1000 amps 2
City: I State: I ZIP: Over 1000 amps or volts 2
Phone: I Fax: I E -mail: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary services or feeders - --
which is not intended for sale, lease, rent, or exchange according to installation, relocal
ORS 447, 455, 479, 670, 701. 200 amps or less r'�, F I 2
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 amps 2
E NGINEER Branch circuits - new, alteration,
or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: I State: I ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 2
Phone: Fax: E -mail:
Each additional branch circuit:
• PLAN REVIEW (Please check all that apply) • Misc. (Service or feeder not included):
— – Service over 225 amps- commercial ❑ Health -care facility Each pump or irrigation circle 2
O Service over 320 amps- rating of 1&2 0 Hazardous location Each sign or outline lighting 2
family dwellings O Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
O System over 600 volts nominal more residential unite m one structure alteration, or extension* - - 2
O Building over three stories O Feeders, 400 amps or more ' *Descnpuon:
O Occupant load over 99 persons O Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
O Egress/lightingplan O Other: Per inspection
Submit _ sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other .
Not all jurisdictions accept credit cards, please call jurisdiction for more information Notice: This permit application Permit fee $ Z• S
❑ Visa O MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $ 5. o7)
Expires accepted as complete. TOTAL $ l' 7 , Sv
Name of cardholder as shown on credit card
$
Cardholder signature Amount 440 -4615 (6/00 /COM)
•
f
Electrical Permit Fees: Limited Energy Fees: k.l
TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Complete Fee Schedule Below: Restricted Energy Fee $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total 4, Check Type of Work Involved:
Residential - per unit
1000 sq. ft. or less $145 15 4 ❑ Audio and Stereo Systems
Each additional 500 sq. ft. or
portion thereof $33.40 1 n Burglar Alarm
Limited Energy $75.00
Each Manufd Home or Modular n Garage Door Opener
Dwelling Service or Feeder $90 90 2
Services or Feeders n Heating, Ventilation and Air Conditioning System'
Installation, alteration, or relocation
200 amps or less $80.30 2 Systems 201 amps to 400 amps $106.85 2 El
401 amps to 600 amps $160.60 2 Other
601 amps to 1000 amps $240.60 2
Over 1000 amps or volts $454.65 2
Reconnect only $66.85 2
Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Installation, alteration, or relocation Fee for each system $75.00
200 amps or less $66.85 2 (SEE OAR 918- 260 -260)
201 amps to 400 amps $100.30 2
401 amps to 600 amps $133.75 2 Check Type of Work Involved:
Over 600 amps to 1000 volts,
see "b" above. ri Audio and Stereo Systems
Branch Circuits 0 Boiler Controls
New, alteration or extension per panel
a) The fee for branch circuits �
with purchase of service or I I \ Clock Systems
feeder fee.
Each branch circuit $6.65 2 n Data Telecommunication Installation
b) The fee for branch circuits
without purchase of service n Fire Alarm Installation
or feeder fee.
First branch circuit $46 85
Each additional branch circuit $6 65 ❑ HVAC %
Miscellaneous ❑ Instrumentation
(Service or feeder not included)
Each pump or irrigation circle $53.40 n Intercom and Paging Systems
Each sign or outline lighting $53.40
Signal circuit(s) or a limited energy
panel, alteration or extension $75.00 n Landscape Irrigation Control
Minor Labels (10) $125.00 n
Medical
Each additional inspection over .
the allowable in any of the above Nurse Calls
Per inspection $62.50 El
Per hour I $62.50 (o o 2. , S 0
In Plant $73.75 Outdoor Landscape Lighting'
Fees: ❑ Protective Signaling
Enter total of above fees $ 6, 2, SO n Other
8% State Surcharge $ 5 '07) Number of Systems
25% Plan Review Fee No licenses are required Licenses are required for all other installations
See "Plan Review" section on $
front of application.
1 Fees:
1
Total Balance Due ` $ (, 7 , 5 0 .
i Enter total of above fees $
• ❑ Trust Account #. -
, _ 8% State Surcharge $
a 3 yy k 7-7_,(2..---5 Total Balance Due • $
/ / x nc 2r' 2E7 2a Fi T FertZ Pe J c, ✓=2 M/ ,4,--4-, -C Ct o 1
i:\dsts \ \elc- fees.doc 10/09/00
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