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Permit • 71 n CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT :111. COMMUNITY DEVELOPMENT Permit #: ELR2013 -00021 T EGARO 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/28/2013 Parcel: 2S103AA00101 Jurisdiction: Tigard Site address: 10865 SW WALNUT ST Project: Fowler Middle School Subdivision:)0 SUPPLEMENTAL PLAT NO.1: ANNE Lot: 7 -6 Project Description: (1) low voltage to add (3) outside speakers, (2) inside speakers, run (2) 18/2 cable to Comm rack to new intercom system, insall new control boxes and terminate speaker wire Contractor: QUALITY COMMUNICATIONS INC Owner: TIGARD - TUALATIN SCHOOL DISTRICT 5923 RHINESTONE CT SE ATTN: BONITA MAPLETHORPE SALEM, OR 97306 6960 SW SANDBURG ST TIGARD, OR 97223 PHONE: 503 - 991 -5625 PHONE: FAX: 503 - 364 -1365 FEES Description Date Amount Specifics: Restricted Energy Permit 01/28/2013 $75.00 12% State Surcharge - Electrical 01/28/2013 $9.00 Type of Use: COM Class of Work: ALT Total Number of Systems: 1 Audio & Stereo: N Boiler Controls: N CCTV: N Clock Systems: N -S Data & Telecommunications: N Fire Alarm: N HVAC: N Instrumentation: N Intercom /Paging: Y Landscape /Irrigation: N • Landscape Lighting: N Medical: N Nurse Calls: N Protective Signal: N Security Alarm: N Other: N Total $84.00 Other Desc: Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through OAR 952- 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 112 or ` or 1.800.332.2344. Issued By: � 1 �_ J / VIA Permittee Signature: ' 4-PP 1~1)77 Ok i 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' Date: LICENSE NO. Call 503.639.4175 by 7:00 a.m. for the next available inspection date. - - This permit card shall be kept in a conspicuous place on the job site until completion of the project. r Approved plans are required on the job site at the time of each inspection. Electrical Permit Application RECEIV Tigard e JAN 2 4 20 matt13 ( / £f g /3 - e 4- City of Ti g Pe nmt 10 Date ttr 13125 SW Hall Blvd.. Tigard, OR 97223 flan Review Phone: 503.718.2439 Fax: 503.598.196� R a batc7ly: (Aber Pemtit TIGARD Inspection Line: 503.639.4175 CITY OF TIG Date Ready;ey: r 0 See Page 2 for Internet: wl∎w.tieard- or BUILDING rwisto Supplemental Information re ified Method: nurmation •r. TYPE OF WORK PLAN REVIEW ' Please check all that apply (submit 2 sets of plans citems chucked below) ❑ New construction © Addition/alteration/replacement ❑ Service or feeder 400 amps or more ❑ Building otter three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards ,. .. , CATEGORY OF CONSTRUCTION • exceeds 10,000 amps at 150 volts or ❑ Flaming buildings. less to Round, or exceeds 14,000 ❑ Commercial -use agricultural i ❑ I- and 2- fancil) dwelling ® Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi- family ❑ Master builder ❑ Other: ❑ File pump. ❑ Installation of 75 KVA or ❑ Emergency system. larger separately derived system -J . O_ B SITE INFORMATION AND LOCATION _ ❑ Addition of new motor load of ❑ A "E 2 "."I -3 Job no.: H2932 Job site address: 69aC11S Sandb>rg St. j('glpiS 10011P or inure. occupancy. ❑ Six or more residential units. ❑ Recrruional %chicle parks City "LIP: Tigard, OR, 97223 LIJA'L - 0.1 , 1 ❑ IIcaltlo-atre facilities. ❑ Supply voltage for more than ❑ Ilazardous locations. 600 solo' ntanmal, - 1 Suite'bldg.'apt. 11o.: Project name: Fowler Middle School ❑Senice feeder 600 amps ormole FEE SCHEDULE ('mss snret'dircctions to job site: Sandburg St. narriptian I Qt.. I Err. I Total i • I. - — New residential single or multi family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,110 sq ft. or less 168.54 I 4 La add'l 5110 sq. R. or portion 33 92 ! 1 ' Tax map'parccl no.: Limited energy, residential 75 , DESCRIPTION OF WORK (with above sq IL 1 Limited energy, multi-family 75 00 I Add 3 outside speakers, add 2 inside speakers, terminate speaker wire, install residential (ix Ih above sq. ft.) I Services or feeders installation. alteration. and /or relocation new control boxes, run (2) 18/2 cable to Comm rack to new Intercom system 200 snips or less 100.70 2 ❑ PROPERTY OWNER ❑ 'TENANT 201 amps to 4(X) amps 133 ,Sh 401 amps to 600 amps 210 14 2 Name: 601 amps to 1,000 amps 301.1 j 2 Address: Over 1,000 amps or volts 552 26 I 2 Temporary services or feeders installation. alterntion. and /or CityiStatc /ZIP: relocation Phone: ( ) Fax: ( ) 200 amps or less 59.30_ 1 I 201 amps to 400 amps I 125 08 , 12 Owner installation: This installation is heine made on property that I own which is not 401 amps to 599 amps I IGS 54 t 2 intended for sale. lease, rent, or exchange, according to ORS 447. 449. 670. and 701. Branch circuits - new. alteration. or extension. per panel Owner signature: Date: A Fee for branch circuits with 0 APPLICANT I ❑ CONTACT PERSON above service or feeder fee, i 42 each branch circuit 1usiness name: Quality Communications, Inc. B. Fee for branch circuits u'irhutrr service or feeder fcc, first Contact name: Cris Andrew branch circuit 56.18 ' - Each add'I branch circuit 7.42 _ 2 Address: 5923 Rhinestone Ct SE lisecllaneous (service or feeder not included) City/State/ZIP: Salem, OR 97306 Each manufactured or modular 67 84 - dwelling. service and/or feeder Phone: (503) 991 -5625 Fax: : (503) 364 -1365 Reconnect only 67.84 - Pump or irrigation circle 67.64 2 E -mail: candrew1P,quality- comm.net Sian or outlive lighting 67.84 CONTRACTOR Signal circuit(s) or limited- energy r� Business name: Quality Communications, Inc. panel, alteration. or extension. r` Pace 2 2 1 Each additional inspection over allowable in any of the Anse , I Address: 5923 Rhinestone Ct SE Additional inspection (I hr min) 66.25/ hr City' /ZIP: Salem, OR 97306 Investigation (I hr min) 66.25/ hr Industrial plant (I hr min) 78.13! hr I Phone: (503) 991 -5625 Fax: (503) 364 -1365 Inspections for which no fee is 90.001 hr 1 specifically listed (%z hr min) Cell Lic.: 132962 9..r g Electrical Lic.: CLE38 Supr. Lic.: 35135 ELECTRICAL PERMIT FEES l 1.' ( ( t: t I Subtotal: Suprv. Electrician signature, required: Plan review (25% of permit fee): Print name: ke .., A 4 o f ./- 2, Date: /.� 1-k-13 State surcharge (12% of permit fee): �((� i 'TOTAL PERMIT FEE: V f I Authorized signature: C ....„------ This permit application expires if permit is not obtained within 180 days after it has been accepted as complete. Print name: Cris L. Andrew Date: 1/25/13 • Ywnber inspections allow. ed per permit_ 1 not ; inp Permit{ FI.C.Penriisrp doe 07.Jl.i1 440- tn1ST(I1 COw -wEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fcc for all residential systems combined $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: COMMERCIAL WORK ONLY: Fee for each commercial $75.00 system (SEE OAR 918 - 309 -0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC n Instrumentation ® Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: I *No licenses are required. Licenses are required for all other installations I Yctnfn ELC- I'nmitAppdoc 0701110 Location: Record Type: Inspection Type: Comments: Inspection Date: Record ID: Result: City of Tigard 13125 SW Hal Blvd. Tigard, OR 97223 Tel: 503.718.2439 10865 SW WALNUT ST, TIGARD, OR, 97223 Commercial - Electricial Limited Energy 135 Low voltage 04/02/2013 00:00 ELR2013-00021 PASS Violation Summary: Inspector Contractor