Permit e CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
IN 2 COMMUNITY DEVELOPMENT Permit#: ELR2013 00296
T IGARE) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/19/2013
Parcel: 1 S136CC00100
Jurisdiction: TIGARD
Site address: 8200 SW PFAFFLE ST
Project: Westside Christian High School Subdivision: 2006-016 PARTITION PLAT Lot: 3
Project Description: Installing security system.
Contractor: FIRST RESPONSE SYSTEMS INC Owner: CITY BIBLE CHURCH
4970 SW GRIFFITH DR#100 9200 NE FREMONT ST
BEAVERTON, OR 97005 PORTLAND, OR 97220
PHONE: 503-207-5300 PHONE:
FAX: 503-207-5301
FEES
Description Date Amount
Specifics:, Restricted Energy Permit 11/19/2013 $75.00
12%State Surcharge-Electrical 11/19/2013 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio&Stereo: 0 Boiler Controls: 0
CCTV: 0 Clock Systems: 0
Data&Telecommunications: 0 Fire Alarm: 0
HVAC: 0 Instrumentation: 0
Intercom/Paging: 0 Landscape/Irrigation: 0
Landscape Lighting: 0 Medical: 0
Nurse Calls: 0 Protective Signal: 0
Security Alarm: 1 Other: 0 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 or 1.800.332.2344.
1
Issued By: e:"./.. Permittee Signature:
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.
Approved plans are required on the job site at the time of each inspection.
ECEWViD
Nov. 14. 2013 2:07PM No. 3247 P. 2
Electrical Permit Application NOV 14 2013 FOR to F1('I litiL ONLl'
C1 of Tigard
Received r�
Permit No.: ;-„ A
" 131255SW Hall Blvd.,Tigard,OR 972 3 Datt+/B : �y� 13't 01
l� 8s 1TX OF TIGARD PlanRevic other Permit:�//
Phan: 503-718.2439 Fax: 503.59 DatelD : / , f 3i�
T1Cir11lf) Inspection Line: 503.639.4175 9 DING DIVE➢®' DateReadylBy. r�is ®See Page 2for
Internet: www.tigard-or.gov Notified/Method: j Supplemental information
., : ;,;7:.' r F,WORD tf,i „'dV` ql , •n , ............ r. .'P AN-.REVIEiY f n. '. '„
❑New construction ®Addition/alteration/replacement Please check all that app ly(submit/sets ofplans w/items checked below);
❑Service or feeder 400 amps or more ❑Building over Three stories.
❑Demolition ❑Other: , where the available fault CUrtenr ❑Marinas and boatyards.
a,i CAT 4ClRX taOlV��r�rrryy UgTION{ ' u ii ii exceeds 10,000 amps at 150 volts or 0 Floating buitdings.
.,o ,:,,', .. ._ ,,4.,,..-.....7"',a,., •..... ....... ....'•.,Ii., ., . . 14,000 Commercial-use egricultural
less to ground,or exceeds 14 000 ❑
[] I-and 2-family dwelling ®Commercial/industrial ❑Accessory building amps for all other installations. buildings,
❑Multi-family ❑Master builder ❑Other: Fire pump. ❑Installation of 150 KVA or
j , Emergency system. larger separately derived system.
, '':,,,,,,,,,u‘:i JOB S�'"INFOR(�A')jO?4'�A+tOi.LOCAaION ,I D Addition of new motor load of 0„A "E"."1-2-,'.I-3..,
Job no.:110-6547 1Job site address:8200 Sw Pfafne St lO0 lP ar"`°�
occupancy.
0 Six or mom residential units. ❑Recreational vehicle parks.
City/Stale/ZIP:Tigard OR 97223 ❑Health-care facilities. ❑Supply voltage for more than
0 Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: I Project name:Westslde Christian HS ❑Service or feeder 600 amps ormore.
E SC ,,,+
Cross street/directions to job site: Dentiti FE
on I orr. I Fee. I Toot I '
Now residential single-or multi-family dwelling unit.
includes attached garage.
Subdivision: I Lot no.: , 1,000 sq.R.or less 168.54 4
Ea.add'I 500 sq.ft.or portion _ 33.92 1
Tax map/parcel no.: Limited energy,residential 75.00 2
,r, LRIPT1QI!$..O14 WQ)kIt wtil above .0.
Limited energy,multi-family 75.00 2
Llstalliug burg system,panel,GSM,RF motion sensors,RF door contacts,Keypads, residential(with above sq.IL
Renewable Energy ❑ See Page 2
Services or feeders InstalltttIon,alteratlon,and/or relocation
-.. o.it,...,.,.._...._,.. .,._+. ,.,^..::- .,,-.•.:-,,,a.,--t : 200 amps or less 100.70 2
:;,_: .4'�P�tOP�I(TX�:bWI!�R'�: �:; _. I= �, � EIt1e1I��'+, ill„,
201 amps to 400 amps 133.56 2
Name; 401 amps to 600 amps 200.34 2
Address: 601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts 552.26 2
City/State/ZIP: Temporary services or feeders Installation,alteration,and/or
Phone:( ) i Fax:( ) relocation
200 amps or less 59.36 1
Owner Installation:This installation is being made on properly that 1 own which is not 201 amps to 400 amps 125.08 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 2
Owner signature: Date:, Branch circuits-new,alteration,or extenslon,per panel
O APPV�YC ; 1.' ;..b C h(,_.. ,;A RSON A.Fee for branch circuits wipe
';: ' ; ) . .. ' ?l' above service or feeder fee,
Business name: each branch circuit 7.42 2
B.Fee for branch circuits without
Contact name: service or feeder fee,first 56.18 2
--- branch circuit
Address: Each add'l branch circuit 7.42 2
City/State/ZIP: Miscellaneous(service or feeder not included)
- Each manufactured or modular 67.84
Phone:( ) I Fax::( ) dwelling,service and/or feeder ^
Reconnect only 67.84
E-mail: Pump or irrigation circle _ 67.84
:' ',,,•..;',.,::, r GONfRA.: OXt.. „ ,.. -.. .,. f Sign or outline lighting 67.84
,i
Business name:First Response Inc Signal circuit(s)or limited-energy I See 75.00
_ panel,alteration,or extension. Page 2 2
Address:4970 SW Griffith Dr Each additional Inspection over allowable in any of the above -
Additional inspection(I hr rain) 66.25/hr
City/State/ZIP:Beaverton OR 97005 investigation hr min) 66.25/br
Phone:(503)641-6795 I Fax:(503)207-5301 Industrial plant(i hr rain) 78.18/hr - I
inspections for which no fee is
�CB Lic.: 111713�/��+.j Electrical Lie.:A, ' C. . Suprv.Lic.: 29531, specifically listed(%hr mire) 90.00/hr
. ��_'� I` I/ iELCICfFII(AIPFiI1>)LI iFl&lrS' ::,:,,.:-
Suprv.Electrician signature,r�quiecd � � Subtotal: 4,n s par. 7 5":")
/ Plan review(25%of pemut fee):
Print name_t/(v//9 L if�' eeL Date.//..-/ -4.5
Stale surcharge(12%of permit fee): ' . %n
Authorized signature: TOTAL PERMIT FEE: & _up
This permit application expires 1f a permit Is not obtained..011,in 180
Print name: Date: days after It has been accepted as complete.
Number of inspections allowed per permit.
t•\BriltdinglPermlizSELC PermiLApp OLR_EREdoc RevOS/210013 440.461ST(IIr05(COMWEB
Nov. 14. 2013 2: 07PM No. 3247 P. 3
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
..............................
Fee for all residential systems combined... $75.00 Dtscrbtion 1 Qty. I Fee 1 Total 1 •
Renewable electric Ai energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
• 5.01 to 15 kva 133.56 2
fl Audio and Stereo Systems*
15.01 to 25 kva 200.34 2
_
Wind generation systems In excess of 25 kva:
El B• urglar Al=
25.01 to 50 kve 301.04 2
n G• arage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva(fee in accordance with
552.26 2
OAR 918-309-0040)
D Heating,Ventilation and Air Conditioning
Solar generation systems in excess of 25 kva:
System*
Each ackliilon al kva ovex 25 7.42 3
n Vacuum Systems* >100 kva—no additional charge 0.0 3
Each additional Inspection over allowable in any of the above:
0 Other: Each additional inspection is
66.25/hr 1
charged at an hourly(1 hr min)
Inspections for which no fee is
90.00/hr
sod tic*listed(%hr min)
COMMERCIAL WORK Ot ELftL PERMIT FEES
Fee for each commercial system $75.00 Subtotal: 75.00
(SEE OAR 918-309-0000) Plan review,if required(25%of permit fee): „er'
State surcharge(12%of permit fee): 9.00
Check Type of Work Involved: TOTAL PERMIT FEE: 84.00
This permit application expires Ira permit is not obtained within 180
0 Audio and Stereo Systems days after It has been accepted as complete.
Number of inspections allowed per permit.
n B• oiler Controls
D Clock Systems
n D• ata Telecommunication Installation
n Fire Alarm Installation
fl HVAC
n Instrumentation
Intercom and Paging Systems
n Landscape Irrigation Control*
n Medical
DNurse Calls
n Outdoor Landscape Lighting*
Li Protective Signaling
El Other Security system
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I:\DuildingTermiLAELC_PennhApp_ELFLERE103x ae 03/21/2013
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
8200 SW PFAFFLE ST, TIGARD, OR, 97223
Commercial - Electricial Limited Energy
199 Electrical final
2013-12-13 00:00:00
ELR2013-00296
PASS - No C of O
Violation Summary:
Inspector Contractor