Permit (136) CITY OF TIGARD ELECTRICAL PERMIT
. :'H'" COMMUNITY DEVELOPMENT Permit#: ELC2019-00368
TFGAR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/01/2019
Parcel: 1S134CC01700
Jurisdiction: Tigard
Site address: 12325 SW KATHERINE ST
Project: Mary Woodward Elementary School Subdivision: None Lot: None
Project Description: Installing(22)branch circuits,fire alarm,and intercom system for new administrative areas,one new classroom,
and a secure entry vestibule within existing building footprint.
Contractor: PRIME ELECTRICAL SERVICES LLC Owner: TIGARD-TUALATIN SCHOOL
3312 SE BELLA VISTA PL DISTRICT 23J
VANCOUVER,WA 98683 6960 SW SANDBURG ST
TIGARD, OR 97223
PHONE: 503-318-5170 PHONE:
FAX:
FEES
Quantity Description Date Amount
2 ea Limited Energy 06/26/2019 $150.00
Specifics:
22 crt Branch Circuits wo/Purchase 06/26/2019 $212.00
Service or Feeder
Type of Use: COM 1 ea Plan Review Electricial 06/26/2019 $90.50
Class of Work: ALT 1 ea 12%State Surcharge- 06/26/2019 $43.44
Type of Const: Electrical
Occupancy Grp:
Total $495.94
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• 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.198 witr:r-.2344.
Issued By: iL<<`— — 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.
Electrical Permit Applicatiolt , p r''''' • aUU FOR OFFICE USE ONLY
City of Tigard -1 q Permit#FLC. \`\
MAY
r Date/By:
0 13125 SW Hall Blvd.,Tigard,OR 97223 M1\ 9 C0 i9 Plan Review, ,��
2 Phone: 503.718.2439 Fax: 503.598.1960 DateBy: t(y'7)1 C, J '+- Related Permit?, \( _„WV -
Inspection Line: 503.639.4175 Ready Date/By: loris: I Id See Page 2 for
1 i h A R D Internet: www.tigard-or.gov <i Notified/Method: 4 /3 jc J3. i Supplemental Information
I#kal. .....•...a-..w:a..:.=s. `.'.."=`.... MMDT.._.__V,.....,._.:.. •'..., .. M >' 'ffiMaiiiiriltrrartidiellidENPIRSERI
❑New construction ®Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑Other: where the available fault current El Marinas and boatyards.
":"";:'"1::':ii;11!"""'''in,,ILINI:L.Hili:1411 :::LAMOirilaillikliiiiilki,11111111111i111exceeds 10,000 amps at 150 volts or ❑Floating buildings.
❑ 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-"se agricultural
amps for all other installations. buildings.
0 Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
at
q 1 = _ ❑Emergency system.
El l
Addition of new motor load of systemargerseparely derived
.
Job#: 1 Job site address: 12325 SW Katherine St 100HP or more. „E","1-z"."1-3"•
❑Six or more residential units. occupancy.
City/State/ZIP:Tigard,Oregon 97223 ploy-
ID ❑Recreational vehicle parks.
Health-care facilities.
Suite/bldg./apt.#: I Project nameeWoodward Elm School ❑Hazardous locations. 11 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: irallialneRIMIIIIWISIMMIliiiillelliiiiingilli
Description I Qty. I Each I Total I *
West on SW Katherine from SW 121st Ave
New residential single-or multi-family dwelling unit.
Subdivision: I Lot#: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: 1S134CC01700 Ea.add'l 500 sq.ft.or portion 33.92 1
z n€. i+lr`"1 ¢i f I,' 1 .`l9ae+ 4 t ts3¢a get_ -
�; '�,,:; <<. . ,,,.,.. tt� t=._ ....1C3111,111111111:111111:1111111 Limited energy,residential 75.00 2
New administrative areas,one new classroom,and a secure entry vestibule are (with above sq.ft.)
Limited energy,multi-family 75.00 2
created within the existing building footprint;no building area increase residential(with above sq.ft.)
Renewable Energy I ❑ See Page 2
TgllhfjiIngeiNnjB2tB**Ttl,,,NBtalihIMMaliigRANJRWgnaMMTIISITLILilliki.eqniiServices or feeders installation,alteration,and/or relocation
Name:Tigard-Tualatin School District 200 amps or less 100.70 2
Address:6960 SW Sandburg 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Tigard,OR 97223 601 amps to 1,000 amps 301.04 2
Phone:(503)431-4000 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
i ®'m F Branch circuits-c new,alteration,or extension,per panel
�.�• < _ •N==• t t ti , ••••_• l�`�•-•s �•e,;� � -i�� �r..= A.Fee for branch circuits with
Business name:DAYCPM,An Otak Division above service or feeder fee, 7.42 2
each branch circuit
Contact name:Juliet Jacobsen B.Fee for branch circuits without
Address:6960 SW Sandburgservice or feeder fee,first 1 56.18 56.18 2
branch circuit
City/State/ZIP:Tigard,OR 97223 Each add'l branch circuit 21 7.42 155.82 2
Miscellaneous(service or feeder not included)
Phone:(503)984-6801 I Fax::( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email:juliet.jacobsen@otak.com Reconnect only 67.84 2
SIMEININSEM5111011ET;f77200,11111111111Entillielniligilill Pump or irrigation circle 67.84 2
Business name:Prime Electrical Services,LLC Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy ® See Page 2 150.00 2
Address:PO Box 872395 panel,alteration,or extension.
City/State/ZIP: Vancouver,WA 98687 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(503)318-5170 I Fax:(360)869-9989 Investigation(1 hr min) 90.00/hr
Email:oleg.p@primeelectricalco.com Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lie.: 217825 Electrical Lie.: C 1324 Suprv.Lie.: 6270S specifically listed(t/2 hr mm)
Suprv.Electrician signature,required: ��� Subtotal: 362.00
Print name: Oleg Primachenko ,' Date: 3/19/2019 ❑Plan Review Required(25%of permit fee): al a so
State surcharge(12%of permit fee): 43.44
Authorized signature: TOTAL PERMIT FEE: y9 s,9iif
This permit application expires if a permit is not obtained within 180
Print name: Oleg Prima enko Date: 3/19/2019 days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Buildng\Fermits1ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB
1
• Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
;i .. ., -F.<r;,draa:i ....n 'is.. 6:_ s 1#!. 1 #.11 1111,.:.
I
Fee for all residential systems combined: $75.00 RenewDescron Qty. Each Tont
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
❑ Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva(fee in accordance 552.26 2
with OAR 918-309-0040)
❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System*
Each additional kva over 25 7.42 3
❑ Vacuum Systems* >100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
❑ Other: Each additional inspection is
charged at an hourly(1 hr min) 66.25/hr 1
Inspections for which no fee is 90.00/hr
specifically listed('/x hr min)
Subtotal(Enter on Page 1):
Fee for each commercial system: $75.00
* Number of inspections allowed per permit.
(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
❑ Instrumentation
® Intercom and Paging Systems
n Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems: 2
*No licenses are required. Licenses are required for all
other installations
I:\Building\PermitslELC_PermitApp_ELR`ERE.dcc Rev 06/17/2015