Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2011 -00703
TIGAID 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/15/2011
Parcel: 25113AC01201
Jurisdiction: Tigard
Site address: 7315 SW BRIDGEPORT RD
Project: California Pizza Kitchen Subdivision: Lot:
Project Description: (2) branch circuits for outdoor awning and heater connections.
Contractor: PC ELECTRIC Owner: BV CENTERCAL LLC
PO BOX 517 ATTN: FRED BRUNING
NEWBERG, OR 97132 7455 SW BRIDGEPORT RD
TIGARD, OR 97224
PHONE: 503 - 538 -6033 PHONE:
FAX: 503 - 538 -6461
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 12/15/2011 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 12/15/2011 $7.63
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $71.23
Required Items and Reports (Conditions)
This permit is - • t to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done accordance with a••roved . -ns. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. TENTION: Oregon law r y• to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-0.1-0010 thro gh OAR 952 -00 -0090. • • may obtain a copy of the rules or direct questions to OUNC by c -, • 503.2 2.1987 or 1.800. 2.2344.
1
Iss - d By: .tea? —4IL_A� - Permittee Signatur � � /.�.
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 Application CEI col tl1 r• u I 1 -.SE UNIX
V `
City of Tigard Dat : /g ®�tW� E .0 o?O 7
Peraat No.r
---- o 13125 5W Hall Blvd., Tigard, OR 97223 � C it 5 ?n Plan Review /2 , l
I. Phone: 503.7182439 Fax: 503.598.1960 l Date/By: Other 1C` Permit. /�tl PO n I -- �1c
Inspection Line: 503.639.4175 CITY OF Dat Jar's: El Sc e Page 2 for
T I ' c A R Lt t fi Ready/By. th mental Information Internet: www.tigard- or.gov LIAR o
� U 1 la►�INO
n rl. N
..
. l r
❑ New construc ® Addition/alterat cheek all that apply (submit 2 sets of plans w/itemschecked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas boatyards.
. r :: ......... ..._,.,.,,aL..�;:.� °:, ». , : .,; u;.::.:;. r ''r 1~'• - exceeds 1 00 am 1 volts or ❑Fl buildin s.
_
e. .......,-.,,, ...._,111,1, -..:, - _ iii; g g
............. : t.. 1111,_ 1111 Ps
-- 1111. _ . � n,:°
.:: - �- 1111 -- _.. -..- 111 g �1
:� ;ry : 1 =11
............... 1111.
rs,,. . . . : :. :., ,..;.. ...__._ :,..� , s l��,_` - .,, :. " ° : '; lass to ground, orex 14 , 000 QCa ueeagricultural
❑ 1 - and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: 0 Fire pump. 0
. ..'...._..,_,,,.... separate derive
.:: - ,, : :,,,�,. :; . :`sa t x ::1,3,' � ;; _ __� g >y
: j �
1111. v,:_;:. - '; r.,1 Y � i.. Addition of new motor load of El t , " r " 1 _ " d
1 111 -
a<
..:. ., r _ .. 1 11 1 ... :
A
- ... : : :. size, ar:4-: :'-._ :._ :;...:,.� -�.- .;scaly . _.... �..u::e :,y "..: 1 111 -. 1 111.. , - 1 11. 11 1_1. - ,. .
Job no.: Job site address: 7315 SW Bridgeport Rd. ioat� or more. occupancy.
❑ six or more residential units. ❑ Recreational vehicle parks.
City /State/ZIP: Tigard, Or. 0 Health-care facilities. ❑ Supply voltage for more than
_ ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: California Pizza Kitchen ❑ Service or feeder 600 amps or more_
-.- .. _ .
,:.., .......... .. 1111. _ „ =-... ,, air, :,.__:
1111. _,- ::.:u:,:_:::. -: _1111. -. 1 1 1 1,._
job site: Description ...Fe l !
� -1111 1111.. 1 Q4• l Fes )_ roml �
Cross street/directions to e
- New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less ' 168.54 4
a st - Ea. add'I 500 sq. ft. or portion 33.92 I
Tax map/parcel no.:
Tax Limited energy, residential 75.00 2
_ist : .
1111,
1111. - 1111... -.�.; .. ..... _ 1111
. 1 111. -, ;:..,:..i;. .,�4,:s} .. < .......,...m. ... ._ .,,, ...x... 1 11_ . �.,.. 1111 ._
j •' I' -as- ..s.13/f x 'L . f, s: .. Y ..: (with sho . ft .
.d -- - -; ::�3ill�' s,s._ -- dil °I�` �pt to !!�. ,��G �.. :_,.. _ - _ : "_ illi ? ` ( 9
., - 1 11 1
' .; _: _.,.. :, Ott •T ' ..... :,.. „ 1111 ._. _.:.. .....- _ 1111: :: _.- Limited f m
' '• �,,.' ,�. e , t. > .__..�_. : :'ff :�r :. :F -��' :.: `. ', 111
Limt energy, multi- a ify 75.00 2
(2) lighting ckts for outdoor awning and heater connections residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
,- �h' 11.11- i i a'ir us - = -. 201 amps to 400 amps 133.56 2
11.1. . , . -: , .
111;1,
t „i s - -I_,. =. 11 11, , s : ,.,.,.:. ,, s��: � 1111. ,....� �: r . , . . , :. . .
1.111_ - ;.,,,, • :
1111,; , :
P amps 401 amps to 600 am s 200.34 2
601 amps to 1 ,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
relocation rvices or feeders installation, alteration, and /or
City/State /ZIP:
Phone: ( ) I Fax: ( ) 200 amps or less 59.36 1
201 amps to 400 amps 1 125.08 1 1 2
Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701, Branch circuits - new, alteration, or extension, er panel
Owner signature: Date: A. Fee for branch circuits with
l q, ,P ;r."• Vii above service or feeder fee,
- ., �. _ - 7.42 2
- -
1111._ ...,,......__ _
..__. _ 1111., .. ........: :;1st °.: • ? :-- ;
1111 ;1111 ::
.;. rst _11 _
:; :,��- ..� <,r�,�a�l�i �t I..,.....�: ;,�i,i;tl -�_. <. : : €�! � - -_ . �.�?�i`��.r :, , i�
1111.
., 1111.
�. :.... :-�::..,..:,. :� °- - . _ .. � -; :- • `� `- each branch c
•:, = 1111. .1111 111 ..,_.__,,,:,...
Business name: B. Fee for branch circuits without
service or feeder fee, first 1 56.18 56.18 2
Contact name: branch circuit
Each add'I branch circuit 1 '7.42 7.42 2
Address: ' Miscellaneous (service or feeder not Included)
City/State/ZIP: Each manufactured or modular 6784 2
tY dwelling, service and/or feeder
Phone: ( ) I Fax: : ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E ___ 2
1111, ii:! w,nl l _:,n , :u :., 4 ; ,: :_s,, Signor outline lighting 67.84
.-.� .,. ..11�[ilif= = is....F_K4lE,�.t,.. ° :it :.::_..,. . +. : : :;. : :..
ac:: ! tl ..__-., ._.. :rF.. :: :: T .t q t : , c s tr 4 rzi� •.;Ei'-i'!"-rv: ,`4 Vic;„ ::_ :r... 1.IS :•i4= i',. : :-:: „- .
( ;ttGi� :�._ :�;lir.,,,.,,jlis -•-• al�tw�sFaE,; -- ..11��- ttta'�M! t; ?. : +':y. .•r :�,, :.,._._, .,�a ..,.3A;;� Signalcireuit(s)orlimited�nergy
,: :� : ............... • - 111_1. -
Business name: PC Electric panel, alteration, or extension. Pape 2 2
Each additional inspection over allowable in any of the above
Address: PO Box 517 Additional inspection (1 hr min) 66.25/ hr
City /State /ZIP: Newberg, Oregon 97132 Investigation (1 hr min) 66.251 hr
Industrial plant (I hr min) 78.18/ hr
Phone: (503) 538 - 6033 Fax: (503) 538 - 6461 Inspections for which no fee is 90,00 / hr
s . iftcall listed % hrmen
CCB Lic.: 187490 ql�� Electrical Lic.: 36-11 I Suprv. Lic.: 5012s , : : 'l if I: i, :E ; „ It .w ' 4 . µ '1 , ,. -..
Suprv. Electrician signature, required: /Ay' Subtotal: 63.60
Plan review (25% of permit fee): 0.00
Print name: Steve Peppmeier Date: 12/15/11 State surcharge (12% of permit fee): 7.63
TOTAL PERMIT FEE: 7123
Authorized signature:
This permit application expires if a permit is not obtained within 180
Print name: Date: a days after it has been accepted as complete.
Number of inspections allowed per permit.
t:\ Building \PermitsELC- PtrmitApp.doe D7/01 /10 440.4615T(t I/O5 /CUMIWfB
Z - d XEI3 13C?I3SEJ1 dH WlJTS :TT TT0a ST ° U
5 " '" : Electric
PO Box 517
Newberg, Or. 97132
503.538.6033 office
503.538.6461 fax
ccb #187490
pcsteve20@front ler.com
Date: 12/15/11
Attn: Electrical Permits
From: Steve Peppmeier
#of Pages: 3
Attached you will find a credit card authorization form and electrical permit application for 7315 SW
Bridgeport Rd. This is for the tenant, California Pizza Kitchen. If you have any further questions or
concerns please contact me at 503 - 929 -2200.
T XH3 13C213Sd1 dH WbTS :TT TTOa ST oaU