Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
lq• • - COMMUNITY DEVELOPMENT Permit #: ELR2012 -00281
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/24/2012
Parcel: 2S113AC00103
Jurisdiction: Tigard
Site address: 7244 SW DURHAM RD, BLDG# 600
Project: Tolt Service Group Subdivision: COUNCIL VIEW ACRES (LOTS 21 -44) Lot: 25 -27,2:
Project Description: (1) low voltage for Data/Telecommunications - prewire from demark to tenant space for Comcast cable
Contractor: BRIDGETOWN ELECTRIC Owner: PACIFIC REALTY ASSOCIATES
5701 N LOMBARD ST ATTN: N PIVEN
PORTLAND, OR 97203 -4113 15350 SE SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 621 -7122 PHONE:
FAX: 503 - 621 -7123
FEES
Description Date Amount
Specifics: Restricted Energy Permit 12/24/2012 $75.00
12% State Surcharge - Electrical 12/24/2012 $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
Data & Telecommunications: Y Fire Alarm: N
HVAC: N Instrumentation: N
Intercom /Paging: N 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 wit
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.
Issued By: 4 Permittee Signature: 1 4 P PC ArI 04 `-t /
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.
Dec 21 2012 4:20PM Bridgetown Electric 503 -621 -7123 page 1
Electrical Permit Application RECEIVED L : t!; t I : ' • .
.
City of Tigard 2 01 Received
may /3' "34- , / +-- ]'Pet e �pl.4, - 00. l
13125 SW Hail Blvd., Tigard, OR 97223 DEC 2 4 2 plan Review
Phone: 501639.4171 Fax: 503.598.1960 Date/By: Other Permit
Inspection Line: 503.639.4175 CITY OFTIGARD Date Ready/By: luee I a So. Pae2 for
Internet: www.tigard- or.gov r 1 ► i _ ISION Notified/Method I �' atggi - cal loformatiea
r
h11, ;+.4:1.:11,:::- ' H• Y'r611:*. '.? '7
; ,t ;,- - 0 . is s x..:'., ' 1 4 1 h iNt.4 J . aT % . :, , 41 . ^: : d �r. � • t ,F , .
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1:1 New construction in Addition /alteration/replacement Plea= ° an ' "` lab of checked below):
O Service or feeder 4 r amps or more 0 Building over three cturies
❑ Demolition 0 Other: where the avai • •fault current ❑ Marinas and boatyards.
r"i ' f • aN- _ ' ' •', ' .gyp£ k �:: r ��' .$ exceeds 10,000 • rat 150 volts or ID Floating buildings.
7 {' !e ....t lit • t es a 1 S ha , , * . i -t, lass to ground, or Deeds 14,000 0 Commeseial -use agricultural
❑ I- and 2- family dwelling ■ Commercial/industrial ❑ Accessory building amp for all other' srallations buildings.
❑ Multi - famil ❑ Master builder ❑ Other: Cl Fire pump. 13 Lit ablation of 75 KVA or
0 Add
t l .: '° 1:7k t+ +'fib r�nrat (gS � star ; i d , , - , .._ El Emerseacy s ystem
larger separately derived ayrtem
,o - ± •;: „{ ,, � r., ::itfl .i. _ ..- ea4.ia;; n • . . . .
� v - ., � • ition of new m •tor load of ❑ "A ", "E ". "1-2 ". "I -3 ",
Job no.: r a Job site address: 7V.1a 5v4 Dv,>~ho-w+b 100 or more a maid Recreational vehicle parks
1 L" UQ p r� 0`• ❑ Six or mare maid � flab units. ❑ Recreation. i
City/State /'LIP: '� r_,,,,�Q Q � a-�,ti4 ❑ H aza rd o us ca • -s. El Supply voltage for morn than
t - ��"" . �- 600 volts nominal.
❑ Hazardous loan
Suite/bldg. /apt. no.: / , Project name: 1 6 l.} 't ❑ Service or feeder I or more.
� i
` � ti:.ia :1 c t yd ,: ,� ,,, ,.• S e td - 4Akzel - '''.44.'''' '
Cross street /directions to job site: Description ors. rte. I rod 1
_____ New residential si l . le- or multi-fatally dwelling unit.
Includes attached rage.
Subdivision: Lot no.: 1.000 sq. f3. or less 168.54 4
Ea. add'I 500 sq. ft. i portion 33.92 I
Tax map/parcel no.: Limited energy, re -. slab
a , ^ ,D..,. N �' ".M„ r '.' � ' (with above 5 ' 1 7500 2 •
' M � Limited energy, mu ' -family
low X1111 - �r -vv, “At- -A �-� � residential (with :,..vesq. IL) 75.00 2
d Services or (cede ' installation, alteration, and/or relocation
A t: (.A \MIaAr lik 200 amps or leas ' 100.70 2
, •a17'"? w "iam+rT:Grtays , 4 1 r ;.. i t , Z717ta�t % !' I ,: t� " e : ` t •tyk 201 am to 400 am 133.56
it ::. • ny
, 4:.., riVS >'.■ala%.'.a� Ja 'LnAtaaAR9eRA�Y' H�/`.�. rte- r .. _ .
Name: 601 amps to 600 am 200.34 2
60l amps to 1,000: ps 301.04 2
Address: Over 1,000 amps or olts 552.26 , 2
Temporary servie' or feeders installation, alteration, and /or
City/State/ZIP: e
Phone: ( )
1 Fa ( ) 200 am or less ! 59.36 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 tint 125.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 am 168.54 2
Branch circuits - ew, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch M. Is with
y ,. r 4u ou,r .*• : a serv or d er fe e,
7 4
.
� .. �` S ir d las ,. r •,,,- ..., each branch cite I t 2 2
_
Business 11811/C: 13. Fee for branch ci. its without
service or feeder , e. first 56.18 2
Contact name: brands ctrcom ,
Each add'i branch ci' cult 7 42 i 2
Address: Miscellaneous (se ee or feeder sot included)
Each manufactured • modular
City/State/ZIP: 67.84 2
by dwelling, service an . feeder
Fax: ( ) R econne ct onl I 67,84 2
Phone: ( ) -
Pump or irrigation e lc 67.84 2
E Sign or outline light . 67.84 2
ll.: :'In i } NIi .• -e,2 amt E -: � r...: .,.-.:.r.
' t�f f c:, �:#�1320F t n• . . .,,.v. ;1 "_ , :iii:.sr Signal clrcatl(s)orl rted- energy
1 7 Bulimia name. gi t ' N EL . (XRIC panel, alteration, or - - sicn. l Pane 2 _ � ' b 2
/� '.E7 f ,�/ Each additional i i ; tion over allowable is say of the above
Address: S7 0 / f l,/ , A-0 rri (3A420 s Additional inspecti . j (1 hr mm) 66.25 /hr
City/State/ZIP: ' i�i „ a OR C11 Q3 -40 i 3 Investi (1 hr in) 66.251 hr
industrial plant (1 h mot) 78.181 hr
P Nag ) l di . l • 7122. I Fax: ( 3 )421 7123 Inspections for whit no fee is 90.00! he
specifically r listed hr min)
CCB Lic.: / I E�ectricail Lie.: I Suprv. Lic.: a 1 7 7 :r r. ,� i '' i a 4 11 IIll ktAiii At,!, i.
i - subtotal: /C.
- "4,4( .
Suprv. Electrician signature, re Plan view (25 %ofpermit fix):
name: ` , eA, • f t • .ra /.gip' ( Date: State su hinge (12% of permit fee): 1.11, TOTAL PERMIT FEE: $i{,0
Authorized signature: This permit appac 'oil expires if a permit is sot obtained within 150
days a er it has bees accepted as complete
Print name: Date: • Number of inspect allowed per permit.
ISBuldmg\PermilitEt.CPer i'tApp.don (Y710 V 10 440.461ST( I1 /05 /COM/WEB
1
Dec 21 2012 4:21PM Bridgetown Electric 503 - 621 -7123 page 2
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
Fee for all residential systems combined ... $75.00
Check Type of Wotk Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
•
❑ Garage Door Opener*
❑ H eating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other.
COMMFR ORL:Ol! M":,_..,.,;
Fee for sigh 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
❑ Instrumentation
❑ Intercom and Paging Systems
❑ L andscape Irrigation Control*
❑ M edical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1: lauildinglitrmitAELC- PemicApp.doc 07101.10