Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
111 s COMMUNITY DEVELOPMENT Permit #: ELR2013 -00011
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/16/2013
Parcel: 25101 DB00101
Jurisdiction: Tigard
Site address: 7460 SW HUNZIKER RD A
Project: Providenza & Boekelheide Inc Subdivision:CONDO SUPPLEMENTAL PLAT NO.4: Lot: 22830 -2
Project Description: (1) low voltage prewire from demark to tenant space
Contractor: BRIDGETOWN ELECTRIC Owner: HUNZIKER PROFESSIONAL CENTER LLC
5701 N LOMBARD ST 3601 WREN ST
PORTLAND, OR 97203 -4113 LAKE OSWEGO, OR 97034
PHONE: 503 - 621 -7122 PHONE:
FAX: 503 - 621 -7123
FEES
Description Date Amount
Specifics: Restricted Energy Permit 01/16/2013 $75.00
12% State Surcharge - Electrical 01/16/2013 $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
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 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 Op, 952- 001 - X7 0090. You
f -
may obb copy of the rules or direct questions to OUNC by calling 503.232.1987 orr
Issued By: l l X Odd "v► Permittee Signature: D A r'V .8 / 0. `( ` K'T!d/L
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.
Jan 15 2013 12: 11PM Bridgetown Electric 503-621-7123 page 1
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Electrical Permit Application IECETVED • ; :„, • ' i ' 5 • ; ; . : ' • "' : '
City of Tigard
.' 13125 SW Hall Blvd., Tigard, OR 97223
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Phone: 503.639.4171 Fax: 503.598.1960
Inspection Line: 503.639.4175
Internet: vmew.tigard-or.gov ived .
JAN 1 5 2 013 D I He (3
Plan Review
Dated3y:
CITY OF TIGARD Date Rawyaty:
B IL 1 ING DIVISION (*Notified/hi hod ,PeriaitNo.: Q.01 3- pop I
. . ELK'
Other Permit:
Aisle] i _ I E See Page 2 for
1 1 k-CF I Soppilentental talermattan
\_ ,„.. ,,,„,-,..-,, , ,,- . ,-. ...- .n , VP7e 4--, .:-.T.,,,,..:,•,.: ,w ,,,,,, 4 ,,,,,,,,, , Triftwrrrarfn■747F . ..., fmtir
..,,'!,.!;.':',7':14414'..cin!egii::41 za,..,, : 4 :' ..-'...,,- ,Z.OV...t'MFA,.::::. :,.;:h:' :A.f,:i,iV':::=.q1Og; Pol r:. , ...1'=i'' '; ',''' !-:'' : =
0 New construction 11.0 Addition/alteration/replacement Plante check all that . • .1y (=batik a soh at plaaawlitems checked below):
0 Service Or feeder P I amps or more 13 Building over three dories.
El Demolition 0 Other: where 11w was • • • (Mull current D Marinas and boatyards.
4 :1Vi? : :! 5 T4'f - t - PNgt/if,t1iff. ‘ r c . i . i 1.1 ' ; :1!• : : N : Z. :.'. 0 - Y - =:0.. -4 - - g,, ..: exceeds 10000 - • • at ISO volts or 0 Floating buildings.
V.t17 DP P -.. •-• r7 '' ' .., -•••••••• •,, . '1•,•-• r ... .•;,..:. ."..4.. • r;W L'• • f':: 91., '1' 1 ''• ,•,...0 .: , •.:.; ,:kr
less to ground, or - - , -• 14,000 0 Commercial-use agricultural
I:I 1 and 2 dwelling IZ Cornmercial/industriql 0 Accessory building amps for all other • - a/labors. buildings.
,
0 Multi 0 Master builder : u Other: 0 Fire pump. 0 Inalantdion of 75 KVA or
- 0 Emergency system
.", • -.,. il, 11/ I P:i - Ai - ;1'_ : : , : :. • ' ,1 1^. 0 Ad of „ , to l of larger separadoly derived system.
r
. .-1".07 IsV P.44.9-87....,-.:.' ,!.`„ ", ',..r. ...., . ,:. r,„ ,,, •.„ ..p : .2,',....,,11 0 "A", "E", "I .2", "1-3",
Job no.: 1 I Job site address: 114 /9C, p 14 „,,, t 4. 100HP or moor.
0 SiX or more rosid. . tial units. occtmancy.
0 Re:national vehicle mins.
City/State/ZIP: - "t 4titm Q , (SR (Ai eils ; 0 Heatilv.caro thoiliti-.. 0 slimly voltage for more than
0 Hazardous !mai - 61H/ volts nominal.
Suite/bldg/apt, no.: A I Project name:9 • ,,,, g c lotk at utiAv _ i .„ o Service or feeder • P , 0 amps err mom.
E7 La7ZET 71f,MMX4
Cross street/directions to job site: owittattwi OW. like‘. Tog •
New residential SI • : le- or - multlarsiatily dWelling unit.
Includes attached 1.,. , !,e.
Subdivision: I I Lot no.: 1,000 sq. ft or less 168.54 4
Ea. add' I 500 sq. ft. • portion 33.92
' t
Tax map/parcel no.: .
. , Limited energy, resi — ,'.
,
aitilarritipliAltItAWINA**thWth (with above sq. ft ) 75.00 - 2
j . a dp,614 --,.. I. . = ^%.'• ,, ' , " .. Vet . ' , 415' 'f' Limited , mut 41=4
Low vol 6.0, 9,",,,,t,46 .,„%sx..... A44 IN 4-ozm4LAtit- residential (with ; , , ve sa. It.) . 75.00 2
Services or feede • Installation, alteration, and/or relocation
4 2tipt.A.A.9-• 1 200 amps or less 100.70 2
tl
:' 201 amps to 400 am • - 133.56 2
Yt .. : , ,.... - _...: ..,!1•1, • - •. , .-.,.... , W..y.. , •,..„7gt , pl.;.':•., P:1.,< ,., - ..,p.-- , - ,5.!.!:r. - .,•.. - . '.„ '--;
401 amps to 600 am 2
, 200.34
Name: ,
601 amps to 1,000 . . ,,, 301.04 2
, ddress: Over 1.000 amps or olts 552,26 2
Temporary servie - or feeders Installation, alteration, and/or
City/State/ZIP: ,
• relocation
Phone: ( ) I Fax: ( ; ) 200 amps or less 59.36 1
201,amps to 400 am , s 125.08 2
Owner installation: This installation is being made on iroperty that I own which is not
401 amps to 599 a , .s 168.54 2
intended for sale, lease, rent, or exchange, according to )RS 447,449,670, and 701.
.Brancb circuits - , , alteration, or extension, per panel
Owner signature: i Date: A. Fee for branch ..' its with
, :A, .: :.' t ,-7 - , A...,:.A1A• above service or i der fee,
742 2
each branch circa , . .
Business name: R. Fee for brmtch ci - its without •
• service or feeder ee, first
Contact name: • . branch circuit 56.18 2
Each addl branch ci - 't 7,42 , 2
•
Address: Miscellaneous (se or feeder not included)
j Hach manulbctured , modular
City/State/ZIP:
dwelling, service ; . Of realer 67.84 2
Phone: ( ) I Fax: : ( ! ) Reconnect only 67.84 . 2
Pump or Irrigation c i k 67.84 2
E-mail: :
Sian (south= lighti .
67.84 2
." :';?. :', ...g 7 Mili i 2 , WV9 ; 0:014V - 01 7, 1 • A*061I*0.0*Oitiaiifi'.‘ 1, -" , ‘ : M'i - , I i:',:j;::4 1 a1:';',:j;'•';' , ;: . !;:i '',' Signal circuit(s) or li , • --energy - 1 4 54 46 2
Business name: l aIR i oceRtAtp.i ELEA:7RO, panel, alienation, or - ,-, :Ion. _ I Page 2
Each additions! i , , pection over allowable in any of the above
Address: S 7 0 / X) , j,... 0 fn. et Al-fty) rie V Additional inspecti , (I hr min) 66.25/ Iv
City/Stater/JP: ?ocrnAmi> OR 0 111 03 - 1 3 Investigation (1 hr , :n) 66.25/ hr
Inclustrial plant (I hr min) 78.18/hr
Phone: (Scr; )/ I - 7122. Fa ( 54 ) 7123 Inspections for will . no fee is
90.00/ lir
...... listed s,,hr min
CCB Lic.: 10'387-4 Eiretrical Lic.: - _ Suprv. Lie.: 4 j 7
. -grrv. Electrician signature, req . .. , -.. 16 4 . 1&' Plan view (25% ofEettn fee):
'---..,•rint nam )",e, _cite ..7„.s ...--cl. Date:
e:,e • 4 Stales • . cage (12% of permit fee): D 4 VD
Authorized signature: TOTAL PERMIT FEE:
• Stt•
This permit applies • a melees if a permit in am obtained within 130
day as * i , It has been accepted complete.
Print name: I Date: • Number of inspect( • - allowed per permit.
lAkildirOPermits1ELC-PaTnitAirp.doe 07/01/110 140-4615T(1 UM/COM/WEB
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