Permit q
CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
IE - COMMUNITY DEVELOPMENT Permit #: ELR2013 -00092
T [CARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/25/2013
Parcel: 2S 101 AD00400
Jurisdiction: Tigard
Site address: 6655 SW HAMPTON ST 210
Project: Curran - McLeod Subdivision: WEST PORTLAND HEIGHTS Lot: 14 -31, P
Project Description: (1) low voltage for Data/Telecommunications
Contractor: BRIDGETOWN ELECTRIC Owner: HAMPTON OAKS LLC
5701 N LOMBARD ST 6665 SW HAMPTON
PORTLAND, OR 97203 -4113 2ND FLOOR
TIGARD, OR 97223
PHONE: 503 - 621 -7122 PHONE:
FAX: 503 - 621 -7123
FEES
Description Date Amount
Specifics: Restricted Energy Permit 04 /25/2013 $75.00
12% State Surcharge - Electrical 04/25/2013 $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 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: Permittee Signature: D a P4-1 (W / re241
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.
Apr 24 2013 1:32PM Bridgetown Electric 503-621-7123 page 4
Electrical Permit A.Dalicatioti,.
City of Tigard
13125 SW Hall Blvd.. Tigard. OR 97223 .
111
Phone: 503.639.4171 Fax 503.59S. 1r ,
laspection Lino : 503.639.4175
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0 Service or toast 440 sower mom 0 Molding marlins seam
0 Demolition 0 Other: %IMO no modeler Audi eminent 0 taro= and lempords.
.V. Of 'MOM 4 . CliCeedi 10.000 amps a 1 %WM In 0 Flaming brildleas.
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0 I- and 2-family dwelling theommereiaVindustr al 0 Accessory building mops for all *duo' i atrallafictrii. buildings.
0 Multi-family , ___,O1Master builder 1 0 Other: 0 Fire !mop CI tounatioa tall KVA or
---; 0 Egnaraeocy systatri.i lallly separately datked systoles
MOO SWELANTIMIPITICK4 , I I 1 ATION 0 Addifton of new maim load of D A. F. - I - 2". - 1 - 3".
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0 I isall1Hare raceliliaa 0 SuPPly valustior mans duo
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Suitedhldgiapt. no.: gi zja 1 Project name: CL, ,...., bk. e. co o0 0 Savioa as hasim 6110 snip or mom
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--.. ..— Ea add'I 500 sq. It. or portion 33.92 I
Tax tamp/parcel ao.:
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13 eaamairevama i C3 TENANT 201 i111111 to 400 amps 133.56 2
Name: I ' 401 aims to 800 same V0.34 2
— _ ........._ MI amps to 1.000 amps 301.04 2
Addrem: Own 1.000 amen or vents 552.26 ,
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Owner ioataitatisa: litis installation is being made on • • , y that I own which is not ../1 amps to 400 nap 125.011
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intended for rale. lease. rent or exchange, according to )RS 447. 449. 670 4W nom; to $99 1611..14 . and 701.
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Owner signature: _ Dote: . , A. Foe air bran* ei . w/44
-C1 ofrucuir al yawner • AMON above amigo or ha 7.43
Business name: B. doe Weimer '
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Contact name: •
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Phone ( ) FI:ax: : ( ' ) Reconnect on 67
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(U3 Lk.: to;; ; :4 Electrical Lie.: 110 - : 43 Suprv. Lie.: .4 i 7 7 . . ,. . .. ..
Suprv. Electrician signature. required , -„:4,4 . IP rt",,, . ,,,
Plan rancw (25% orpasadtba):
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