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Permit
CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT III 2 : COMMUNITY DEVELOPMENT Permit #: ELR2013 -00089 1 3125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/22/2013 T E G' R L� 9 Parcel: 1 S 134AA01800 Jurisdiction: Tigard Site address: 10220 SW NIMBUS AVE K10 Project: Interlane Inc Subdivision: IKOLL BUSINESS CENTER, TIGARD Lot: 2 Project Description: (1) low voltage for Data/Telecommunication Contractor: BRIDGETOWN ELECTRIC Owner: HANSON, RONALD D 5701 N LOMBARD ST ROBINSON, CONSTANCE A PORTLAND, OR 97203 -4113 ROBINSON, CHESTER TRUST ET AL 203604 EAST FINLEY RD KENNEWICK, WA 99331 PHONE: 503 - 621 -7122 PHONE: FAX: 503 - 621 -7123 FEES Description Date Amount Specifics: Restricted Energy Permit 04/22/2013 $75.00 12% State Surcharge - Electrical 04/22/2013 $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 OA 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: • J 2 . . yI ' Permittee Signature: ©AL / ' 8 PT .8 L6v (An OI` L 1 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 22 2013 9:31AM Bridgetown Electric 503- 621 -7123 page 2 mimminnim Electrical Permit ADDlicatioI4 CEIVED ill City of Tigard 13 ;n7:-.1-1LIs.„„..1:::,2-#1.:,,...,..°°°.s-9 13123 SW Han Blvd., 'fiend. OR 97223 A P R 2 2 2 013 Pl.n tote,. : Pea 503.639.4171 Fax: 503.598.1960 D ae7By: lnspecdon Line: _ . ..,...., 5 �v7s CITY OF TIGARD _ I DIVISION • y' ."u'e" " r„ _., i 1 r� is�, 7._ . L .�S r. i':.. ❑ New construction ® Addition/alteration/replacement Plow alma all roty (salmi _set` ' pram sarlasdbelOw): 0 Service or 40 Alder 0 amps or more 0 Butldiis owe aws stories. ❑ Demolition 0 Other: whore the available fault currant 0 Marino rod eorya des. . X` ._':O '1 1C11°14 ercoeds 10,000 autos in ISO soft. or 0 Floa ne bdldiap, lcu to ground, or esc.ds 14.000 ID Conaaeir`srs agricultural ❑ 1- and 2- family dwelling ® Commercial/industnal ❑ Accessory building amps for ail etas ieaanatiesm, building. ❑ Multi - family 0 Master builder ❑ Other: 0 Piro pomp. 0 Iomllulon od75 nvA or (] k.xrpe.vY system larpr.ap.aaly derived totem. 1 .oc* Jg)Ni 0 /Whim anew motor load of 0 -2". "Ice ", /t 10011P or more. Vow Job n0.: ) ? - Z 9 S 1 Job site address: /0 t i o J 1 `, ri uK. ID Sib Of mote teaiderpiaI aria. 0 Rsawlea.l whit. perks. City/State/ZIP: 'r 0 lia.lth.o a twilit' - . 0 Suppler vamp fie store than rla-•di , Ay • 4' 2 r_-------- - - - -�_ 0 ttaredoaa towt'. . 600 volts aeaat.ld Suite/bldg. /apt. no.: s i c go Project name: "r.n #re r /�� s = 0 ferries or 6ssder • ■ r • or more. a Cross street/directions to job site: -- — r'3�l�0 --_ N e e residential r .. or radii -6uHlt theelleg cult. ' lad.da attached • Subdivision: j lot no.: 000 sq. ft. or loss ` 161.34 4 Tax map/parcel no.: j ' Ea imited laden 500 messy. s or portion 33.92 I °ul�' Rsanttial 11.00 2 SiROWSION OS :! r with above sa• 14 _ • WOW energy. men-fumy , 7100 2 17/(. 6+i/4 "H ' " c 1-tiLw f. 'd..1 -_42 w ._� fvic Mitws.9.R.) - - pp � +- Services or ke0art itp411Mti0a ageratiotl, sailer '1 try cv,.. 414. tik c....6 k 200 amps or ems 100.70 , 2 1 CI mon . 20 f amps to 400 133.56 2 401 amps to 600 200.34 2 , Name: I 601 amps to 1,000 a 301.04 2 ; Address: Over I.000 amps or Its I 532.26 2 - --- r Tetaporary or feeden issedlstioa. aUer'adoa, and/or City/State//..IP: relocation Phone: ( ) l Fax: ( ; ) - 200 amps or lost 59.36 125.00 l 201 amps to 400 amp. 2 2 Owner installation: This installation is being made on operty that I own which is not 401 amps to 599 amps 16834 intended for sale, lease, rent, or exchange. according to RS 447. 449, 670. and 701. Owner signature: _......__ ' --- - -. -__ Date: . --._ �ee fix r branch cih - dew. ta with alteration. or alttnio wsr cent Fee fix bce>•ahtt with Q -- t . above service or Roder fee. 7.42 2 �' obeli branch circutl - Business name: H. Fee for breach ciruits withorrr - ._ service or feeder tee. fast 56.18 2 Contact name: �t f - _-- fish add'I branch c' uit 742 i 2 Address: MMoelletteeO feeder . ( or feed sot Whined] 1. I?ach msnutbctw.d modular - City/Sta e/I.IP: dwelling, eine s feeder 67.134 2 Phone: ( ) Fax:: ( ) Roconnect only _ - 67.84 , 2 - -- Purpp or irr*aion c 67.84 3 E -mail: I. Sips or online lighting 67.24 2 i " ' l Sigel cireuit(i) a licked-ener , .� Business name: lR N .LE. �)1g panel, alnratltua, a ageeesiot- 1 pa�s�Z �3' 2 ��j _�.�j lath addl«aaal ilpeectien over glen tkb fe use bhp above a Address: S 7 01 tJ • 1- M- 8 � r) S re ar Addit iortal mopes her (1 hr rein) 662S/ Ar City/StateJZIP: ' IAtJt, OQ � 7 2 0 -'`' l 3 My itC (1 hratas) 66751Itr "� ♦ lndits rte (I br min) " 78.18/ Mr Phone: ( e ms 441 . 7 $ 2 2. l Ft": ( ) eii 7 l Z 3 inspections for white no tee is 90.00/ r listed Si he see t'GB Lie.: 103 814 Electrical Lic., W, .-.45 Suprv. laic.. j 1 776 :':'':, ." 1 ,.1 : .__':` "ti• . - _ ..._, _ ti Suprv. Electrician signature, required - -� Sabo* 4•� r ! .0-e.,,„ - Plan review (2s%of permit fan): Print narne:4, y -' va.S /.- Date: I / Z.t.1 /7 Stabs bunch rge (E2%ofpermit fie1K R- - __..._ TOTAL Mai/TEES: g y Authorized signature: Tan permit appfcalteo noires ita psred1ssl — d wider IM Print name: Dale: days slaw h has ban accspesd a complete. • N um b er of imp.Miom allowed par patent. I lBuildhagNmniMalC4trmMAp.di. 07101/10 440-461 sT( 1 1/05 ,00041W04/1