Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
e • COMMUNITY DEVELOPMENT Permit #: ELR2013 -00125
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/10/2013
Parcel: 2S112DA01400
Jurisdiction: Tigard
Site address: 6650 SW REDWOOD LN 105
Project: Pneu Logic Subdivision: 1996 -048 PARTITION PLAT Lot: 2
Project Description: Data telecommunications system.
Contractor: BRIDGETOWN ELECTRIC Owner: PACIFIC REALTY ASSOCIATES
5701 N LOMBARD ST ATTN: N PIVEN
PORTLAND, OR 97203 -4113 15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 621 -7122 PHONE:
FAX: 503 - 621 -7123
FEES
Description Date Amount
Specifics: Restricted Energy Permit 06/10/2013 $75.00
12% State Surcharge - Electrical 06/10/2013 $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.
7 0" 1 1111111b
Issued B.i � _ ��i ( , li Permittee Signature:
—
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.
Thls 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.
Jun 06 2013 3: 19PM Bridgetown Electric 503-621-7123 page 1
Electrical Permit A lica ; : ,:-: . ,. ,. , - • , •,.. : :
City Of Tigard 1111 (.e/ / , 7- II :Peritrit Noe. - LF,4,4„.,AN 1 - 0 0 i xs ._
1 .. 4 0125 SW Hall Blvd., Tigard. OR 9 r A L V. 06 ?013 Plan Reid •
' lr: Phone: 503.639:4171 Fax: 5015 • .. '`'. I tuted13v: I Other Permit:
1 I , Maps:lion Line: 503.639.4175 • ..... ,, nn I N Date R .. . : y: Jurls. El See Pop 3 tor
' ' ' ' Ititernet www.ligard-or.gow CITY Jr U Not' - hod: il Supplemental llalonsatioa
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to.t. • . ..., • - .:iarsetiaLittulLi.a:ra r 2._ - .....;413' krzt, i ;-dh,',..,..!......ri .;:..: . :.!:: . ',:. J.,. ; ,.:'2 t ,. 1 154 k.". L., J1'...-...! ...- < .4
0 New construction MI Addition/alteration replacement . Pleath check &Mitt . . • Otekliit 2
. ' °Semis° as Omits .. emir militia °Building awe ihree stories.
El Demolition . 0 Otber: • where the wag Sault anseot 0 Tebsinas sod ballyarth.
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4 .1;47 :: ' 3- )P.R4 1 4 4 . e .Vi ze l:.7 . ' tealn.2 ,'"-,- ectecoda 10,000 . ..• d ISO :rob w 13Sioatiog heildiap.
less to ground. or • • - - - • 14,000 0 COmmattial-use agricultural
1:1 1 - and 2-faitily dwelling Contrnereial/industlial 0 Accessory building amps roc all other .. • -
0 Multi-familk .. 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 75 KVA or
largo' separately derived eyste a.
''0 ) T .C 1' 10.' 11‘. .4,- Z41 - R.....217 C .E 4 0 , 1114!-14 141-"rtEl lin-roi r .s. 1 & 11 1, 1 :t r ;le=cL'2 4 ;12 3 r.. - ... :01 011 rg 1 . 111; 4 : 0 . "'" bd of 0 "A", "e",, "1-2", "1-3",
lob no.: ‘ -.. S t Job site address: loLo F30 5vJ qtros4T017 ti4 100HP corneae.
0 Six cc more - • ... - • . Intim occupancy.
0 Recreetiond vdiela parka.
CitylStfite/ZIP: . :‘,ARb OR 6 11 - 0- 1 4 ' 0 Health-ours barn - 13 Supply voltage for more than
011azordow lour-. 600 volts combei.
Suite/bldg./apt. no.: 105 I Project name: I ikitliti,A," 1.44,‘,./ , O'Serviee or feeder .' . , ems or mom
, ,. .; ? Aligrf§4. Ea .4
Cross street/directions to job site: p I f..A.A .. ,:..,..
...:-Iiiii-6--.,..Aiiiiiill
New reakiendal d • .. - or multiAbunily thvelliagenit.
Includes attached
Subdivision: . Lot no.: 1,000 sq. ft. or less 168.54 .1
Ea. Well 500 sq. IL. portion 3192 i
Tax map/parcel no.:
_ Limited energy. re :. - ...
ALY Pitii 7 ' —fwith!lbove • . • i • . . 75.03 .)
..
-
Limited energy, mu .;-lianily III
7100 2
Low, VO tAIL , • •.- 11.6 %WOG , yvL, ,. . , residential with . I • - , ... ft.
Services Or feed hastallado . alteratio . sad/or reloeadon
t
_A:A.6.1..r.. • 203 amps Or less III 100:70 ..
...s1 'Roll, , i - ..
'Pbr_ ; i : gS . rgrIL : '44•ATAA , antE011 1.1 ' Pirin
— 201 amps to 400 .., - 133.56 9
..
N
401 amps to 600 ... - 200.34 :! •
ame: . • ' .601 amp to 1,000 • .. 301.04 2
Address: Over 1,000 amps es olts 5$126 . 2 • City/State/DP; • Temporary antic - • or Emden Installation, alteration. mud/or • relocation
Phone: ( ) Fax: ( ) 200 Kreps or less • 59.36 I
201 amps tO 400 . : - III
Owner installation: This installation is being made en property that I own which is. . 125.08
.
401 amp to 599 am . - 16&54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branekciten113-- • alteration. or extension; per. pawl
Owner signature. Date: • A. Fee fbr branch ci - 'Is with
ail 7A2 ' .1 eganitanIFFIn . ' ab ° I *- - " fee.
, ..L.1.. .- ..=1..........t,i4.6,. "...4.31. . emit brach drcu
Business name: • • B. Fee fir branch c' - Is without
service or tbeder : • Ms:
56.18 ;!
Contact name: branch circuit
Each add•I branch -'. it .,
Address: mbeeliaaeons ( .., • or feeder not included) • Each manstketamd .. modular
City/State/ZIP: 67.84 • , dwelling, service .. . . fisecter
Phone: ( •) I Fax: :1 ) Reconnixt only 67.84
• Pump or Irrigation ci - e 67.84 2
E , . Signor =ninon:. •
i 'T`;?.' 'V . agr.M ' ' •
43: . Sigma eireuir(s)or li .1W-energy
ic 00
Business name: '7131M901410414 ELscrpat - • -.., - - an. • um. •.. 2 • Each additional . • . don over allowable la any afire above
Address: . ff 7 0 / /V . L-0 (n.64e) - oar- Additional .. (1 br min) 66.25/ hr
bwestigarites(ttur ,. ) 6615/ hr
City/Stater/IP: I PORTUiNte a r CO I 03 -40 1 3
. Industrial pima br ,. ., ) . ' 78.IV br
Phone: (Scp; ) .,,, ... 712 • Fine (t .) . 7123 • .......... Ibr whi
--in.- Jima' 59iIIIII "Mb?
' -
CCB Lic.: 1‘,;( ; E - .. ' at Lie.: .,. -9 4 , Suprv. Lie.: Li I
. .. .
, Subtotal:. •
Supry. Electrician signature, requiret17.., 7.,!..k ‘.....e...,,,#4..: .6.0
Print name: / e ) .s /•-ti
, SP -- # Date: , Plan ev Inv (2914 pf Damn foe):
.
. State .. ' • :: (1294 of permit fee): q." • Tommommr4. • 6 .. • Authorized signature: •
Thle permit.. • . ; .. exploetipartriehlo sot alttalse4 within 160
day. • . - bas bats aticeptcd as onitidste.
Print name: — 1 Date: • it Number of insperni • . :dittoed yew permit.
INIaildineermiti1E„LC-perraitApp doo amino • , 440.46151(1 I/0S * . - :
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Jun 06 2013 3:20PM Bridgetown Electric 503-621-7123 page 2
Electrical Permit. Application - City of Tigard
Page 2 Supplemental Information
LIMITED ENERGY PERMIT FEES:
RES10132004*(00.01110
Fee for gi residential systems combined........ $75.00
Check Type of Work Involved:
0 Audio and Stereo Systems*
0 Burglar Alarm
E Garage Door Opener*
0 Heating, Ventilation and Air Conditioning System*
El Vacuum Systems*
0 Other:
Fee for each, commercial $75.00
system
(SEE OAR 918
Check Type of Work Involved:
Audio and Stereo Systems
• Boiler Controls
El Clock Systems
gi Data Telecommunication Installation
O Fire Alarm Installation
O HVAC
O Instrumentation
O Intercom and Paging Systems
O Landscape Irrigation Control*
O Medical
El Nurse Calls
• Outdoor Landscape Lighting*
O Protective Signaling
El Other
Total number of commercial systems:
*No licenses are required. licenses are required
for all other installations
IM3uildiaPerinht1ELOTtrrnitApp.doc 07101110