Permit 1 , 1 CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit #: ELR2013 -00168
13125 S W H Bl Tigard OR 97223 503.718.2439 Date Issued: 07/16/2013
TIGARD Parcel: 2S101AD03100
Jurisdiction: Tigard
Site address: 6950 SW HAMPTON ST 310
Project: Oxford Brothers Subdivision: WEST PORTLAND HEIGHTS Lot: B
Project Description: Data telecommunications
Contractor: BRIDGETOWN ELECTRIC Owner: WESTON INVESTMENT COMPANY
5701 N LOMBARD ST ATTN: JOSEPH E WESTON
PORTLAND, OR 97203 -4113 2154 NE BROADWAY ST
PORTLAND, OR 97232
PHONE: 503 - 621 -7122 PHONE:
FAX: 503 - 621 -7123
FEES
Description Date Amount
Specifics: Restricted Energy Permit 07/16/2013 $75.00
Type of Use: COM 12% State Surcharge - Electrical 07/16/2013 $9.00
Class of Work: ALT
Total Number of Systems: 1
Audio & Stereo: 0 Boiler Controls: 0
CCTV: 0 Clock Systems: 0
Data & Telecommunications: 1 Fire Alarm: 0
HVAC: 0 Instrumentation: 0
Intercom /Paging: 0 Landscape /Irrigation: 0
Landscape Lighting: 0 Medical: 0
Nurse Calls: 0 Protective Signal: 0
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Security Alarm: 0 Other: 0 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: 4, 5 W- - Permittee Signature: ate_ � / L , (�/?O,./
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.
Jul 12 2013 2:04PM Brid town Electric 503-G21-7123 page 1
Electrical Permit A ep licatiogrECEIVED
g
1 i ,!,-. i i 1 . i, ! 1 ,..i
City of Tigard Received ,-.
Da /6 /3 0;'i Penni' No.: 6 - 4/2.20/3 --.'/P NI „....,, 13125 SW Hall Blvd., Tigard, OR 97223"-'L 1 5 2013 Plan Review
7
'I Phone: 503.718.2439 Fax: 503.598692 Date/By: Other permit:
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Inspection Line: 503.639.4175 1 IYOFTIGARD Date Ready/By:
Notified/Method: Airis• , RI See Page 2 kr
Sappleokilial kformadem
Internet www.tigard p , iltikfilDMIG DIVIVnii
'1 4 •;,. ..: : :Zi -',, y4;'41 - 51 - 24ig. -" E j, i ' .?;Kft - liPift , Ot::::10,0401tic:: - .'.:-' v r:Y 1 .: ,4 ".. :, '"-:''' ' ': ::: :.; . P: - ...::: . :,: : - :i ' - ' 1 ... ' Attir: ' k.A
El New construction I Addition/atteration/replacement Masa cheek all that apply (submit laces of plans sr/items cheated below):
0 Service or feeder 400 amps or more 0 Building over three !dories..
0 Demolition 0 Other: where the ava0able fault =rent 0 Marines and boatyards
' . .
',,'", jP: f '`‘‘' ,Ii ,,, v ' ,,,, .,,, ,' ... . . -.- exceeds 10 000 amps 01 150 volts or s .
! 4anol!rPr:11. , i' ‘. ; n;:' :,,, : . '!'H;:: less 14.000 B Floatiric _ b uild' a lik- 1
0 1 - and 2-family dwelling g Commercial/ituJustrial 0 Accessory building ta ren ot °r her list/Mations. buildinp. "aSe -..----tii rai
0 Multi-family CI Master builder 0 Other: 0 Fire pump. 13 Installation of 150 KVA or •
- - -- *Eiotki:' , ::: , ...‘.....',..-,z.:, cl. 0 Eme7.FncY "black' larger separately derived system.
: i :: , 4.f.'4.C;: ,. . , ;;;; , i; , .:.:411;*.Lf.':'ArrimeN . . . ,' .. , .. .., ..- , .. - ...; - .....-.. .. ... .'... . , .,,•-• ,,. .---' -;. . , , -.. - .. 2, 0 Addition of new motor load of El "A", "E"„ "1-7". "1-3",
100HP or roore. occupancy.
Job no.: 1 Ili ti I Job site address: ZaCtS0 SW 41 rom.pkv.‘, °A. sk 3 to 0 six or mom AtAidentiai gam,. eational vehicle park
0
City/State/7 ,,
-
y . 11 • --,,.., OR 1
6 11.1.- 3 0 Healt Hazardou i h-care facilities.
0 s location& Recrs.
0 Supply voltage for more than
600 volts nominal.
Suite/bldg./apt. no.: \ O 1 Project name: 0 xL "tt 0 Service or feeder 600 ,. ., - kir more.
.:i.i 0Yt: T. . : ,:' :7
Cross street/directions to job site:
- ,.,.., • '11 ..TmEIN •
New residential single- orImuld-family dwelling unit.
Includes attached garage.;
Subdivision: 1 Lot no.: 1,000 sq.11. or less 168.54 4
Ea. add'I 500 sq. ft or portion 33.92 1
Tax map/parcel no.: Limited away, residential
7500 2
iti:**60:* '':...' Y : , i ::: :. : - I': : '1.-" (with above sq. IL)
• a 1 Limited energy, multi-family
75.00 2 !
L ow it cNILIA•r4 SONO..., cil..C.h•kmatrte 4e 1-04.-e.w.A" residential (with above s9. ft.)
- RieneswiliitEtter T'
5 irr-<" Cov...44,Act CAJAR- Services or feeders instellation and/or Monition
i'Ebi,+diff .. ..-..!' ',-.;. ;I: .2.,;;;' 200 amps o I'm 10970 2
. . , f • .. . . . . .. .. .. . •••:.•
201 amps to 400 amps 133.56 2
Name:
401 amps to 600 amps 20034 2
mps
Address: 601 a £o1,000 amps 301,04 2
Over 1,000 amps or volts 552.26 2
City/State/ZIP:
Temporary services or feeders installation, alteration, and/or
Phone: ( ) Fax ( ) relocation
200 arnps or less 5936 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 12508 2
intended for sale, lease, rent, or exchange, according to ORS 447. 449, 670, and 701.
401 amps to 599 amps 16i 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per Panel
;', 'ili !.''' :' A - Fee fOr branch ciltuits with •
&awe service or feeder fee,
742 2
Business name: each branch circuit
B. Fee for branch circuits without
Contact name:
. service or feeder tte, first
56.18 2
branch circuit
Address: Each add'I branch circuit 7.42 2
Miscellaneous (service or feeder not included)
City/State/ZIP:
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Each manufactured or modular
67.84 2
Fax: :
Phone: ( )
dwelling, service and/or feeder
) (
Reconnect only 67.84 2
E-mail:
Pump or irrigation circle 67.84 2
.. • - , ..•... ,• .. .. :,
*: ' ...'... . , ,, • , , ' -1',.‘' , I, Sign Or outline lighting 67.84 2
Business name: Bridgetown Electric Signal circuit(s) or limited-energy i See
panel, alteration, or extension. 1 Page 2 15i" 2
i Address: 5701 N Lombard St.
City/State/ZIP: Portland, OR 97203 Each additional Inspection over allowable In any of the above.
Additional inspection (1 hr min)
Investigation (1 hr min) . 66.25/ hr
66.25/ hr
Phone: (503) 621 Fax: (S03) 621 Industrial plant (1 lu min) 78.18/hr
Inspections for which no the is
CCB Lic.: 103824 Electrical Lic::' • 6 Suprv. Lic.: 4I77S • ticall listed % hr min 90.00/ hr
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'I ' ',6•7): i' r .fi r . r .F.M . 71 77 113nq :" ZellgIagrain
Suprv. Electrician signature,
Subtotd: 15,0*
Plan review (25% of permit the):
Print name: Keith Steenslid Date:
State surcharge (12% of permit fix): 1,66 s
Authorized signature:
TOTAL PERMIT FEE: 84 .
This permit appliattion expires Era permit boot obtained within 180
Print name: Date: days after it has been accepted at complete.
• Number of inspections allowed per permit.
I Rev DS121/2013 440-461 ST(11/051COMMES
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2 page 2
Jul 12 2013 2:04PM Bridgetown Electric 503-G21-71
Electrical Permit Application — City of Tigard
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Page 2 — Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
; Tow •
awriowo
Fee for all residential' systems combined ... $75.00 ow To
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 1 oo.70 2
5.01 to 15 kva 133.56 2
0 Audio and Stereo Systems*
15.01 to 25 kva 200.34 2
Wind generation systems in excess of IS kva:
0 Burglar Alarm
25.01 to 50 kva 301.04 2
fl Garage Door Opener* 50.01 to 100 Lira 552.26 2
>100 kva (fee in accordance with
552.26 2
-
Heating, Ventilation and Air Conditioning OAR 918309-0040)
Solar generation systems in excess of 25 kva:
System*
Each additional kva over 25 7.42 3
0 Vacuum Systems* >100 kva — no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
0 Other Each additional inspection is
chased at an hourly (1 hrinin) 66:25/ hr 1
Inspections far which no foe is
90.00/ hr
s. fscaU listed Vahr min
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Fee for each commercial system....................... 575.00 Subtotal:
(SEE OAR 918-309-0000) Plan review, if required (25% ofparnit fee):
State surcharge (.12% of permit fee):
Check Type of Work Involved: TOTAL PERMIT FEE:
nit permit applicable expires If a permit in not obtained within 180
days after it les bets accepted as complete.
i
El Audo and Stereo Systems
• Number of inspections allowed per permit
O Boiler Controls
0 Clock Systems
Z Data Telecommunication Installation
0 Fire Alarm Installation
El HVAC
El Instrumentation
0 Intercom and Paging Systems
0 Landscape Irrigation Control*
O Medical
fl Nurse Calls
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0 Outdoor Landscape Lighting*
El Protective Signaling
O Other
Total number of commercial systems: _____
*No licenses are required. Licenses are required
for all other installations
IABuildingTennits'ELC_ParmilApp ELR_ERE.doe Rev 05/21/2013
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