Permit n CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
' • g . COMMUNITY DEVELOPMENT Permit #: ELR2013 -00166
T [GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/16/2013
Parcel: 2S113BA00400
Jurisdiction: Tigard
Site address: 7632 SW DURHAM RD 200
Project: Allstate Subdivision: ROSEWOOD ACRE TRACTS Lot: D
Project Description: Low voltage for data
Contractor: BRIDGETOWN ELECTRIC Owner: PORTLAND SW CENTER LLC
5701 N LOMBARD ST BY FELTON PROPERTIES INC
PORTLAND, OR 97203 -4113 ATTN: FELTON, MATT
520 SW 6TH AVE, STE 610
PORTLAND, OR 97204
PHONE: 503 - 621 -7122 PHONE:
FAX: 503 - 621 -7123
FEES
Description Date Amount
Specifics:, Restricted Energy Permit 07/16/2013 $75.00
12% State Surcharge - Electrical 07/16/2013 $9.00
Type of Use: COM
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
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. ATTENTIO • Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -001 rough 0 952- 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 CL6L4AA Permittee Signature( f t 0---...___.
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 02 2013 2:37PM Bridgetown Electric 5 0 3 - 6 2 1 - 7 1 2 3 page 1
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ElectricalPernhitApDljcatioR :CEIVED , , . r: i3 I i 1 : '.1
I City of Tigard j L 2 2013 Fteceived 7/ ' DetetS : 6 I/ Permit No.: fa.aat5-410 /&#
.11 , -- 13125 SW Hall Blvd., Tigard, OR 97223 p Revi t "
1
• Ir. Phone: 503.718.2439 Fax: 503.5911.1d te/E4v: • Other Permit
Inspection Line: 503.639.4175 OFTIGARD D 'Date Ready : y: I Jura:
gi See Page 2 for
Intentet: www.tigard-or.gov
'' 1 G DIVIStOV Notified/M- hod:' I Supplemental Information
III
-fflAV.r galtitiA ` ... :. ' ; t' ' :•:',..;''. • '' ''''''.': fI'A.'4!IN:Il.ttii
0 New construction 1174 . .dition/alterati . , eplacement Please check all that : • • y (submit lett& of plans v./items checked below):
['Service or feeder 4 I amps or more 0 Building over three stories,
1
D Demolition 0 Other: where the availabl .4hult current 0 Marinas and boatyards.
, 7 , , LI: asea — , trArjr u t=1, ,4, , .
01- 6, 4.7440 :''' V '' INEEISSII1 exceeds 10,000 : . .. at 150 volts or 0 Floating buildings.
,:,:qt
less to ground, or I -, cads 14,000 0 Commercial-use agricultural
El 1- and 2 - ly dwelling gi Commercial/indti. ia1 0 Accessory building am f all other , • anomie. buildings. El Multi 0 Master builder 0 Other: 0 Fire pump. 0 installation of 150 KVA or
1:IEmergency systen larger separately derived system.
::. ' . ,:.
:`:;0';' ,"iirf:/ ',-.I. ' " ,, ;r. 1 ' 4 AP' i 7'. 410 rit :. '..- ,... ' '-- ' ..: '• , 0 Addition of pe q . „toad of
,,..P:'.. . .-.' „ ' ' - . ,,,.... ','...' ..... — '' I -. : 0 "A", "E", "1-2", "1-3
DU W'
A ., , ' .7
Job no.:13.- ',T1 1 lob site address: '. S kTlitrt , , or:• H o r P . 0 ,%""::::. 'j wafts. .
occupancy.
0 Recreational vehicle parka. City/State/ZIP: % \ , Ate zier,_ .20 6 _.....°4— , 0 Health-care fecal -,.
0 Hazardous locatiM1 0 Supply whose for more than
600 volts nominal.
. 1
Suite/bldg./apt no..z.... •-- -;;. Project name: J , AStir41$4. +. CI Service oe feeder • 1 • snipe or more.
toie• I IMNIV7P I A ' '," ):4iIIII'. '
Cross street/rt ; lions to job site:
W r- ia,' -, - '-,-- ii :=1■1■Iii - oniiiiaiiiiialiiiiiminiviiiita
New residential si - , '..le. or muld-fandly dwelling unit.
1,
includes attached :. arage.
Subdivision: Lot no.: - ! 1,030 sq. ft less I 168.54. 4
I Ea. addl 500 sq. tl. . portion 33.92 i
Tax map/parcel no.: I Limited energy, mil untie'
75,00 2
.. 7 '„.. '. ..'. Yt,. ,.--'',:- ::;,' i ' . ' : 1" : ::Hi i'l: ::: ::` i 1 with abtwe 5 ' ft 11
! Limited energy, tout-family III
75,00
residential with 1 • . ..... 13
, mestaffilmE=aimatism
Services or , !installation alteration and/or relocation
• c - i:, 1 200 amps or less = loa
I n Ell
-..il "I. :,,',' : 43.4tratA14:.. -: : ,'_;-, -,: , .,‘, 1
i 201 amps to 400 am.. 133.56 2
Name: i
401 amps to 600 am. 200,34 2
Address: } 601 amps to1,000 : . .. 301.04 2
Over 1,000 amps or i, .11s 552.26 2
City/State/ZIP:
Temporary servi . or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( )
200 amps or less I: 59.36 I
Owner installs ion: This installation is being made 0 , property that I own which is no 201 to 400 am: 125.08 2
intended for sale, lease, rent, or exchange, according t ORS 447. 449, 670. and 701.
401 amps to 599 =la 168.54 2
Owner signature: Date: Branch circuits - !: , alteration, or extension, per panel
'1:'.'''. ''',";VI.'..'.gi!!Wlii IZ,'„POrlir.4004011)90,',. , A. • 1:
" . • ; above service or - • ..- r fee,
Business name: each branch circ 1 7.42 2
B. Fee for branch ci 'i Is without
Contact name: ; service or feeder 1.-., first
56,18 2
I branch circuit
Address: 1 Each add'l branch ci it 7,42 2
1
Miscellaneous (se cc or feeder not Included)
City/State/ZIP :
, Each manufactured o modular
Phone: ( ) I Fax: : ( ) dwelling, service a .. 67.84 2
or feeder
I Reconnect only l: 67.84 2
E 1 Pump or irrigation c' I 67.84 2
6 ' :',.., , : :. 1 - , :' :1 r !' I Sign er outline liiih '18 67.84
Business name: Bridgetown Electric 1 signal circuit(s) or Iii ited-enerpy Fil, ___, See e ill
! . , i aheratio . or -;,.. - ion. ,.:-..C11 P ! 2 ....ao.
Address: 5701 N Lombard St. ' Each additional in' . . on over allowable in any of the above
Additional inspect'. 1 (1 hr min) 66.25/ hr
Clty/State/Z1P: Portland, OR 97203 I 1
Investigation (1 hr In' ) • 66.25/ hr
Phone: (503) 621 Fax: (5)3) 621 . bxkstrial plant (1 hr' in) 71L18t hr
, inspections for win — no fee is
CCB Lie.: 103114 Electrical Licr:' 887C I Suprv. Lie.: 4177S , s. - 'find! l i s t e d '4 1. r min 90 hr
lanan.; ..
Suprv. Electrician signature, Seo...A:AP-4X , I Subtotal: lifL11;g1Phill
Print name: Ketith Steenslid Date: 7 .15 I Plan I, 'ew (25% of permit fee):
. State gull. .. l (12% of permit fee): ';'" A.
Authorized signature: ' . TOTAL PERMIT FEE:
.
, This permit applies on expires if a permit Is lot ■ , Pt , -, within 180
Print name: ! Date: days a • r it has been accepted as complete.
• Number of Unocal. allowed per permit. fY Au
latildinglertetuNELC_PermitApe.,ELAURE dot Rev 0512I2013 440 11 Ii AlSiCOMAVER ' li
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