Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit #: ELR2013 -00178
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/24/2013
Parcel: 2S102AA00490
Jurisdiction: Tigard
Site address: 12085 SW HALL BLVD 150
Project: Secret Beauty Salon Subdivision: TIGARD HIGHWAY TRACTS Lot: 13
Project Description: Low voltage for data
Contractor: BRIDGETOWN ELECTRIC Owner: HALL STREET CROSSING LLC
5701 N LOMBARD ST BY MR & MRS ROGER W TOM
PORTLAND, OR 97203 -4113 8067 SW RIGERT COURT
BEAVERTON, OR 97007
PHONE: 503 - 621 -7122 PHONE:
FAX: 503 - 621 -7123
FEES
Description Date Amount
Specifics: Restricted Energy Permit 07/24/2013 $75.00
12% State Surcharge - Electrical 07/24/2013 $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 $84.00
Other Desc: Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 thro c • c 952- 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.23 •87 or 1.800.332.2344.
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Issued B • ' ' � � 7 Permittee Signature: ' `' �� /
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE: Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project
Approved plans are required on the job site at the time of each Inspection.
Jul 23 2013 2:22PM Bridgetown Electric 503-G21-7123 page 1
r
Electrical Permit Applicat 11 L CONIF U
City of Tigard ,,‘ :
ail . DataBv: / 4 q /3 P e r mit N et: 2.4_tszi-3- 7S
13125 SW Hall Blvd., Tigard, OR 972231111 2 3 2.0 i, Ran Review ,
. _
Phone: 503.718.2439 Fax: 503.598.1940' DateiBy: Other Permit:
•
- ., Inspection Line: 503.639.4175 Cfry OF -MAID Date Ready/By: Juria I ill See Page 2 he
t...1:1
Internet: WWW.tigard-or.gov inN 143tifiediMed I
Supplemental infornisden
l l'4,4 :,.-,$,;':•:;;; M:: p :1.. I .,-: ji4akki*'.'i4`,4H41,0.,",
0 New construction lig Addition/atteration/replacement Please check all thatapply (eubseit a sea of plans Weems checked below):
0 Service ar feeder 400 amps or more 0 Building over three stories,
0 Demolition - 0 Other where the available fault current 0 Marinas and boatyards.
:,, :: .:.,,,...; ; ,,:,. • .;..;..,;:: exceeds 10.000 amps at 150 volts or 0 Floating buildings.
, • • k : lw ,, IshiwIRIFY14:...S4Ns•:,:- :.:-. ;-; •:,:-..; --.... -,-...,!..--is-;-: : less to ground, or exceeds 14.000 0 Commercial-use agricultural
13 1 - and 2-family dwelling ria Commercial/industrial 0 Accessory building amps for all other installations. krildings.
0 Multi-family 0 Master builder 0 Other 0 Fire pump. 0 Installation of 150 KVA or
larger seconately derived system.
• •
': :: '' S. - 40 31 D.00 : 000**.05i.4 ,: i*.n.'140**.OK. ' 1' '.:;;':':"...''':-...-:::: ''.;.':;;',..::?'` l a Addi motorload of 0"A", "E"."1-2". "1-3",
100HP or more. occupancy.
b no.: 11„ 5 I Job site address: Ito a 5 s g fil
o Six or moro residental i units. 01u:creational vehicle pats.
Job
OR crra3 0 Health-cere facilities. 0 Supply voltage for more than
a 0 Haardous locations. 600 volts nominal.
Suite/bIdgJapt. no.: 0 156 I Project name:5841MT Srehary SAt,ON3 CI Service or feeder 600 amps or morn
..1..N.2
Cross street/directions to job site: Desahnioa On. Fan I Toms I •
New residential single- or multi-family dwelling molt.
Includes attached garage.
Subdivision: 1 Lot. no.: 1,000 sq. ft or less 168.54 4
Ea. add'i 500 sq. ft. or portion 33.92 1
Tax map/parcel no.:
Limited energy, residential _
7 5.00
2
:1,....;!..:::T.,::`.:::i;.:::■:..,•,:—,.;:,:::,:-,:',-,„.-:::.*:TOiriet0144e; WOK ,7::,,,.-i,-,:!;::;
with above at 11.)
Limited energy, multi-family
C 73.00 2
1 V crift4M•Por TMSW1/4 OkiLiAkt4/41.- AD -6maLsor residential (with above sq. it)
• lieseitililiiEirsitii: " `Y ::: ',',1:14CiBitgail:;,;:•;.,•:, : ,;- :::::•
Q&412.. rrOr Co'&4444 e(a!) \.e.- Services or feeders Installation alteration, and/or rulocadon
: • ''.: :. : L - i :.. • :' t: ::.:: .!' :';: 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Name:
401 amps to 600 amps 200.34 2
Address: 601 amps to I.000 amps , 301.04 2
Over 1,000 amps or volts 552.26 2
City/State/ZIP:
Temporary servkes or feeders i ostallatioa, alteration, sad/or
Phone: ( ) 1 Fax: ( ) relocation
200 amps or less 59.36 1
Owner Installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
401 amps to 599 amps 168.54 2
Owner signature: Date: Branch drealb - mew, alteration, or extension, per panel _
:' - r : ;'•:. 0416A '.f..:::- • - ,f - .: : , , , „ . ,,:' : :: , :::•",..;;;; ; ,,,.; A. Fee for branch circuits with
above service or feeder fee,
7.42 2
Business name: each branch dirUit
B. Fee for branch circuits without
Contact name: service or feeder fee, first
56.18 2
branch circuit
Address: Each add'I branch circuit 7.42 2
Miscellaneous (service or feeder not included) _
City/State/ZI P:
Each manufisctured or modular
67.84 2
Phone: ( ) Fax: : ( ) dwelling, service end/or feeder ..
Reconnect only 67.84 2
-
F. Pump or irrigation circle 67.84 2
'::, ; ! -,: ,,,:-'„■.::: .. -: _. . : .- '' :: ''-';::::-..:: ,':. :- ' -...:'.: ; Sign or outline lighting 67.84 2
Business name: Bridgetown Electric
c\i
panel, a
Address: 5701 N Lombard St. Signal circuit(s) or timited See - ic., 2
So
ltemtkok cam:tension. I Pap 2 1 j
Each additional Inspection over allowable in any of the above
Additional inspection (1 hr min) 66.25/ hr
City/State/ZIP: Portland, OR 97203
Investignien (1 br win) • 6625/ hr
Phone: (S63)621-7122 I Fax: (503) 621-7123 Industrial plant (I hr min) 78.18/ hr
Inspections for which no fee is
CCB Lic.: 103824 I Electrical Lic::" , 6-887C I Suprv. Lic.: 4177S 90.00/ hr
s icall liste )4 br inir
.4 ...,....
• „. ,:•. v xli
Suprv. Electrician signature, • n '-,7F
Subtotal: 1,'
Print name: Keith Steensl id Date: Plan review (25% of permit fec):
• State surcharge (12% of permit fee): q . °
Authorized signature: TOTAL PERMIT FEE: .814 .°
This permit application expires If. permit Is not °Imbed wittde 180
['tint name: I irate, .
after it has been accepted as complete.
• Number of inspections allowed per permit.
Elluilding■PermitaLC_PernitApp_ELR_Pitf.doc Rev 05,21/)011 4404515111u0s/commEa
. . . .
Jul 23 2013 2:22PM Bridgetown Electric 503-621-7123 page 2
Electrical Permit Application — City of Tigard
Page 2 — Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
Otv.
Fee for all residential systems combined ... $75.00 TWA •
Renewible electrical energy systerns:
Check Type of Work Involved: 5 kva or less 1 co 70 2
5.01 to 151tva 133.56 2
01 Audio and Stereo Systems*
15.01 to 25 kva 200.34 2
0
Wind generation systems in excess of 25 Wm
Burglar Alarm
25.01 to 50 kva 301.04 2
D Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kve (fee in accordance with
552 26 2
OAR 918-309-0040)
12 Heating, Ventilation and Air Conditioning
Solar generation systems is execs@ at 25 bra:
System*
Each additional kva over 25 7.42 3
D Vacuum Systems* >100 kva— no additional charge 0.0 3
Each additional inspecdon over allowable in any of the above:
Other Each additional inspection is
chapted at an hourly (1 lv min) 6525/ ht 1
Inspections for which no fee is
90.00/h
listed !strain
Fee for commercial system....... ........ $75.00 Subtotal:
Plan review, if required (25% of permit fee):
(SEE OAR. 918-309-0000)
State surcharge (12% of permit fee):
Check Type of Work Involved: TOTAL PERMIT FEE:
This pe reek application expires ifs partite is not obtained within 180
days after it has been accepted as complete.
El Audio and Stereo Systems
* Number of inspections allowed per permit.
Boiler Controls
0 Clock Systems
tig Data Telecommunication Installation
El Fire Alarm Installation
fl HVAC
O Instrumentation
O Intercom and Paging Systems
O Landscape Irrigation Control*
El Medical
El Nurse Calls
O Outdoor Landscape Lighting*
• Protective Signaling
• Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
lAlluildi*Permhs1ELC_PertniappyLki EREdoc Roy 05/2 W2013
I .