Permit CITY OF TIGARD ELECTRICAL PERMIT
1111 �: COMMUNITY DEVELOPMENT Permit #: ELC2013 -00452
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/31/2013
Parcel: 2S113AC01201
Jurisdiction: Tigard
Site address: 7315 SW BRIDGEPORT RD
Project: California Pizza Kitchen Subdivision: COUNCIL VIEW ACRES (LOTS 1 -20) Lot: 18
Project Description: (2) branch circuits
Contractor: THREE PHASE ELECTRIC Owner: BV CENTERCAL LLC
5618 SE 135TH AVE ATTN: FRED BRUNING
PORTLAND, OR 97236 7455 SW BRIDGEPORT RD
TIGARD, OR 97224
PHONE: 503 - 263 -2558 PHONE:
FAX: 503 - 651 -3540
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 07/31/2013 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 07/31/2013 $7.63
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $71.23
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 throu • • e • ' •52-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 50 .1987 or 1.800.332.2344.
Issued By: • � —eC-‘2 - L i 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' � o /tom �� Date: 7 3
LICENSE NO. 3 3 J � S S
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 Inspectlo .
it C NI:75 I _ I . : - ,i, ... _ - - - , . .. •
2013-07-30 13:43 .
. .
Electrical Permit Applicant' I 1, H; 1 it - I- 1
.. _...
• . City of Tigard Received , , ' I 2
Datell3v: t ..1-- API , Permit No. 7 Zke a26 /5 — 0 0 / /5 . :,
Ili ....-. 13125 SW Hall Blvd., Tigard, OR 97223 U L 3 0 2013 e' f.
Plan Review
Perm
' a Phone: 503.718.2439 Fax; 503.598
CV OF TIGARD ''''''' Other it:
, , , , Inspection Line: 503.639.4175 Date Ready/By: ' larili la See Pgae 2 for
,„ I .
Internet: www.tigard-or,gov BUILDtNG DIVISIOt1/41 Notified/Method:
Supplemental Information
-
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Please check all that apply (submit 2 sets of plans w/itcms checked below)!
0 Ncw construction PA Addition/alteration/replacement
psi or feeder 400 amps or mare 0 Budding over wee stones.
0 Demolition EI Other: warm the available fault ciment 0 Marinas and boatyards,
ig r12',11r:54:117,"7",'EPaririilliMiglai 4EININAKIER mew& 10,000 amps at 150 volts or 0 Floating buildings.
EitEgliaMantnLi.tii. s.04,4+;..v:%w■tig.'il,7...i.i.,4:ts;aoliiiii;.t.,.:6iiitiiii•ridstihtitolear.4.1(21:usulmri.v..wwtil less to ground, or exceeds 14.000 0 Commercial-use agricultural
El I- and 2-family dwelling Commerciaindusnial 12 Acre-tsory building amps for all other installations. buildings.
13 Multi-family Master builder 0 Other: 0 Fire pump. 0 Installation a 15n KVA or
I •
,p -,Enterge y m.
dff"77"'''''''''P'7 o 77.7 "711 1 .1111/Mii • - ' "642 larger separately derived system.
till Z■F -411 I .11 L46, q„ 4,i:,6., "X■Ptiaoi.AM,04 ". litr ,' j Addition of new motor Load of
occupancy.
EIMME Job site address: Is 1 ! 4 1.7S.1,111M 0 S HP or m was. 0 Recreational vehicle parks.
-. ..
City/Suite/ZIP:
1 4 • A. • P 4: 1 , 0 Health-cam facilities,
0 Htuardous locations. 0 supply voltage for more than
600 volts nominal,
if' DSc/vice or feeder 600 amps or MOTC-
Suite/bldg./apt. no.. A rel Project name: ' ' s P
, • . 1 r ,
r ,ii a.' # I 1 1 Vittif.'!"44
‘tc;idazi;iii tiOvIr
Cross street/direction • i job site: Deserladon Oir. Fee ram •
New residential single- or multi-family dwelling unit.
includes attached garage.
Subdivision: Lot no.: Loon sq. ft. or less
168.141 ..... 4
Ea. adcrl 500 sq. ft. or portion 31.92 1
Tax map/pArcel no Limited energy. residemial 75.00 2
5 r (with iiii'. ' a OrciEM. (with above sq. ft)
1, 2 fit. i 1 5 lb:. ',466,,,a,, is tr . ,. A ` .,. ' A Limited energy. multi 75,00 2
residential (with above sq. ft)
itenewabitEnergy • El SeeTage 2
Services or feeders inslallationolteration, and/or relocation
WINITIPEEZ;Z:::17r7STES argintEN 2(4 amPg cl les'---- 100.70 .. 2
201 amps to 400 amps 13336 2
Namc: , 401 amps to 600 amps 200.34 2
Address: 601 amps to 1.000 amp% 301.04 2
Over 1.000 amps or volts 552.26 2
City/State/ZIP: Temporary services or feeders Installation, alteration, and/or
relocation •
Phone: ( ) Fax: ( )
200 amps or less 59.36 1
Owner imbibition: 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 circuits - new,e1 keration, or extension. Dec Panel _
Ilfirr7p77",`IrIntlrer/C9Fil/Ft ifiTrilital,.;;;Flr,7,4t',1`11frrrMITREM A. Fee for branch circuits with
;:.,,.. ;,.ittkr A' g 1 4.,', araftivo4,, , iitAi;ii,i' .. `ri•Litg:%.'.• ':■4 i gat SiT.Z.LUIS 4 fli ,1,20,1,,,,,6 above service or feeder fee,
7.42
Business name: each branch circuit 2
B. Fee for branch circuits without
Contact name: service or feeder fee, first
- branch circuit I 54 -5(2•1 2
Address: Each add'l branch circuit 7.42 1, i..42, 2
Miscellaneous (service or feeder nit included)
City/Statc/ZIP: Each manufactured or modular 6714 2
dwelling, service and/or feeder
Phone: ( ) Fax: : ( ,,
Reconnect only 67.84 2
E-mail: Pump or Irrigation Circle 67.84 2
INEECIVEriantraitarer,74 Sign or outline lighting 6714 2
Business nam. Signal circuit(s) or limited-energy See
. ' ' 419 - • • ' :M A pane 1. alteration. or extension. Page 2 2
Address: 5" , s
• , . . i.
Ai l • 4I Each additional inspection over allowable In any of the above
Additional inspection (1 hr min) 6625/ hr
City/State/ZIP: 11 ' 62_ ' 2:3
.11_1•11 I. ..._■_. • • Invegivaion (1 lir min) 66.2.5/ hr 111
Phcme: ( 51 t „ 25 aliZ, Fax: (5-6 ) as - s -- th Industrial plant (1 hr min) 78.18/hr
Inspections for which no fee is
EMIRERIM, Electrical Lic.: - 332 Suprv. Lie.: e • C s....; call listed hr min)
et. 90.00/ hr
/ r / y 1 0 „ . ',.;t:' 7.,Fr..E.7:::: a SO
3
Suprv. Electrician sign. re, required: )04.&•-0: •tof 4,141 Subtotal:
Print name: 1 i s ■ . \ A) DJ Gt h...... Date; 0 , plan review (25% of permit fee):
State surcharge (12% of permit fee): "7-. i 3
Authorized signature: TOTAL PERMIT FEE: -71, 2
TIM permit application expires It a permit is noribtaioed within 180
Print name: Date: days after It has been accepted as complete.
• Number of inspections allowed per permit.
IABuiabagwermitnELC_PercleApp_ELSUREdor Rev OS/212013 4dA46151111/05/COM/WEB