Permit n CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
'- 2 ' COMMUNITY DEVELOPMENT Permit#: ELR2013-00191
T 1G A R O 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/06/2013
Parcel: 2S113AC00101
Jurisdiction: TIGARD
Site address: 16655 SW 72ND AVE 800
Project: COPYTRONIX Subdivision:COUNCIL VIEW ACRES(LOTS 21-44) Lot: 37
Project Description: Data telecommunications system.
Contractor: BRIDGETOWN ELECTRIC Owner: PACIFIC REALTY ASSOCIATES LP
5701 N LOMBARD ST ATTN: N PIVEN
PORTLAND,OR 97203-4113 15350 SE SEQUOIA PKWY#300
PORTLAND,OR 97224
PHONE: 503-621-7122 PHONE:
FAX: 503-621-7123
1 FEES
Description Date Amount
Specifics: Restricted Energy Permit 08/06/2013 $75.00
12%State Surcharge-Electrical 08/06/2013 $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 $84.00
Other Desc: Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may ob:'. : opy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. `
t
Issued By: Permittee Signature: _,,,e ,____534 _,.
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale,lease or rent.
OWNER'S SIGNATURE: Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR.ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the Job site until completion of the project
Approved plans are required on the job site at the time of each inspection.
Aug 02 2013 3: 39PM Br ' ectric 503-621 -7123 page 1
Electrical Permit A PP lic> c, D City of Tigard AUG 5 2013 g'5/,) , — PermiINo.: pt.12)-o t3--cam/a i
1312$SW Hall Blvd.,Tigard,OR 97223 Plan Review,
Phone: 503.7182439 Fax: 3ry� GARD ��y: Other Parent:
Inspection Line: 503.639.417 v TI 0 See Page 1 for
Internet: www.tigard-or.gov BUILDING DIVISION fete cd/Met y: Juries
Noti6ed/Metled: ' .,--eo Supplemental teforsatia■
❑New construction ZI Addition/alteration/replacement Please check all tharapply(submit isms of plans w/aem■checked below):
❑Demolition ❑Other: 0 Service or feeder 400 amps or more 0 Building over three stories
where the available fault current 0 Marinas and boatyards,
- ';;'i a:!,ti!';' :3; "a: 'i. .'UCTLO l.`.: . . _ exceeds 10.000 amps at 150 volts or 0 Floating buildings.
less to ground,or exceeds 14,000 0 Commercial-tae agricuhural
❑ 1-and 2-family dwelling 1n Commercial/industrial ❑Accessory building autos for as other installations. buildings.
❑Multi-family ❑Master builder ❑Other: 0 Fins pump. 0 Installation of 150 KVA or
!.:.'4-. F•� O Emergency system. larger separately derived system
i Q FE'. N *Tl;?'i 1;OQr►'IE '.:.. O Addition of new mote load off
Job no.: 13- 5 y$ J lob site address: 1 LoLA 55 $w 1 100HP or Inoue. occupancy.0 Six or more residential units. O Recreational aehicle parks.
City/State/ZIP: ,ibt � �'i Z2I 0 Health-care facilities 0 Supply voltage for more than
0 Hazardous locations. 600 volts nominal.
Suite/hldg./apt.no.: O0I J Project name: Coput�YTMr�(„ 0 Service cc feeler 600 amps or more.
U 7
Ni-.::4 Spit,'....:.il�%�044.•, 4;':rs jiri's, .t c'1
Cross street/directions to job site: " � '- � - '
..naoseuaa -�Qcr. Fee. Tint •
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq.ft.or less 168.54 4
Tax map/parcel no.:
Ea.add'l 500 sq.ft.or portion 33.92 1
Limited energy,residential
: ,. 'r. 'D•Sc I (with above e4'ft.) 75.00
�tO limited ,multi-family
75.00
2 Vo t� y- Q E AA ^� 1iN..cl 1I ri A& residential(with
:Renewable . '. 1:� i : n r .:, ;;
1 11 n am`A-� Services or feeders installation,alteration,ad/o relocadoa
p .. 200 amps or lam 100.70 2
Name: 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Address: 601 amps to 1,000 anipti 301.04 2
City/State/ZIP: Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Phone:( ) I 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. , ,
amps 168.34 2
()caner signature: Date: 401 amps to 599
Branch circuits-new,alteration,or extension,per panel
�?p01 N'J!' .- °i•'; A.Fee for branch circuits with
' _,.' �J'GtOT!C!'AtK :a111Qi': s' or feeder fee,
above service or 2
Business name: each branch circuit
B.'Fee for branch circuits without '
Contact name: service or feeder fee,first 56.18 2
branch circuit
Address: Each ttdd'1 branch circuit 7.42 _ 2
City/State/ZIP: Miscellaneous(service or feeder not Included)
Each manureetrued or modular 67.84 2
Phone:( ) I Fax::( ) dwelling,service and/or feeder
Reconnect only 67.84 2
E-mail: Pump or irrigation circle 67.84 2
. , , f CONTRACTOR . . • ' . , •, ..',‘• Sign or outline lighting 67.84 2
Business name:Bridgetown Electric Signal circait(s)or linked-energy 1 See
panel,alteration,or extension. I Pape 2 s • 2
Address:5703 N Lombard St. Each addition'inspection over allowable in any of the above
Additional inspection(1 hr min) 1 66.25/hr
City/State/ZIP:Portland,OR 97203 Investigation(1 hr min) • 66.25/hr
Phone:(503)621-7122 I Fax:(503)621:7_123 Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
CCB Lic.: 103824 Electrical Lie:: 6-887C Suprv. Lie.: 4177S s?ecifically listed 14 hr min
Suprv.Electrician signature, -.. ? ` � 6� . a°
�_ Subtotal: 7t;.
Print name: Keith Steenslid Date: Plan review(25%of permit Ike):
State surcharge(12%of permit fee): q,6°
Authorized signature: TOTAL PERMIT FEE: 64,Ise
e
This permit application expires if a permit Is not obhieed wit im 180
Print Warn
Date: days after it leas been accepted as complete.
• Number of inspections allowed per permit.
VeuildingTernus\ELC_PernnIApp_ELR_ERe.doe Re%05/21/2013 440.4615T(I I tosreoMAYEn
Rug 02 2013 3: 39PM 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:
Fee for an residential systems combined $75.00 wftio7nenu-m_- limn= •
Renewable electrical energy systems:
Check Type of Work Involved: s kva or less 100.70
5.01 to 15k va 133.56 2
D Audio and Stereo Systems* --
15.01 to 25 kva 200.34 2
Burglar Al Wind generation systems in excess GPM kva:
arm
25.01 to 50 kva 301.04 2
P Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva(fee in accordance with
fl552.26 2
Heating,Ventilation and Air Conditioning OAR 918-309-0040)
System* Solar generation systems in excess of 2S
Each additional kva over 25 7.42 3
E] Vacuum Systems* >100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
p Other Each additional inspection is
6625/hr
charged at an hourly(1 lir min)
inspections for which no fee is
90.00/hr
—.cc& listed 54hrmin
Fee for mil commercial system...... $75.00 Subtotal:
(SEE OAR 918-309-0000) Plan review,if required(25%of permit fee):
State surebarge(12%of Nan it fee):
Check Type of Work Involved:. TOTAL,PERMIT FEE:
This permit application expires if a permit is sot obtained within 180
El Audio and Stereo Systems days after it kas beta accepted as complete.
Number of inspections allowed per permit.
El Boiler Controls
El Clock Systems
E Data Telecommunication Installation
El Fire Alarm Installation
1:1 HVAC
El Instrumentation
El Intercom and Paging Systems
1=1 Landscape Irrigation Control*
El Medical
El Nurse Calls
O Outdoor Landscape Lighting*
0 Protective Signaling
1:1 Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1:11luildityAPami1s■ELC_PcnnisApp_ELRFIE4oc Rev CY3/2 1/2013
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