Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
m ; COMMUNITY DEVELOPMENT Permit#: ELR2013 00234
Date Issued: 09/19/2013
TIGARD 13125 SW Hall Blvd,Tigard OR 97223 503 718 2439 Parcel: 2S101AC01600
Jurisdiction: TIGARD
Site address: 7100 SW HAMPTON ST 128
Project: NEIMEYER Subdivision: BEVELAND NO.2 Lot: 18-19,P
Project Description: Data telecommunications system
Contractor: BRIDGETOWN ELECTRIC Owner: NEIMEYER,JOHN
5701 N LOMBARD ST 15 82ND DR STE 210
PORTLAND,OR 97203-4113 GLADSTONE,OR 97027
PHONE: 503-621-7122 PHONE:
FAX 503-621-7123
FEES
Description Date Amount
Specifics: Restricted Energy Permit 09/19/2013 $75.00
12%State Surcharge-Electrical 09/19/2013 $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 obtain a copy of the rules or direct questions to OUNC by calling 503 232 1987 or 1 800 332 2344
Issued By:-lam -_ Permittee Signature: 477-( 204,.s
//
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 503.639.4176 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. ,O
Sep 18 2013 8: 47FIM Bridgetown Electric 5 0 3-6 2 1-7 1 23 page 1
Electrical Permit Application jt 7refil F----
City of Tird
.11
13125 SW Hall Blgavd.,Tigard,OR 97221 i Cil
Phone: 503.718.2439 Fax 503.598.1960
Inspection Line: 503.639.4175
Internet www.tigard-or.gov EP I 8
CITY Of DGARD
I VE ;;.: :113' -y; 9 ,i,/,7 437,— permit No.: Leap i 3—00A-31(
2013 cft are/ v:Phmt Revv:iew
Crate R cadyfily
blonfled/Method. Other Permit:
Juri.. ..,____s El See Page 2 for
1-j-Co Supplemental laformation
jpqr.rptio ,!:,,- ,-,--.:.:"-,:li. rm..11212.„-:
;: , , ,:A.,.531,14ti,,,a4o,Vii,..mwf.1,-(1,-.4,,, , ,...1 At,, :,. , , Avi•;T fo ,,, . .—.•, , ,, „,, .„ ...,,, " . ,,-,......
0 New construction 14 Addition/alteration/replacement Please cheek all that apply(eubnut luta of plans wfitems checked below)-
O Service at'fr.eda 400 amps or more 0 Building over three stories.
ID Demolition 0 Other: where the 6voilable fault current 0 Marinas and boatyards.
, .,,,,....,.-..,.:„. ,-•,.) ..-', - exceeds 1 ,000 amps at 150 wits or 13 Floating bwldings.
less to ground,ar exceeds 14,000 0 Coalmen-ill-use agricuharal
0 1-and 2-family dwelling Ea Commercial/industrial 0 Accessory building amps tor all other installations. buildings.
El Multi-family 0 Master builder 0 Other: 0 Fire pump, 0 installation of ISO KVA Or
`6"'S'cr)9"Fr"r'r.51419"''IFT:7M2k?1.111,5 ? tYA‘ix. ttpliti''..'i•---' ', '. " . ',
. . -.. 0 Einergency system. larger separately derived system.
/.■;J:0.-4,,U.4„..1t;,;:,i .4.„,1.1:.,i‘',„, t",--):--,: ''.,. ' .!, ,, , ,, ,'.. ., . . ,-!.. - -'. - ,.- ,„ ", .0 Addition of new motor load of (3-x-,-r,"1-2","1-3".
100HP or more. occupancy.
Job no.: VS-zoil Job site address: I too abgAl
. 0 Sin.or more residential units. CI Recreational vehicle pads.
City/State/ZIP: ---T7,01s0,41, Oa. Ritz 3 °Haan-cm famhties 0 Supply voltage for more than
O Hazardous locations. 600 volta nominal
Suite/bIdglapt no.: ite I Project name:etwAtithNti - ArIA.6.4) ,Oservice, ,°:feed=60. 0 irlyt 0roo!!.
; ; .•.:i'01, . 1:g.iqk. ,1;11,7.,34..,it'N:
Cross street/directions to job site: DesariPtkn I Qty. 1 Wm I Total I •
New residential single-or multi-family dwelling snit.
Includes attached garage.
Subdivision: 1 Lot no.: _1,000 sq.ft.or less 168.54 4
Ea.addl 500 sq.It or portion 33.92 1
Tax map/parcel no.:
Limited atergy,residential
75.00 2
"f--.'',''''3•::';'4'•i•-q",:t':41'''',;4•!.411147,-;41010-41j1lik*rOiWitiOi;;;;.:,1'.';'''.;.,,!:;',:: •--'-4,,::,' ''''4';"-:, ":': '-',` (with abo e sq.ft)
Limited energy,multi-family
2'
75.00
LA./ vb14ty... i;t1rICAA4A•E .)?%4INSA..efittMA.ort, 41;0 -42Juukt,A - residentia.(with above sq.ft.)
•
a ReDiAtiableitiliiiii'=: . ;-:'-•L'--'.=44:erteiPattell.-,. '
,,,-:.• .
• •i- e4iltill-' Services or feeders inetallatioasiteradon,and/or relocation
9 :',, • . ".:' :allthijtagr, .,-. '' r" .'.t'l, amps or less 100 70 2
201 amps to 00 amps 133.56 2
Name:
401 amps to• 'amps 200,34 2
Address: 601 amps to .000 amps 301 04 2
Over 1,000•••ps or volts 552.26 1 2
City/State/ZIP:
Temporary services or feeders installation,alteration,and/or
Phone:( ) I Fax:( ) , relocation
200 amps or .• 59.36 1
Owner installation:This installation is being made on property that I own which is not 201 amps to I I amps 125.08 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670.and 701.
401 amps to•99 amps 168.54 2
Owner signature: Date: Branch ci • its-new,alteration,or extemlon,per panel
'',:'''.‘'''`•-"'-‘-;14nO'CrAiatayjile'lZtl.%"'if,;frz04:11f,r,,:ak',1,-Aqlt,'iti*tfitt,-*Siitaiez-",:::';',2!'i,,:'.4 A.Fee fth"' - circuits with
above. ce or feeder fee,
7.42 2
Business name: each• , • circuit
B.Fee for. :, h circuits without
Contact name: service or -- fee,first
56.18 2
branch ci un
Address: Each add'1.•• h circuit ,-- 7.42 1 2
C ity/State/Z1P: Miseellan-, ••(service or feeder not included)
Each manu;=• ,••or modular
67.84 2
Phone:( ) Fax: :( ) dwelling, tie and/or feeder
Reconnect o y . 6714 2
E-mail:
Pump or i ' 'on circle 67.84 2
!'::,'.•IMZ-?:•''',1•1,SX,i4a.;111titlell;ii,tiAtIONWOOVi ••!,;,',••'-i•,.„' 1 .'... -• ' . :....'•:'•_ • 21 Sign Of chili ontllie lighting 67.84 2
Business name:Bridgetown Electric Signal circa s)or limited-energy a See
panel,air ' or extension. _ 1 Page 2 15.('6 2
Address:5701 N Lombard St. Each additional lasneetton over allowable in any of the above _
Additional inspection(1 hr min) 66.25/hr
City/State/Z1P:Portland,OR 97203
Investigation(1 hr min) 66.25/hr
Phone:(503)621-7122 I Fax:(503)621-7123 Industrial plant(1 hr m .in) 78.18/hr
Inspections for which no fee is
9000/h
CCB Lic.: 103824 I Electrical Lic:: .. 887C I Suprv.Lie.: 41775 ,specifically listed 'A hr min .
''•''''-"'•''4-;' 1',''''"':1 ''-..::::',. , .,•^.! '1,'•2 litl
Suprv. Ii'::,..s.. ,'.';'2,1e0;,W4'(,:,
su .Electrician signature, -•• -6.:,
.c-e.d94w•r,d--1-..A Subtotal: -is,do
Print name: Keith Steenslid Date: Plan review(25%of permit fee):
State surcharge(12%of permit fee); 41,-0
Authorized signature:
TOTAL PERMIT FEE:
Thh permit application expires if.permit is not obtained within 180
Print name: Date: lays after It has been accepted as complete.
- • Number of inspections allowed per pennit.
1:1Bui1dies■5ermitgELC_PermitApp_ALR_ERE.doc Rev 05/21/2013 4404615TO 1/05/COMAVIII3'
: ,
Sep 18 2013 8: 48AM Bridgetown Electric 503-821 -7123 page 2
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renew ble Energy Permit Fees:
Miggb— VagAtikt"- —st M`!cl.FrtrI771713. 24,:'21,"
Fee for gJ residential systems combined. $75.00 _ UNNEnonimomMlismonnamim‘•
Recemb electrical energy systems:
Check Type of Work Involved: S kva or - 100.70 2
5.01 to 15 133.56 2
D Audio and Stereo Systems*
15.01 to 25 va 200.34 2
Wind gm- don systemin excess of 25 kva:
E Burglar Alarm
25.01 to 50 30L04 2
Garage Door Opener* 50.01 to 1 to kva 55226 2
>100 kva(f- in accordance with 552.26 2
OAR.91.-309.0040)
Heating,Ventilation and Air Conditioning
Solar gen-4 don systems in excess of 25 kva:
System*
Esch kvaover25 7.42 3
Vacuum Systems* >100 kva– o addhional charge 0.0 3
Each addi nal inspection over allowable in any of the above:
ID Other: Each additi .1 inspection is 66.25/hr
charged at hourly.(1 hr min)
inspections or which no fee is 90.00/hr
- isted l4brmin
--'"*SOgrigt- t.,41 r":r:7.1:23.ri3174.–ZT:DIEMBI.2430t
Fee for each commercial system...---..... $75.00 Subtotal:
(SEE OAR 918-309-0000) Plan w.if required(25%of permit fee):
tate surcharge(12%of perrait fee):
Check Type of Work Involved: TOTAL PERMIT FEE:
This•— application expires If.persists noi obtained liii.180
0 Audio and Stereo Systems days after It has been accepted u complete.
• Number inspections allowed per permit.
El Boiler Controls
0 Clock Systems
.4 Data Telecommunication Installation
CI Fire Alarm Installation
El HVAC
El Instrumentation
El Intercom and Paging Systems
•
El Landscape Irrigation Control*
O Medical
0 Nurse Calls
•
0 Outdoor Landscape Lighting*
O Protective Signaling
El Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
BRuildingWemsits\ELC_PermitAppj../R5142,doe Rev OS/21/2013