Permit K, ELECTRICAL PERMIT
��;:_ CITY OF TIGARD
' t — 2 ''' COMMUNITY DEVELOPMENT Permit #: ELC2009 -00564
TIGAA
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/23/2009
D;
. ,. _, ,:, , - <r x. Parcel: 1S135BC00700
1.., : :
Jurisdiction: Tigard
Site address: 10831 SW CASCADE AVE
Subdivision: Lot: 0
Project: Comcast
Project Description: (20) branch circuits for workspace reconfiguration.
Owner: FEES
CH REALTY III /PORTLAND INDUSTRIA Quantity Description Date Amount
PO BOX 4900
SCOTTSDALE, AZ 85261 1 ea Services or Feeders - 200 10/23/2009 $100.70
amps or less
PHONE: 19 crt Branch Circuits w /Purchase 10/23/2009 $140.98
Service or Feeder
1 ea 12% State Surcharge - 10/23/2009 $29.00
Contractor: Electrical
BRIDGETOWN ELECTRIC
22732 NW GILLIHAN ROAD
PORTLAND, OR 97231
PHONE: 503 - 621 -7122
FAX: 503- 621 -7123
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $270.68
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 0 • R 952 - 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
t ,r � • Issued By: Air • Permittee Signature: r�/ i/ /'_1 � — r a A/
i
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.
CaII 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
i 8PM B
09 4
�l ct 22 20: 0 r dg _; { rtr e pll o ry I � k f F . '. f ` y 1N 1 4 1'UR.I)I SI ( ,) t 4 1
tr' �
City 'Y' st , f tY?±J#�trN tiie,Jlkrs ice:; a2 e:.s na>ti :
Received
ri.:,.: r 4 13125 SW of Hall B lvd., igard Tigard, OR 97223 0 C T 2 2 2009 Dat '' /11 ����' Permit No.
Phone: 503.639.4171 Tax: 503.598.1960 Plan Revew
>" In ctionLine: Date/Ely: OtherPennit:
llt:,r� Pe 503.639.4175
h > t' Internet: www tgard or gov CITY -? I IUARD Dare ediMet y tun La See Page i for
_ Nohfied/Method B
k; } K 7 i L r e:r a ss t z Supplemental Information
.:!- •�:. .?.t.,c -'t ',...,,c- is ., y.',ricav '' I`�� � ....F =.�:1.1F'�i �r;.¢��` ' +£�,.�.� . ui. : a:.'i 3!',...4., . r .. �„4 y t i 3 t. .! s r :"i_�j
1` s .,; - s -�,. }i ax : �,, >. {,.;.� x , , t i;, ,
ddition /alt eration/replacement
-�ri xL :r.r . ' t , .,, '. E 1 ar, --
❑ Demolition Plea heck all that apply (submit j sets of pl w�tems c heck ed below):
❑ New construction
� ❑ Other: ID Service or feeder 400 amps or more
? � where the available fault ❑ Building over three stories.
�.� � «...9Fry �>< , t.�'t �,...a�r., rc��h a ±� .,.4�r �t`"'�``il
��t�.� t c� � ;" � i r � , �, .., F , current ❑Marinas and boatyards.
'.
'• R ss vt. r ` 31- ZZJI—;: f. i$ a i exceeds 10 ,000 amps at 15 voht or
El l - and 2 - family dwelling ommerCial /industrial ❑ Eloatingbaildings.
w'tit,_Lie 1 e38 [O
grol l other exc ons.
❑ A cc essory buil O c ommerc i a l -ase agr
❑ Multi family ❑ Master builder F ire for all other installations. In buildings.
❑ Other: ❑ Fire pump. ❑ Installatio n of 75 KVA or
y �r,-° .�" G•+ ;�:_c,�f rifi E"s"i l hs1; 2d� "at!r` , ' 4 ❑agec. arge separatelydenved
.a u..._ .., . Ai:l2l -1P!a 'CE. S).a.r3F:,'tt ` d9'Y��.�„ Ktl"a$i,1, ..}} t� "t
: IS�.a_ ❑AdGmditionnotnewysyatemmotorbad ❑' ", "E" "1 -2" "1.3" system.
lob no.: O3, lob site address: 1 411
1 00H1 or more.
City/State/ZIP: ❑ Six or more residential units. 1::) Recrearional vehicle parka.
❑ Health -care facilities. ❑ Supply voltage for more than
Suite/bld /a t. n0.: [Project /'aye„ , L . '. 4_ _ .. 1.1 ., ❑ � «m locations. 600 volts nominal. $• P name: vc ! i rc +W--1 I.R�f!'r'`• ❑ Service or feeder 600 amps or more.
Cross street/directions to job site: ( �/ ' "
�IJQ�'\
ABM. ti's a �'" .j" r . ..... �! �•
� .
L ° to � :., MRS #r,°- e 1 t (i
Drarrlptloe Qq Fee TeW"
/`!r GtrCir'� ho vo . �� i'! `/1 New residential single- or multi - family dwelling unit.
r..4f
division:
Includes attached garage.
Lot no.: 1,000 sq. ft. or less 168.54 4
Tax map/parcel no.: � Ea. add'I 500 sq. ft. or portion 33.92 I
ti �Y tH r - r frr r `` i 1'yY ! `R 1 31'r �, � ; '�' <n� 'f! r� e - ,r . �u Limited energy, residential
f
l.,. _.. _.:, i , ...:.h .- v?...li i;a.,rs�::i':v�!r iEG >-.:.i�l.'ttar E '� >d 1' t:{, i, !+ s._� i CF -�'+: c s
�.,�tCe� >:;n.r; h.;....r�..s,i:.: � (with above sq. fl.) 67.84 2
Limited energy, multi - family -
residential (with above sq. ft.) 67.84 2
Services or feeders installation and/or relocation
i (( 200 am / 100.70 fa e 2 •
s or less
t 9 2 isle y t t K �'5..-'u' 12 rn °- . r sr ; "t f r-c p f
Y
...�:_ ...,, t��,� r 3,._3_!e:,_iw.�..t ^4±•�_ .. �i; i'?YdS.�i;.��.'� i � 1 - tir<ni'�; 'Gt'r•'� �.• 201 amps to s;.rt� :rr..d ,3p mp
Name: 401 amps to 600 amps 200.34 �a -
2
Address: 601 amps to 1,000 amps 301.04 2
_ Over 1,000 amps or volts 552.26 2 -
City/State/ZIP:
Temporary services or feeders Installation, alteration, and/or
Phone: ( ) relocation
1 Fax: ( ) 200 amps or less _
Owner installation: This installation is being made on property that I own which is not amps to 400 am s 25 .08 .r,.a 1
201 f
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 am ps to 599 amp 168. 2
401 p s 168.554 4 2
Owner signature: Date � Branch clrcuils - new, alteration, or extension
A. Fee for branch circuits with r er panel
•r r: li .. , 9 .I+.c__ lt IIi'�.- .:.�,C.L _-5 J r �si.;,.�t +�"f: r ' i f r ti -.'Fr! ��T�r.,. � _ _
~^ --' -��•�r•• 'f`4)"t�- l` , , <_'.4�.�.t5.•,tap .. lyilli Y � above service or feeder fee,
Business name:
each branch circuit /)P 7.42 /�Q,9g 2
B. Fee for branch circuits
Contact name: without service or feeder fee,
Address:
first branch circuit 56.18 2
_ Each add'I branch circuit 7 2
City/Stale /ZIP; Miscellaneous (service or feeder not included)
Each manufactured or modular -
Phone: ( ) I Fax: ; ( )
dwelling, service and/or feeder 67.84 2
E-mail: J Reconnect only 67.84
w J t . ^ i :, , y , _ Pump or irrigation circle 2
t. _..,.,,n ! 67.84
.; .�r.Ey: "t�:t� :«o?,lt a Sign or outline lighting
Business name: Bridgetown Electric _ 67.84 2
Signal circuit(s) or limited -
Address: 22732 NW Gillihan Rd. energy panel, alteration, or
extension. Describe: Page 2 2
City/State/ZIP: Portland, OR 97231 Each additional inspection over allowable in any of the above
� Phone: (503)621 7122 ' Fax: (503) 621 7123 Per inspection 66.25
�/ CCB Lic.: 103824 Investigation per hour (I hr min) 66.25
UUU 1I ' l� f ecttical Lic.: 2.; :: 7C. 1✓� Suprv. Lic.: 4I77S ✓ industrial plant per hour
tr r 7818
Suprv. Electrician signature, requ - ::. 62',! Pa ?III.n s z <,,,
y .., Subtotal:
Print name: Keith Stet nslid Date: • of permit foe); Plan review (25%
• State an rev r (25%
of may/
Authorized signature: surcharge (12% permit fee): d ,
I TOTAL PERMIT FEE: 7 ` �
Print name:
This pp P P
Hate. permit a licanon e: irr if a ermit is not obtained within t Bp
da ys after i h as ban accep as complete.
I: hBuildinalPemuu lELt- PerviiiApp,doe 10/01/09 • Number of inspections allowed per permit.
' 440- 46IsT(IINS/ODMAYHa
/
�o a ; �M � L I` C �
n
„ CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit ELC2009-00564
• p 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/23/2009
Parcel: 1 S135B000700
Jurisdiction: Tigard
Site address: 10831 SW CASCADE AVE
Subdivision: Lot: 0
Project: Comcast
Project Description: (20) branch circuits for workspace reconfiguration.
Owner: FEES
CH REALTY III/PORTLAND INDUSTRIA Quantity Description Date Amount
PO BOX 4900
SCOTTSDALE, O BOX 4900 AZ 85261 1 ea Services or Feeders - 200 10/23/2009 $100.70
P
amps or less
PHONE: 19 crt Branch Circuits w/Purchase 10/23/2009 $140.98
Service or Feeder
1 ea 12% State Surcharge - 10/23/2009 $29.00
Contractor: Electrical
BRIDGETOWN ELECTRIC
22732 NW GILLMAN ROAD
PORTLAND, OR 97231
PHONE: 503-621-7122
FAX: 503-621-7123
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $270.68
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503..246.6699 or 1.800.332.2344. /
Issued By: Permittee Signature:
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
Call 503.639.4176 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept In a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
SU.j-bCl- ~ 1c.) ,
Oct 22 2009 4:08PM Bridg ffwT3-,E1eiptric
.,Ca trtcat rermlt Application
City of Tigard Da eiva1 3 Permit No
" 1312$ SW Hall Blvd., Tigard, OR 97223 T 2[ Plan Review
Phone: 503.639.4171 Tax: 503.598.1960 Date/B : Other Permit:
Inspection Line: 503.639.4175 Date Readyf8y. reel 0 See Page 2 for
Inlemet: www.tigtud-or.gov Notifie4/Method: Supplemeetallnfermatio I U=
❑ New construction ddition/alterationlreplacement Please check all that apply (submit 1 sets of plans wI tents checked below):
❑ Service or feeder It10 amps or more ❑ Building over three stories.
IBM= Demolition 11 ❑ Other: where the available fault current ❑ Marinas and boatyards.
exceeds 10,000 amps at 150 volts or ❑ floating buildings.
le
13 to grattnd, or ekcecds 14,000 13 Commercial-use agricultural
and 2 y dwelling ommerciallindustrial 13 Accessory building amps for 811 odter installations buildings.
❑ Multi-family mily ily ❑ Master builder ❑ Other: ❑Firepomp. ❑Installationof75KVAor
❑ Emergency system,
larger separately derived system.
_fi ; [3 Addition of new motor load of ❑ "A" "1-2" "1-3"
lob no.: D~~ Job site address: ~ l00HP or mare. occuparwy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: I" ❑ Health-care facilities. ❑ Supply voltage for more than
❑ Hazartlaars locations. 600 volts nominal.
Suite bldg./apt. n0.: Project name; CI lq ❑ Service or feedar 600 amps or more.
Cross street/directions to job site: rC~ U r / Deacri d°. Fee rew
<94 /~aa New residential single- ormulti-family dwelling unit.
r' j kl"`Iw 4p- f7Q~JSeJ Includes attached garage.
ubdivision: Lot no.: 1,000 $q. ft, or less 168.54 4
Ea, add'l 500 sq. ft. or portion 33.92 1
Tax ntap/ptucel no.: Limited energy, residential
with above s q. fl. 67.64 2
Limited energy, multi-family 67.84 2
residential with above Sq. ft.
Services or feeders installation, alteration, andlar relocation
200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 55226 2
CitylSffite(ZIP: Temporary services or feeders iastallafion, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 gimps or less Qle 59.36 1
Owner Installation* This installation is being made on property that I own which is not 241 amps to 400 amps 125.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 67D, and 701. 401 amps to 599 amps 168.54 2
Branch circuits- new, alteration or extension er panel
Owner Signature: Date: A. Fee for branch circuits wiM
above service or feeder fee, 7.42
Il~ 2
each branch circuit /
Business name: B. Fee for branch circuits
Contact name: wl6ouf service or feeder fee, 56.18 2
first branch circuit
Address: Each add'I branch circuit 7.42 2
Miscellaneous service or feeder not luded)
City/State/ZIP: Each manufactured or modular
dwelling, service and/or Feeder 67.84 2
Phone: ( ) Fes: ( ) Reconnect only 67.84 2
E-mail: Pump or irrigation circle 67.84 2
Sign or outline lighting 67.84 2
Business name: Bridgetown Electric Signal circuit(s) or limited-
energy panel, alteration, or
Address: 22732 NW Gillihan Rd, extension. Describe: Page 2 2
City/StateJZIP: Portland, OR 97231 Each additional Inspection eyeraHowabiein an of the above
Per inspection 66.23
Phone: (503) 6217122 Fax: (503) 1 7123 Investigation per hour (I hr min) 66.25
CCB Lic.: 103824 5 !x rical Lie.: 2 7C . Supn', Lic.: 41775 Industrial plant per hour 78.18
I ',4 MEMO= I
Suprv. Electrician signature, requI Subtotal:
J Date: Plan review (25% of permit fee):'
Print name: Keith 5ttxnslid
State surcharge (12% of permit fee): C
Authorized signature: TOTAL PERMIT FEE: Al "k.
Print name: This permit application expires if n permit is not obtained within Is
Date: days after it has been accepted is compkte,
• Number of inspections allowed per permit.
r:tBuildinoVermitslELC-PemiiApp.doe tWOM 410-461ST(Itro5K)UAWPB
1
C ~t fi L