Permit :11P CITY OF TIGARD ELECTRICAL PERMIT
I
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COMMUNITY DEVELOPMENT /g It Permit #: ELC2011 -00452
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/09/2011
Parcel: 1S126BC01506
Jurisdiction: Tigard
Site address: 9020 SW WASHINGTON SQUARE RD 505
Project: SFA Design Group Subdivision: Lot:
Project Description: Electrical for TI. 8/16/11, reprinted to correct suite number. 8/17/11, reprinted to add low voltage for data. 8/18/11,
reprinted to change suite number.
Contractor: BRIDGETOWN ELECTRIC Owner: WISCO REAL ESTATE EQUITY FUND I
22732 NW GILLIHAN ROAD 1501 SW TAYLOR ST STE 100
PORTLAND, OR 97231 PORTLAND, OR 97205
PHONE: 503 - 621 -7122 PHONE:
FAX: 503 - 621 -7123
FEES
Quantity Description Date Amount
4 crt Branch Circuits wo /Purchase 08/09/2011 $78.44
Specifics: Service or Feeder
1 ea 12% State Surcharge - 08/09/2011 $9.41
Type of Use: COM Electrical
Class of Work: ALT 1 ea Signal circuit or Limited 08/17/2011 $75.00
Energy Panel
Type of Const: 9 12% State Surcharge - 08/17/2011 $9.00
Occupancy Grp: Electrical (manual)
Total $171.85
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 ac • e 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. ATT. TION: • ego law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0s 0 through O',' 952 -I s -0090. You may obtain a copy of the rules or direct questions to OUNC b call. • .•32.1987 or 1.800.332.2344.
�� i
Issued B � ��� . Permittee Si. Si • ►'�� �' �' l (l�� J
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.
it CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT W `! Permit #: ELC2011 -00452
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 �: D ate Issued: 08/09/2011
• Parcel: 1 S126BC01506
Jurisdiction: Tigard
Site address: 9020 SW WASHINGTON SQUARE RD 500
Project: SFA Design Group Subdivision: Lot:
Project Description: Electrical for TI. 8/16/11, reprinted to correct suite number. 8/17/11, reprinted to add low voltage for data.
•
Contractor: BRIDGETOWN ELECTRIC Owner: WISCO REAL ESTATE EQUITY FUND I
22732 NW GILLIHAN ROAD 1501 SW TAYLOR ST STE 100
PORTLAND, OR 97231 PORTLAND, OR 97205
PHONE: 503 - 621 -7122 PHONE:
FAX: 503 -621 -7123
FEES
Quantity Description Date Amount
4 crt Branch Circuits wo /Purchase 08/09/2011 $78.44
Specifics: Service or Feeder
1 ea 12% State Surcharge - 08/09/2011 $9.41
Type of Use: COM Electrical
Class of Work: ALT 1 ea Signal circuit or Limited 08/17/2011 $75.00
Energy Panel
Type of Const: 9 12% State Surcharge - 08/17/2011 $9.00
Occupancy Grp: Electrical (manual)
Total $171.85
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 thr••gh OA' 952 -09 • 091 You may obtain a copy of the rules or direct questions to OUNC by calling 511-. 32.1987 or 1.800.3,32.2344.
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:
C ONTRACTOR 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.
CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2011 -00452
IGAR.L� 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/09/2011
Parcel: 1 S126BC01506
Jurisdiction: Tigard
Site address: 9020 SW WASHINGTON SQUARE RD 550
Project: SFA Design Group Subdivision: Lot:
Project Description: Electrical for TI.
Contractor: BRIDGETOWN ELECTRIC Owner: WISCO REAL ESTATE EQUITY FUND I
22732 NW GILLIHAN ROAD 1501 SW TAYLOR ST STE 100
PORTLAND, OR 97231 PORTLAND, OR 97205
PHONE: 503 - 621 -7122 PHONE:
FAX: 503 - 621 -7123
FEES
Quantity Description Date Amount
4 crt Branch Circuits wo /Purchase 08/09/2011 $78.44
Specifics: Service or Feeder
. 1 ea 12% State Surcharge - 08/09/2011 $9.41
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $87.85
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 rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ... . - Perm ittee Signature: � ^
0'
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 17 2011 11:49RM Bridgetown Electric 503 -621 -7123 page 1
Electrical Permit ApplicationRECErVED I :OR ort ..1( t -,1 ()NI 1
e.. ... ..„.
City of Tigard Received • e /7 // n Permit No.: CAL4,2„41n!,/,
14 . -- 13125 SW Hall Blvd., Tigard, OR 97223 UG 1 7 2011 Date/3 :
Plan Review
' I Phone: 503.639.4171 Fax: 503.598.1960 DatelB : • Other Permit:
Inspection Line: 503.639.4175 Date Ready/Hy: ; Aube er See Page 2 tor
Internet www.tigard-or.gov
I I k .. ) , I:, i ) CITY OF TIGARD Notified/Method: i Sup i temente' Information
T ., ,
,UtADING DIVISION — . . -
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: ::VVORK'' : .!- - : DIVISION - ' '::: : - ‘ '- ! : 1:4: ° Y, iF ." ot :. _ ;'o t '-'.:' •i.
m :- :::• 1: :. :: : -- :t : .. - - . • : . • . . ,,,, -:::,..... ,.... , ,,, :,. .,.,........--. - -..• • .-- - - - a• . ... ...Al . la, 1.1).1.,,o
: Please check all that apply (submit a sets of plane w/items checked below):
Ej New construction 0:Addition/alteration/replacement
CI Service cg feeder 400 amps or more 0 Building over three stories.
O Demolition 0 Other: where tic available fault current 0 Marinas and boatyards.
. f . Oilitiki4VaiiigtittriO0 14 -; - :.! :•' '' exceeds 10,000 amps at 150 volts or ID Floating buildings
iit .
■%, ''' f ' '',," , ,,, ft; '''' ' 'k'''''' ' - ft "''' , ft k ''''''' ' 'ft '''''' ft ` '' '' ''' ' ' ' ' ' ..': ' ' ' ' '-'''' ' ' . ' . . * - ' ' * ben to ground, or exceeds 14,000 a Commercial-use agricultural
O 1 - and 2-family dwell ing 0 Commercial/industrial 0 Accessory building : amps for all other installations, buildings.
.,
0 Multi-family 0 Mater builder El Other: . 1._ , aire pump. 1:11Installation of 75 KVA or
larger separately derived system.
4Afks i7:C.r grl r '1 Pt:;fritiiiinr,::::: 7..-,:..;y ;.,.. , oAdd f , I m a f
! 1001-11' ur more. occupancy.
Job no.: Job site address: et 0 et,NM61111.461014 %), ‘1„ 5IX) ! 0 Six or inure residential units. Cl Recreational vehicle parks.
City/State/ZIP: 9afenjekt4t) OIL 1-71/1A Ditealth-cate facilities.
0 Bazardous locations. 1:1 Supply voltage for more than
600 volts nominal.
Suite/bldg./apt. no.: Goret I Project name: i 0 service or feeder 600 amps or more
re NiliV■1^4.flit • ._ "• I ' 1 li WY'i" 71 3111 1" ,:ci2SriltilirelEMBRIVf
Cross street/directions to job site: I i . Moth 13t7. 'Oa., .., rata .
- " • '
--- — New residential single- or multi-famlly dwelling unit • "
, Includes attached garage.
Subdivision: Lot no.: : 1,000 sq. ft. or lass 168.54 4
Ea. odd' I 500 sq. ft. or portion 33.92 1
Tax map/parcel no I Limited energy, residential 75.00 2
•.; llM‘4,..P!:: '..,lc , . ,. .P-4•FI:'.";1,;giFtWailQiilithaJiaaasi-ai/.:,;:aiaiisisi • .. . . • • :' .•' H: -•,' ,,.: L (with above Sq. ft.)
14,11,1-fAti,,tm41 - • - • • . . ' ' ,:'..;" ''' •.:' '.. l . .
, Limited energy, multi-family 75.00 2
e gjf \t■/:Ak 1 ; . -1.-.C , WI 1
-. 14,C0 640 its it4717 LA .8A rat) ! residential (with above sq. ft.)
I Services or feeders installation, alteration, and/or relocation
c.)-Itsztvy 4 -. iz..m.o ( . 200 amps or less 100.70 2
VV j :;". 201 amps to 400 amps 133,56 2
401 amps to 600 amps 200.34 2
Name: - 601 amps to 1,000 amps 301.04 2
Address: . Over 1,000 amps or volts 552.26 2
Temporary services or feeders Installation, alteration, and/or
f' /0 relocation
Phone: ( ) I Fax: ( ) 200 snips or less 59.36 1
201 arnps to 400 sunps 125.08 2
Owner installation: This installation is being made on property that I own which is not
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intended for sale, lease, rent, or exchange, according to ORS 447 401 amps to 599 amps 168.54 2 , 449, 670, and 701.
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
;.:.:Vqlgprliiiqltrjrc*trqi.ZV tizjsiijit:. $ :g.;:?..::.,::VrV:4:;M:t:(;eert..ttit*fi:::''/:: above service or feeder fee, 7,42 2
i i i', , imistesiv, .. , . AUM, '-, 1 :...:-....,..: : :. ' r , .. "..,. , ... ',., : ....... , •.. - . . . each branch circuit . ,
Business name: B. Fee for branch circuits without
service or feeder fee. first 56.18 2
Contact name: branch circuit .
,., „ , ..Each.addl.bm
Address: ..
Miscellaneous (service or feeder not Included)
, Each manufactured or modular
City/State/ZIP: . dwelling, service and/or feeder 67.84 2
Phone: ( : ) I Fax: : ( ) : Reconnect only 67.84 2
Pump or irrigation circle . 67.84 2
E .
Sign or outline lighting 67.84 2
11U;i",igi■iti ?1' jj'„,';,:1 • :, .• ., ... :, i, : .: . : :.. , : ,' .1 i! 1 Signal circuit(s) or limited I '
1.5 tf0
Business name: Se ipeemsw, E sum c 1_ panel, alteration, or extension. i Page 2 2
Each additional inspection over allowable in any of above
Address: 510 1 ry . Lti ()....bo..rcl "y-t''1" Additional inspection (1 hernia) 66.25/ hr
1 investigation (I hr min) 66.25/ hr
City/State/2M: e POWTI-oksi.)1) OR ( Ai 7.01 : 13 1 Industrial plant (1 hr min) 78.18/hr
Phone: (Co; veil ,.. .7 12 2- Fax: (io4 ) 42,4 I i z3 . inspections for which no fee is
90.001hr. .
; s recificall listed 'A Mr min
CCB Lic.: 10 fsiLi Elgetrical Lie,: : - 8i5/0 1 Suprv. Lie.: a i 774s liy,,;moinom mr--EITE
i., _ subtouit: -7 c,,,ro
Suprv. Electrician signature, require:: :,..4C-X,.,....6.......0-4 . Plan review (25% of permit fee):
Print name:4//--,/, _giea , 7.,.s //c Date: : Si ate surcharge (12% of pennit fee): il l Cre
.
Authorized signature: i TOTAL PERMIT FEE: gill , ito
' This permit application expires if e permit is not obtained witistn 180
Jays after it has been accepted as complete.
Print name: Date: • • Number of' inspections allowed per permit,
1:\BuildingTermitstELC-PermitApp Joc 07/01/10 440-4615T(11/05/COMMEB :
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Aug 08 2011 4: 17PM Bridgetown Electric 503-G21-7123 page 1
Ele P
Ap plication
''; : . V E D
I;OR ■11•1•1C1:. I SI:' CI \ I N
City of Tid D :tes , 0/f/Inf=11
I __ _ . 13125 SW Hall gar Blvd., Tigard, OR 9722..A UG 0 9 2011 Plan Review 1=11 ."7.ffill
- 111 Phone: 503.718.2439 Fax: 503.598.1960 DateB : Other Permit: I
,,
._
„ . „,„„ Inspection Line: 503.639.4175 CITY OF TrA9D
0 1 Date Ready/By.: 63 See Page 2 for
• Internet: www.tigard-or.gov Notified/Method: r.Z Supplemental Information
Oil;: l h 4 "1 ,,,A*4717= 1 4* 1 .44MANtiitiii ' 4 7 11 ; NI,E 11 .9 1 ,M i tl#05**NORM.W. C tlinigegg
0 New construction 1$1 Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w/items checked below):
0 Service or feeder 400 amps or more 0 Building over three stories.
El Demolition El Other where the available fault current 0 Marinas and boatyards.
4 , .` ' ' .:!' .', tr , •ll•I' , , 1;.:9F.i'.s , 4' , .' 4 .. 7ialv.:1; ''' exceeds 10,000 amps at 150 volts Of 0 Floating buildings,
, ,,,"4,..:.0 t,', tt':, ', 0 , ,: ':, ',?,■ ,',„. 'A ', ',.'; 1.; , ., ,I 4P,',1140■1i:,■!1: less to ground, or exceeds 14,000 0 Commercial-use agricultural
0 1 - and 2-family dwelling IEI Commercial/industrial El Accessory building amps for all other installations. buildings.
0 Multi-family 0 Master builder 0 Other: 1:1Fire pump. 0 Installation of 75 KVA or
q•lkilWrii•Prfa :11 ,' ' `'''',' V• I•iiiil-U,sAil:6:,•44;,.....i p::„....,,, El EmagennY sYslem. larger separately derived system.
ItUlaitadAtttMlitttitatigWsirehAiralgAiltlienlintal, :',!,:. ' --. '.. .1. .', t k,11 0 Addition of new motor load of 0
Job no.: 11-213 Job site address: 9020 SW Washington Square Dr. 1001iP or more. occupancy.
0 Six or more residential units. 0 Recreational vehicle parks.
City/State/ZIP: Portland, OR 97223 0 Health-care facilities. 0 Supply voltage for more than
0 Hazardous locations. 600 volts nominal.
Suite/bldgJapt. no.: 595 Project name: SFA Design Group 0 Service or feeder 600 amps or 0101n.
t4'44.?i0,!
Cross street/directions to job site: Description Ott. Pee, I Total I ”
New residential single- or muld-family dwelling unit.
Includes attached garage.
Subdivision: I 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
(with above so.
75.00 2
gt-WitegilaggitliarrEralliMit';':':*0*-2:".Y.41:argiga'A gin:AO:l ft.)
Limited energy, multi-family •
75.00 2
Adding receptacles, & moving receptacles residential (with above sq. ft.) _
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
intagaiegr:41 ".. o4g.N'.:-* ' i ,;-' ..' . 201 amps to 400 amps 133.56 2
433 Slitiit,,,j/iaa6kauttikafdead' ' - .. 9 :';: , e' l .' , !' gv, , It•. , , 11 3, ‘ "14.4,...m.,
401 amps to 600 amps 200.34 2
Name:
601 amps to 1,000 amps 301,04 2
Address: Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and/or
City/State/ZIP: relocation
Phone: ( ) I Fax: ( ) 200 amps or less 59.36 I
201 amps to 400 amps 125.08 2,..
Owner installation: This installation is being made on property that I own which is not
401 amps to 599 amps 168.54 2
intended for sale, lease rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits — new, alteration, or extension, er panel
Owner signature: Date: A. Fee for branch circuits with
"
,11 il4' : -1 ,, , 4 1 ,,,,r;,V. : "7 t4i'r 4 :. 6 -rovig.t-: above service or feeder fee,
7.42 2
each branch circuit
Business name: B. Fee for branch circuits without
service or feeder fee, that 1 56.18
56.18 2
Contact name: branch circuit
Each add'Ibranch circuit 3 7.42 22.26 2
Address: Miscellaneous (service or feeder not included)
Each manufactured or modular
City/State/ZIP: dwelling, service and/or feeder 67.84 2
Phone; ( ) I Fax: : ( ) Reconnect only 67,84 2
Pump or irrigation circle 67.84 2
E
Sign or outline lighting 67.84 2
, liVAL : ?. - plieLIMIELANNINGET,Eat i :• 1; ,ti;_fAlii : 14004;: , ? , ,i0:',NO;: , 4:444 ; ,afi:l , ";''',* . i'j.i4,'S": Signal circuit(s) or limited-energy ' '
Business name: Bridgetown Electric panel, alteration, or extension, Page 2 2
Each additional inspection over allowable in any of the above
Address: 5701 N Lombard Additional inspection (1 hr min) 66.25/ hr
City/State/ZIP: Portland, OR 97203-4113 Investigation (1 hr min) 66.25/ hr
industrial plant (1 hr min) , 78.181 hr
Phone: (503) 621 I Fax: (503) 621 Inspections for which no fee is
90.00/ hr
specificaiR listed ( hr mi) ,„
CCB Lic.: 103824 I Electrical Lic.: 26 7C I Suprv. Lic.: 4177S TBltIWNTOAEtktOakidatals0ittV.:__--:',Ngai0.W!:;,
: d , _. Subtotal:
Suprv. Electrician signature, req 'red:
..e ..-o v- iist---/-4-Z.--2.- Plan review (25% of permi 78.44 t fee):
Print name: Keith Steenslid - Date: 8/8/11 State surcharge (12% of permit fee): 9.41
gr - er• ot ,
TOTAL PERMIT FEE: 87.85
Authorized signature:
This permit application expires if a permit is sot obtained within 150
days after it has been accepted as complete.
Print name: Date: * Number of inspections allowed per permit.
1:113uildinglilereate\ELC-PermitApp.dot 07/01/1 o 440-46151(11 /05/COIMMED
Aug 17 2011 11:49AM Bridgetown Electric 503 -921 -7123 page 2
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
z 5 a `rg �' c ��_ `���i ; ki � '•.�{ ���ip,� ������ ������� .�v.r
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
El Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems'
❑ Other:
tly�fI9a ITOR ,.(MJ Y Y:rE i `..
Fee for each commercial $75.00
system
(SEE OAR 918 - 309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
N . Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
El Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1: 1Bui1ding\Permiu\ELC- PermicApp.doc 07/01/30