Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit #: ELR2013 -00022
T I G ARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/28/2013
Parcel: 2S 101 DB00101
Jurisdiction: Tigard
Site address: 7460 SW HUNZIKER RD F
Project: Green Options Subdivision:CONDO SUPPLEMENTAL PLAT NO.4: Lot: 22830 -2
Project Description: (1) low voltage prewire from demark to tenant space for comcast cable
Contractor: BRIDGETOWN ELECTRIC Owner: HUNZIKER PROFESSIONAL CENTER LLC
5701 N LOMBARD ST 3601 WREN ST
PORTLAND, OR 97203 -4113 LAKE OSWEGO, OR 97034
PHONE: 503 - 621 -7122 PHONE:
FAX: 503 - 621 -7123
FEES
Description Date Amount
Specifics: Restricted Energy Permit 01/28/2013 $75.00
12% State Surcharge - Electrical 01/28/2013 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio & Stereo: N Boiler Controls: N
CCTV: N Clock Systems: N
Data & Telecommunications: y Fire Alarm: N
HVAC: N Instrumentation: N
Intercom /Paging: N Landscape /Irrigation: N
Landscape Lighting: N Medical: N
Nurse Calls: N Protective Signal: N
Security Alarm: N Other: N 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 52- 001 -0090. You
may obbttainn a copy of the rules or direct questions to OUNC by calling 503.23 or AP' v 1.800.332.2344. L ,
Issued By: `�+ "`" Permittee Signature: o /v / �
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.
1
Jan 25 2013 1 0:06AM Bridgetown Electric 503-621-7123 page 1
Electrical Permit Application • ; .
City of Tigard
AMIN .:Pftilit Na ' t a ao( 3 -d00.1
, ....- 13125 SW Hall Blvd., Tigard. OR 9
It
vie
' Phone: 503.639.4171 Fax: 503.59RC E IV ED w
pabilaPiRe:Rcive: Otter Perth:
I . Inspection Line: 503.639.4175 Date Ready/By: 1 I lif fiat Papa for
Internet: vnvw.tigardorgov JAN 2 8 2013 lOotifiod/Method:
1 Supplemental Wonsan
. .
. ' ': ' ' ,' ' '. :•:.', * i , - •kiGARD • ' ,.,', ..; ,.. .,4?Ac . '' 12 rfESC::'
•
ID New construction rz1 Addition/altmg . 1
1 ' DIVISION please check all • • apply C- • . ,' • •' Of : : .. , tiehisam•checkedbektw):
0 Sorvice or • • - • • • 400 amps minis plialdiiitoverause wake.
12 Demolition 0 Other:
where the avai - 1.1e faith amens 0 Madman bonfires.
exceeds 10.000 , • • • at 150 oohs or 0 Pbating Whams.
less to ground, •• meth 14.00o 13 Commercial-use agricultural
0 I - and 2 dwelling r21 Commercial/industrial 0 Accessory building amps for all • • - installation &sidings.
0 Multi-Family 0 Master builder 0 Other: 0 Fire pwsp. 0 lassallialoo of 75 KVA err
: • . ; A g**4 0 .:: ' • ') , • ' : : . , ;. E Eale9WneY 5 :: — bad o f 0. IY1te
tocatP or mo otteupanY.
Job no.: 13 -S? Job site address: - 7/.1& a , i
S v its "2:14/ Si - O m Six or more •••••• • -• dal MI13. 1:1 Reautiotal which) paths
City/State/ZIP: - 7 06 , ,A og q 7.P.7 3 0 Health-care , .• • • ties.
OM:anon • 0 &poly %cottage for atom than
•W tolls nominal
Suite/bidgJapt. no.: S4-c F Project name: (r -,c4, 4) 0 Service or • - 600 • • . cm mere.
I'
Cross sIrect/directions to job site: fq6':411i'Vli
■ ......... ,,, IM1111111.11111■111.M Iiii •
— New residential . ,.= . or mulatelnilY dwelling oak
Includes attae ..- . garage.
Subdivision:
11n0.: 1.000 sq, R. or .-- • 1 168.54 4
• Fa add', 500 sq. ' or pordon 33.92
fax map/parcel no.:
Limited energy. - ,....• .al
. 2
75.1:0
. , . ' ,.'• AiSi ','• : ..f:• S:' . ! .- lf: ?: !?; ) 0,4 { with down ' ')
Limited energy, m ig' family
7500 Lo L./ "lb., 4 r ilf:c.1.4 % eo 4 " nie A ft, 4 A --4 Sp4,e residential ( . • •, • bove sq. R.)
Services or - • - - lastallation idteratloa. and/or rekmadoa
tiv,-- Co,ot.:M4- C.44 , 200 amps or less 100.70 2
a PRoPtorie,troji**5 -' 1.;.,': l' - - , ....,. - „:,.:4-..60,404 , ,f::, : : .: :.:::-.;‘..:,..; -,:: 201 amps to 400 .: - I 33.L6 2
N e
401 amps to 600 2
am:
601 amps to 1.000 301.04 2
Address:
Over 1.000 am a snips 552.26 2
,
— Temporary or feeders installadon, alteration, and/or City/State/ZIP:
reloesdon
Phone: ( ) I Fax: ( ) 200 antps or len 59.36 1 2 I 2
1
201 amps to 400 25
Owner:installation: This installation is being made on property that I own which is not
1 :74
401
intended for sale, lease. rent, or exchange. according to ORS 447, 449, 670, and 701. amps to 599 1 68
*Iteration, or estensioa, ear panel
t)wner signature:_ ate: A. Pea lib ch - ci - .• : WM '
• 1 : 3 74440 4 44'k. '. ' :. ::.:'•!: .::: 1 '; :•' :'d . 0 . 00 4 000** 1 0k4 : :','• : •::::: :.` I c tir Service . . fee 742 2
Business name: B. Fee for branch -',. - its without •
service or feeder • . Eno
56
Contact name: branch circuit , .18 2
--- Each addl branch e• uit 742 _ 2
Address':
Miscellaneous (se . or feeder - not included)
Each manufactured , modular
City/State/ZIP:
dwelling, service • • or feeder 67.84 2
Phone. ( ) I Fa7T : ( ) Reconnect only 67.84 '2
Pump or irrigation c' , le 67.84 2
E-mail: .
. , 67.84 2
Sign or outline 1 :■ • ' • ,:
i . ' . ,,: i .,‘,. .: 1 1 ,1',. ..dtitilikilVOlki74(14.':::`•':. ' 1 , : 1: ...; •-;;; • : . .. • '. • ' ''.;"L Signal clanks) or I' . • ited-atcritY ' 1
Business name: 13(ztpcimmiN Ei.E.Mts., panel, altennion, or --‘,• enslon. 1 Pap 2 35 — 2
Each addidonal: 1 , ,• - , on over allowable la aay of Mealtime '
Address: £ 7 01 Aj , L. 0 ()t &412/) S 71eCE. ' Addilkad ' ••, , - -.' • : (1 hr Min) 605/1w '
-
Investigation 0 hr • ! • 66.25/ hr
C:ity/Stater/JP: ?DWI-LAND • Oil 2 ID. ' I 3
Industrial plam (I ta • in) '
Phone: (e I .. 112 Fax: (C ) 4 1123 inspections for which o fee is
90.0011a
- • I listed 1 6 • • ;•
Cell Lie.: 103 B1,4 ,qiectrical Lic.: - , - • , r G Sursv. Lic.: 4 1776 1 ,.';!'q5Krr-r: 7 i 7 ;: r ?? (- P::ES. - T'321111;4 1,, :6:AM
masa -
Suprv. Electrician signiltrk required--- -a.0
0.... 4...,
Plant vlew5%ofraifbe) :
„_.
Print name:/, A S-,l ••-a_s A...es" Date: 1 ,/51/ 5 State s (12$ ofparmk fee): 6 1 -
70 T A1 4 3 .4RMTPEP . ; t8 Li -
Authorized signature:
This permits applies - explrevitapims,t,somosognandssitala ten
It his beenitergasYsi essnasta.
l'rint name: 1-13;e:
• Number of inepectic s allowed per man
I ‘ 07A I/10 44040 t Sf(11/011COMAVEB