Permit a CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
II I ° COMMUNITY DEVELOPMENT Permit #: ELR2013 -00030
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/07/2013
Parcel: 2S 101 AC01600
Jurisdiction: TIGARD
Site address: 7000 SW HAMPTON ST 219
Project: Wen Jiang & Company PC Subdivision: BEVELAND NO.2 Lot: 18 -19, P
Project Description: (1) low voltage Data/Telecommunications for tenant space
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 02/07/2013 $75.00
12% State Surcharge - Electrical 02/07/2013 $9.00
Type of Use: COM •
Class of Work: ALT
Total Number of Systems:
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 $84.00
Other Desc: Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -001 -0010 through 0 R 952- 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
I
Issued By:
/Wiley J Permittee Signature: Oki A �L 2.
/ C l`i' / 6&.
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE: Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for the next available Inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project
Approved plans are required on the Job site at the time of each inspection.
Feb 06 2013 11:25RM Bridgetown Electric 503 - 621 -7123 page 1
Electrical Permit Application RECEIVE
• City of Tigard ,; . .�, ? 13 s5 '2�eto$ top : l [-Q COI 3 - a?� jo
13125 SW Hal Blvd., Tigard. OR 97223 ptm, Revievr Ott
• Phone: 503.639.4171 Fax: 503.398.1960 .FEB 6 2 013 tamer
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Impaction Line: 503.639.4173
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❑ New construction (g,Addition/alterad . replacement t�toere cheek alitbmi y (777.1 3 ettt. phi, : r
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O&M.° or feeder 4130 Word er Miro 0 Brilldhii me slots
❑ Demolition ❑ Other. where the available eolt 0 Maim* end bptlysds.
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:.i'' "�' ±rl _ r: «; f . ; i :,i moods 10.000 arpe at 150 vela a D north* north* north* Dsiidisps
3 ' •' : , . " ! . . ,• , •i - n " y s 1 , i , a 'it ` ?, •, :. less to ground, or 'speeds 14,000 D OomamoioFme egrlouCmel
-. 'i I!!:' .;� , :'Sif�� � A!'" a;_ .,.� sY" . 1:: avi:ir:a�uki:,u refsf -'
El 1 - and 2- family dwelling Commercial/in ,., at ❑ Accessory building ems far ell other ,mimtrfoor. beddinga.
❑ Multi- family ❑ Master builder • • Other: O Frs pomp. ' mstellatioa of 7s KVA or
: '1iK ; nv_ ! �., ,11x() r 7'..:::1'. ., • A k Y. .: \- c c� • 1 . ,.. OEn 8., ey.[C. larger dallied system.
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Job site address: 100HP or norm ate•
Job no.:
13 - to W Q :'An.l lava g? S+ Dsix or more residential mite. D Reaeedeo.l vehicle pets.
Clty /State) /.[P 0Herbh�e Smithies. D Supply whey mr more tam
� is(��w� I O i 9 73 OHazerdoeslocatiom. 600 volts seminal.
Suite/bldgfapt. no.: Sic. 111 Project name: V . 3 }�,• r)C Dscrviee or feeder 600 ...... or more.
! J �" °«' : 417.41 tar ii `:; r r, ;IL ' 'fi t '; MMIe . :i';;
Cross street/directions to job site: ; ,.,. :, . , stl'riig1117_a111111 •
New midentis1 stogie- or Iteild& - dinning ask
Iatludes attrnbed �rsg•
Subdivision: • I Lot no.: 1,000 sq: R. or less 1611.54 4
1 En. add') 500 sq, ft. or pardon 33.92 I
Tax map/parcel no.:
CC r d residential 73.00 2
r!k k: 9 hM ` . >-,= — 1' 'r•' r � . � _ - .• . - 7 '• I ,i • ",- ' L� c Witba • ��
�ry� L - A_ ! have . & t 75.00 2
1 _ it - � R,A• , .7. • ... .r`.p1 - - _ -
l astallatien. alto stio n. md/ar man
- ro% G 200 amps or leas 100.70 2
. ': . rhk :. i { 0 , ,J ,u'a!tIt s:_:;:7:::.';', 4 i'; 5=; i "•t'' ,, 201 atnpato 133.56 2
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c �Ji ]:ffi �arucr w..dJilf t .�,i. .� YkU �.: i' . :• ' '. . - i..; ,fl�!'� ,.
401 amps to 600 aims 200.34 2
Nam`: ,— 601 amps to 1.000 a npa 301.04 2
Address: Over 1.000 ampe.or volts $5226 2
City/State/ZIP: Temporary ser'4 s or finders tornaltation, duration. and/or
relocation
Phone: ( )
I Pax: ( ) 200 helps or less 59.36 I
201 ampsm403ems 125.08 2
Owner instaUadoa: This installation is being made • :property that l own which is not 401 ,E a 168.54 2
intended for sale. lease. rent, or exchange, according '. ORS 447.449.670. and 701.
11101101i4ireallis .-stew, a terroden, or extension, wound
Owner signature: Date: A Fee farbeandS oinOte wW+
• ; arm ;ax K , •r . • �. [ , mam.,:�w..p" i 5
, : fy�p:, . abOV aerY•Oe ar 7.42 2 keder fee.
;: A ::'.: y (i 'a i!!r? PPS awl Z . r j . 1 i• �'';, . 1 , 1: 5...
.y Li,. :, i ".;:b' i:��� wti: � �. ,rj� ;•S �W=.0 L ..d�a6:�tan1 �. i•�iu-aw,vdr�$'iS; At',F :CB�b'� be1rC'1at •
Business name: B. Fee for branch cvcuita widow
.service or feeder Im. flits 36.18 2
Contact name: :branch circuit
Each addl branch circuit 7.42 2
Address: • Mlseellaeaans tagvbee Qr feeder not Included)
City /State /ZIP: 1 a Dania 67.84 2
Phone: ( ) I Fax:: ) Reconnect only 67.84 2
Pane or irrigstton circle 67.84 2
E -mail: 2
_.. . , , . , n fi � r ;rz: � ; r..�rr:�; f i �:•.,,,,1> „ Siga � outline lighting 67.84 r
2
r AC41 {� • .)ii :.. i�`S,i';: ' "" ,j .a- d 1 citmiti) 1, l
;,:..;::::'� �±•.. `�:.,�'ar. wi , I�.i�..,.,,.:e.. -., .-.ct.. ,',:�;� .���:'k,tr�,:,.; $` a a► 1 r �2 I � �"
Business name- ��,;p - • panat -Or let ees&of,
sv'@i.r ! .(. V lle 8aet iai letiti9 ea over ells able In Ray attbe above
Address: £701 !U . LD n16 • : r.:13 S T GE7 tStlopel AA latpootiea (1 hr IWO 66.25/ hr
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D O ' lnvestlgation (I' iu rain) 66.251 hr '
CitylState/ZIP: R R1 Z . 3 i 3
le ¢uingiatMant(1*min) ' 73,18/br
Phone: (Co33 ) 144 . 7 + 22. I Pax: ( . - ) feat 7123 hums: Maria tttiz,vitiidino.fee is 90.00/ hr •
CCB Lic.: 1 824 I Et cirica1 Lic.: • ^ GI Suprv. Lie.: 4 f 7 7 S )'..; a rk1ia1 , y - . _ ...' ...i qigr10, .4 .
Suprv. Electrician signature. requited' :,L./ % .„ s e,p , ,,0,.4 esTe., _ P lan r eview C2S96.ot��ermlt the)
Print name:, y% S1e vr.,s ,,, I Date: g/ 4/17 Statoaurdtarge,(l2 ofPermit fee):
Authorized signature: T;a pariah app n onehm Via' : 1y,o;e obsettedwahaatS0
aimater Nato finatirrnirindiiieniiident
Print name: I Date: • Number of inspect0ns ellowed•perposit
1: larritd 'mgWamit11Et.C- Pe.milkpp.doo 07101!10 440 UDS/CUM,W6a
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
7000 SW HAMPTON ST 219, TIGARD, OR,
97223
Commercial - Electricial Limited Energy
199 Electrical final
02/20/2013 00:00
ELR2013-00030
PASS - No C of O
Violation Summary:
Inspector Contractor