Permit . •
y r � CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
'� COMMUNITY DEVELOPMENT Permit #: ELR2013 00060
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/18/2013
Parcel: 25101 DB00101
Jurisdiction: Tigard
Site address: 7440 SW HUNZIKER RD F
Project: Elliot Associates Subdivision:CONDO SUPPLEMENTAL PLAT NO.4: Lot: 22830 -2'
Project Description: (1) low voltage for Data/Telecommunications
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 03/18/2013 $75.00
12% State Surcharge = Electrical 03/18/2013 $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 952-001-0090, You � ' t k1 may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: , UI 1 r Permittee Signature: �fO 0 _i Yr / 7 C/n, I
M-
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.
Mar 15 2013 2:45PM Bridgetown Electric 5 0 3 - 6 2 1 - 7 1 23 page 2
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Electrical Permit Application p. w EIVED :!,,,,..! ,,, ,,• :,,,.,
City of Tigard
ail •
13125 SW Hall Blvd., Tigard, OR 97223
Phone: 503.639.4171 Fax: 503.598,1' :
Inspection Line: 503.639.4175 I TY OF TIGARD
Internet: www.tigard-or.gov I MAR 1 8 203 Dat Recei • : 3 / I 1 g l /
i 3 Sr Janis Other Permit
Plan Revraew
e lo ... ..... l s :
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II : 6.
Supplements eformaea
tl Eaf t nate/B.A E :
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,Iv ISION .....
4r-vvv:14:jii,..V ,.; :. „..,::,..:..!;;.: ;...iP ii.:§k 1 i'filS } r :P.- IttrZarr. t,:L:r.ARZTIflatn...F '
0 New construction II Addition/altemti • n%replacement I ' Plano check all .;: ' apply (Windt a seu of plan a **steals erected
. : 0 Service or fee& 400 amps or more 13 RuDdirtg over three stories.
El Demolition 0 Other: where the : •. .. • fault current 0 Maims and boatyards.
7V•t 'Illf821,==1741:.:=MIZERMIlin exceeds 10,000 .... • at ISO volts or 0 Pleating bolding'.
less to ground, • exceeds 14,000 1:1 Commercial-mac agricultural
1,3 1 - and 2-family dwelling El Commercial/indw lal 0 Accessory building amps ibr all • ... • installations. buildings.
0 Multi-family 0 Master builder ' 0 Other: i °Fire pump, a Installation c(75 KVA or
0 Emergenoy sy • .• . • larger separately derived mystin
0,..e:•41..161,1114.'.'%:ffl-11''..Irrrlf?Mr:IfT7,7; ez,vfnmainammell,,
im 0 Addition °Pilaw . .. . load of 0 "A”; "E". '1-2". "1.3",
. _ • .g. -..rtabSyr:vutegillal/Mttiti....M.-,12.that.• . alai 4tE4124iLIMS6
100HP or TIID. ampozy.
Job no.: 11- 1$5 Job site address: 74 , 1 $ 14 Mr,' i , 'A.,. . Sk 0 M
Six ar MOM . , ■• . dal mitt. CI Recreational vehicle parka
City/State/Z1P: • • a 1.77..23 0 Health-sem — ' ' - . OS veiltago for more than
600 volts nominal.
Suite/bldg name: ./apt. no.: p Project name. 5
MIIITYPIF#111116111 OService or
',411'i, , t;...?:.'1'!v.n9li , iy: Sigterti.r7,79;1: Mrtar
Cross sireet/direcdons to job site: , , , .,. . MIII=.' O ii• A111151=111• •
' . New residential ogle- or multi-fandly dwelling unit.
. ! Includes attic . - • garage.
Subdivision: Lot no.: 1 1,000 sq. ft. odes: 168.54 4
, Ea. add'I 500 aq. I. or panicle 33.92 I
Tax map/parcel no.: ; Linsioad energy, -, • • -, .'al '
k t;
:f,;:itg, ?.,::,...i4':.:::firii=r1IMMTri.r::.;,:%Gi'$i:;:'-',.i',M.:.;:::';.,:4;.'f!'iife: 7500 2
. i:.-9'4 —•,-(Zlig.labrie - . '
1 Limon enera, ni Iti-fimsily ---o"--o 2
residential (wi above sq. ft.)
...es t _MALI If,.2.4. FI-,_._,.:3._......., 0" . -2' al I
Services or feed - handiation, alteration, and/or relocation
- - I
S 'w - 200 111799 or less 100.70 2
Mg finT"..,27rIti q-tcp.r.i.i
R
riENIW:! ....- • : : : ;: ,. ?mi
201 amps to 400 pa 133,56 2 1
401 amps to 600 • .0- 200.34 2
Name: I 601 amps to 1,000 ps 301.04 2
I Address: . Over L000 amps 0 volts 552.26 2
. 1 Temporary sirs.. 9r feeders installation, alteration, and/or
City/State/ZIP: , relocation
i 200 amps or less 59.36 1'
Phone: ( ) Fax: ! ) 1
Owner installation: This installation is being made I 0 property that I own which is net 201 amps to 400 • . 125.08
mops 599 ••
intended for sale, lease, rent, or exchange, according ., ORS 447, 449, 670, and 701, I
Owner signature: . I Date: ! -lian401 m ps to eiretd , 0 168.54 2
ts nevi, alteration, or extension* per-nanel
A. Fa for branch moils with
v .q q..tiiihiP•' - "es •- •._; t ''''r. J..
' l4:'•-•-g-ei.' :ii.Y.n .i.1 above seivice - redder lae.
: {'• 1::.t•rimkis •A:',Y.li'3 '7 % • - 1 ,- ,•' , .• , - .- - .1 - stiii,owirk.: f "", 1 . each branch circ 742 2
Business name: '
. B. Fee for branch • is without
: . service o r - - • -. Gm first
56.16 2
Contact name: ' 1 branch circuit
, Eech add'i branch •.'reuit 7.42 2
Address: Ntiscelhmeons ( - • or feeder not included)
City/State/ZIP: Each manufactured . modular 67.64 2
dwellin ._ service • • or feeder
Phone: ( ) Fax: : ( ) Reconnect only q 67.84 2
Pump or irrigation • . .• 67.84 2
E-mail: ,
67.84 2
1 ''Aili.i gigot:dream GT , . -. • _ sy
61 1 • - 7 r — 2
panel alteration, PI -. " ,, hat
Business name: 1 2 1 RW I Cal5WW: ELS ir .. IC Rath additional . • calm over allowable In any of the above
Address: • £701 xi , i_o fh.6 • r 0 s T1PcE.77 Additional' .... - -.' 0. (1 hr min) 66.25/ hr
investigation (I hr • .•n) 6625/ hr
City/State/ZIP: 'Pail •" Cri 1 6 3 - t 3
. Industrial plant (1 min) II ' 78.18/hr
Phone: (C)03) e 1- 7 1 22- Fax: (MERMEN= inayeetions for %via.' no fee is
90.001 hr
■!,- . listed Ural*
CCB Lic.: 10381-4 Fir:trial! Lic.: .. ;. I, ,C, Suprv. Lic.: a i 77s -,41illiNSMI711.T.P.1`. ''
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Suprv. Electrician signature, reqiiinn — r : ° .... . .. 0 - e . ,
Print name:AM, 'ye-A. .5, e er,,s/'c( I Date: 3//51/ State , , • - lie (12% of permit the): 1 —
TOTAL PERMIT FEE;
Authorized signature:
This portaft spit . tioa empires II a pini1sisect astabpd widths 180
days a .. it has been acca as cetited itplete.
Pr int name: Il Date: • Number of ' .... , • ons allowed per penefr.
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smatiointrermitinELC-rernanpoic osioulo 440•46157(11005/COB
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