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Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT = COMMUNITY DEVELOPMENT Permit #: ELR2013 -00088 T [GA R D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/22/2013 Parcel: 2S113AB01201 Jurisdiction: Tigard Site address: 16535 SW 72ND AVE Project: Canon Solutions America Subdivision: COUNCIL VIEW ACRES (LOTS 21-44) Lot: 30 Project Description: (1) low voltage for Data/Telecommunications Contractor: BRIDGETOWN ELECTRIC Owner: PACIFIC REALTY ASSOCIATES LP 5701 N LOMBARD ST ATTN: N PIVEN PORTLAND, OR 97203 -4113 15350 SE SEQUOIA PKWY #300 PORTLAND, OR 97224 PHONE: 503 - 621 -7122 PHONE: FAX: 503 - 621 -7123 FEES Description Date Amount Specifics: Restricted Energy Permit 04/22/2013 $75.00 12% State Surcharge - Electrical 04/22/2013 $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 may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: � h di I t-f Permittee Signature: DM b PPLI C 4 l /4 n' 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. Apr 19 2013 8:49AM Bridgetown Electric 503 - 621 -7123 page 2 Electric Permit AnnIic P+, !City of Tigard - ' `"� Ra�a„ba s 3125 SW Nall Blvd., Tigard R ayr,i. or./e r Prenlit IQ j /� t�UO �� 503 .639.0171 Faa ' 5 O 03. a. 9 , 2 2013 P'°° aa� Date/07. other Penni: gl ttapeetlowww tigar+ �uv 0 !GA RD iu .iii ( a Neff* 11 for +■P ae�.v � m,.� t� lrfoeraaaiae 0 New construction *" a , 'r ' CB replacement moo chock .II .apply (aenbs liit3 sap • dime *halm . "^ . bsNwv); 0 Demol iti . • 0 Other: a where On avail i>,„ awn O amass war *pm swags ; Cili;ll ; Or , ' i OH aaceadr 10.000 • al ISO volts or a Flowing bild as. � FbtataK �dMtps. ❑ 1- and 2 dwelling (J CommcrciaUindu fiat ❑ Accessory building ." to ground, • mounds 14.000 O C.a nniereJahra aariwberal n its for all • inahtWions. ❑Mu familly 0 Master builder 0 Other: O Fire pomp. O Imbibition of71KVAor 0 . " 3 1 Er a eseacy sy .. r;$ g' IIDDORllfDff/01Y D LOCATION derived a'yam ❑ Addition of new • a load of ❑ `A'- "E ". 1 -2 , 'ti Joh no.: } 3 - -zq lob site address: 1 ti 5 • S Li 7 ad A 1o0NP a reons. ,p eaty- ❑ Sis or more toga. 0 Repppiow v bidle parts City /State/ZIP: -r' J 0 a .r '7 Z Z " O Neakb.earo feel 0 Sepply volapt Sw naet then — — - - - - - - 01 ieeardoua i ' e. 60o robs ro/ ut Suite/bldg./apt.' no.: Project name: • ah So jr.-i.•.ovr ['Service ortbeder .1 • oe aloro. Cross streeUdirrclions to job site: u, ' • . " I \env rasdenthd or naafi - haally Medias oak. udrs _ gan g.. Subdivision: 1 ) Lot no.: 1 .00o sq. ft or less ' 1611.54 4 Tax map/parcel - Ea- add' 1500 sq. f.. r portion 33.92 I t. irnited energy. ma'• di 7SA0 ! . with above • . 2 : � OF . I wi p Limited es". an ,. d . Nee, „ . ",•r -. ,F-O , 1 41 rrsidenWl with T a 75.00 2 — trL iota �.S.Ie 5 p , 4-1-• Services or - - • - haddladen, adleratl oe, and/or relocation t"' ' C6,41 ik 200 amps or km 100.70 1 3 CI mum I 201 amps to 400 am • 133.56 2 Name: 401 am to 600 . .. 200. 2 ___ r..._ -_ _.- - -- _ -• 601 amps to 1.000 a ps 301.04 2 Address: Over 1,000 amps or • Its 1 352.26 2 City/State/ZIP: _.__ _.._..._._ --- Temporary sery • or feeders iaatadtloa, Mondial, aald/ir relocation Phone: ( ) Fee: ( ) 200 amps oa lea 99.36 i I Owner installaOor: This instal lotion is being made o property that I own which is no 201 emits Qe 123.011 2 intended for salet lease, rent, or exchange. according t s ORS 447, 449.670. and 701. 'w I atom to 599 1t f1134 2 Owner signature; _.___.... Dote _ _ _ ' _ A. Fee foe brands - • to th 0 0 CONTACT' via above service or he. 7.42 2 each brands cheat" Business name: I B. Fee for branch c .. 'b withal,. I service ar feeder r f , first Contact name: branch dank 36.13 .1 Address: , Each add'I branch it 74 Maeda soots •,:u er feeder 0011 .1 11. City/State/ZIP: • dwelt' service . m eed er 1111 67.34 �© 4tvelf service .. foed Phone: ( ) Fax:: I, ) -- 111 Reconnect only 6734 E-mail: _ Pump or irrigation -' 6734 I Si • • or «Nine 67.34 Business name: rr ,r T Sipai ci ruk . )rrr1'. ' ;on • � . o S - e Eseb additional' Address: 7 01 r • I-0 IIN 6 • .r / r a 'T t ee-67 Additional inspecpon 1 hr min) Ill 66.25/ br AJrj f X 2 11 Y - I 3 Investigation (t be ,'.1 66.151br �, City /State/ZIP: (c > " • T 122 - lrtdaatr;at pant (! hr • ') 78.1!! br Phone } b2 ( 7 l 3 fnap0aions fir which o tar it . 90.00/ hr 11111 C:CB 1.ic.: $03 RR Electrical Lie.: ' • MI Suprv. Lie.. 4 7 7 b S. - L dated .tin Suprv. lileetrici nature �` ` f y_o: 1.. .: T. ItANSEMINI signature, required ' ���. �,� ..e...,...-.....4...e � Plan w(25%of' • h fee : Print name:, i44 ...c-Pee • rx,s; /..-'re' ■ Dale: / I `0 � fee): IJ -� 7 _ ' State (12%oP Authorized sigtlatUrc: TOTAL PERMIT Plat 8 ii .- I Print name: II I This permit applies • =pine Ica penal* lam st akalead date Ile Date: says .rtes} it bee bess +waged as.-_bl_Lle, • Number of inspection* allowed per permit I uteiWfg4Permisriat- PninitApp.dee 07A01/10 400.40131(IINtK' t 1 l