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Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT s : COMMUNITY DEVELOPMENT Permit #: ELR2013 -00094 T [ G A.R D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/29/2013 Parcel: 25113AC00103 Jurisdiction: Tigard Site address: 7236 SW DURHAM RD 500 Project: JB Group Subdivision: COUNCIL VIEW ACRES (LOTS 21-44) Lot: 25 -27,2: Project Description: (1) low voltage for Data/Telecommunications Contractor: BRIDGETOWN ELECTRIC Owner: PACIFIC REALTY ASSOCIATES 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 04/29/2013 $75.00 12% State Surcharge - Electrical 04/29/2013 $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 OA 2 -001 -0 90. You m y obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. C � 1 � .800.333 + i4 2..2 �� Issued By: Permittee Signature: ©� , or1.." 4 -7(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. Apr 26 2013 3:31PM Bridgetown Electric 503 - 621 -7123 page 2 Electrical Permit ApplicatioRE EIVED City of Tigard P , y aC (3 Nt.nitt4a �C r 3 .��c>'c� 13125 SW Hall Blvd., Tigard, OR 97273`' 2 9 2013 inn K�aN Phone: 503.639.4) 71 Fax : 503.5 71960 I Aanity - , l er Paned: Itlmple o. Lill 503.639.4175 B i D F TIGARD w a { � e a�i. . �' i `• i.a.,..w. ItYesrut' ...lizard-mow L DS - I S[ON — . WrE of wan z rte' ,e r ❑ New construction Ea Add ition /alts ration r4 is cntcnt ma thec► an dna r stub air 2 MS of plan wham cleats Woo: ❑ Demolition Other: o lSernco or feeder 400 ampg or wore l Building over %no caries I ante talc wadable suit c rma 0 Nrrassa and boatyards CATEGORY Or cos jeaeeeds 30.000 antra at 150 oohs or 0 Finality buddies. � ❑ 1- and 2- family dwelling ® CoinlnerciaUladustrie 13 Accessory building Sew s to r a ll m "' ea�.ear $4,000 ❑ cownma:tal�ae aw,,,rr,r.i """i amps for all .Miser rngelbttona buJde.ga. ❑ Multi - family ❑ Master builder 0 Other: 0 hro pump 0 tawltalio. of 7S KVA or JOS 01•wargcno uvalont; larger separatelytYriaed fie' I I<",'1 4 l! > 71a(Oltt Amnion Aoa „f new mobs stud of p A'. "V, "ice"_ °t.3 Job no.: } 3 _313 1 lob site address: o73 V w 10011P of must. occupancy. !e!I+ll r !. ..._ R __- ....._.._. _. i' $tv iN moo: reRide sal atilt. 0 Ftereauosal wands parks C'ily /5tale/XII'; A . (' 0 lta aardo arc faalin 0 Supply voltage for more din __ . _....... ._. _... 011avdcw. WM roatmal. Suite/bldg./apt. no.: c,k j a I Projcel name: 71$ ClrolftoP _� ❑ of reader amps or more Cross street/directions to job site: • • rr 9opowwow I l last T tow 1 - ------- . _._._ _...--- _. - - - New reaitlertitlt iniski dwelling nelL laclades attaeileti . - . -- Subdiv ision: 1.ot nit.: Loon sy. R or leas — _ I'u add'I 5(10 sq. R. Or patios 11 I'ax map/parecl no.: Limited energy. residential II tvMh 73.00 Or !. altos sq.11. ) AV*. {� l.inntcd en orgy, multi - family . 75 CO 4. Atad:^V* �b� f.L ..� i!.�y4 . .. .. .40� ___- .. (wttfi . R. ►'a'►GS 4• Cs 1 tJ 11 _ _ mot) amps or ois 1 iatlior. alienation, or 2 0 �A►1f3R'! Y owns 0 TENANT 2(11 !amps to 400 aelppls 133.56 2 Name: 401 vows to 600 rasps 200.34 2 Address: --_ _ _. , .. ._. - .__ - , 601 amps to I.00D anops r 301.04 t3ve k 1.0(10 amps ur Oohs& Nig 552.26 8 City/State/ZIP: 1s+Y assets or feeders installed" aMenMor• rnilor l Phone: t I 11'ax: I 1 200 ps ar less 59.36 —0 Owner installation: 'Chic installation is heir matic on _ _ ... _._ , 201 amps to 400 amps 111111 12,5.011 — b P►o 44 that I own which is not wa amps to 590 amps 168.34 2 intended for sak, lease, rent. or exchange. according to +. RS 447, 449, 670, and 701. Branca circa* - sew, alteration, or enstenaler. sand ()miner signature: _ Date: A 1?me that branch circuits with 0 APTUCANfI above service or feeder fee. ; JhA� 11� each txaadt circuit 742 , Business name: • H. Fee far brooch circuits without __.._..__......._. _ .r ... service or launder foe. first Contact name: hranch circuit 56.18 - II ._, -. _...._ _.. - ----- _ _ - -- Itch add I txamh circuit _ ®111111111 Address Miiedhtwcaaas (service or feeder not iacirdrd) (city /tittle! /,I1': 1-dwelling, manu(hct dal or modular 67.$4 3 dwelling, semen and/or [teener Phone: ( ) Fax:: ( ' l Rocomeat only 67.14 — 2 13 1 _ � _.. . —_ —. —_ __ _ ... Pump or imption circa 67.84 • 1 mail: _ _ 4 T12R - . - Sign a whine lighting 67.84 2 �.r� panel, circuits) or limited -energy Business nume: jpj ELEC 1 Mil alterytwn. or =Senators. ' !C . 7 - 2 _k ac additional iteeetiar over .. L. a ;tie above Address: S7 0 / N , L Q m. & S 71Z7 __ - - Additional inspection (I ter rain) — « 66.25/Iv _■ C'it /Slate/ /.IP: ! Invaiu tan ( I hr nun) 111111 66.25/ hr y [1.�.. �. it 2 Q3 + •- - r11 • __ _ _ _ - . Industrial plant (I hr min) ' 78.18/ hr _ Phone; (So; ) e4I - 112 2• 1 Fax: (t4 } , (or� 1 i - i 2.3 Inspections for which no fee is 90.00/ hr C'e'll Lie,: 7 7 ___ _ apectlicallx bated�yi hr mw 1 Q ci " 4 Electrical l.ic -: ;,r:, . .. Suprv_ I.1e.: 1 7 7 ~ . , InArr . Suprv. Electrician signature, required'' . y, . S 814 it kci r > w : .+a •.r .rE.. • Plan review (25% of _ .. ..._._. — ...- -- -- ------ dam ): Print nanne; .S sf r ___.._._. f 7� /x r s r. car Dot J J (� //� titase surafwBlr (12% permit tee} _ Authorized signature: TOTAL PERMIT FEE • -- - - rti. permit sse&aac• *spina if a p - i- (sd whole no days after ii has bum . _ pariah Print name: I Date: • [V,uiiticr art t i11mW allowed pea remit. 1'W4dictronsi U. LC- wunlApp OTAttto .1.1lN.h11 tId$.('0%I,Wh$