Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
III
$ , COMMUNITY DEVELOPMENT Permit #: ELR2013 -00104
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/13/2013
Parcel: 2S102BA00303
Jurisdiction: Tigard
Site address: 9806 SW TIGARD ST
Project: Barrier Corp Subdivision:RTH TIGARDVILLE ADDITION, AMENC Lot: 21
Project Description: (1) low voltage for Data/Telecommunications
Contractor: BRIDGETOWN ELECTRIC Owner: ANDREWS MANAGEMENT LTD
5701 N LOMBARD ST TIGARD INDUSTRIAL LLC
PORTLAND, OR 97203 -4113 5845 JEAN RD
LAKE OSWEGO, OR 97035
PHONE: 503 - 621 -7122 PHONE:
FAX: 503 - 621 -7123
FEES
Description Date Amount
Specifics: Restricted Energy Permit 05/13/2013 $75.00
12% State Surcharge - Electrical 05/13/2013 $9.00
Type of Use: COM
Class of Work: ADU
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 0 R 952 - 001 - 0090. ' Yoo � uu A may obtain a copy of the rules or direct questions to OUNC by calling 503.. or 1. ,.,�
Issued By: �� V'K.f Permittee Signature: V/H r�
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.
May 10 2013 8: 33FIM Br-idgetown Electric 503 -621 -7123 page 2
Electrical Permit
Blvd., T1ga City of Tigard
gi
Hall nt OR 97223M
AY 1 3 2013
Phone: 503.639.4171 Fax: 503.598.1960 503.
Internet www.tigard-or.gov j,. / 4 / 3 / ; W - P°6Ift N°!:
13125 SW Ha 8 0 0/3 .- Cir)/05 /
Plan Review
Data/By: Other Permit:
Inspection Line: 639.4175
I W See 3 for
GT/ OF TIGAIW Dare Rced/BY: l' .f i l CO I Pige
NotifetVMethod: Supplenentel Wound's
,: . '' '''.. ..;?:;. 1.1:j.';''.:: i.`er.0-f*t ` --,'.: - , ,, ,;:::!;...1 , :i:,::.•,.7.4. , gil:'; : .. nr.:,.,;..:734)...4F • 4
0 New construction ':■ Addition/alterati . daednent : ?Memo dads aBlhal •• . -.- • :". ;OW or. • "Moms eheekodhigow):
0 Service or Seeder + • amps or ROM a BiEdiiirovei three modes.
0 Demolition 0 Other: when dm wallah! fault cement 0 Moines and boatyards.
::.., i:! '.;,. t :.' 4.:1, '*:.., !: .-: : meads 10.000 - • at 150 volts or 0 floating Mildings.
leas to ground. or - - - — 14,003 0 Commacial-use agneubonl
El I - and2-farnily dwelling ' Commerciallind - ' 0 Accessory building amps thr aIl other • - 1 . • ... . buildings_
1:3 MUI114311111y 0 Master builder 0 Other: ()Fire Oatalt 0 tamsllatioa 0/75 KVA Of
• . '': 1 ' .: ;)'' ' '• •-'''');Y • .4; • ;, • i • . "7,; ' ' il• ' ...", , I ; —. 4 s . ■ -?':•.., ;1•;; ,;• ,,....., ,A,7 ,,,,.• . 0 Emergency system Ismer separately derived :yawns. j
Tt •-• : ' ,.., „ , - '., ,,,- .• X , . ." . : 5.,:e-f -., ' "",::',..':.:-- . :,!.! :i ::1...r OAdditioa of new m . tor load of 0 "A", "S".'1-2^.
100HP or more. mmmmy
Job no.: 1'3 - 3 -ED I Job site address: Igoc, i s/ -1-.- s 4-
0 Six or more nein • I urns. 0 Recreation! vehicle palm.
City/State/ZIP: 1 - % / Of. • : 2 f 0 Healtheare theili ' ... a Supply schist for more than
1 o.,,-- 0 limeadous losazi • . 600 voles munimil.
Suite/bldg./apt. no.: I Project name: 4 6. ...ed.- ciServisse ce bode. • ■ • .. or inn
. •fl.; . J IF A: itiar:=7:
Cross street/directions to job site: MIMI= ie
. New residential al • - or mtiltRainily dwelliag unit.
Includes attached i rage.
Subdivision: I Lot no.: 1,000 sq. ft. °Hess 168.54 4
Ea. add'1500 sq. It. • portion 3392 I
Tax map/parcel no.:
• Limited energy. ries • -.. ' 7100 2
• (with above 54: ft,
. Limited energy, . , family
7100 2
.1?r-J1r.••..- (IOW Prse•se•-x,. i. 0 g— 0 a. 4v 4, . ... : residential (with • • • SQ. ft)
Services or - • - hastallation arillirr ntloustion
‘ . , - Cgr,,,M,t, C - • • - 5. * - . - ' •
1 - 200 amps or less 100.70 2
!NT'
-,'. ,,. - • :. .. r. - .',:.,' , ',4;'3.: 0 40 i 4 2 :: ainPsamps to an::: 133 2 2
Name:
m . 34 56
• 601 amps 01.000 - . 301.04 2
Address: Over 1,000 amps or • - 552.26 2
Temporary unit - or feeder installation. alleradon, wadi°
City/State/ZIP:
relocation
Phone:( ) I Fax: ( 1 200 amps or less 59.36 1
201 2
Owner installation: This installation is being made or . roperty that I own which is not
amps to 400 am . • 12108
- 401 amps to 599 , • • 168,54 2
intended for sale, lease, rent, or exchange, according tc LS447.449,670, and 70l. .
• Brandt thenity- • : , Amities. or estemaisn: per panel
Owner signature: Date: : A. fete or WW '' '. • "
. • ..'i; ;gatli; iIi=ranainnitiMpl=„7.`!0, IR'Ir'T`Tri: ,,,,, •:::;,, ,;:, r; above service or • - .
7.42 ,
Business name: ' B. Feo for branch ci - without
service or feeder • - first
56.18 2
Contact name: • branch circuit
F. st h WW1 brands ' - ' 742 2
Address: • Miseellaarns - or feeder not Included)
Each , • , , , , - . modular
City/State/ZIP: 67,84
2
dwelling, sewico - , /Feder
Phone: ( ) Fax: : ( ) _ RI:cermet-tally 67.84 2
Pumpmirrigationcile 67.84 2
E-mail: , , g Signor outline Ugh '.--: 67.84 2
1 :'....'; , .; ; !-", , k - iitti■m,t,i,:-1 , ,:;Nt , 0'..5 . q--:•:• :- , ,. , .14:: Sigoal eircui(s) or Ii , ', - • - - :,
Business name: 13et9GMlig N E . it tic, : mei, atter:sine, or -.,-- •' • ' s 2
S 7 0 / KV i- 0 rh- 8 ' i) g re -Car
City/State/ZIP: r AATLAND OR C O 2 .1 3 - 4/ I 3
ne:co 44,1 .. 712z, Fax: ( '
Cal tc 1
I .- ) (al 7ii3 I
: Each addltioniaki : - •, ; , . over alkovable any of the
Address:
Additional , - • - .. • - 0 hr Inin)
Investigatiort
industrial plain (I • lir • : )
nspecsions for .. ,ao fee is 66kr
66.25/ br
' 78.18/ br
pho
90.00,011r
1036z,4 1 Fitectrital Lic.: • . ; • • I Suprv. Lic.: 41 7 7S : 4.
.— .
Suprv. Electrician signature, reqUittli 4,eC, I _ .„,,,.a.,,., „
name:
Print name:4, ytA .S'e' .-i,s //cy• . Date:
Authorized signature:
Print 51/ofir
Date: :Went&
Plan Jew (25% of pamitiee): (.,.
Se:, - . .:.. ,:-- lIfieflsrutlifire): 1 ,1
TotAuemiti FEE:. E3 ii.-
. ,..,4
nil WWI +POW - ,. n0 *tuned wind. MO
days of* ft hai bee* Mer*id ai Mantels
. • Number of inspxticns anon:4pm penal,
tnadinatPerennELC.Peratitappne onelito no-roverei 1054'Oldnia
i - ■ '
. .
_. .