Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
$ COMMUNITY DEVELOPMENT Permit #: ELR2013 -00121
T f GARD 13125 SW Hall Blvd., Tigard OR 97223 503 718.2439 Date Issued: 06/04/2013
Parcel: 1 S135BD00100
Jurisdiction: Tigard
Site address: 9600 SW OAK ST 525
Project: Suite 525 Subdivision: ASHBROOK FARM Lot: PTS 5 &
Project Description: Data telecommunications system.
Contractor: BRIDGETOWN ELECTRIC Owner: SUN LIFE ASSURANCE CO OF CANADA
5701 N LOMBARD ST BY NORRIS BEGGS & SIMPSON
PORTLAND, OR 97203 -4113 121 SW MORRISON ST #200
PORTLAND, OR 97204
PHONE: 503 - 621 -7122 PHONE:
FAX: 503 -621 -7123
FEES
Description Date Amount
Specifics: , Restricted Energy Permit 06/04/2013 $75.00
12% State Surcharge - Electrical 06/04/2013 $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 =: — — — •ermitteeSignature:
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 29 2013 2:29PM Bridgetown Electric 503-621-7123 page 1
Electrical Permit Application . . . . .
gl City of Tigard RECEIVES Riallownislii ' Pau* Ne . - • 1
13125 SW Hall Blvd., Tigard. OR 97223 f
Phone SO3.639.4171 Fax: 503.598.1960 W ll Ma Paudt:
Inspection Line: 503.639A175 MAY 2 9 2013 Dete . • ., y: I. sedifle' el SeePage 2 ise •
Edema: www.tigard-or.gov r
....''. '),1* r 4 , :7. - (0-a1RMINDE; 1151Ec; EZIAE8EMFIZE..rr,',.:::?EVRTIRAPCAr'
O New construction ES Addition/ P ....-1. ' SION Mass diedislithat . , Onbois'axint ofplap • ,..: . - tislow):
[3unit:co ot smoker • . moat more 011106iiiinse-three Manes.
0 Demolition 0 Other; whore the a 0 - Omit onstent C) Magma and boatyards.
r s, 'ktOr- ' ' ' , ' ; ! • i: ' " - ;a! . .: ' ' - ' , . 7 ';t.' . '.- ,:', s-' • :.', : '-':: ;, ,:■:-", mew& 10,000 - I. at ISO labor 13 Floating boildies.
." '; --1 - R "11, • -..■ :' .I-ti sa/S.ii,;,..L.44.4.'q ' , . ÷.1' :I ifi4-1.1. - , .. i ,
Rea (0 Illowld. Ix -./ • - . 14.000 0 Commerobi-use embalms,
CI 1 - and 2-family dwelling Igj C.ommercial/industrial 0 Accessory building amps for aloha i--• .• • - beildingx
O Multi-family 0 Master builder 0 Other: 0 Pmt pump 0 Iratallatioa of 73 KVA or
*Ps separately derived geom.
.,,4 ; ;•SE7:3 fl.,.. ' ; ' ;1 1 / 0 Addition of now .. ... load of D-* -r. - 1 - 2", t
Job no.: II) - 1170 Job site address: CI 1 0 0 a 004, ciik. tiillt.,S 100HP or more. I
0 Six or roan - 7 • ..• units. oustmatcy.
13 Recreational %%Aida pmts.
City/State/ZIP: 1:1 litalih-arre &A le . 0 Siqsply mimes for roam dun
. I '
.• 600 volts nonsinat.
Suite/bldg/apt, no: ...LT f Projcct name: 9, 6.. aoorg, CI &evince honor • • . — • or atom
' ":,• Eier ,' , r1: ',
Cross street/directions to job sitc: it= — 7111•111111ME.MM - iii: - .11EnWIMEMMIt •
New residential : • or snatti.. •!• dwell/ft anti.
indoden attached : . rage.
Subdivision: Lot no.: boos sq. R. or less I 168.54 4
Ea. addil SOO sq. ft. portion 33.92 I
Tax map/parcel no.: Limited eaglet, - • -•• '
. w 2
, d til/k:'
;A:Y.;•F'‘44 !. .X , O,' 1 '.r2,,, • .." .!:. l''' ' 4'24 ' with • 2 ' • 75.0D . ''
Lew Vet •
Limited energy. • •• -family 11111 75.00 2
• ■ 4 0 "%1SVI...- IlANWATX. AIL.W41•Ak. 1
raidadid • . 1 ,• • It
Serving or , - • • • ' installatins andlar relocation
zoifee.,ey o-1 Ce CAJAL-- 200 amps or less 100.70 2
• . • '',.-P.1.1**00*******.:IT.:r.;r:';-;24-.M?.,V, ,.04 ..,;,A:, 201 antra to400 • ,:'• 133.56 2
,... „ . . ,..
401 amps 0600 - ,!.• 200.34 2
Name:
601 amps os1.000 • i: - 301.04 2
Address: Ova. 1.000 amps or .• - 552.26 2
Temporary 4 I. or feeders lust elletion. ablentdon, andkir
City/State/ZIP: relocation
Phone: ( ) I Fax: ( ) 200 amps or kw 59.36 I 1
201 ea .'• 125.08
Owner installation: This installation is being made or property that I own which is no' amps SOD •
1 1
401 amps as 599 1
intended for sale, lease, rent, or exchange, according tt ORS 447, 449, 670, and 701. eh ,iL. a ••!, 6814
8 ' T - • -• • • el' - oP' • - ' ' , • ' °el
Owner signature: Date: A. Fee for branch .•'• ' • - telt
above hand service or ; • • • 7.42 2
each
Business name: B. Fee for branch -'• , . • L whkorm
service or feeder i -- first
56.18 2
Contact name: \ ,,,,,,,,„,„s,... Motrvt. Insatiate:tit
Each WW1 branch 01, .- •- 7.42 2
Address: «2.0 9 IV4 Oak ° Jr. eStg., IdS Media • - • •• , L2 ice orikeder not ineteded
City/State/ZIP: -- 14. eg, Cirriel,d.6 . TM
Each '". ,
thvell'•• .. service . • . Fg11111111 67.84 2
Phone: ( ga 1 ) 'IL -64011 I Fax: : t ) Reconnect only I 6714 2
Pump or irritation ei, 6714 2
E-mail: • Sig:tarot:dile ,...•• .',. 67.84 2
MENEINEMEMM,., ,.,,,, *, •--= .,f.i..; "V. Signal circuilik or li . .. - - - ., ION rig 1 5 i P4 2
Business name: laila -
P • 7.s_.J. .■: , ' . ...KR.. •-...i.. • - .,.. • ac ••...1,1,•L.•..1
.
Each addtritotal . • ! . • • • 'aver allOwabk hinny at the above
Address: £ 7 0/ Kt . j„.. 0 01/4.6,feo s -17 additiatal .- • - — (1 hr win) ' 6625/hr
' Investigation (1 br • MMIIIIIIIIIIII assas:th,
City/State/ZIP: "PtATLANID OR cri2.p3 --tti I 3 Inthuariat plart(Ctu, ..... • 78.18/ hr
Phone: (c)0S ) 4. -1 Fax ) -11 : s1,1 eel -lin Inscectinni Mr attic 90.001 la
, . s. - 'fical ■ What ' • .,_il.
wmammmwornmr,Tor
CCB Lie.: 103 ' 2.4 saiiiiwaamirim SuP rv. Lk': ii 1776 'ir:lk.. qiiii6liE 1; `
... Si: •
Suprv. Electrician signature, reqUiretr::: '4,*... r 1/4. r.Z‘: 9 - . o..„ Obtoti
e
Plan • kw of permit fee):
Print name: e , 'ye Sile .., 07,s /ref Date: State • - • •••• (129i4Painiffte) • , 0
TOrAlAFPtit RE, ; . 00 Authorind signatIlre: Thb peewit eppliee 1 • eapiree,ifispippreltbowl • . - . - within 100
OM - It Ims bias ametiied as arandinis.
Print name: I Date. • leembee of • . • • - -. • - allowed per perialt.
1.kaut1alne.PantheLLC.-ParrikApp.sloa- 0/01/10 4404615TO ItafiCCAPOU
. .
. „ i
May 29 2013 2:29PM Bridgetown Electric 503 - 621 -7123 page 2
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
,
Fee for all residential systems combined .. $75.00
Check Type of Work Involved:
El Audio and Stereo Systems*
❑ Burglar Alarm
El Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
El Vacuum Systems*
El Other:
Fee for each commercial $75.00
system
(SEE OAR 918 309 - 0000)
Check Type of Work Involved: •
El Audio and Stereo Systems
❑ Boiler Controls •
❑ Clock Systems
Data Telecommunication Installation
❑ Fire Alarm Installation
El I-[VAC
❑ Instrumentation
El Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
El Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems: _
*No licenses are required. Licenses are required
for all other installations I ;{
1.1Hulldin amib\EL6?a mm.da c 07/01/10 �4t
•