Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
+ COMMUNITY DEVELOPMENT Permit #: ELR2013 -00149
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/01/2013
'TIGARD g Parcel: 2S101AC00900
Jurisdiction: Tigard
Site address: 7128 SW GONZAGA ST 100
Project: Holmes & Co Subdivision: BEVELAND NO.2 Lot: 18
Project Description: Low voltage for Data - Telecommunications
Contractor: BRIDGETOWN ELECTRIC Owner: BARMASS LLC
5701 N LOMBARD ST PO BOX 23849
PORTLAND, OR 97203 -4113 PORTLAND, OR 97281
PHONE: 503 - 621 -7122 PHONE:
FAX: 503 - 621 -7123
FEES
Description Date Amount
Specifics: Restricted Energy Permit 07/01/2013 $75.00
12% State Surcharge - Electrical 07/01/2013 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio & Stereo: 0 Boiler Controls: 0
CCTV: 0 Clock Systems: 0
Data & Telecommunications: 1 Fire Alarm: 0
HVAC: 0 Instrumentation: 0
Intercom /Paging' 0 Landscape /Irrigation: 0
Landscape Lighting: 0 Medical: 0
Nurse Calls: 0 Protective Signal: 0
Security Alarm: 0 Other: 0 Total $84.00
Other Desc: Required Items and Reports (Conditions)
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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 ' 9 ` 52 -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: /- y Permittee Signature: 5E.L. A }t�L ZA T.YUn1
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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.
Jun 27 2013 9:09RM Bridget•ra 7 i '=.
6 i 1 5 03 - 62 1 - 7 1 23 page 3
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Electrical Permit Application . " - - • — s,l 1 ..,
City of Tigard
Ell
Phone: 503.718.2439 Fax: 503.598.196 i
tiine 503.639.415
: 7
Internet www.tigard-orgov JUN 27 2013 Re4eived ./
CITY OF TIGARC
Plan Review
Dale/By:
I tlintlIG DIVI SIC tr,Redtcht:d, 9 1-5 Penith1411 Je 2G1
13125 SW Hall Blvd., Tigard, OR 97223 4 4,0/1,9
Other Permit:
InspeCon L
ILIA& I 111 See Page 2 for
I Supplemental lotbreadon
‘.;;;.'''' !: ; ;.; 'k'Nf . i 4 : . i . !;0 "''" f '; j4 . '-- : ** .0 k1;*i* ', ! .. : :::::'' '' ‘; ';" :- ' ' . ''' '7- ''' ;:: .;::- ' 1 :;:;:' '''' "41! i:;4;..: 1' ' !;0::;;' ; 04iii-;'..!. '. . --....
ID New construction RI Addition/altcratio replacement Please check all that apply (subaiit 1 sets o plain wlitems checked below)
0 Service or feeder 400 amps or more CI Building over three stories.
0 Demolition 0 Other: . whereas availa . e fault currant 0 Marinas and boatyards.
5,11ri : . . . :.'0t,':ii , , . . ,,. -,,-,::: , , . ; .. .: : 1 ' . , , ! exceeds 10,000 p aa 150 volts Of 0 Floating buildings.
less to ground, or exceeds 14,000 0 Comincrcial-use agricultural
0 1- and 2-family dwelling gg Commerciallindu lal 0 Accessory building snips torah othc installations. buildings.
0 Multi-family 0 Master builder , El Other ID Fire plump. CI Installation of 150 KVA or
. DEmereeney sy .. larger separately. derived systeu
: .4 1 .:41*IttigOltitt*ii0014 :
14 i1414710Pi :: . . .. . ' . :. , 1 .1, 0 Addition of new otor load of 0 "A", "E", "I -2" "1-3",
10014P or more. occupancy.
Job no.: O +4 10 [ Job site address: 1 118 '::: 0,47 Nr. 0 Six or more r ...,- nnal units. ID Recreational vehicle parks.
City/State/ZIP: Health-cam facih ies. 0 Supply voltage for more than
'T tofrr g , pg 11
. r 91 , CI
o Hazardous bean.— . 600 volts nominal
Suite/bldg./apt. no.: 100 I Project name: t,,' 14 g p 0 Service or feeder . . ■ amps or more.
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Cross street/directions to job site:
Description ' I Otoj roa I Toil i •
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' New residential a4ng$e. or multi-family dwelling unit.
, Includes attaehcj garage.
Subdivision: II .ot no.: 1,000 sq. ft. or less 168.54 4
Ea. addi 500 sq. fl. . portion 33.92 1
Tax map/parcel no.:
Limited energy, rest. ntial
75.00 2
O:i '...! . .• .: : . (with above sq. ' .)
residential <with bove sq. ft.)
LIMA/ VOI iliPtILLAA.Me 1/4/ISSIIA., - 6 -VIV.A.RAAA 75.00 2
RenessibteRiC ..:', •::-. ',..:;- .'•::
. Y KT CAW C64 • 16 1. 4 -• ' Services or fed. - installation, alteration, and/or relocation
.,, : '4:', 7,919kikigfi,...:1' • ••,S..: : .t . •' . ;;; ' : ' li • . 1;1 iti,biNt. , • . - • .1 l i,. : 200 amps or less 100.70 2
201 amps to 403 am . 133.56 2
Name:
401 amps to 600 am ,- 200.34 2
Address: 601 amps to 1,000 ... 301.04 2
Over 1,000 amps or oils 552.26 2
City/State/ZIP:
Temporary servi or feeders Installation, alteration. and/or
Phone: ( ) I Fax: ( ) relocation
200 amps or less 59.36 1
Owner installation: This installation is being made on property that I own which is not
201 arnpa to 400 am. 125.08 2
intended for sale, lease, rent, or exchange, according te ORS 447, 449, 670, and 701.
401 amps to 599 am .5 16834 2.
Owner signature: ; Date: , Branch eircnift -. , : , alteradon, or extension, per panel
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,'.'. ''' '•,. : ; H :.,,. • f. •: tricostiAerl . ,.,, ,.. A. Fee braz !I:tn w
Business name: each branch circif. 7,42 2
B. Fee for branch e uils withou•
Contact name: service or feeder - • first
56.18 2
branch circuit
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Address:
Each add'I branch c' it 7.42 2
City/StateIZIP: • Miscellaneous (se ice or feeder not Included)
Each manufactured o modular -
67.84 2
dwelling, service an. or feeder
Phone: ( ) I Fax : ( ) -
Reconnect only 67.84 2
E-mail: '
, , Pump or irrigation c 1e 67.84 2
• ,; - : 4. ZX.q; , 1 -' ; ' ;;;16:00R - ilt 4 t*OR.'. , '' [ : ' ' ; ;;; i . ' : • - '' Sign or outline filth'' : 67.84 2
Business name: Bridgetown Electric Signal circuit(s) or 1', • - . -. .., 14 . - See
panel, alteration, or . - ion. I Page 2 1 5." 2
Address: 5701 N Lombard St. Each additional I • .ecdon over allowable in any of the above
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• Additional inspection I hr min) 66.25/ hr
City/State/ZIP: Portland, OR 97203 .
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• Investigation (i hr ' ) 66.25/ hr
Phone: (503) 621-7122 I Fax: (5 )621-7123 Industrial phut(' hr in) 78,78/ hr
Inspections for which • lee is
CCB Lie.: 103824 I Electrical Lic:: 6-887C I Suprv. Lic.: 4177S s. - ineali listed S4 min 90.00/ hr
, - i , . , :t i :N' 4 1 1 .17 , : 77 : 17 Dir ry IZZ,r
Suprv. Electrician signature, 0 ,..
Subtotal: IS, 00
Print name: Keith Steenslid Date: Plan - iew (25% of penal! fee):
- State sure urge (12% of permit fee): 9.00
Authorized signature:
TOTAL PERMIT FEE: aLl. 06
' This perrait a ppliead . a expires If a permit is not ohtained within Iso
Print name: Date:
days a -, it has hero accepted u complete.
• ' Number of inspectio - allowed per permit.
1 : 11 ktilding■Parmits1ELC_Perroil4.y_ELR_ERE.4oe Rev 05121/201.1 . 440-46i ST( I I /05/COWWEB
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Jun 27 2013 9:101RM Bridgetown Electric 503 - 621 -7123 page 4
Electrical Permit Application — City of Tigard
Page 2 — Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
� `; .:;. . _ ....: •;;::'.'.:;`:;,:� � >i: `� ,�:� ...F:�,,�"`�;" ����k��i
Fee f or 111 residential systems combined... ! $75.00 owertorsan :: Ow. Fee Toni •
Renewable eiec .: I energy systems:
Check Type Work Involved: 5 kva or less 100.70 2
❑ Audio and Stereo Systems* 5.01 to 15 kva 133.56 2
15.01 to 25 kva 200.34 2
❑ Burglar Alarm Wind generation systems - in excess of 25 kva:
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25.01 to 50 kva 301.04 2
❑ Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva (fa in accordance with
ID Heating, Ventilation and Air Conditioning
OAR 911- 309.0040)
55226 2
System* Solar generation terns in excess of 25 kva:
Each additional kva wer 25 7.42 3
❑ Vacuum Systems* X100 kva — no additional charge 00 3
❑ Eacb additional i . , - , on over allowable in any of the above:
Other: Each additional ins.. ;on is
charged at as hourly 1 ht thin) 66.25/ hr
Inspections for whit no fee is
cifical listed Y2 hr min 90.00/ hr
..cC.v. —.Z�. _. ' .,.'J�� i�� � �y;� ; i e '�.,., i { t . f, .t •�, >::.`.nyA•i• ��:...: � l .A�.i t L� °Flt..l.::.....,,�.'�''`r`.Y' �R '� i .^N.
Fee fore ch commercial system. $75.00 Subtotal:
(SEE OAR 91S-309-0000) Plan review, if - pined (25% of permit fee):
States harge (12%ofpenmit fee):
Check Type of Work Involved: TOTAL PERMIT FEE:
This permit applies .'on expires if a permit is not obtained within 180
❑ Audio and Stereo Systems days a • rid has been accepted as complete.
• Number of inspecti • . allowed per permit.
❑ Boiler Controls
❑ Clock Systems
® Data Telecommunication Installation
❑ Fire Alarm Installation •
❑ HVAC •
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❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
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❑ Medical
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❑ Nurse Calls
❑ Outdoor Landscape Lighting* •
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❑ Protective Signaling
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❑ Other
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Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1s 13uildingTermits NE1.C_PennitAaa_ELR_ERE doe Rev 05/21 t2013
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