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Permit q CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT ;F�1 a COMMUNITY DEVELOPMENT Permit#: ELR2013-00215 T[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/28/2013 Parcel: 2S 101 BB01400 Jurisdiction: Tigard Site address: 12060 SW GARDEN PL Project: Expressions Printing Subdivision: CROW PARK 217 Lot: 2 Project Description: Low voltage for data cabling Contractor: BRIDGETOWN ELECTRIC Owner: WALTON CWOR PARK BC 8 LLC . 5701 N LOMBARD ST BY CTMT-WALTON RE TAX PORTLAND, OR 97203-4113 4678 WORLD PARKWAY CIR ST LOUIS,MO 63134 PHONE: 503-621-7122 PHONE: FAX: 503-621-7123 • FEES Description Date Amount Specifics: Restricted Energy Permit ' 08/28/2013 $75.00 12%State Surcharge-Electrical 08/28/2013 $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) • 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. ATT • •N: Ore"• law requires you to follow the rules adopted by the Oregon Wilk • ,.. 1 . Center. Those rules are set forth in OAR 952-001-'.,10 through OAR 9 101-0090. You may obtain a copy of the rules or direct questions to OUN by ca .•• 503. • 1987 or 1.800.332.2344. Issu=• By: L — Permittee Signature: eigr��/rS-t , —- 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. Aug 27 2013 9: 06RM Bridgetown Electric 503-621 -7123 page 1 Electrical Permit ADDlicatiRECEIVFf ! ,•,, ,1 1: 1 ..; .. City of Tigard `ate/B d m�� f o?al3_c S` Da1dB : i , • i Permit No.: / 13125 SW Hall Blvd.,Tigard,OR 9722AUG 27 2013 Plan Review Other ` Phone 503.718,2439 Fax: 503.598.1960 piny; at Permit: Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/Ely: ied/Maeod: • '�' SSupppllemestal Information E� Internet: www.tigard�or.gw I1'�y,1 5:t'hfc�,'�,1J q�7�yt�, �. i,y •n: :I,: %`6,`1 (/r rnil leeQ/'�•At :�i':i'::i � s:�'a, ',02;.:.),;,/,.116..t,'' { n"'/,(,."1'ee?n};�xsn�p[tsra+nLw::.ls, 1� ;Ib :.°rTaA tiNf i ai 4 F_, -.4: „ - i t ::'1;,.4%!- _M,.';' . :',:t � !gi7��' .i j.'�I,,I IS,.:.7i,1. •.'1i1.. J r r N 'a.;,:J�'ry '. 0. : d: (Q was:,..W,.�l...ia,�.u.�.v....;.. Sys..... u.��d ❑New construction =4 Addition/alteration/replacement Phase ch.• all that apply(submit a eats of plans w/items checked below): 0 Service or feeder 400 saps or more 0 Building over three stories. ❑Demolition 0 Other :;i„ where the available suit manna 0 Marinas and boatyards. fy'<i�,1' v,14,5 °, c,. ,sr,; o.> '"a r,s :d:` .h :,,,�' exceeds 10,000 amps at 150 volts or 0 Floating buildings. t4 :..,..1 74� t .� i�._:,. 1 '.. ..,r.`., ,.__ � 'i '; sl:.'11.:c�'.:, less to ground,or exceeds 14,000 0 Commercial-use agricultural ❑ I-and 2-family dwelling it Commercial/industrial ❑Accessory building amps for all mbar installations. buildings. ❑Multi-family ❑Master builder ❑Other: 0 Fire per. 0 Installation of 150 KVA or 0 Fmergeay System. larger separately derived system. ,r ,. :(" ,:3 ' $ `; t:, 4Oh!;.::. ;;,;',g :::::: < .._. Addition of new motor load of Job no.: I .,biti 5 I Job site address: i 2.0(pp gW t7pc&a _v 1001 B,or mores occupancy.0 Six a more residential unite. 0 Reueational vehicle parks. (T r City/State/ZIP: "'"� 0f kz x111L 0 Health-care facilities. 0 Supply voltage for more than 0 Hazardous locations. 600 volts nominal Service or feeder 600 ma SttitelbldgJapt no.:�1,o_ 5' Project name: y y), Q 0ns more. Cross street/directions to job site: .tie.;._"`:;%v;yl' r 1#1,17R7-1.7-7,717,......7,14;'1 s ,ii?'toii y{ iF-. ,nserbr►ee Oct. Pea 7etd New residential single-or multi-family dwelling unit. Includes attached garage. Subdivision: I lot no.: 1,000 sq.ft.or less 168.54 4 Ea,add')500 sq.ft.or portico 33.92 1 Tax map/parcel no.: Limited energy.residential ::, y'h:i;YF '1 • +r ;;'i'i�y 4 �t•�',,.k: _r.:,; ,'. ; 75.110 2 . gar.,, ��,�Y:;:,�,,,'���..,;::.�r�`.I"t� '14x�ya-W�.rt ,�.[,- . ;>i '; {withabtrvesq.ft.) 555,5,;.-'i',...,." � . .:1'��`::.�i:::'�_ 5555:�:::':.. . 75.00 LOW c tt ( Limited energy,multi-family 2 1/12 /� ®Triti.A.M It� K1ACl d PAAA.P.fe, 41 4-OM atAA residential with above s4 8� :..' °`' „ ,..,,.,`, '�; � rs Instal, . .o Q n,. relocation , . Servieesen'rude latioa=a1 never a'-1 t© 'y;h3 y,• .-,z;.e"::a ,,,.: :, =:fz 200 arctps or lace 100.70 2 2 .,. .. x, :.•, a ir.:dH,.,,e4'[ ru,,+?,Y::, ..,.,,,, r.,up 1.N ir,:e. i!", 201 amps to 400 amps 133.56 2 Name: 401 amps to 600 nerds 20034 2 i' Address: 601 amps to 1.000 amps 301.04 2 Over 1,000 snips or volts 552.26 2 City/State/ZIP: Temporary services or feeders installation,alteration,and/or Phone:( ) I Fax:( ) relocation . 200 amps or less 59.36 1 Ci Owner installation:This installation is being made on property that I own which is not 201 amps to 400 amps 12508 2 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701, 401 sum 599 amps 168.54 2 Owner signature: Date: Branch circuits—new,alteration,or extension,per panel ;° ; i ':.li,, u,� i ,.:, �!!iA: ',.`,;} ,,Id,ig.�r r. a(j ?' ; A.Fee for Much circuits with ; l :. "v _ i; above service or feeder fee, 7.42 2 Business name: each branch circuit h.` . B.Fee for branch circuits without i Contact name: service or tboderr fee first 56.18 2 branch circuit Address: Each add'I bnutalncirealit 7.42 2 City/State/ZIP: Miaeeilaneous(service or feeder not included) EaCh manufactured or modular 67.84 2 Phone:( ) I Fax: :( ) dwelling,service and/or feeder Reconnect only 67.84 2 E-mail: Pump or irrigation circle 67.84 2 1 a (N a„s1i r, n h ��4pp0��� 55 -., , ., Sign ocoudine fighting 67.84 2•I Business name:Bridgetown Electric Signal circuit(s)or limited-energy See 'extension. ' I„41.1 Address 5701 N Lombard St. Each additional�inspection over allowable inn any of the above 2 Additional City/State/ZIP:Portland,OR 97203 it>9pecsice(1 min) - Investigation(I hr rain) -66.25/1v Phone:(503)621-7122 I Fax: (503)621-7123 Industrial plain(1 hr mia) 78.18/hr Inspections for which no fee is CCB Lic.: 103824 I Electrical Lic:: —6-::7C ] Suprv.Lie.: 4177S listed .iibrmin 90.00/hr Suprv.Electrician signature, -.,r s ,...: •'!.s' i t. I` :rvr°." K°6_ ! , 14'�1 . Subtotal: 1 ,oa Print name: Keith Steenslid Date: Platt review(25%of permit fee): Authorized signature: State surcharge(12%of permit fee): 09 TOTAL PERMIT FEE: eq.o0 Print name: Date: This pia application expires ifs permit b sot obtained within 180 days after It has been accepted as complete. 'Aiwa inakPernamm.cParmIApp i&_ER Edee Rev 0541/2015 • Number of inspections allowed per permit i • a+oast set 1 uosiconrru�a Aug 27 2013 9: 06RM Bridgetown Electric 503-621-7123 page 2 Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: Fee for an residential systems combined ... $75.00 Timill•IMIIIIIM11177ANII • Renewable electrical energy systems: Check Type of WO rk Involved: Skvaorless 100.70• 2 5.01 to 15 kva 133.56 2 0 Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 D Wind generation systems in excess of 25 las Burglar Alarm t 25.01 to 50 kva 301.04 2 O Garage Door Opener* 30.01 to 100 kva • 552.26 2 >100 lora(fee in accordance with 552.26 2 OAR 918-309-0040) 0 Heating,Ventilation and Air Conditioning Sntftr generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 O Vacuum Systems* >100 kva—no additional chuge 0.0 3 Each additional Inspection over allowable Is any of the above: 0 Other. Each additionid inspection is ch 6.25/In arged at an hal*(1 hr kio) 6 Inspections for which no fee is .90.00/la •• cal listed 14 hr min '!", 'LAI&L.L.:.:LCILtl-,11. 7:fnal;;TiA=.17_.E27.-.:20VIVIL Fee for glsk commercial system......... ... $75.00 Subtotal: (SEE OAR 918-309-0000) Plan review,if required(25%of pamit fee): State surcharge(12%ape:mit fee): Check Type of Work Involved: TOTAL PERMIT FEE: • This permit waistless expires Ifs permit Is not obtained within 180 El Alldio and Stereo Systems days after 11 has been acatpted as complete. Number at inspectioas allowed pi*permit O Boiler Controls O Clock Systems E Data Telecommunication installation D Fire Alarm Installation • • HVAC O Instrumentation El Intercom and Paging Systems D Landscape Irrigation Control* Medical O Nurse Calls O Outdoor Landscape Lighting* • O Protective Signaling D Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations • 1Alluild1080.ermits‘ELC_PeratitApp_PLIIJItEdoe Rev 03/21/2013