Permit a CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
>s . . COMMUNITY DEVELOPMENT Permit#: ELR2013 00229
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/17/2013
Parcel: 2S113AA00300
Jurisdiction: Tigard
Site address: 16330 SW 72ND AVE B3
Project: A Cut Above Subdivision: ROSEWOOD ACRE TRACTS Lot: C
Project Description: Data telecommunications system.
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 09/17/2013 $75 00
12%State Surcharge-Electrical 09/17/2013 $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 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 By: � " , _ r Permittee Signature:
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.
Sep 12 2013 3: 48PM Bridgetown Electric 503-621-7123 page 1
Electrical Permit Applies I! , • I vl
C
.: ,,„: ,,:. , ,, , , ....! ,}".., . ..,.,: .
ity of Tigard Received r M .�' F-
��++r pa, Panels No.:
13125 SW Hall Blvd,Tigard OR 4731?fiP 1 2 2013 Plan Review "- •---11
Ir. Phone: 503.7182439 Fax: 503.598.1960 Date/13v: Other Permit:
inspection Line: 503.639,4175 CITY
O IGARD Date Ready/Sy: RI See www.tigardar.gov
Notified/Method: �erm.8oa lk
ti;. ' 7xi 0 . n Q„i} r 1 . i r 4!; Z I a .1A f' k.t'^ Z4i'ji V E5E t rir Wenn a 4 1 1�"'jK �r t6T r
❑New construction Addition/alteration/replacement Please ob-- all that apply(submit 2 seta of plans wfitema checked below):
❑Demolition ❑Uther !]Service feeder 400 arfspa or more ❑Building over throe stories.
xa y-. :.� f ��c,,. �r; where, available fault current 0 Marinas and boatyards.
hlaa:,. ,.l ,: ''tat,,l•,�' , •+ r "':,�If 'I : 4y� `41 exceeds 0,000® at 150 volts or O F7 buildings.
F �.. 1•.i A N, .r„ .,,II,.Y,1 r... ' ,:I,';t ;;'* Pa ^•.-••p
❑ 1-and 2-family dwelling .1 Comtnercial/industrial ❑Accessory building less to:• nd,or moods 14,000 0 Commercial-use agricultural
❑Multi-family ry 8 amps fo all caber installations. buildings.
1 a, fly ❑Masterlowider 0 afire pun.• DI1,etallaaienof1SoKVAm
;ni"I'+'1Tge. i �-'. 7 r,^a:. ' •.[ ',,1 r _t• r� ' :.';r. DE,,...,-. . system• larger separately derived syslen
,•,,2 , .r t-''' '' O Addition of new motor load of 0 A, °E.•-1-2"."1-3",
Job no.: %4j.is1(� Job site address: 1(d?x'75 0 4A J -�rat. t0o10+• more. occupancy.
r� !' O Six or residential units. D Reeroatianal vehicle parks.
City/State/Z1P: 'r . • Q16,114 Dues .: :facilities. OSupplyvollageformorethan
Suite/bldg aptno.: .3 IA
Project nam ❑Service., t 6 600`0>'soomillal.
l� amps or more.
Cross street/directions to job site: �.7L 0' �' °` l i!'. .r •;
l/tTt Desolation Ow. roe Tow
New real• • •, I single-or multl-family dwelling unit.
Includes cited garage.
Subdivision: I Lot no.: 1,000 sq.ft.or leas 168.54 4
Tax map/parcel no.:
Ea.add'/5 r1 sq.ft,or portion 33.92 I
v_x l,' ;."_ u _�}i. ',o, " H s Limited v,residential 75.
.•} -t1; Mme";tat;;;:-G4:; ,.-.. W. + ''.• n 'i.tr -l.0 y..- t (with••,.c sq.f.) 00 2
Lam,, w1 a�,l., , '`"1"~t /40.• �g Limited. :a,multi-family tha a • 73.00 2
t, rttaid with above •.ft..
1�•• t. 1. .41 Services o feeders I>t stlallation,alteration,and/or relocation
•: I ..,,fi�agg
�'.d•<, ! �•:,, e, iE'.fi SN�p..� � ,Li'rr ai lr0a�ry? .Y' ,°r',. ,js;,�. ���'M'�.-�4, g -t"'-',.40'� 200 amps., less 100.70 2
Name: 201 amps to 400 amps 133.56 2
401 amps to 600 amps , 200.34 2
Address: 601 amps to 1,000 amps 301.04 2
City/State/Z1P: Over 1,000 or volts 552.26 2
Ten•• : services or feeders tostaliatiioa,alteration,and/or
Phone:( ) I Fax:( ) relocation
Owner installation:This installation is being made on or 5936 1
B property that I own which is not 201 amps to 1 1 12508 -
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701.
Owner signature Dom 401 amps to•99 amps 168.54 2
Date:
- Brands • Its
-new,altnatlan,or extension,Qerpsnei
v ? i y � i,n 1 „,.i,y$ -„ 4,-4.Iy , ^,t ,r•'`1,,,•s A.Fee for• • di circuits with
. ,..iti„ . .s.4 < >;a: , , :r ,,Is/,,;
above ice ortbederfoe,
Business name: each b : Is circuit 7.42 2
B.Fee for• • h circuits without
Contact name: service or feeder the,Nast
Address: branch c' • 't
56.18 2
Each add'/b• h circuit 7.42 _ 2
City/State/ZIP: Miacella, 1 us(service or feeder not included)
EaCh••:I rod or nodular 67.84 2
Phone:( ) I Fax: :( ) dwelling,se '• and/or feeder
E-mail: Reconnect••1ly 67.84 2
"''n •;3:- "S r,v°�., 1yr,� •, �i Pump or irri: •ion circle 67.84 2•::1;;;It�'+1,.;..+t'11;i='`xf, .; Y N.. (ny�i�/.1� • ._..
•.. `�i Sign or oud” e lighting 67.34 2
Business name:Bridgetown Electric Signal circa'.s)or//riled-energy 1 Sec -t V
panel,&era•1•• coextension. Paget t5." 2
Address:5701 N Lombard St. Each additi I nal Inapeelfon over allowable in any of the above
City/State/ZIP:Portland,OR 9 203 Additional i •oar(1 hr loin) 66.25/hr
investigation 1 hr mitt) -66.25/hr
Phone:(503)621-7122 ✓ I Fax:(503)621-7123 / Industrial pl:, (1 hrniin) 78.18/hr
CCB Lie.: 103824 I Electrical Lic::';6-887C /rSuprv. I..ie.: 41775✓ ,
Inspections 1..-. l4 r Pee is 90,E
yrbrmbm lir' , ;{ "r,a 72:.='. ,TM7 "a I" F ' f
a :R1 Suety.Electrician signature, •I,Z■09- J rza∎se- yw Subtotal: 76.cOct
Print name: Keith Steenslid Date: Plan review(25%of permit fee):
Authorized signature: l surcharge(124leof permit fee): q,O
TOTAL PERMIT FEE: y,0'0 d
Print name: Date: This permit •• ketlon expires if a p e r m i t is dot o b t a i n e d within 180
••ys after it has bean accepted as complete.
[1Bu ldinalPerm 1s\El C_Dame ' Number of ,-pections allowed per punk
App_H18_AREdoc Rev 03/21/2013 440-4613T(11/03/COMIWE5
Sep 12 2013 3: 40PM Bridgetown Electric, 503-62.1-7123 page 2
Electrical Permit Application City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Feei: Ren • ble Energy Permit Fees:
•
";":TZE da'..:721_q..;,..4; •
Fee for gij residential systenti combined........ 575.00 .1)sossi ...11111/111/MlaliPnill •:a"n11111
Rariewa electrital energy systems:
Check Type of Work Involved: Skvaort. 100.70
5.01 to 15, 133.56
Audio and Stereo Systems*
15.01,to 2 kva 200.34
DWind sea- don systems la excess of25kva:a
25.011to 5 I kva 301 04 2
0 Garage Door Opener* km to I 552.26 2
>100 kW(ae in accordance with
552.26 2
OAR 91 309.0040)
0 Heating, Ventilation and Air Conditioning
System* •Solar • don systems in excess of25kva:
Each addi.*., lora ow 25 7.42 3
D Vacuum Systems*
>100 twos-no additional charge 0,0 3
Each add •aid inspection over allowable in any of the above:
0 Other.
Each additi 1 inspection is
66.251 hr 1
charged at hourly(1
Inspections or which no fae is
9000/hr
- Wed hr min
4P,..Sn''1::;-Ti=2E:77.F.47., Mig-4,3a6,11:
Fee for mk commercial ..... $75.00 Subtotal;
(SEE OAR 918-309-0000) Plan - • ,if required(25%ofpermit fee);
• • surcharge(12%ofpermit fee):
Cheek Type of Work Involved:
TOTAL PERMIT FEE:
This pe I application espinte lira permilis oat obtaised withto ISO
0 Audio and Stereo Systems daysetteMit has beta accepted se complete.
• Number-inspections allowed perpeenit.
0 Boiler Controls
O Clock Systems
fEl Data Telecommunication Installation
O Fire Alarm Installation
HVAC
O Instrumentation
• intercom and Paging Systems
O Landscape Irrigation Control*
O Medical
0 Nurse Calls
•
0 Outdoor Landscape Lighting*
El Protective Signaling
11 Other
Total number of commercial systems:
*Nor licenses'are required. Licenses are required
for all other installations
tAlkilitisaVitenitdELC:PcnnitAMOELTLERPriee hey 0121/2013