Permit (5) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
g • COMMUNITY DEVELOPMENT Permit #: ELR2012 -00220
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/19/2012
Parcel: 2S102AB01902
Jurisdiction: Tigard
Site address: 9399 SW TIGARD ST
Project: Competition Motors Corp Subdivision:RTH TIGARDVILLE ADDITION. AMENC Lot:
Project Description: (1) low voltage for Data/Telecommunications
Contractor: BRIDGETOWN ELECTRIC Owner: ALLRED LIMITED PARTNERSHIP
5701 N LOMBARD ST PO BOX 23144
PORTLAND, OR 97203 -4113 TIGARD, OR 97281
PHONE: 503 - 621 -7122 PHONE:
FAX: 503 - 621 -7123
FEES
Description Date Amount
Specifics: Restricted Energy Permit 09/19/2012 $75.00
12% State Surcharge - Electrical 09/19/2012 $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 ac • • -nce • • 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 ION: Oregon - requires you to follow the rules adopted by the Oregon Utility Notificati• • - enter. Those rules are set forth in OAR
952- 001 -0• 0 through OAR 952 -0.1 -• • • • •u ma •btain a copy of the rules or direct questions to OUNC b -call' • • 32.1987 or 1.800.332.2344.
• - r
10 Issued : y: � .f Agallt• .S. - /. // Ir Permittee Signe e: /' /1.i/,/7/
• —
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 18 2012 2:44PM Bridgetown Electric 503 - 621 -7123 page 1
Eledtrical Permit Annhicatio x !`
•PiVED ,,L ,„ , r; i
" Aeeei�ed i
City of Tigard Q (ci 13- `' Na.: : Lit tP0G2— 00 1 •
f i - . 13125 SW Hall Blvd., Tigard, OR 97223 S E P 1 0 20 q 12 ln Review
Phone: 503.639.4171 Pax: 503.598.1960 Date/By: Other Permit:
inspection Line: 503.639.4175 p ., - Date Ready/By. 13 See Page El for
Internet: www.tigardor.gov C � Y 6 1de i U Amu Manfred/Method: l i (O Supplanesell Info
3G� ",: d:, ""RA �' UrrTwYS ,. ..rr�l^ v, P,�r 'M w •is fir F py u, �i - < r r • � i l7 u,aMCir, 1,[arrL iJa uRtd#.I'VSht N t /:•.
P 4 14e�S .q a.'.� �C 1I.i i. ° S'.l� / j f '� fi i,`� F 1 ' ' p� a 7di4Y i h i n Z `i f �1 ti 1
' 7.., I.',•L !' L �� '�I.`7.L•.}:',rigbAClil� / w .Yt:rri Y4Y�4QV��a n. ?k �i�+, ; �YI� `~ ��.:• � . � ..c]... .s u[.a.. u�.�;Jias,.,f ,s.>,.. �r1 �5- ..�,7��'. Y''J+1:�
❑ N- construction /: Addition/alteration/replacement V l asecheekau.t>a •It( : , 111111sw/! !fi' •
1 ['Service or feeder' r r Angie to i alt on! la Bial'ding• • • • three : • • 'at
❑ De option ❑ Other: where the availab 6ulr ounce o Marina, and boatyards.
gt I tp, aria .lt ;r iu+�rt�ea} e TI:4 , cy ntr ., I gtv, •' "''td •/ •J.i . .. exceeds 10000 I . 'at 150 volts or lI Floating bail e
3 9' i } i � t f 5 t ) f K 1 � . i , :it ..n } ;h; �h ` �;, 9
' ? r. ° W ,. fi .,. s ;. .a • a �t rt li`f; : leas to grand, or I , -•.: 14,000 Commene 8a agrie • tare
❑ 1- , r • 2- family dwelling 7 .4 Carnmercial/industrial ❑ Accessory building sni Ear all . _ , .• 1 ,, oars I bmidiaga•
El Mu . - family ❑ Master builder ❑ Other: CI Flu pump. 11 Installation of 75 KVA •
. ltper aoa^,r, f irm- } . ea�rf .P, -, VOTT 'sr r �v , { f D gei F1eer yay , I larger eepant$yderi system.
•-,Q;t' ,,, 'ri. : ;via3..1.15inr.i stytdr�cialriiiii iili er:tLimiUF•.w:els e.�.� 1a :'•i++';I.bir-,'•, iJAdditimtof new • �otorloadof lr "A ", "B ",`1- 2"."t_3",
(1- y (Z Job site address: q %4q ° ryW T GAR0 t+. larch+ « , �,: t
f �i�l ❑ S1x or mine mat. . ;, �.
Job no �ele . . .
- :.
(Sty /St le/ZJP: �iQ►AR 4 11x23 ❑ health -care/oil'�,•s. •r Supplyvolutglofarm• than
I I n 0 Hazardous • I 600 volts aor Ong Suite/b4dg/aptno.: ect emes c 1:19arviat orfeeder amp or mom
Cross street/directions to job site: > M O I VIII' jlUI IN" ' •
"New residential a, ortaidt1- t' 'ay dwelling 1 - t
' Includes attach - garage,
Subdivision: I Lot no.: 1,000 sq. ft orient ; _ - 168.54 4
I Pa. add'I 500 sq. It. portion 33.92 1
Tax • arcs! no.:
YI ��1' ' �Y1.G' ! rf. • fu t °x•r1 or t z f n •ar ca Yaw k- 1.II11Lt energy. s .•�: 75A0, 2
a � M q I,t :, t '.�,; d a y , 5 , f ,tr o 1 • 51 1 I - 9i3r�14 "iF�aa�rrn R+.rararwsS+.Na 1' 1, • • (WithablD 6 _,,}
lif �t..�,: - il„.:i. #dC i _.,, rr lxrt,Y ' w� ril3.1 Ir:s Kir sl .: .r
,�'�Q� Lrnlited energy. m ffit-iy 75.00 2
i VQ UMW-. dV L IAA4T� A ... ir r cto li ""`r't. 4-b Ll residential (with l hove sq.. ft)
0 Services or feed installed st onrandfo rd , ,- .
�)l I (�A�/ 200 amps or lets , - ' 10170 2
141 ,•' y t; v ,Ma�iwc[rrcr�r�r s .. _., r r rcx^ ni pp • 1i A. ' 1 5 tIa.P..,.. s - ' lnr i tr6miWa sf1, :wh - '�" a 3hl . V ;u . t �.tir. t :t 14 r,r, 1 -,.. 201 amps !33.56 2
Name; 40I amps to 600- I I •- 203 2
I L L Qt- C7 L v-t t i l:.'A Pr �Q 6 -'4/ P hilt amps to 1,000 ! 301.04 2
Addres s: O roc, ONL O`3 1 L I LI Over rood, amps a I I . • Its 532 2
City /Sthte/ZIP :��n -fa b C12.... Q? ° �
Temporary °e or feeders ins lotion at eon, a : •
Phone:1( ) I Fax: ( ) 200 amps or less I 5936 1
201 amp to400.•, 125.08 2
Owner} installadon: This installation is being made on property that I own which is not 401 amps to 599 t 68 54. . 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. I
Brandrei`rt ulna !i; aloe , don , i !Staid') , =
Owner signature Pate A. Pao for blanch c i 'ts with
li 4�,) '� P� I^l• il• " ,1- 1 z- -^yw 1,-:-.1).,..c.1.1:-. rw •:, ,glo r : 1 ti °iia ,N r ;x r.r - ...1 1,1, h. : , � a 4 above service or . , fee ,
t . ,1 .fi::3nt vu...Nr_1l iltya"Jflf.P �l . ;; r, rye' t ta l each: C I it 7.42 2
Busiae name: B. Fafa:branch. ' • without
sorviceor • - -: eet first 56.18 2
Contact name: brmchcaeuit
Each add') branch •I•-•'t - . 7.42 2
Adtlrests: Miscellaneous (_ or .feeder n,'Retarded)
Each manufhctuied t; . modular
Cety /StatcJZIP. due fling. service ,, . , or feeder 6714 2
Phone: I( ) I Fax: : ( ) Reconnect only I 67.84: 2
Pump or irrigation . !, 67.84 2
E—mail �r 1 ?�ar t ;tli �7y I Hhl "d ` ° ` `{> , i g ' p r r ! Signor outline Ugh ;1 _ 67.84 2
#,.Faa 1 ` 1 ' I . ! r {F1 m 11 ! , P Ir i 4. r� tij � N9 , t _,t'.& V4 1� @ lird Signal.ciraail(s) or i. _ •
B
• ,. .srielne: 4 ' <iEl - Se:Va E d a rea•i J 2 � 2
} � ' Na In
, of the a . ,
Addres : • £701 i ' l • � 1 - . Q /Yl. 6 / 1 • d, ! ) s 71e E f Additional • ... ; 41 hr min) 6625/
City/St4 te/ZIP o Jar I D OR (112'03 - 1 '"`"� (I`�` . , 6625/ bt�
Industrial _phut (1 , 5 ; mia> ' 78.18/1u1
Phone: lap'; >/41 , ' 1 I2' I 9oa>a ( ) fbr will i; no fee ls. .
/�y Fait 50$. do2 7 2 Inspections limed bar mw r
CCB 14c.: 14 I F. ctrical Lac.: .w I sum. Lie,: 41776 iii :';fi! .u xl . , u i..! 9 .4_ I r t ,. l?:iF laliillo-
Suprv. bcctrician signature, rerlu?lekP ' , ��
I �^ 1 • 'rovientaS%. • r': t ke -
Print ttdtme: 4 / ' i. ..tie v,.. /.•d I Date.: State ' � . _ • (1 " to • F :. ' lee):., r w
,
Autho>ized signature: I T AIr °' ° �' i KT , ,
7Lh perm° appl - ' rsod; pe b ••• l . ..1
days: it. bee tisetf , r) . `..
Print name: I Date: • ?lumbar of Mane l'owallowrod't ••
•
:Roe *mum 44046141 I1/05/COM/WEa V i -
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Sep 18 2012 2:45PM Bridgetown Electric 503 - 621 -7123 page 2
Electrical Permit Application - City of Tigard I '
Page 2 - Supplemental Information
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LIMITED ENERGY PERMIT FEES:
Fee fo1r a residential systems combined .. $75.00
Checlq Type of Work Involved:
❑: Audio and Stereo Systems*
Eli Burglar Alarm
❑ Garage Door Opener*
❑' Heating, Ventilation and Air Conditioning System*
1
❑: Vacuum Systems*
El: Other.
:COM iERC oW0144 *`• ;,
Fee fott each commercial $75.00
system
(SF* OAR 918 -309 -0000) 1 i
i
CheckType of Work Involved: i
El :Audio and Stereo Systems i
I
Boiler Controls 1
1
❑ ;Clock Systems
! Data Telecommunication Installation 1
❑ ;Fire Alarm Installation
❑ 'l-IVAC I
I
i
❑ ■Instrumentation
i 1
i
❑ 'Intercom and Paging Systems 1
❑ :Landscape Irrigation Control*
1
❑ Medical i
❑ :Nurse Calls
I '
❑ !Outdoor Landscape Lighting*
I
❑ : Protective Signaling
❑ iotheT 1
i •
Total number of commercial systems: _ 1
*No licenses are required. Licenses are required i
for all other installations
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