Permit (246) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
4
. COMMUNITY DEVELOPMENT Permit #: ELR2013 -00027
•
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/04/2013
Parcel: 2S115BA02500
Jurisdiction: Tigard
Site address: 16200 SW PACIFIC HWY Y
•
Project: Dollar Tree Subdivision: 2004 -015 PARTITION PLAT Lot: 1
Project Description: (1) low voltage for Data/Telecommunications
•
Contractor: BRIDGETOWN ELECTRIC Owner: SN PROPERTIES PARTNERSHIP •
5701 N LOMBARD ST 1121 SW SALMON ST
PORTLAND, OR 97203 -4113 PORTLAND, OR 97205
PHONE: 503 - 621 -7122 PHONE:
FAX: •503 -621 -7123
FEES
Description Date Amount
Specifics: Restricted Energy Permit 02/04/2013 $75.00
12% State Surcharge - Electrical 02/04/2013 $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 0 R 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: /1 /�ri( �`! �1.(e/1 Permittee Signature: D PP I C / r 0,00.
•
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.
Feb 04 2013 11: 02AM Bridgetown Electric 503-621-7123 page 4
. •
Electrical 11
' --. P ermit ADDlication RECEIVE 1
_ . . . ‘„,mii , ,
. : •. , • ,
. . .. .
I 131 Hal Tigard. OR 97223 FEB • 4 2 013 Man . . 1
■ : : . ..: MrraNifireatal
41
- '.. P f . pi3- cx)D a-7
Mae: 503.639.4171 Fax: 503.598.1960 Dawitty: Otttrt Panic
%wake Lkor. 503.639.4175 Date Ra4/By: . 17 ‘ t E rse*
N Paso 2 fay.
emec www.tigadcr-.gov OFnUARD " ffla " law: '
— 3! - . 1 ;:is , k ir''grEffrf,t'l; I 'ig. si.kmfigarri-HE I'M f.M .; •::, i ,'.;,':''.•:.r:
0 New construction La Addition/ - , ;••, iiiiii.1111111 • • cheek cdtat • - , :. • , • , , . *Mew below):
°Service or (rotor • , . astriO'i tale tiiiallitini Over three soda.
0 Demolition 0 Other: ; where the anal . • flak eurreot 0 Mensal trod bostyonto
• . A W • .-' r7 If \Aft. 4 4 1 ,4'1 ::sp : 61 "edg IC ' ' " ' • ai I" vatta cf , CIFIcada8 Wi/d4s
','A'f !,' ,t1. 11'_,w!::: "....'.;,.11aL •: ..,.1....t,,..t:to • ...' 1 .1 "ai .■ A 44, • . kw to wood. or -• .- - - • , 14,000 LI Coarromtise agricultural
0 1- and 2-flunily dwelling 'F4 Commercia//ind ; 0 Accessory building I amps for all Woo intoollatioas. buildings.
El Multi-fiunily 0 Master builder 0 Other: CI Fire pump. 0 Instanatioact7s KVA or
-
'.-..." .::"i'c:•.g.4yfflr'nl
Emepac ,,.. al ilii?,:`;.4 Igt,4 law teperahtly &Atari
; system
-. . • ••. :i . IZI.No:tos ' ' ell.,,aa,..?.:.,,"... i...)..A.,:n.■.41.....d..:•••••1.,. .tt-iN.A.ricx.a•athl . . • ... : - '• • - •-• , • ,.' Manes of ow ...• • toed of 0 "A", "B". *14". " 1.3",
; 100HP or roore. oortaremy.
lob no.: 13 ..o , lob site address: 16 20 LI,/ vac...Pc Pi...1 , 0 six . MIMI . .• . , ..1t1 vas. 0 Reereetional whittle pork& •
(It y/State/ZIP: •179,,i.) oil q ; -'24/ a Hetalreare i - i .1 ' .. . 0 &apply voltage for more thao OHUOIIOUi 600 yetis imertioaL
1 16 Urea refrain . , - • or more.
Suite/bldg./apt. no.: s .k. y I Project name: 014, -r etsd
•••`. -::
!
Cross street/directions to job site: •_=1711•11111111111111111.11111;iii:iiii.7.41111=6.779111111 •
N regildentill - - 01 - , - . ' .. .. , 11 MI I 1 I MI . WO.
I.0 ft. oriels 168.34 4
Subdivision: I Lot 00sq, no.: '
• 150q : ft. or portion 33.92 I
Tax map/parcel no.:
75.00 2
.... - . :. .... i ■NA , ' 41' .. .1 , )777' ‘iiippfu .. 7 l
way , . - mily 75.
rilthera lb 75.00 2
idenial (With • . - v. 11„) •
.. vl , ......... loa :0 ma ' 1. ',11.,.. .6. • ' ' 1
' li Servbies or ir•dr , instoilattankalteratian, auditor Maiden
P., C-4/atc..44 • C..47k, 200 amps or less 10030 2
-
c s.:.( . • cri r; . ' , "'"A" - rn - ';' 4 '" , . 4- rwctaignig t - .::e-f gal v 4. NO =Imo to 400 '. 'I.• 133.56 2
- • • '' , . ‘E ,!..• ‘.;,1,&,--4.,1, . a A 0 ... - , ,..0 .„,„1,..., aAt :,-, - 1_ 0.4,.. . .. MN
• ail amps to 600 . • 200.34 2
Name: .
' Nil mnps - to 1,000 ,, ps 301.00 2
Address: i Over I,000 ampa - • , ,.. 14226 2
I Temporary servl - - or feeders inetallallesti attrition, andAir
City/State/ZIP:
r 2tt a i tt prir WU 59.36 I
Phone: ( ) Fax: ( : )
• Nil 400' . , i•-
Owner Installation: This installation is being matte • 1 !property that I own which iS ru4 amps to 12108 2
401 amps to 599 •,, . • 16834 2
intended for sale, lease, rent, or exchange, according .. PBS 447, 449, 670, and 701. I
, atandrekcolle • . . , allerittloni.or torleadomiker pond
Owner signature: - I Date: Anteerforbnusils •-•- , ; • 'WM
-
- : ' „ i : , . . ' . * : - . A t l y i " . ' . ' N r - I F P 4 ` 1 1 0 9 N ff P f t r : 7 F ? , - . c l ' " ' " A - L . T 4 ' . 3 ' g ' t r l ' ; ' , 7 • M S 1 1 1 1 4 C C errkr or .- ' -' BM 742 2
..,, „ . - .04.- : -,.t.i.... . ••• . . ,. 1,M, ... ..: tr.4'.....216.:1W::vi :+k,.:Iik,•..b•mix.,:luk,1: • - . loath brartelscire .•
Business name: .
i 11.Pedfor bomb ; - , ts *Num
!service or feeder - - fart 56.18 2
Contact name: 'branch circuit.
Each addl.bitoch mit . , 7.42 _ 2
Address: . Mipeellanemmtse ke or•tretler mittldpnen)
•
. RIM mud . modular 67.84 2
City/State/ZIP: , dvtellbia, envie* - -,•, (bed=
•
. *connect only. 6724 2
Phone: ( ) I Fax: : • )
Puirnp or Migration - - 6724 2
E-mail: •
. fi . - pa Vr outliorlit* 67.84 2
•
: -: '.. , --4 •? Si eircrifkiftor "--. ' - I , 7 r— 2
Business name: , • P . ;so ., ' • , -•., x if i lirNIIIIIIIIIIIIIIIII. • ■ • litigia. • / P4 2
' • .. , , , _r,. , = • Ittier , , ,.„, . . la , , at - above
Address: £ 7D / ?J. 1-0 th.(3 ° 7 0 S i1-C7 . , . t , .- . ::' , , : , • , . - ' . : 0 ti inho • 6415, hr
. '
City/SIM/ZIP: RanjklilD OR .k12” • -till 3 1 In -. callotte10 . . .) 66 MI hr
1 tedistriei plant(1 , min) ' Wino
Phone: (ivici )i - 7 i 22. I Fax: ( . .4 ) 64,1 112,3 inepeoonsary4,- no* is 90.00/br
CCB Lic.: lin 82.4 I Et:lc:Weal Lie.: -. • . (, I Suprv. Lie.: 14 1 7 7 . i .":1 .
_
Suprv. Electrician signature, regairetr 4 !
Plan r.- • •,-, ,... ' r-
•
Print name:4, ' ye-A. ....Ta- e e eo 0-0..s /.-ty- : I Date: PAO 7 State.. ... - - , :, - tlIffiCifisemnifcc): ' -
TOTAIMP,444F-P..-
Authorized signature:
nas Pollall ' . .- . 81 within lte
das - , kW, bier. ! i5 ' ii141 . ir clielfile.
Print name: Date: • Number of hapret • L alkovetiper nein&
•
1 kauilditaiermitsa.C.-PareritAptuiee 07(01110 . 4404613T( i I/O
• • .
. . .
. . . .
. . ' . • • 1: • i : • . •
•
.. . f .