Loading...
Permit 1 ~7 ~10 0-t - CZ'~' EL~TRICAL RESTRICTED ENERGY PERMIT CITY F TIGARD COMMUNITY DEVELOPMENT Permit#: ELC2009-00671 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 12/22/2009 IN Parcel: 1 S134B000300 Jurisdiction: Site address: 12210 SW SCHOLLS FERRY RD Subdivision: Lot: 0 Project: Coffee Rush Project Description: (1) 200 amp service and (15) branch circuits. 1/5/10, adding (1) feeder. FEES Owner: FW OR-GREENWAY TOWN CENTER LLC Description Date Amount PO BOX 790830 Services or Feeders - 200 amps or less 12/22/2009 $100.70 SAN ANTONIO, TX 78279 Branch Circuits w/Purchase Service or 12/22/2009 $111.30 PHONE: Feeder 12% State Surcharge - Electrical 12/22/2009 $25.44 Services or Feeders - 200 amps or less 01/07/2010 $100.70 Contractor: 12% State Surcharge - Electrical 01/07/2010 $12.08 OREGON ELECTRICAL GROUP INC PO BOX 66157 PORTLAND, OR 97290 PHONE: 503-701-5555 FAX: 503-760-5986 Type of Use: COM Class of Work: ALT Total Number of Systems: Audio & Stereo: N Boiler Controls: N CCTV: N Clock Systems: N Data & Telecommunications: N Fire Alarm: N HVAC: N Instrumentation: N Total $350.22 Intercom/Paging: N Landscape/Irrigation: N Required Items and Reports (Conditions) Landscape Lighting: N Medical: N Nurse Calls: N Protective Signal: N Security Alarm: N Other: N Other Desc: 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. ATTENlaw requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-001 01- 100. You may obtain a copy of the rules or direct questions to OUNC by calling 503. . 699 or 1.800.332.2344. Issued B Permittee Signat e: 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 an inspection that business day. 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. CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit#: ELC2009-00671 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 12/22/2009 Parcel: 1 S134B000300 Jurisdiction: Site address: 12210 SW SCHOLLS FERRY RD Subdivision: Lot: 0 Project: Coffee Rush Project Description: (1) 200 amp service and (15) branch circuits. 1/5/10, adding (1) feeder.2/5/10 ADDED limited energy for voice/data. Owner: FEES FW OR-GREENWAY TOWN CENTER LLC Quantity Description Date Amount PO BOX 790830 SAN ANTONIO, TX 78279 1 ea Services or Feeders - 200 12/22/2009 $100.70 amps or less PHONE: 15 crt Branch Circuits w/Purchase 12/22/2009 $111.30 Service or Feeder 1 ea 12% State Surcharge - 12/22/2009 $25.44 Contractor: Electrical OREGON ELECTRICAL GROUP INC 1 ea Services or Feeders - 200 01/07/2010 $100.70 PO BOX 66157 amps or less PORTLAND, OR 97290 0 ea 12% State Surcharge - 01/07/2010 $12.08 PHONE: 503-701-5555 Electrical 1 ea Limited Energy 02/09/2010 $67.84 FAX: 503-760 5986 0 ea 12% State Surcharge - 02/09/2010 $8.14 Electrical Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Total $426.20 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 952-001-0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. i Issued By: Q ~.J~ LY~o~oQ 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 an inspection that business day. 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. CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit#: ELC2009-00671 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 12/22/2009 Parcel: 1 S 1346000300 Jurisdiction: Site address: 12210 SW SCHOLLS FERRY RD Subdivision: Lot: 0 Project: Coffee Rush Project Description: (1) 200 amp service and (15) branch circuits. Owner: FEES FW OR-GREENWAY TOWN CENTER LLC Quantity Description Date Amount PO BOX 790830 SAN ANTONIO, TX 78279 1 ea Services or Feeders - 200 12/22/2009 $100.70 amps or less PHONE: 15 crt Branch Circuits w/Purchase 12/22/2009 $111.30 Service or Feeder 1 ea 12% State Surcharge - 12/22/2009 $25.44 Contractor: Electrical OREGON ELECTRICAL GROUP INC PO BOX 66157 PORTLAND, OR 97290 PHONE: 503-701-5555 FAX: 503-760-5986 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Total $237.44 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 952-001-0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503,246.6699 or 1.800.332.2344. Issued By: Permittee Signature: v 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 an inspection that business day. 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. 12/21/2009 15:45 13602537503 PAGE 02/02 Electrical Permit Application IXL EIVE City of Tigard DEC 212009 Recoivocl G cnnit No.~~°~1 6 DatalB : 7 f~ ~ a 13125 SW liall Blvd„ Tigard, OR 97223 Plan RCvlcw Uttlcr Fermi~W 00F"-'90'Rag e Phone: 503.639,4171 Pax: 503,598.196~ITY OF TIGARD Dattc/Gy' ~prlA. Sec Page z for Tnspcctionl Line: 503.639.4175 Dao Ready/(.iy' Internet; www,tigard-ongov BUILDING DIVISIO ntificd/Method: supplerocntal lnformnHnn ,r •r ir,.,~,r, 1'p'+"I:dv, 'r:l 'lPr~'r (9i. I ..II, il'I riiYlir '.i'.i';r ~ „ r,,, ~ ll,):'I ,.f "ar'yl,rr;l ~';il;il~i d''li!1'r'S;!r'P!%•I L.. ,It~lr r., 1'i(x'1 l"lylf. ~(II ~.ify( 1~,~17~~p lril ti'r.,l lo- ,.(.rll., {i~'J,,.,q.."r y'.rv r n,rv I ',still"1/Irlr lll.i 1,~ii''f'rli'{~i'rvJj!',rl farhl, Blip+'ln~r1'IfP/t,,hl; r,! f'},1 nr 1,..,, r,,,l~ ,l, rrirJ~3, cl, j,l, r ' Ju rr,_,.~ ,r).l,l,. ylrl{,tlit6Pa )Itt ,r116r ~,,f,ry, llc~ i r ;0&4 11 rl , „ r4! i , r ..r ` rl t ,),,~i u4+'.u.r.u.c.,91.1r~-LPI/~,~11 r rlllr I>Icasc chock all that apply (aubtnrt Z acts or plans w/items checked below): New constrt1Ct10n Additiatl/alter tion/rcplEtcement: [i Service or fccdar 400 amps or morc ❑ Buildinp over three stories. 1~C1n0lltion p Otller: where the available Fanlt cultonl: ❑ MBrhlas an(I boatyar(ls. "fr -1", ::1:'''•°r I 'ti*r', rr; 17' :!i"('~q~r/'ailj'il';;j+,:~I~~'ji"r;;,jif;fi;i!'ujCiNi;rr;i exccads10,000amps at'150voltsor ❑Floatingbuildings. less to 1Sround, cr exceeds . 14,000 d Cnmmcroinl-use agricultural l -and 24amiiy dwelling © Cornmcrcial/industrial ❑ Accessory building Imps forall olhctinstallotions. bnlldings, r-y ❑ Fir* pump. ❑ Installation of 7,5 V VA or Multi fAmily Master builder I 1 Ot11e1': HmcYl?ancy system, larger sc-ppratcly derived aYstem. ri;i', r. ,;,i:,,. r,:,tf','f!ph';11,4±1,1 1 IYf;ii'j;ji!"'ij'ii' iilffi'ijijil'IJ (iii l':P%i'1r, ❑ • ~',Jr1,Ir y)IP{:p r,r'1;1„t,iy{ f{ bfl l(1f. 0Addition ornewmotor load or ❑„A, „E„.,1-Z., a1 10014p or , p occu pine y. Sob n0. • Job site addTCSS / six or morme rorc csidcntinl units, © Recreational vehicle parks. City/state/ZTP: - ~'A~~ ❑ H0aI111-enrc facilities, ❑ supply voltngc for morc Than Frszardonns locations, 60D volts nominal. Suitc/bldg./apt:. no,: Proj ct name: C IP-u-sl'-4 d Service or feeder 600 pimps or more. I" Ilyr p n , 111 fl~ l'lrl, ,q' ;I"~'~'~~°r',•(~~". .~~41 lir,l",I{ , r'c'1,"i.i ~ 1, ,~ru, r „rllhll1111 rI,I,A„frltr' I,L'I"48, at r. job site- S~ Merl rtnn t Fee. Touet Gross streeUdirections to New residential single- or multi-1•amlly dwellinn unit. dnclndcs attached garage, Subdivision: Lot no.: 1,000 sq. ft. or less - 168-54 4 Ea, add'( 500 sq. 11. or pordon 33.92 1 Tax tna11/parcel nn.: Limited energy, reoidential :1!ii,llril;l, V11, ' about R o, it. G7,R4 2 l ! .,1 , tl 1/ bLblr d'•rl,ln~ ! , ,,1 _,..f,l .i I. •r „,nh e)u Limited energy, multi-Family 67,84, 2 residential with above s . ft, + I Y O Services or feeders installation, nlterA ton, and/or relocation W ()200 amps or less 100.70 2 rr(• 7x 2t) 1''r I{ KCU>r! tl♦ ~ I ':+1111I`,Ij I +r ,Irll( r l /i~'l~l 'r ,l 111 1 7r Pr' 1 amps to400amps 133.56 2 S„ub!ul.lrljl. it I' y1Ji IN, ,Name: 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301,04 2 Address: Over 1,000 amps or volts 552,26 2 City/State/ZTP: Temporary services or feeders installation, alteration, and/or rehlention Phone: ( ) Fax: ( ) 200 amps or Icss 59,36 1 Owner installation; This installation is being made on property that J own wilicb is not 201 amps to 400 amps 125.08 2 intended for sale_. base, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amp& 168.54 2 Branch circuits W new nlteration, or extension, cr panel ONVner signature: Date: A. Fee for branch circuit4 urirh 'tii,S gill; r;)':,il,l i~ , f i fr,rp,;j~"rr, 'rp.,'. „ . 1.,",1 ~r•.+~. rpvi;,t:r.?,g tin " . rl 1 it f:l III~1~Y J>i, ,i .1 n"!I rr 1!'>r, f{' , . t 1I E~~ ll,' r{ 1 ~ c1 111~111WI I I I { I. shave service or feeder fcc, 7.42 2 each branch circuit _ 13usifIC55 name: T3, Pee for branch circuits Contact name: i0rhow service or feeder tbc, 5(1.18 2 First branch circuit Address: Each add'1 branch circuit 7.42 2 Misceiinneoua service or fecdcr not included City/State/7 P: Each manufactured or modular 67.84 2 dwellin , service and/or feeder Phone: ( ) FAX= ' ( ) RoconnW only 67.84 2 E-mail; Pump or irrigation circle 67.94 2 I It''111 k',' I ` ,r' rl'('(''~~•pp (t" Gj 1 !t"`t''rI h,;;rl ''1'+l 1it' 1,"Iy+ ,"1 P 1 i'1 Sign or outlinclighting 67.84 2 / Signal circuit(s) or ]imitcd- 8ustt1eS5 name: cnctgy panel, alteration, or Address: 7 extension, Describe: Page 2 2 r / City/State/7TP: L~ Each additlonal ins ectlon over allowable in an ofthe above Per Tnspcction 66,25 x+ate: ( I Fax', 1 vcsligatiol per hour (1 hr mIn) 66,25 CCB Lie.rl ectrical L " Ind stnal I h ic.: 5upty, Lic u pant per our 79,18 ` • I`~l{i_,,;~ n j7,' f . Suprv. Electrician signature, required: Subtotal; Plan review (25% of permit fee): Print name: ( ~ Dflte: State surcharge (12% of permit 'Fee): Authorized signature: TOTAL P.P.,RM1T'PEE: 7r This permit nppliention expires if n permit is not obtninel within 18o Print name: Date: days after it hoe been nccopted nc complete. * Aoc 10/01109 410•=1615T(1 1/051COD41WF.n Ntlmhcr of inspections nltosved per permit, 6.\auildinglrcnnitp\P.i.~_PormitApp, 02/04/2010 15:06 13662537563 PAGE 01/02 f Electrical Permit A. iica ' FOR orrici.,,,-(jsi',QNLV' City t)f Tigard "tIj I I)Atu/.Niv~ - I ";Ib Receive Parrnft No. ag zov 0(% l "t 13125 SW Hall Blvd„ Tigard. UR 9722 Plan Review ® Phone; 503.639.4171 Pax: 503.59 Q .4 2 Dntc/f3 : Other Permit: inSpection Tjnc: 543,639,4175 hale R40dy/fty: h 9 0 See Page 2 for Internet www.tigard-or,gov O'1= Notlfltrl/Mtthod; Supplemental Information ,~„!u.... I,~:.,','.:" . da., , '...,o-'•,,,.:: ,Il, J.~t, I,:o', r. 1., ~ 1.~r~4r'''vt,. :ffi, r'. .I; I'i ~~y:J.i .,i.l,q t.ci, :.'r?' ✓I, .:I. ~I.AA, v✓ .I ~1~ I Fljw~~~l', ~l a.~ "Vic . P[ame check nl I Ilia apply (submit I ger^, of Plans w/items checked below); n New construction ❑ Addition/AT leratiot)/repltacemCnC © Scrvicc or fccder 400 amps or more ❑ Building over duce stories, [I Demolition El Other; wllCre the ovnitnbfc fault current [I Marinas and boatyards. Ji ii,oll J „r uti cxcccrls 1 D 000 am sal 150 volts or FI01 a in +uiltdin P ❑ R l f-s. lust to ground, or exceeds 14,000 L] ommercia ruse agrfcu mrn L] 1 - and 2-family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. hudhdinRs, Mutti-family ❑ Master builder Other: ❑ Fire pump. ❑ Tnstollation of 75 xvA or ❑ Emeryoncp system. 1nrRer ~epnrkltuly derived system. 'lff1~9l~fil;Y~~V ❑Addldonofnetvmororloadof I OOIIP or more. occupancy. I: ~J ~Job no.: lob site address: ❑ Six or more rositlmrtdal unlrs, ❑ Recreational vehicle parks, City/State/7TP: ❑ 1- cDlhcnrt fncllifics, ❑ Supply voltage for more tbnn CI1-Tozardous locntions. 600 volts nominal. Suite/bldg./apt. t10.; PI'gject name: 0 Service or feeder 600 amps or more. Cross street./directions to job site: nceer+ rmr r .R~~ Tntnl New residential single- or multi-family dwelling nail. Includes attached garage. Subdivision: Lot n0.: 1,000 sq. ft. or less 168,54 4 Tax map/parcel no.: Ca, add'l 500 sq. R. or portion 33,92 1 Limited energy,residcntial 67.54 with above s q. (1. r ~ Limited energy, multi-Family 67.84 2 add ozrnA~-k ( a Wq - residential witl+ nbovc "g, fL Services or feeders installation, alterntion, and/or relocation 200 amps or Ics< 100.70 2 r {,i' lJ r Y ' 4' I)I 1 n I' 1,, , ,l Yl r , , , l I I: 201 amps to 400ampS 733.56 2 Name: 401 amps to 600 amps 240,34 2 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552,26 2 City/State/LC.P: Temporary novices or feeders Installation, alteration, and/or relocation Phone: ( ) Pax: ( ) 200 amps or less 59.36 1 Owner installation: This installation is being mode on property that I own which is not 201 amps to 400 amps 125,08 2 intended for sale. lease, rent, or exchange, according 10 ORS 447, 449, 670, and 70 1., 401 amps to 599 amp,9 168.54 2 Branch circuits- new, alteration or extension, er panel Owner signature: Date: A. Fee for branch circuits with ' sties e service or feeder fee, 7.42 2 cach branch circuit Business name: B. Fee fbr branch circuits tt,itltorll service or feeder fee, Contact name: first branch eircttit 56.18 2 Address: cach add'I branch circuit 7,42 2 1vllscellinneous service or feeder not included City/State/Z.TP: Poch manufactured or modular 67.84 2 Phone: ( ) Fax:. ( ) dwellin , service and/or feeder Reconnect only 67,84 2 E-mail: Pump or irrigation circle 67.84 2 Sign g g or outline li htin 1 ❑hw : i`. 1a w n , , {,1l , , 67.84 2 Business Signal circuit (s) ~J rl J (4) r limhcd- h-' ene ergy panel, alteration, or Address: extension, Dcscribe, Page 2 2 t 66(5--7 City/SitiTC(7IP: t1~p I- tAch nddltionn] ins ection over allowable in an of the shove Per inspection 66,25 Phone: ( 01' :?O-~ T ttx' (7-,,66) 2-63 760-3 Investigation per hour (1 hr rein) 66.25 CCB .Lic.: Electrical L ic.: ' Suprv, Lie,: tndustrial plant per hour 79,18 Print Sf,tprv, Fleetrician signature, required; btPrint name: Date; Plan it fcc); I. L:E-e ;i;:'.~' , WFEE- State suit fee): Authorized signature: PE) Print: name: Dale: This permit npplicnfion expires if a permit is not obtained within Igo dnys after it has been accepted as complete, 1/05ICOM/WKh M Nmnbcr of insp 00Otis nllowed per permit. 1:\(3¢ildinp~PcrmltnlP..1..(`-rrrmlt~pp.000 10/01/09 4qD-n(,15T(1 ~r Q~on E ec,~~~ ca0rc~>.~~p K.Q.\ l • am{" CITY OF TIGARD ELECTRICAL PERMIT • • COMMUNITY DEVELOPMENT Permit #: ELC2009 -00671 T I GAR.D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 12/22/2009 Parcel: 1 S 134BC00300 Jurisdiction: Site address: 12210 SW SCHOLLS FERRY RD Subdivision: Lot: 0 Project: Coffee Rush • Project Description: (1) 200 amp service and (15) branch circuits. 1/5/10, adding (1) feeder.2 /5/10 ADDED limited energy for voice /data. Owner: FEES FW OR- GREENWAY TOWN CENTER LLC Quantity Description Date Amount PO BOX 790830 SAN ANTONIO, TX 78279 1 ea Services or Feeders - 200 12/22/2009 $100.70 amps or less PHONE: 15 crt Branch Circuits w /Purchase 12/22/2009 $111.30 Service or Feeder 1 ea 12% State Surcharge - 12/22/2009 $25.44 Contractor: Electrical OREGON ELECTRICAL GROUP INC 1 ea Services or Feeders - 200 01/07/2010 $100.70 PO BOX 66157 amps or less PORTLAND, OR 97290 0 ea 12% State Surcharge - 01/07/2010 $12.08 PHONE: 503 - 701 -5555 Electrical FAX: 503 - 760 -5986 1 ea Limited Energy 02/09/2010 $67.84 0 ea 12% State Surcharge - 02/09/2010 $8.14 Electrical Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Total $426.20 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 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.248.6699 or 1.800.332.2344. Issued By: gckot & `Q 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: 7[ CONTRACTOR INSTALLATION ONLY . SIGNATURE OF SUPR. ELEC' p Date: LICENSE NO. ` � V Call 603.639.4176 by 7:00 a.m. for an inspection that business day. 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. 02/04/2010 15:06 13602537503 PAGE 01/02 Electrical Permit Applie Fos orric:i. t_isr, out.v Received N City of Tigard � � - Receive II Permit No.: LO ZO(E .r ° 13125 SW Hall Blvd., Tigard. OR 9 W� 1 g 4 20�Q P lan R eview I ` Phone; 503.639.4171 Fax: 503.59 0' Datr/By: Other Permit: 1't c:. A R r Inspection t,inc: 503.639 ©�4 r t�QD bate RcadyiBy: Notified/Method: J ® See Page 2 far Internet www,tigardor,gov �ry 11G� l C-1 Supplemental information � � .,� ,::' �.._ .: r. i..,, , :'Ii'll ".r': r.�,: I::. � . , , .r7Y •'1�. ' , 1, ;:1, �r:l� � ::.1 ,i r.; ':rir .•:rl:• • • i�i Y . � I' .i. �_,;�._,:,,: .... , „ , ., ..1 �.�•, i .. i , ,. , r . i. �,1 , I � / ,'1�t , � Y r. ;.r a , ire∎: ;II:i! r'. ..1 : 14, I • ?I j,� • � •l.. .. . � I .. , ,,... i.,..,,..,...r,,.,., r . .. . ...... ...........a d �„ ., ::.:,,•, ';1... ,,::�`;' ,,r I: :`'�'tJii�,•, flit'! �Y�tY!,;,: �.'.';:•.. ,. ,,,, , .... , ,aL,,;,i,l „�.,, ,., u � r _ tT ei,,.�,cltr , I ... � , . , r' , . . I ; ..,; �; �:,' " ,r,q ; ,a . ti...... ,. ,..... ❑ Ncw construction ❑ Addition/a' ter'atiot, /replacement Please check nil that apply (submit t sets ofpinns w /+terns checked below): ❑ Demolition Other: ❑ Service or feeder 400 amps or more El Building over three stories. where the available fault current CIMarinas and boatyards. ... ,r:,;,t.,;!i , rr l! i ' 1: ' .,: .,,.r Gil,.' i! d ' I;,i... :;i: ':; ! cncccda 10,900 am at ISO vnlla or FIDa : Nn bnildin i. ..•:,... ,'!.,, 'Ir , , . , ! •, , . ,., 1 ;; .. l i' � ' 1 exceeds ❑ QC nto r. ,:c ,U., � ., : „_ , •;o., ), , ..�....,,�,..,: , n .•;�, ! ���ic.� r ,,, + lcrs to ground, or cccds 14,000 Commercial-into agricultural d 1- and 2 - family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installatimts. buildings. ❑ Multi family ❑ Master builder 0 ❑ Fire pump, ❑ Installation of 75 KVA or �� Em c om. inr s , 1 Other: 0V..;;F; ii1l.:;;:w...:.. •y� �j,� µ yy � flgi , • ..,t .. ,: • .; , : - 1 .: ❑ agm Y gef rsrtc y derived system. I,., il I ti' i! 4.'.,. ' i .a1 .r : F..! ....r� ��':I. .: t` .:! :; : y dr; : ;l : i : ' i: '! ; : 1i:; , , r °ji'.iii't, ' l ,.i Jrir' i�;:: , . L .. ■. . .. . ... . .......... y .� ,•,,,,:.•,r�,.. ,,,,,, ..A "�� !i � I;:;:. i �, , ry,.p• ,II :.i.y ❑ Addition of new motor load of O.. _2. "1-3". Job no.: Job site address: \ t 11 ` A 4 I00HP at more. occupmcy. ❑ Six or mare residential unite. ❑ Recreational vehicle parka, City / Statc/ZIP: ❑ Health -care facilities. ❑ Supply voltage for more than P_. ��� ❑ Htamdous locations. 600 volts nominal. Suite/bldg. /apt no.: I Project name: ❑ Service or feeder 600 amps or more. Cross street/directions i it i ; I' ^ ', E , ';,0,1V �..,v.�� '..;._,.. . :- rections to job site: .,ii,� (�i,,1�.44ri,i.ir . i :i;li, �I` 1 �!ti oa o t ... a l '.. • `i >' C J DelCriat:On � Qty. j Fce�� � Total , . New residential single- or multi- family dwelling unit. includes attached garage. Subdivision: l Lot no.: 1,000 sq. ft or less 168,54 4 Tax map /parcel no,: Ea. add'I 500 sq. f . or portion 33.92 1 Limited energy, residential i'1',; : ;I, ;:,:, ;.:i,l..;:,r,; .; ; 1;' :.; :; i i , ` I l{: 1 ', • I .I::l;�;i:l' i, ;;! TiIll ? ;1 :: ;F; . 1 .i. •:� �. ,r,.,., .. .. , , . �. ,.,: ? I . , r . • 1::•1., •, :. ,ri ,. , ;;'i:.r' , tll:,�.;aN I. (with above sq. fl.) 67.84 2 4, 4 1 Limited energy, multi - family 67,84 2 • * y a a'- C.�IJ 1 6?' residential (with above sq, ft,) r Services or feeders installation, alteration, and /or relocation n . . r I I Q' I I. I : `:i.:'!' : amps or less . 100 70 2 ss . . I., � �yt�� l h r. :.. :1 .1'i. :! :I r; l!:. I 1 p 1 !;� :•i;;i 1 :iii „I: i! i.,. ,,,, ,.. r ,1'', .. 'Ql' ; �r!rii;l'4! I 'I I hA.•• ,I I: N• .. rl, n l;•iq , �l . i !•!:i' , UW" ! ""S11J 1 1�1 ,11:1 , ,.. , .., • .,, „., 'p. ,.,.L. ,;!r•i,r��: ^ 11 201 amps to 400 amp 3356 9 L 2 Name: 401 amps to 600 amps 200.34 2 Address: _ 601 amps to 1,000 amps 301.04 2 Over 1,000 amps or volts 552.26 2 City/State/ZIP: Temporary services or feeders Installation, alteration, and /or relocation Phone: ( ) Fax: ( ) 200 amps or less 59.36 ' Owner installation: This installation is being made on property that I own which is not _201 amps to 400 amps 125.08 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.. 401 amps to 599 amps 168.54 _ 2 Branch circuits – new, alteration, or extension, er panel Owner signature: ,:.: ���� �y� yt Y1 A. Fcc for branch circuits with I''. :••.i: ll:� h , � n�'l.tN i:� a';ki:.' � iii � 'l d:� Q{l ' rl l•:1 1. i7 ' ; f � i, :t:; � :: u !' , :ii above service I, "' . '' ,rLna� ".. . r , .•1,,.. „ , .,'(l•T1... ,.r, ;i;. . , . , . ,,., . ._ ."r 4 1`': 1 h x or feeder fee, each branch circuit 7.42 2 Business name: B. Fee fbr branch circuits Contact name: without service o r feeder fee, 56.18 2 first branch circuit A.ddress: Each add'I branch circuit 7.42 2 Miscellaneous (service or feeder not included) City/ State/ZiP: Each manufactured or modular . 67.84 2 dwelling service and/or feeder Phone: ( ) I Fax : : ( ) Reconnect only 67.84 2 E -mail: Pump or irrigation circle 67.84 2 ! UA°'.I..,.,.i'.1: �•l , i ili . 'i,i ,; ! :;2 ;•a •,:I �' I:'::I r' .11f .., .'i.. .: ■ t ' {: 11 rY~�I�1.i.�" I��r . , . I :. ,r:; , t, I I .,`.'.'I:'; , ;'.::•:;:i:; Si or outline lighting �'�i��� il'i ?i'i(lai'1 ",�{ li• }iI "'(' . , � , r.,. .,� � . , i it ,,. ;�,• y , �� +` ...,��. �� Sign IEdI g 67.84 t�, ,, ., ,I lr .. ,.. , � r,l". , .r. �' •'1 ,i4N •4 , , +ic,•1 Id64 q�� tin Business name: �� i ' ir ��)� ) )Inn esiglral circtait(s) or limbed- 2 - LJ�W r l X ene rgy panel, alteretion, or Address: 1 0 rJ N 6,6 ( extension, Describe: Page 2 2 City / State/ZIP; f>ele fain -af jt� co 2-5 v Each additional inspection over allowable in any of the above vv �t Per Inspection 66,25 Phone. (5:3)7/04065 Fax: ( ) 263 750.3 Investigation per hour (1 hr min) 66.25 CCB Lie.: ) ` g I Electrical Lic .: 3 f 5 P per - 78.18 $�j C� Suprv. Lie.: Industrial lane hour Suprv. Electrician signature, required: — .:;. ::;!, ";i: i;:∎z: iittiEC�IYet.V.Ari;:i.EB. Trtillitt.B: ' ";i'; '.,:.. ,:::'- 7 _Y- `Y_'�- _ subtotal: ; Print name: i ' l4 Date: Plan review (25% of permit fcc); J State surcharge (12% of permit foe): Authorized signature: ____ TOTAL. PERMIT FEE: / 53 Print name: D ate; This permit application expires if a permit it not obtained within Ian days after it bus been accepted as centre c. I:Viuitdir \PamlulP.l.r.P • Number of inspections allowed per permit. e rnnitApp.aoc to /ol/o? 4 40.4415T(I t/05/COM/Wgg Oreor, e Q cce-I Grow k0e - . • o CITY OF TIGARD ELECTRICAL PERMIT Iz .... COMMUNITY DEVELOPMENT Permits: ELC2009 -00671 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 12/22!2009 Parcel: 1 S134BC00300 Jurisdiction: Site address: 12210 SW SCHOLLS FERRY RD Subdivision: Lot: 0 Project: Coffee Rush Project Description: (1) 200 amp service and (15) branch circuits. Owner. FEES FW OR- GREENWAY TOWN CENTER LLC Quantity Description Date Amount PO BOX 790830 SAN ANTONIO, TX 78279 1 ea Services or Feeders - 200 12/22/2009 $100.70 amps or less PHONE: 15 crt Branch Circuits w /Purchase 12/22/2009 $111.30 Service or Feeder Contractor: 1 ea 12% State Surcharge - 12/22/2009 $25.44 Electrical OREGON ELECTRICAL GROUP INC PO BOX 66157 PORTLAND, OR 97290 PHONE: 503 -701 -5555 FAX: 503 - 760 -5986 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Total $237.44 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 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. ,, / Issued By: Permittee Signature: C� %�Z V 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 603.639.4176 by 7:00 a.m. for an inspection that business day. 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. sr. 12/21/2009 15:45 13602537503 PAGE 02/02 — —,_ —. - - -- — Electrical Permit Application RECEIVE h(,1; 01 1 1('h. IISIC t -)til,V Received City of Tigard DEC 21 2009 ` - 2 0 o ' '4:4 N° c2eo.o , 7/ ) 3125 SW Hall Blvd., Tigard, OR 97223 Plan Review Outer Perm ieteo2 ®0 a0S 11 : Phone: 503.639.4171 Fax: 503.598.1960, OF TIGARD Date/By: - e1 P 2 for 1, brio: o Rea /A Dan d Y' • Supplemental Information Inspection l 503.639.4175 flaw/maim : T't " "z1 lntemc Hgard�rr.gov BUILDING BUILD t: www 1 l I "'''nn::, ',:; I :, ;... ; ;l:i'•n:' ;•:s,!• „ �(r'; �l' l ' i ✓ r• •II'•'�t•': 111 .1i Iqi r,('�1'9 ra id L i . , ; r l 11'� L a l l , ; 6r ,, ; .., q , r ' ri' I r r' ilig "r:•:; 'ti:fFa:r'i ,7, , i... 6 e f ,j l r rl r l! r�( /P1 ri� I '� 4 , �: :.t�,l. �,. . . �t i,,h.,yl:yl�ih'It :, '.: ri: y . ........ "' ; l " :liliil,,; y; ,' 1 •,: ri ;....�. �y.1 is '�1. R �y 1 �!',Il lll.11rl ll'1111., .h r.l .1•�i� G n�ll ;l�i fil rl ;i ;r; ock i ; ap :i y �. �.,I: ;:7r , 1 ..:. 1 , .,. • '! , :i r� ; . • , 1. �.7lQ Kry "7i!�I':. r...., �!+S!1 i, . rl1 rlr. 1 lr r.: 1 submit 2 acts of plans w /items ehcclrcd below); .. ' !'�:i ;•; n : r• t i Please shock all that apply (• Et New construction ❑ Addition /alteration /0 em m 0 ScrviCe or feeder 400 amps or more ❑ Building over three stories. Other: where the available fault current ❑ Marinas and hoatyerd.s. • Demolition ;. ,,, ; . l ,, jll "l ,; , ; ,i,i , ,:r'�i'IFf iii :It" exceeds 10,000 amps at 150 volts or ❑ Floating buildings. l ,:,. , y , ,' yl�uy�it,y i11,, r •rii•',,r;f •i ;: la ,r•i'l ❑ mccaWttacalJliculturo .:Vii::: ':i 4 :: :'d'l:'"" 1.11, .,. ' , ,,fJ ' . 'IV:.l''''' :,'.!':li9.'''' ll: 1 r' less to wand, or exceeds 14.000 Com 0 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building mnpa for all other installations. Q b n dlloda ❑ Multi- family 0 Master builder ❑Other: ❑ installation KvAor ❑t � � systtxn. larger separately derived system. ; ;;• . ;.:;:! ,1:,. . 1 'l i n , i :; : "1-2", „ 3 u.,i . , lIr ;, i ! - VI I I if; r • I �, .1 , .'d ❑ f new motor load of ❑ "A " • ;1:': °r: ;i sAi(•` 1,'' ;'It'li,,ll':1'"1' 1 ��,,,�y ,y���� a dll _ �!' .1 19.. ,,./ /�d i� 4i r, 1�,, �, i l : j; l ;. L11�p' H47Ri'I (' il !1�`!•!"V. � 'lvuw;.., .:f" � ,a ll:,:,;, i rq; 1.� I i,.. a 10014 or mare. OCCUPanCY Job no.: Job site nddre : / al /.l � Six or more residenti d units, Ei Reereationnl vehicle parks. � tul�l � ❑ Supply voltage for more than ` �y 1✓ ❑Haa erd o in locations. 600 volts nominal. City /Statc/71P: ./ e ❑ Ha nIth - a IocaNm ❑ Service or Feeder 600 amps or more. Suitc/bld . /apt no.: Prot Ct name: C �� _ �, II ,,.,p;',r) 'ill, r, l of u p': :4" i 1:b�1! it�t!�•'! :`.'. • Cross street/directions to job site: , rogA,� V �(�(/ S ,, r Jr esidential single- or multi-family dwelling unit. Includes attached garage. — Lot no.: 1,000 sq. ft. or leas _ 168.54 4 Subdivision: Ea. add'I 500 sq. R. or portion 33.92 1 _ lax map /parcel no.: Limited energy. residential 67.84 2 ,0{1I, ,,,� F,W,�.,�i :liViii,i:,i':Gi!;I Ir . ,,il/i:,l ir;44 11; 1 4 %iii; "i with above t , tt ) : ';llj:ii:;•;' z:!! ;ii ;!irl ;i'; iii ;i ;:jllli ;iiili'll . I” �F�! JA" !G'FM,W ;��l'i:' ;' tl` lii�� 'r ; ;(,�Il� ;r:.P "!1'r, ;:r�:1.1 ..� '1.,. ; �, r.r, �,.� I ;��1:7'; •.l.r r,:,ll:,,:.',,: ! ' Limited energy, multi - family 67,84 2 f a �� • I. lA t C r • _ residential (wis above 8) t seas • • a 03 amps or less installation. alteration. 2 Services ins Itera on. and/or relocation U, I - 200 � � 100 70 � y y{, . ,:,. , , I;7;.,.., ,;..l 1.01 !' ; ; ; +•' ! ,' %t:',.iii•ji': ''A:il;' 201 amps to400amps 133.56 2 _ �� ., r , 'y r r':i� "�ilr ��IIIII,I )'tl {� i,l it L'I , ii! ' ., !I;� ;:,� :'flll 2� i!. ;j� ;, ;• r.r;, 1; i 1;,�71VWi`I�d,Kli'.1, :,1,�.� ". 1 '� ,:1 rj,: 1 . 401 amps to 600 amps 200.34 2 Name: 601 amps to 1.000 amps , 301.04 2 Address: Over 1,000 amps or volts 552,26 2 Temporary services or feeders ins tallation, alt eration, and/or City/State/ZIP: ✓ relocation Phone: ( ) Fax: ( ) 200 amps or Ices 59.36 1 201 amps to 400 amps 125,08 2 Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. - Branch circuits- new alteration, or extension, Qer panel __ Owner signature: , Date: A. Fee for branch circuits with „'iI'''• 1 rt 2 „ ' ,•'; ; ;1 + ,,, ; ,:r , t; , I !'' 1 i ,fit yy,t� I" �, ;! i I i above service or feeder fee, 7.42 .... ,.. , . I,,r r 1 ,r 1 „,,' ' p : Iii ' I?g f' n a 0,00$.. o � !•'1 r rll!i rr j !ilif`IF+1t1w"7f'j,,4 %'�:e• ;,I, ;it.i i l� t ;� ; ;�i".., l...i '..' Il;;,,; /S IIFi'iilis• i Business ., ,y,;!„ ,', / L I ,rG; Itil , ... each blanch circuit Business name: B. Pee for branch circuits without service or feeder fee. 5G.1 R 2 Contact name: first branch circuit - Each add'I branch circuit 7.42 2 Address: — Miscellaneous (service or feeder not included) City/State/11P: Each manufactured or modular 67.84 2 dwelling. service and /or tbedcr Phone: ( ) Fax: - ( ) Reconnect only 67,84 2 E -mail: Pump or irrigation circle 61.84 2 1,• I 'll:u'I ;: ;pt'rl ". ;I:y ".pr's' ; ;il' "! ;iwi Ir:l� :+ Sign oroutlinehghtin 67.84 2 "1: : r ,r ': I '( I, ;1, i : i 1: 1'„ S gn fi ';.r:,l''! ;:1i j1 :l,I;1�Ib 111 i 1 liP.i" ' :•i i : li :'i -1,I 152 V?"o I� r I( t I� .::il:r' ' I, jyallS1 F, ;pit S ;i:!�IGSi .�:1 ;,•'iMdU;• ;Ji- i;llll �'' 'A,Irl.(p.�„I ;I,.I..z d .,.',, 1hljlnll:�,i:,: ;i �'fi,I'!e4' ;ttil d F.r'�r, 1.,.,iY• 11 la, 0n �� Signal p al e r limited- or •. Business name: / � � (J� �� energy panel, alteration, o F , —� extension, Describe: Page 2 2 Address: 0 A ar • / c;ty/statc/�f.P: ,1, i�. / //e ' � � a y a Each additional ins r ection over allowable _ in an of the above � d '-7 Per inspection 66.25 n., (503 5 Fax: P 0) # ,3 — /60.3 I estigation per hour (1 hr min) I= 66.25 / ` I plant per hour 78,18 C CB Lic 6 ectricalLic.: Supty. Lic.S / , : .. ! i::l ;� 1. ':!; :.I : '� ' � , r , t i •:;: r. : , �El� � �JR ',iilf!arl ;�11'' ii' tiig5'�.... ;. .. Supty. Electrician signature, required: 0 / Subtotal: Plan review (25 % of permit fee)_ Print name: L Date: r State surcharge revs (12 %ofpermit fee): Authorized signature: TOTAL PERMiT'FEE: � �i )7 This permit application expirrs if a permit Ls not obtninr within 180 Print name: Date: days after it hat been accepted as cumptete. • Number of inspections allowed per permit. t:\ Building \Permits \F.I.C- PttrmitApp.doe into 440 .4615T(11 /051COMIWF.A