Permit . CITY. Of TIGARD. ELECTRICAL PERMIT
„ ii .',.p..:,,,,:..,• COMMUNITY DEVELOPMENT Permit #: ELC2010 -00034
T j CARD 13125 SW Hall Blvd., Tigard OR.97223 503.639.4171 Date Issued: 01/21/2010
Parcel: 1 S 134BC00300
Jurisdiction: Tigard
Site address: 12264 SW SCHOLLS FERRY RD
Subdivision: Lot: 0
Project: Snap Fitness
Project Description: (10) branch.circuits for TI. .
Owner: FEES
FW OR - GREENWAY TOWN CENTER LLC Quantity Description Date Amount
PO BOX 790830
SAN ANTONIO, TX 78279 10 crt Branch Circuits 01/21/2010 $122.96
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 01/21/2010 $14.76
Electrical
Contractor:
COHO ELECTRIC INC
PO BOX 40 _
WILSONVILLE, OR 97070
PHONE: 503 - 582 -9774
FAX: 503 - 582 -9840
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $137.72
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. ATTE. a : -gon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -001 -r 10 through OAR 952 • • -01 r r. You may obtain a copy of the rules or direct questions to OUNC by callipg.603:246.6699 or 1.800.332. 344. •
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Issue By: . i . ..d /At A _il Permittee Signatur ro 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' ai iiim ik. .40 - /- Date:
/ r
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 the job site until, completion of the project.
, Approved plans are required on the job site at the time of each inspection.
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Electrical Permit A�D11CatiQ�1 RECEIVE
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a .. - �'`Q ��p Permit No � tJ - U
ry ��c .13125 SW Ball Blvd., Tigard,.OR,,972?3 1 �d� Piau'1Lsviery
i.., _' 1 b 1 A H � i# y - � r N . =Phone: 503 :639.4171 Fax: • 503.598.1960 `' A 2 D Other Permit:
' I Ins tort Line: 503 639 4175 el See Page 2 for, ' Ih+te heady/
tt' �!t ? ternet www.timd-or.gov ` C1TY l g OF'TIGA , _ �otl •
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app reformatld
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0 New COnSIIUCtion ;: Additioi /al• ation/rep1acement Please cheek • all that ape Y (. 2 seta o plans w/items oh elied below) :, ,
[1 Sernee or'feeder 400 mmpp of more 0 Building over three stories,
Demolition . ❑ Other available fault urrent. Marinas sod boatyards. .
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.F.," :;;'w "'�'„ ^t5d( ,�• ° v .sw , ., r M= G4 4 y r ` ( : =tads 14,000 amps at 150 Volta Or 0 Floatalg.buildings, •
y"', w 4 , �! n . ,, . '., , , ..... , . .,,. ,w.,,k.a.cm � ! trrotmd,'or wicoodd 14 ,000_ ❑ Coraancscaal -uao eglCnhills!
0 1- and 2- family dwelling O. ,Commercial/industrial Q Accessory building amps far all other installations: buildMge. KvA or
0 Multi family x ❑ Master builder 0 Other t $m¢r systenh. 0 install separately or7 " systetu.
r ` t ti 0 Addivan of now motor toad of "-$" 1 - ".
Job no.: t y � ( 3ob'site address, 1 _ . �'� c j 11 ' p 2001„ .„mare. �ch
Six or mote risideanal ittiits_ 0 Reoteation2l vehicle Packs,
City/State/ZIP: '�'' tY
ll Health -eore &taities. Supply voltage for, more than
1,, . 600 wilts nominal. "
� " o b� � 1 • ❑ Ii3xardous locations.
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Suite/bldg./apt no.: Project nalne: 9 y- 4. F p Service or feeder 600 amps or more
Cross street/direcfions to job site: :: a '1, ®
New residential single- or multi - fatuity dwelling unit
Incliide:i attached garage.
Subdivision:
Lot no.: 1,000 sq. R or less 168.54 4
Ea. add') 500 sq. ft. or portion 33.92 1
Tax map /parcel:no Limited energy, residential 67
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t i' r ^', N I{ f r _. o� r �V i. F ":a , r^ with ab6ve'A .13:
'" T u �,� "a �..tiwndrs:ckttn✓,lrvr,u,,,,, ,.�, �..r:w. .!k.,.e: , „,+ .'�� ay � 1 -)'
Limited energy, multi- family 67.34 III
y •a residential with above R,
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$crwecbs or feeders installation, alteration and/or relocation
Ill' 200 amps or less 100.70 2
a v, . s " ,'.' ` `' M ` . ` a ' M 2 01 mps to 400 aiups. 133 - 56 �
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4-01 amps to 600 amps 200.34 2
~ I. ' _ - Over l 000 amps amps 30104 2
Address: « c. I
ps or volts 552 26 2
city/state/zip: q Q, C — +i, Tcmpotr n ryrserviw or feeders installation, idles/ Won, and/or
_ � � relocailon
Ptlone: ( ) 07 y 96 %( F ax: ( ) 200 amps or less _ 59.36 111111111111111 () wrier rnstalI$tton; This installation i being made pm property that I own which 201 amps to 400 amps ss not 401 amps W 599 amps E 168: 125.08 54 �
intended for sale, lease, rent, or'exchamgc, according to ORS 447, 449, 670, and 701.
, alters n or extension,
A. for branch circuits
�,,, a n , r7 t x r y D '', a .. _ a s ervi ce or fewer with'
f ee, tt
0 o ez on, per palm
Owner signattlrc Pco
•::..: „, e- "• .C; :; .,. ' x ^�"%; ",:,.. : `. , ti ,.. m�" „ 5� ? era: ':,; ; , .,;.�:......:_e3.; a,,. , , . , . _ .. _. nz. •.; . 7A2 2
_, each ianch CirCtrit
Business ttame B. Fee for branch circuits
without " service or fbeder Yee,
Contact name: first branch circuit i 56.18 Sb . le,, 2
Address: Each add'l branch circuit gatmerliMiel
t►4iseellaneous (service of feeder not included)
City /State/Z1;P: Each niariufactured or modular ' 67,84 2
dwell' : service and/or feeder
Phone: ( ) Recon only 67 -84 Es
Pum or i ' : l . on circle 67,84
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,,,. . , - � Sign or.otrtIme I�tr.
x � ' $i 67:84 2
Signal CirCitit(s) or limited
Business name: 0 B 414 th, e.. energy panel, alteration, or
Address: S 7qa extension. Descrt Page 2 2 cl,
City/StaIe/ZIP: r -' b�vt 1 L Ck 1 Q1 A. Ea �� al hnSpeetlon over allowable an of the a b o v e
a Phone: ''.•-1- ) 5Q C'1 . 7 7 C.1 Fax: ( ) 5 .� cZ t. "." lnvcatigetion per hour (t hr mm) 66 -25
CCB Lic.: 1 '"1 t IC.q Ere al Li c.: .� . _ '15 Sup rv. Lic.: �4
ctac Lic Indlrstrlttl pltmE er hour 7818
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NE 5tlprv, Electrician signature, required: _ W.,.. . \% , (o
Print name: ' • Date Plan review (25% of permit fee):
i ) t 1 C as 1� _ t �\ F l l r ° � Std surcharge (12% of permit fc ):
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Authorized Signatu � _ . 'TOTAL, PERMIT FEE: 1 - 1 ,7cA
' permit apniitatioo expires if a permit is not obtained within 140
Print mater l Date: I— - ,,. ,K days after it has been accepted as ebmpiete.
* Number of iuspoed0119. allowed per permit -
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