Permit CITY OF TIGARD ELECTRICAL PERMIT
31111 w.,r� COMMUNITY DEVELOPMENT Permit*: ELC2013-00533
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/10/2013
TIGARD Parcel: 1 S135DD03301
Jurisdiction: Tigard
Site address: 11945 SW PACIFIC HWY 238
Project: Southside Christian Fellowship Subdivision: METZGER ACRE TRACTS Lot: 9
Project Description: (5)branch circuits for new lighting.
Contractor: COHO ELECTRIC INC Owner: COMMERCIAL ENTERPRISES LLC
PO BOX 40 8320 NW HWY 99
WILSONVILLE, OR 97070 VANCOUVER,WA 98665
PHONE: 503-582-9774 PHONE:
FAX: 503-582-9840
FEES
Quantity Description Date Amount
5 crt Branch Circuits wo/Purchase 09/10/2013 $85.86
Specifics: Service or Feeder
1 ea 12%State Surcharge- 09/10/2013 $10.30
Type of Use: Electrical
Class of Work:
Type of Const:
Occupancy Grp:
Total $96.16
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 95 9 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: Permittee Signature: (ice 1/98O"e ./C 61r770/�
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 09 13 02:39p Coho Electric Inc 503-582-9840 p.1
Eleetrilal Permit Agplicatio RECEIVi .__
FOR OFFICE USE ONLY•
City of TigardSEP 9 2013 &ate a f0 J,;;� Permit 14°-.ELCo20/3-DOS33
114 ° 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
6
' .= Phone: 503.639.4171 Fax: 503.598.1 A Date/Bv. Other Permit '" `�/5_66/5T�
Inspection Line: 503.639.4175 L T�. 'tf® Date ReadyBy: lusis: ' ® SeePage2 for
T1G1\l D: Supplemental Information
Internet: www.dgard-or.govUIL®��^DIVISION Noti6etllMethoi
TYPE:OF.WORK PLAN REV1ERt
❑New cor struction 131 Addition/alteration/replacement Please check all that apply(subunit 2 sets of plans wntems checked below):
❑Service or feeder 400 amps CT mare ❑Building over three stories
❑Demolit on ❑Other: where the available fault current ❑Marius and boatyards.
_-C4TEGORY OF iCONSTRVDTION.:•...:i . exceeds 1000 amps at 150 volts or D Floating buildings.•
less to ground,or exceeds 14,000 D Commercial-use agricultural
❑ 1-and 2-family dwelling ,,Commercial/iindustrial ❑Accessory building I amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other. ❑Fire pump. ❑Installation of 75 I:VA or
. ❑Eme•geacy system. larger separately derived system.
-JOB-SITE LNFORMATIO\'AND LOCATION O Addition of new motor load of
• (+ p IOOP.P or more. oxvpmntry.
Job no.: �� i lob site address: >,9�5 : )�a ire L, �+� �e La Six m men residential units. ❑Re ational vehicle parks.
"—��- ❑health-eve facilities ❑Supply voltage for more than
CirylState/ IP: rt q a Q t ❑hazardous locations. 600 volts nominal.
S aite/btdglapt.no.: 7�% I Project name: ❑Service or feeder 600 amps or more.
•/ FEE.SCHEDUI . .7-• .
1./.
Cross stree directions to job site: oeietiptiaa I an•• 1 Fee. I 'total I •
New residential single-or multi-family dwelling unit
• Includes attached garage
Subdivision Lot no.:
1,000 sq.ft.or less ! 165.54 14
I
Ea add'L 500 sq.ft.or portion I 33.92 1
Tax map/parcel no.: Limited energy,residential 6184 2 i
(with above 91 i
I '
DESCRIPTION Oh`Vl'ORLi.... '' - sq.'.
=�-, , 1 - --a Limited energy,multi-family 67.8 4 2
-.X.-51�° '0. C\ .-› \t 8 a1 e� k e‘ 4;"!-r.
residential or fee(with ns installation.)
�") Services or feeders installation,alteration,and/or relocation
: ,?c t_e_ 200 amps or less I 100.70 2 i
. 11 PROPERTY OWNER- • Q It 1,4N-r . „_ 201 amps to 400 amps 133.56 2.
Name: • t ( r 401 amps to 600 amps 200.34 f 2 t
Name: C�.-a"4`1'1°✓t( , �*-1. 3t`aG 'I-e i I 601 amps to 1,000 amps t 301.04 '-
Address: I Over 1,000 amps or volt I 552.26 2
City/StateZIP: Temporary services or feeders installation,alteration,and/or
200 amps or less 59.36 � t
Phone:(Sht )aa'.-- v a3 Fax:( ) I 2
201 amps to 400 amps 125.05
Owner installation:This installation is being made on propery that]own which is not
401
amps to 599 amps 168.54 2
intended f r sale,lease,rent,or exchange,according to ORS 447,449,670,and 701.
Branch circuits-new.alteration.or extension,per panel
Owner si ature: Dale: i A.Fee for branch circuits with i
above service or feeder fee, 2
)] 2,PPtrIC4N?f : : I]:COh"TaCT:PER5QN_ each branch circuit 7.a2
i
I
Business tame: B.Fee for branch circuits �
without service or feeder fee,
Contact names first branch circuit 56.18 5 ��
Each add'l branch circuit I 'i 7.42 Qp b-`,t 2
Address: I Miscellaneous(service or feeder not included) I
City/State/ZIP: . Each manufactured or modular 67.54 2
. dwelling,service and/or feeder
Phone:( 1 ) Fax: :( ) Reconnect only
67.84 7-
E-mail: Pump or irrigation circle 67.84 2
. CONTRACTOR... : ..
Sift or outline lighting I 67.& 3 I
i Signal circuit(s)or limited-
Business ame: t......_.„-.2,--IC; ly, --I - ` ''• ._.. i energy panel,alteration,or
Address:i . extension.Describe: 1 Pare 2 12
1
1 i . i . Each additional inspection over allowable in aor of the above
City/State/ZIP: , , Iv% . 2 �1' :"��° ''.t 7
V I� �'���- •" ��� Per inspection b6s
Phone:( ,t;�) ` t"•"t :-. , i Fax:( } ; t i ice'. �i ci.�`'.to I Investigation per hour('hr min) 1 66 25
• COB Lid - Electrical Lic.: _ p _;.i i Industrial plant per hour 78.18
l; --4'i;=.t•, Su rv.Lic.: ' ' c:.' ::.,
V = y - •ELECTR1:CAL•PERMIT FEES •
Suprv.Electrician signature,required: .'�f.�� i 7,../..-..- --) Subtotal: SS.$SQ
,• Plan review(25%of permit fee):
Print nar�te: 4�llti �'� (DU��1-c,,q.iC.` DEC-' �'�`(1 State surcharge(12%of permit fee): q0.'b
(Th.'•"1 e )x1• TOTAL PERMIT TEL: I r
Atlthori�cdsignature: erJ
I_ ``, y 1 .'- ;t, •, �'�' � This permit application expires if permit is sot obtained within 180
l Print narfte• -`.---t--1.-t',.11...• `4.`•„ I Date: 1 days altar it has boon aces oat as caesislo^•I Number of inspections allowed per permit. / //--
I:\BuileieSFcn i:s5LC•PemitAyp.dae trot:oe :40.1615T(111a51COMAVEB 9C r /to
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11945 SW PACIFIC HWY 238, TIGARD, OR,
97223
Commercial - Electrical
199 Electrical final
2013-11-22 00:00:00
ELC2013-00533
PASS - No C of O
Violation Summary:
Inspector Contractor