Permit ' �' i a CITY OF TIGARD ELECTRICAL PERMIT
to V
'` COMMUNITY DEVELOPMENT Permit #: ELC2010 -00184
T [ GAR L7 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 04/20/2010
Parcel: 2S102BD02000
Jurisdiction: Tigard
Site address: 12885 SW PACIFIC HWY
Subdivision: Lot: 0
Project: Texaco
Project Description:
Owner: FEES
COMET CORPORATION Quantity Description Date Amount
BY WSCO PETROLEUM #225, 2929 NW 29TH
PORTLAND, OR 97210 2 crt Branch Circuits 04/20/2010 $63.60
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 04/20/2010 $7.63
Electrical
Contractor:
NORTHWEST PUMP & EQUIPMENT CO
2800 SW 31ST AVE
PORTLAND, OR 97210
PHONE: 503 - 227 -7867
FAX: 503 - 205 -1465
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $71.23
Required Items and Reports (Conditions)
•
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952- 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503. or 1.800.332.2344.
Issued By: Permittee Signature: MT
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
From: 04/20/2010 09:47 #325 P.001 /001
04/20/2018 08:37 5035981 IIECEIVED CITY OF TIGARD PAGE 01/81
Electrical Permit r 2 �t �i ; ;:r .r
�,>�>��3�a�ugAPR :2 0 2010 .� , � ,., �� � � l� -��� � � �� _ `�. �n�
City of Tigard ���/ .'+*� :' CO s� Pawl No.CL. 2 0/0 — 1 / ?
13125 SW lief Blvd., Tigard, OR 9i�9 1 OF TIGARD 3 Phone: 503.6]9.4171 Feel: so].$USING DIVISION . �� P c a r s.: / i .4
•,64 r hllpcc t i l..le: 503.639.4I73 Dole Ra rF J� 5ee1 i
:J 'Fa ,iul Maned tw1'w.tigatdrat.gdv
NaLillodJMtehad / i 9eppfemratal IaTarmmtlma
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❑ New construction 10,Additionieheradalfreplacernein '!tore dal ail that apply Gnaw Zeta eru wears • •
❑ 11E1lt0Ht1om ❑ Qibor' ❑ &Maeor;atter460 tape et more OliMdtng ova ths aedo ck
where the available fault cetmet ❑ Wanly' sad Sanwa
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• ''' .`._ ••: -..'YI " _ _ W. - , o rotat 't4,06 e ct I:Floating • oxaet4l0.OD
"' ' , ' " " b■ t tP�a� or exceed' t4,000 O Cdnmatelaf• ageieolmml
�Q 1- and 2 - family dwelling gl Commercialfmdusdial Q Accessory building 031110 (WA' other iastellatioan. baildiese,
Q Multi family ❑ Master builder Q Mar Onto pomp. 010 ef ?S lcvA er
,1 i " ", • i' ...... • . - ' . c s 4 n . 1�EaacrYerc7 epeoom• ]arpia RWi deo.al worm ■ ❑Addlefoeof new mow lad of 0 "A "."o". "t - r. "1-3".
.rob no.: ( Job site address: 12 9y B S Sw Qa. j 1 y Nano era,rp a, oesacawy.
C �: t ��
f
, Moot now taldentid 1111!6. ❑ RoaeeNOeal wane pana
City/State/73P: ity/5oaorJ7_1P T. �t!`k r ft,, y'7sZ s Olted9+•oa+o te:gtMee. ID !treacly velar tor more than
ID Resent ea lateens. ace volts aomiaat.
SuiteeMdglapt. no.: ! Pro)ect Hama: - Ts+no: t o ❑ Ssvice err seeder 406 stop, or more
Cross street /directio to Job site , .. "''
' tr�eeori� awe f • tae � - �i
ns - 7 ••
Now rtsitlen tn) single. err malts bratty &Ritt g alit,
Inelades stmahed map.
Subdivision: ! Lot 1o 1,900 eq. It or has 16854 4
Tex mnp/pnrcct no.: Ea e ¢�� ]3.93 • i
:. .. . • 'nailed mnfd•iilmt 67 84 3
c am' f' 671 2
__AL ��4.,... C.4sa w., A wilufas w Air, 1--4 reefdmdel fwhh above der. R.) --- -
-,a"., ; • haters Iasi en Wanda tmdJer reload= irto c A _IC tk s a 200. • : less 100.70 2
' , •• •' - 0 • ( : ' .... :' ; •,. ., ',. • a roof aft lump to =amp
t
17356 2
401 ernes to eon elope 200.94 - - 2
601 tops to 1.000 ma _ 301.04 2
Address: Ova 1,000 amps err volts 552.26 2
City/State/ZIP: Teo wary *Mee it orte daehundatioe,.teeratimn,and/or
rdocilion
Phone: ( ) 1 Fat: ( ) 200 amps or las 5936 1 1
Owner installation: this installation Wag tloadc on woody that I ooret which is not tot cra to 40D enRn 135.06 3
s bei
intcadod for sale, lease, rem, or exchange, to ORS 447 449 670 and 701. 401 range to 599 amps 168.54 2
Re, B + 0 line mil eiriaitp tAai4@@' alternih{ar or extension, per nand
Ownr signature: Date A. Fee the bir .. em tadm yea
- - 'r�'•11 'T• mele 7.42 2
13USi'6e95 name: ,,A/ }A s+asi 4 C... .. _ , , ,_ . _ ,, B. Fee rile hands circuits win4aof
aetvide ar fader tae, lint
Contact namc: ptr.: ` 6...—...1,%.4.4.1r breech circuit 56,18 j 2
Addra55: — - Each An brand circuit 7A3 1 1
.?�� oa, W a t er Aim M lard= or hexer not included)
Gity/StaMJZIP: Fall ttatiuthd+med at modeler
�s}r`ews , 0 e. Q 732 t dadlinlctervlce =Nor ftoder 6784 2
Phone: (5 a a ) s" l e i 6 o6 4 , I F a x : : . , ) :e f /y I. S' Rcammmct only 67.64 2
E- Mail:
fi � Faatporitripgl@a 6724 2
r , 1 . _ ,r`1 M an • t:•0_ ► is Il�htie 67.114 2
;,: • ; • �,.: ,:, .r.... ;_ .. Sign or oodles .�..`�. 8i8md oitovit(a) or lintlitdetsagy
Business nettle: r fHne..• k p 4- pmsd, eltamtiaa, at main on. Pager 2 _ 2 ,
Each mtditien,(trspaetlao toe aileerable to osier the awn
Address: e o 0 , . . , .,•, 3 t J a Maim! inapeetfat (1 hr min) 66251 hr
City/State /TIP: Po t .� �n •, . OF., 9 r 7 3 Z 1 r�ewst Batioa (1 In ruin) _ 66.25/hr
t - IndWttielplent(1hrmin) 78.18/hr
Phone: ( /e+}) 5 - tT t. 11'6 I. Fax: ( rot) i m Y f • (• Inweetk is ht. whirls TM tilt is
1, 7 � ,� � -- heed tempo 90.00/hr .. • C CF► iC.: fps 5 b , ;, ► r
Seism. - I ib.: 8� 5 y , +, - w' r v 1 '
Electrician signgtu00. r equited: dr it l '�i • 6o
-'" �_ - -- Plan review (25%a:wil loo),
Print nem ; 'f > „ Date: At !
1 i? Stele sachem (t29iefpemtittee): 7, 6 j
Authorized signature; _ TOTAL PERA7T FEE: '
•!reps permit eppl&saar empires ire permit II brae dpaha' / d wine 060
Print nome: Ne Date: y dyer eaaar it has been accepted a noted.
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