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Permit CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2010 -00095 T[GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/26/2010 Parcel: 1S134BC00300 Jurisdiction: Tigard Site address: 12264 SW SCHOLLS FERRY RD Subdivision: Lot: 0 Project: Snap Fitness Project Description: Install sign /outline lighting for (1) sign. Owner: FEES FW OR- GREENWAY TOWN CENTER LLC Quantity Description Date Amount PO BOX 790830 SAN ANTONIO, TX 78279 1 ea Sign or Outline Lighting 02/26/2010 $67.84 PHONE: 1 ea 12% State Surcharge - 02/26/2010 $8.14 Electrical Contractor: COHO ELECTRIC INC PO BOX 40 WILSONVILLE, OR 97070 PHONE: 503 - 582 -9774 FAX: 503 - 582 -9840 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Total $75.98 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: .0.41 ' .1■ I ' 1 . ►.0 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' ■ •4,' 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. Electrical Permit Applicati n H - V E r 1. •9', X j.,,e, i ti ,t l (ill (.)ly,1G F l"sttp f ?�ti °•Di . , .A.i D 1 4 Lutt-I!t FEB 2 2 010 D . t Permit No.; (' , , , , , bio City o 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review f Tigard Receive ��4 S Otber Permit N 0: Phone: 503,639.4171 Fax: $03.590 b OF 3 ��a�i �i.) I3ate/RY vJ�" I nspection Li11e: 503.639,4175 n f ' r� ` ■�. Date Reedy/By: 1. B See Pace 2 for .1'1. ; c 4 147 tJ ld i L i i ‘a>~l { �" a �? I ( J Notified/Method: 1 `tom Supplements' Information ]ntcrtet: www.tigsad or.gov .. ....___.� -. ..- ."_. .._., ., .._:... ::_, , :.. , .>•-. , -.._ : -. •- - {r{...o.�._'�:.:c.cr_a-' -,. :- . :u- -•:S`^ -urx`7 .Y - ,:.ca a..'Y':; -;r!;: , , - :,x�.z• , t , -_ �•c .c z' r ..ti.G.;M_ . ' : �r .7 : � i ;,F' ;= ;- :-"x,,. -=""a.,°- .,. "._z : t..�; T � -r :,�;r w s ue `''4: re,.� : 4. ,. � % :5 „ . . 4 . E ., $ ,...,. , - -- yam g --,, ^'e; .,..9 ?r.:' =- . -- - F ` . -_ ,,,, 1 , `, , ,o ' .. A Y=;�s^ {o .'«rye' _�. � °. „b,,.:r -1 �! :! ",- tx." .w��._�_«4- �l >,.l :d✓r- ... , S: >.�~w....,...., -,.. -� . 'h � �C�.•; � .v`.a�'.c,:`_c.•�. ..,' "S�w,.,.w. «iEn�`;C�: ❑ New construction t Addition/alteration/replacement Please check all that apply (Submit 2 sets detain w /items checked below): ❑ Service or feeder 400 amps or more ❑ Building over three stories- ❑ Demolition ❑ Other: where the availoble fault current ❑ Marinas and boatyard.. a \7r• as M -. x� tiT: ;= •, sr s7 - :,�,7: ;:a: W rw a '"P"4 t :;' :.,'^ Fi r ∎Ti.. exceeds 10.000 amps at 150 volts or (0 Floating buildings. '& x aX - * 7 13 y I � x �i _ s' ;Ig. x- 4F �� 3 ' ',rf„ rZr , r a aa."A.F,.2:'»%'3 ` .' . . ,_i"s; :,, less to or exceeds 14,000 ❑ commercial-use 1 - and 2- family dwelling t Commercial/industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi-family ❑ Master builder ❑ Other: 0 Fire pump. ❑ Installation of 75 KV A or or more ,,,:.^x. .�. ,,...u:�<x - - - ,. ,......y ^3. . ;.. .,; ' - o "w•:; «c_:rr Y :15t r S ,, 'y^. V,:^ _ system. ., >,- I'"_ ?- �R- -`- -�° � ' . ,,l M ", �, � h Emm'Ber�cY 6yetem largersepstatety st em r¢ .. ✓ .:.� a , ' ; , G - -- - ,5 o- k ❑Addition of stew motor load of D - A", ' E' - 1 - 2 - , "1.3 ", ''��,v.aYV:a �� '�'�,�;:a"- �%e.�:Y'��,1+'h� ax �:,°;? � "";���;��,�- `ar.�'.rti.<� ., . ! . a..ou .- ,\ \L �� I Job site address: 1 aQ b 100HP or a re s. Recreation. Job no.: � y ` 0 sue e residential units. ❑ r vehicle parks. City/State/ZIP: �� �� • ❑ Health -care 48Cilities. I:1 Supply voltage for more than �� - - 1 +, 0 Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more . ate' tij� SAYP = Lt44,', ;^, - ^: e rr, - --a: y;. r ,; ,v. . 1 ? v ' :.,4k.�.F'G . ':.a' ,r.. .:.:.3*.at:� = ::: . ✓��'1�_;ivl;��!.Tft'`,. g Cross street/directions to job site: nescti• �ila0 New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less - 168.54 IIIIIII 4 ,r Ea. add'I 500 sq. B. or .. ion MI 33.92 1 Tax ntap/parccl no.: Limited energy, residential xq,, - v1,,- , -•r 1 aS, APee,^ =::: ".4rt:: 7,4- ; - 31 _ - 'r-.'_: `i' y.P ���'. kmiE ter:: v.-.=.',$.es7• e 4 "* - L above . ft. 67.$4 2 fi t - r st r ',, '"� `�'� L L --23.n^,k:.', .- : -4,W;t <, _G r, ?1 -7"- . ,Qr: with abo ■ }..z , �r �ti�r. *..� -. c� e Limited energy. multi - family in �� i t P i . � v t 1 1 i 1 n c�,�c 1 ' • , t 3 Y m residential (with above s. , ft. Services or feeders installation. alteration, and/or relocation 200 am • s or less 1111 100.70 11111111© r„1 -..R. •�`: ; `2:,: y c__ --. .'7,: n-- *•gz.<•:ie-'..::21::.:tiTx _ lr ; ? ." 4 . c .F.;;,- si , c -a. ,;;; c: : `§. ;:z ::•: --.!; .v .rz` ; .. 4 d { & A? a L , Y : 201 amps to 400: 's 1111 133.56 � -.?. - ..•. «..,., r . 1YiTCS /._b� !j.."aa -'`e.. ...:..'`_ >__c+v��e_x� ', t .:tia -, , ,SY..",':r 401 amps m 600 amps 200,34 111111111113 foe �`e- �p - Y►�a � _ - 1 - Q.... 1- % C.. 601 amps to 1,000 amps _ 301.04 -MI Address: 'J' - a . Ra a Over 1,000 amps or volts 552.26 2 City/State/ZIP: b • p Temporary services or feeders mstallahon, alteration, and/or .� relocation _ Phone: (...6A3) �C;3 "'"4-11,(. Fax: ( ) 200 amps or less 59.36 201 amps to 400 amps 123.0 111111.B Owner installation: This installation is being made on property that 1 own which is not II intended for sale. lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps Ell 168.54 111111M1© B , , .: - .T...• ;lt. : 1 1 • ,' II, tua Owner signature Date A. Fee ter branch circuits with �s`'7'. ' y"cr ay ,Wr p?:7 , •i ;, ; )F^r?K f'�- Zi,:t�rn Y ,,�.1.,. '4 '.i.� + .,�' 1 9 ti Fh b ;� : ,r r '+ , cx` c^:�� , � r M r u..4 - ; above service or feeder fee, 7.42 2 each branch circuit Business name: B. Pee for branch circuits . Contact name: fir without ranch ciirrcu or t feeder fee, 56.18 2 Address: Each add'1 branch circuit 11111 7.42 2 . Miscellaneous (service or feeder not included City/State /ZIP: Each manufactured or modular I 67.84 -© dwell • service and/or feeder Phone: ( ) ltax:: ( ) Reconnect only 67.84 i 2 E Pun • or irrigation circle 67.84 � -r1 d .M.c : . .i ' ':: 5 -' r. c . 7, i ' :' i MN"�,'. r � Sign or outlinc lighting gm 67.84 Wit] 2 Signal circutt(s) or ,3- c �'t� J� frxv5u � 1!..,a •r.. 3 " � -` "�'S ,K � 5 9'-�;� ..Y ,wK..✓A >_,._ � ✓� „�✓s.',:acl',. Business name: limited- m t _ 1e_ • ' c_. i Z ' 5 1�. . energy panel. alteration or Address: R ©x LA extension. Describe: Page 2 2 City/State/ZIP: kz ' C R 'S 1 c "I i� Each additional ins { • etion over allowable in a , of the above v. \ V t �� ' Per inspe,ction 66.25 Phone: (s) 5Q, „' 4 i Fax: ( ) SPA- .. gV4 U Investigation per hour (1 hr mio) 111.1 66.25 -- CCB Lic.: 1 S 1, LC‘ Electrical Lic.: - 75 Suprv. Lic.: _ S Industrial plant per hour 78.18 1. ;?tom ? p:. ., .:::;,•..- ,.. ltoill �. L �a� Suprv. Electrician signature, required: / y � Subtotal • 4g Oir Print name: l r tA. ,{ d i U r l r , e f Date. ��' 4ti Plan review (25 % permit fee): tr. State surcharge (12% of permit fee): %• ak Authorized signature: ~ % 1lk ��1 TOTAL PERMIT FEE: - 1 , q !! This permit application expires if a permit is not obtained within 180 Print name: ....1 1,0 l 1 Date: .. - , i4...� Jaya after it has ken accepted as complete. • Ntunbor of inspections allowed per permit t^� O 1: 16uitdittalPermits\ELC- PermMpp.doc 10/01 /09 440.4615T(11 /a5 /COMIWEB / �, 1 1 l5.9