Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2009 -00316
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503 639 4171 Date Issued: 06/24/2009
Parcel: 1 S 1260000300
Jurisdiction: TIGARD
Site address: 9751 SW WASHINGTON SQUARE DR D01
Subdivision: Lot: 0
Project: Signature Day Spa
Project Description: 20 branch circuits
Owner: FEES
PPR WASHINGTON SQUARE LLC Quantity Description Date Amount
BY THOMPSON PROPERTY TAX SERVUCES,
2235 FARADAY AVE STE #0 20 crt Branch Circuits 06/24/2009 $173.20
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 06/24/2009 $20.78
Electrical
Contractor:
FRAHLER ELECTRIC CO
11860 SW GREENBURG RD
TIGARD, OR 97223
PHONE: 503 - 639 -4627
FAX: 503 - 639 -4673
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $193.98
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 OA 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: Qni
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.
‘411 1 1 1 1 e r ttrical Permit Applic RECEIVE I FOR OFFICE. USE ONLY
/
City of Tigard Received Q, Permit No
Date/By
III n 131 Hall Blvd, Tigard, OR 97223 JUN 2 3 2009 Plan Review p wZo 'L
Phone: 503.639.4171 Fax: 503.598.196 lb Other Pemut
T l G , R D Inspection Line: 503.639.4175 C ITY OF TIGARD Dale Ready/By rams El See Page 2 for
Internet: www.tigard- or.gov BUILDING DIVISION Notified/Method Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ® Addition /alteration/replacement Please check all that apply (submit 2 sets of plans w /Items checked below)
❑ Service or feeder 400 amps or more ❑ Building over three stones.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building amps for all other installations buildings
❑ Multi -family ❑ Master builder ❑ Other: ❑ Fire pump ❑ Installation of 75 KVA or
❑ Emergency system larger separately derived system.
JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A ", "E ", "I -2 ", "1 -3 ",
Job no.: 66741 Job site address: 9751 SW WASHINGTON SQUARE RD. IOOHP or more occupancy
❑ Six or more residential units. ❑ Recreational vehicle parks
City / State/ZIP: TIGARD, OR 97223 ❑ Health -care facilities ❑ Supply voltage for more than
❑ Hazardous locations 600 volts nominal
Suite/bldg. /apt. no.: Project name: SIGNATURE DAY SPA ❑ Service or feeder 600 amps or more
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total I •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map/parcel no.: Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq ft )
TENANT IMPROVEMENT Limited energy, multi-family 75.00 2
residential (with above sq. ft )
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City /State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, 1 46 85 46.85 2
first branch circuit
Address: Each add'l branch circuit 19 6.65 126.35 2
Miscellaneous (service or feeder not Included)
City / State/ZIP: Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Signal circuit(s) or limited -
energy panel
Business name: FRAH LER ELECTRIC COMPANY panel, alteration, or
Address: 11860 SW GREENBURG ROAD extension. Describe: Page 2 2
City/State/ZIP: TIGARD, OR 97223 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (503) 639-4627 Fax: (503) 4673 Investigation per hour (I hr mm) 62.50
CCB Lic.: 37410 Electrical Lic.: 34 -13C / i / /- Suprv. Lic.: 1816S
i c Industrial plant per hour 73.75
� ELECTRICAL PERMIT FEES
Suprv. Electr s g ° natttre, riled: ���� i v / 0 Subtotal: 173.20
Print name: R . W. FRAHLER Date: 06/22/09 Plan review (25% of permit fee):
State surcharge (12% of permit fee): 20.78
Authorized signature: TOTAL PERMIT FEE: 193.98
Print name: Date: This permit application expires If a permit is not obtained within 180
days after it has been accepted as complete.