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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.