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Permit CITY OF TIGARD ELECTRICAL PERMIT IN � V 3 COMMUNITY DEVELOPMENT Permit#: ELC201500725 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/09/2015 TIGARD Parcel: 25101 BA00101 Jurisdiction: TIGARD Site address: 7500 SW DARTMOUTH ST 110 Project: Joy Teriyaki Subdivision: WEST PORTLAND HEIGHTS Lot: Project Description: (1)200 amp service,(10)branch circuits,(1)sign lighting and(2)low voltage for data&fire alarm. Contractor: PORTER ELECTRIC INC Owner: WAL-MART REAL ESTATE BUSINESS TR 7320 NE ST JOHNS RD BY PROPERTY TAX DEPT STORE 5935-00 VANCOUVER,WA 98665 PO BOX 8050 ATTN MS 0555 BENTONVILLE,AR 72716 PHONE: 360-574-1366 PHONE. FAX: 360-573-3723 FEES Quantity Description Date Amount 1 ea Services or Feeders-200 09/09/2015 $100.70 Specifics: amps or less 10 crt Branch Circuits w/Purchase 09/09/2015 $74.20 Type of Use: COM Service or Feeder Class of Work: ALT 1 ea Sign or Outline Lighting 09/09/2015 $67.84 Type of Const: 2 ea Signal circuit or Limited 09/09/2015 $150.00 Energy Panel Occupancy Grp: 1 ea 12%State Surcharge- 09/09/2015 $47.13 Electrical Total $439.87 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 thC OA 001-Or'•. Yo may obtain a copy of the rules or direct questions to OUNC by calling g.U32.1987 or 1.800.332.2344. Issued By: / 0 i Permittee Signature: �� i �L,--____ 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' : �� 9 `/ 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. Electrical Permit Application. FOR OFFICE USE ONLY IN City of Tigard �ECEiVEL7 C 13125 SW Hall Blvd.,Tigard,OR 97223 DatetBe: S�� Permit#: CLe� 5----60 67 9 2 015 Plan Review Phone: 503.718.2439 Fax: 503.598.1960 S E P Date/B Related Permit#: Inspection Line: 503.639.4175 Ready Date/By: Dui: ® See Page 2 for TIGARD Internet: www.tigard-or.gov CAN OF TIGARD Notified/Method: Supplemental Information TYPE OF PLAN REVIEW ®New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): ❑Service or feeder 400 amps or more ❑Building over three stories. ❑ Demolition ❑Other: where the available fault current ❑Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings. ❑ I-and 2-family dwelling ® Commercial/industrial ❑ Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural amps for all other installations. buildings. ❑ Multi-family ❑ Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived ' ❑Addition of new motor load of system. Job#: Job site address: 7500 SW Dartmouth St. 100HP or ❑ A',°E',°1-2", 1-3", more. City/State/ZIP: Tigard Oregon 97223 ❑Six or more residential units. occupancy. / ❑Health-care facilities. ❑Recreational-vehicle parks. Suite/bldg./apt.#; 4/ /D Project name:Joy Teriyald ❑Hazardous locations. ❑Supply voltage for more than v ❑Service or feeder 600 amps or more 600 volts nominal. Cross street/directions to job site:SW 72' Ave FEE SCHEDULE Description I Qty. I Each I Total I • New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add'l 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential 75.00 2 200 Amp Service/Feeder (with above sq.ft.)Limited energy,multi-family residential(with above ft.) 75.00 2 Circuits and Outlets ( sq. ) ❑ PROPERTY OWNER I ❑ TENANT Renewable Energy ❑ See Page 2 Services or feeders installation,alteration,and/or relocation Name: 200 amps or less X 100.70 100.70 2 Address: 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP: 601 amps to 1,000 amps 301.04 2 Phone:( ) Fax:( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: 401 amps to 599 amps 168.54 2 ❑ APPLICANT 0 CONTACT PERSON Branch circuits—new,alteration,or extension,per panel A.Fee for branch circuits with Business name: above service or feeder fee, 10 7.42 74.20 2 each branch circuit Contact name: B.Fee for branch circuits without Address: service or feeder fee,first 56.18 2 branch circuit City/State/ZIP: Each add'I branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:( ) Fax: :( ) Each manufactured or modular dwelling,service and/or feeder 67.84 2 Email: Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: Porter Electric Inc Sign or outline lighting 1 67.84 67.84 2 Address:7320 Ne ST Johns Rd Signal ler n or limited-energy ® See Page 2 150.00 2 panel,alteration,or extension. City/State/ZIP:Vancouver WA 98665 Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:(360)574-1366 Fax:(360)573-3723 Investigation(1 hr min) 90.00/hr Email: Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lie.: 46678 Electrical Lic.: 37-334C Suprv.Lie.: 2909S specifically listed('/:hr min) n ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: I(,�„re „, 4j ,-7,,,e Subtotal: 392.74 Print name: I/__,,,,,t___-t--If e 1t_L_ Date: ,-7"4 r. - t 5 ❑Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): 47.13 Authorized signature: TOTAL PERMIT FEE: 439.87 This permit application expires if a permit is not obtained within 180 Print name: Date: days after it has been accepted as complete. Number of inspections allowed per permit. 1:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06,17/2015 440-46 15T(I 1,05/COM/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Description 1 Qty. 1 Each 1 Total 1 • Fee for all residential systems combined: $75.00 Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 1 00.70 2 5.01 to 15 kva 133.56 2 ❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: El Burglar Alarm 25.01 to 50 kva 301.04 2 50.01 to 100 kva 552.26 2 ❑ Garage Door Opener* >100 kva(fee in accordance with OAR 918-309-0040) 552.26 2 ❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 ❑ Vacuum Systems* >100 kva—no additional charge 0.0 3 Each additional inspection over allowable in any of the above: ❑ Other: Each additional inspection is 66.25/hr charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed('/hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Subtotal(Enter on Page I): Fee for each commercial system: $75.00 * Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems n Boiler Controls El Clock Systems ® Data Telecommunication Installation ® Fire Alarm Installation El HVAC El Instrumentation n Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* n Protective Signaling ❑ Other: Total number of commercial systems: 2 *No licenses are required. Licenses are required for all other installations I:'Building'\Permits'ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 7500 SW DARTMOUTH ST 110, TIGARD, OR, 97223 Commercial - Electrical 199 Electrical ﬁnal PASS - No C of O ELC2015-00725 Jeff Grove Violation Summary: Inspector Contractor