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Permit (289) 1111 CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit#: ELC2017-00490 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/29/2017 Parcel: 2S 115 BA02500 Jurisdiction: Tigard Site address: 16200 SW PACIFIC HWY W1 Project: Dirty Dog Day Spa Subdivision: 2004-015 PARTITION PLAT Lot: 1 Project Description: (1)200 amp service and(8)branch circuits for TI. Contractor: ADVANCED WIRING SERVICES INC Owner: SN PROPERTIES PARTNERSHIP PO BOX 644 1121 SW SALMON ST CLACKAMAS, OR 97015 PORTLAND, OR 97205 PHONE: 503-310-3655 PHONE: FAX: 503-698-6372 FEES Quantity Description Date Amount 1 ea Services or Feeders-200 06/29/2017 $100.70 Specifics: amps or less 8 crt Branch Circuits w/Purchase 06/29/2017 $59.36 Type of Use: COM Service or Feeder Class of Work: ALT 1 ea 12%State Surcharge- 06/29/2017 $19.21 Electrical Type of Const: Occupancy Grp: Total $179.27 Required Items and Reports(Conditions) This permit is issjlpcLlubject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done i ccordance wi 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. A ENTION: Oregon req res you to follow the rules adopted by the Oregon Utility Notification Center. Thos= rules are =et forth in OAR 952-001 0010 through OAR 950.1-0090may obtain a copy of the rules or direct questions to OUNC by calling 503.232.19:j /•I 32.,234;# 61 Issu By: _ _• �� y / 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' 1/1111111111/ -I 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 ApplicaticRECEIVED ro►z oil lcl: l si: Oy►.v City of Tigard Received 7 Date/B : 1�� 13125 SW Hall Blvd.,Tigard,OR 97223 ZEIMINEMBIMI Plan Review III Phone: 503.718.2439 Fax: 503.598.19.x01 N 2 9 2017 Date/B : Related Permit#: A_ u a r Inspection Line: 503.639.4175 Ready Date/By: H See Page 2 for I I G A R D Internet: www.tigard-or.gov CITY OF TI law Cy) Notified/Method: liM1111 Supplemental Information TYPE iDd11t G DIVISION PLAN REVIEW ❑New construction ®Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): 0 Service or feeder 400 amps or more 0 Building over three stories. 0 Demolition 0 Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. ❑ 1-and 2-family dwelling ®Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. 0 Multi-family ❑Master builder ❑Other: 0 Fireum . p p 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived AddJob#: 7.617-4 0 Job site address: /G ZOO go wife /7 t,/, ❑100HP ion of new motor load of system. or more. ❑"A","E","1-2","1-3", City/State/ZIP: — A o/2 , 0 Six or more residential units. occupancy. / 0 Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Gt)! Project name: bier( bei 0 Hazardous locations. 0 Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: nr Tl�r-�i 1) /G1�I/� „S(�G�/1�G FEE SCHEDULE. Description 1 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 Alai) (with above sq.ft.) N 75.00 2 ToO� �/Lg Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Renewable Energy 0 See Page 2 0 PROPERTY OWNER 0 TENANT` Services or feeders installation,alteration,and/or relocation Name: 200 amps or less t 1 100.70 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: Date: 401 amps to 599 amps 168.54 2 0 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, S 7.42 2 each branch circuit Contact name: B.Fee for branch circuits without service or feeder fee,first Address: branch circuit 56.18 2 City/State/ZIP: Each add'1 branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:( ) Fax: :( ) Each manufactured or modular 67.84 2 dwelling,service and/or feeder Email: Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: Athisica, ij/etNG- bZ(hct', 4/6... Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy Address: Pa 1 wi 144 panel,alteration,or extension. 0 See Page 2 2 City/State/ZIP: Cl 47�Q Q�. ??0/.5 Additional additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:( 54) 31D . 3655 Fax:(S.0 ) &29 , (.9*/q Investigation(1 hr min) 90.00/hr Email: AW s t3 re, b ea-4,3Z® oka II. certY) 1 ! Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is CCB Lic.: ih25 cl 1 Electrical Lic.: 67 S prv.Lic.: 4b75 c, specifically listed(%hr min) 90.00/hr ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: _ Subtotal: Print name: ^j L.. 0T.,01,11-csN Date: b l 29 /(.7 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): Authorized signature: TOTAL PERMIT FEE: /7 9'. a l 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. I:\Building\Permits\ELC_PermitApp_ELR ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SC I.LE Description I Qty. I Each I Total ..S+i *. Fee for all residential systems combined: $75.00 Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 2 5.01 to 15 kva 133.56 2 El 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: n Other: Each additional inspection is 66.25/hr 1 charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed(/2 hr min) U11 t'RCIAL WogIc©NL;Y. EljECTRildid PERMIT FEES Fee for each commercial system: $75.00 per l SubtotaEnteron Page 1): 3' * Number of inspections allowed pepermit. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls El Clock Systems n D• ata Telecommunication Installation ❑ F• ire Alarm Installation El HVAC ❑ Instrumentation ❑ Intercom and Paging Systems El Landscape Irrigation Control* El Medical ❑ N• urse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations L\Building\Permits\ELC_PermitApp_ELR_ERE.doe Rev 06/17/2015