Permit (203) CITY OF TIGARD � � ELECTRICAL PERMIT
: •• COMMUNITY DEVELOPMENT N alb Permit#: ELC2018-00444
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439' Date Issued: 07/02/2018
T t C AIM i7 g r Parcel: 1S136AD04300� { Jurisdiction: Tigard
T 4u,� i
Site address: 11477 SW PACIFIC HWY ' !.1L i. `., N
Project: Bannings Restaurant Subdivision: VILLA RIDGE Lot: 2
Project Description: Provide new wiring to install(2)type 1 kitchen hoods for TI.
Contractor: DELSTAR ELECTRIC INC Owner: WESTSIDE INVESTMENT GROUP LLC
PO BOX 1371 PO BOX 2166
TUALATIN, OR 97062 LAKE OSWEGO, OR 97035
PHONE: 503-684-8848 PHONE:
FAX: 503-684-8312
FEES
Quantity Description Date Amount
1 ea Limited Energy 07/02/2018 $75.00
Specifics:
1 ea Temp Services or Feeders- 07/02/2018 $59.36
200 amps or less
Type of Use: COM 7 crt Branch Circuits w/Purchase 07/02/2018 $51.94
Class of Work: ALT Service or Feeder
Type of Const: 1 ea 12%State Surcharge- 07/02/2018 $22.36
Electrical
Occupancy Grp:
Total $208.66
Required Items and Reports(Conditions)
i
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other ap•icab- law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days •• issuance, or if work is sus.end:d for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility No '•n Cent,r. Thos: rules ars set forth in OAR
' • 1 :10.3 2.2344. A,.
952-001-0010 through OAR -.-001-0090. You y q y g
Issued By: //`.. _ la
,/tam �r Permittee Signa . �n ��5� � i '
- r Nt
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 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: I. ONI.v
City of Tigard ReceivedDateB : / Permit#: . _ 4,
w 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review '/
S Phone: 503.718.2439 Fax: 503.598.1960 DateB : Related Permit#: rj —
Inspection Line: 503.639.4175 Ready Date/By: Jutis: El See Page 2 for
l 1 h A R D Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
0 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.
❑Demolition 0 Other:
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
❑ 1-and 2-family dwelling E Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
AddJob#: Job site address: 11477SW Pacific Hwy 100H❑10011 tion of new motor load of system.
P or more. ❑"A" "E" "1-2>,«1-3"
City/State/ZIP:Tigard,Oregon 97223 ❑Six or more residential units. occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Banning's Restaurant 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: FEE SCHEDULE
Description 1 Qty. I Each ( 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
(with above sq.ft.) 75.00 2
Provide new wiring required to install(2)Type 1 kitchen hoods
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
0 PROPERTY OWNER 0 TENANT Renewable Energy 0 See Page 2
Services or feeders installation,alteration,and/or relocation
Name: 200 amps or less l 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: 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, 7
7A2 51.80 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'l 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:Delstar Electric,Inc Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy 4 See Page 2 75.00 2
Address:P.O.Box 1371 panel,alteration,or extension.
City/State/ZIP:Tualatin,Oregon 97062 Each additional inspection over allowable in any of the above
Additional inspection(I hr min) 66.25/hr
Phone:(530)684-8848 Fax:(503)64 -8312 Investigation(1 hr min) 90.00/hr .
Email:randy@delstarelectric.com Industrial plant(]hr min) 78.18/hr
Inspections for which no fee is 90.00f hr
CCB Lic.: 63667 e.(/,s/j,0 Electrica 4 \,, .u,rv. • • 1.457 b ii—,0 specifically listed(%hr min)
�r! ELECTRICAL PERMIT'FEES
Suprv.Electrician signature,require.: -k py. r/ Subtotal: 227.50
Print name: Randy McAlister ;' Date: 7/2/2018 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): 27.30
Authorized signature: TOTAL PERMIT FEE: 254.80
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: EEE SCHEDULE
Fee for all residential systems combined: $75.00 Re`newaewa° c I Qty. I Each I Total
electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01to15kva 1.33.56 2
El Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
El G• arage Door Opener* >100 kva(fee in accordance
with OAR 918-309-0040) 552.26 2
El H• eating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System*
Each additional kva over 25 7.42 3
E 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 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed(1/2 hr min_
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Subtotal(Enter on Page 1):
Fee for each commercial system: $75.00
* Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
El Audio and Stereo Systems
El Boiler Controls
El Clock Systems
❑ Data Telecommunication Installation.
El Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ L• andscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
El P• rotective Signaling
® Other: Kitchen Hood VFD Control.
Total number of commercial systems: 1
*No licenses are required. Licenses are required for all
other installations
IABuilding\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
11477 SW PACIFIC HWY, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Electrical ELC2018-00444
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor