Permit
r
CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit ft: ELC2009-00583
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/30/2009
Parcel: 1 S 1260000300
Jurisdiction: TIGARD
Site address: 9751 SW WASHINGTON SQUARE DR D01
Subdivision: Lot: 0
Project: Signature Day Spa
Project Description: (3) branch circuits for chairs. (Previous permit already finaled)
Owner: FEES
PPR WASHINGTON SQUARE LLC Quantity Description Date Amount
BY THOMPSON PROPERTY TAX SERVUCES,
2235 FARADAY AVE STE #O 3 crt Branch Circuits 10/30/2009 $71.02
wo/Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 10/30/2009 $8.52
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 $79.54
Required Items and Reports (Conditions)
This prNPON: u ct to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be donwith app ?ved 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. egon law e ' s ou to follow the rules adopted by th e Oregon Utility Notification Center. Those rules are set forth in OAR
952-00R 952001 00. Yo y btain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issu Permittee Signature:
111~~ 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 INSTA LATION 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.
Electrical Permit Application FOR OFFICE
USE ONLY
CI of Tigard Received 9
Date/By: .,7 Q Permit No.: ~'LC/ O D
° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date/B : Other Permit:
Inspection Line: 503.639.4175 Date Ready/By: lur1 ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental information
i % III' OF NN Okh PLAN REV[E.ti
❑ New construction Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w/items checked below):
El Service or feeder 400 amps or more El Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
l 7 IT16010 OF CnNSTRIA I JO-, exceeds 10,000 atbps 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: I ❑ Fire pump.. ❑ Installation of 75 KVA or
1013 tiI1E IN G0109aT[r)N :NA' D L[ rt 1110\ ❑ Emergency system. larger separately derived system.
El Addition.of new motor load of El "A", "E","I-2", "1
OOHP or
.lob no.: 66741 lob site address: 9751 SW WASHINGTON SQUARE I x or o more. occupancy.
RI 1 ❑ 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.
rLL SC%IEDULL
Cross street/directions to job site: Description rv. Fee.- Tooil
New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft or less 168.54 4
Ea. add'I 500 sq. ft. or portion 33.92 1
Tax map/parcel no_ _ Limited energy, residential 2
67.84
DESCRIPTIO\ OF WORK (with above sq. ft.)
- Limited energy, multi-family 67.84 2
ADD 3 CIRCUITS FOR CHAIRS residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
❑ PR01'1_R'CY OWNER ❑ CLti;~i1"f 201 amps to 400 amps 133.56. 2
Name: 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 1
Owner installation- This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale. lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
A. Fee for branch circuits ivith
❑ Al't'L14 ,,kAT ❑ (O\T;vl 1 PI:RSO` above service or feeder fee, 7.42 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, 1 56.18 56.18 2
first branch circuit
Address: Each add'l branch circuit 2 7.42 2
Miscellaneous (service or feeder not included
City/State/Z]P: Each manufactured or modular
dwelling, service and/or feeder 67.84 2
Phone:( ) Fax::( }
Reconnect only 67.84 2
E-mail: Pump or irrigation circle 67.84 2
( X ''T"' Li OR I Sign or outline lighting 67.84 2
Business name: FgAYII ER ELECTgIC COMPANY Signal energy circuit(s) or limited-
energy 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
Phone: ( Fax: ( Per inspection 66.25
503) 639-4627 503)639-4673 Investigation per hour (lhrmin) 66.25
CCB Lie.: 37410 Electrical Loc.: 34-13 Suprv. Lic.: 5110S Industrial plant per hour 78.18
EI,ECTIt~CALPERMIT "FEES
Suprv. Electrician signature, required: Subtotal: 71.02
Plan review (25% of permit fee):
Print name: ADAM ETHERINGTON Date: 10 29/09 State surcharge (12% of permit fee): 8.52
Authorized signature: TOTAL PERMIT FEE: 79.54
Print name: Date: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:Building\Permits\ELC-PermitApp.doc 10/01/09 440-4615T(II/09COMMEB