Permit n CITY OF TIGARD ELECTRICAL PERMIT
11111 s . COMMUNITY DEVELOPMENT Permit#: ELC2015 00667
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503118.2439 Date Issued: 08/20/2015
Parcel: 2S102BD01601
Jurisdiction: Tigard
Site address: 9855 SW WALNUT PL
Project: United Car Wash Subdivision: FREWING ORCHARD TRACTS Lot: PTS E&
Project Description: Installation of(4)branch circuits for new addition.
Contractor: JM3 ELECTRICAL&CONSTRUCTION LLC Owner: DAVIDSONS TIGARD CAR WASH LLC
10500 SW CLYDESDALE TERR 8915 SW COMMERCIAL ST
BEAVERTON, OR 97008 TIGARD, OR 97223
PHONE: 503-961-3537 PHONE:
FAX: 503-718-7268
FEES
Quantity Description Date Amount
4 crt Branch Circuits wo/Purchase 08/20/2015 $78.44
Specifics: Service or Feeder
1 ea 12%State Surcharge- 08/20/2015 $9.41
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $87.85
Required Items and Reports(Conditions)
This p it is issued su.'- t to the re•ulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be ne in accordance with -••ro d pl. s. This permit will expire if work is not started within 180 days of issuance, or if work is s • .. or more the 180
da . ATTENTION: Oregon la- require, ou to follow the rules adopted by the Oregon Utility Notification Cente • e rules are set forth in OAR
95 -001-0010 throne OAR 952 r01I0 may obtain a c..y of the rules or direct questions to OUNC by calling 503.23 .. • 1 ;••0.332.2344.
Is ed By: 1/
l Permittee Signature: /'�� S
- I
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:
rx''.. CONTRA 6 TOR INSTALLATION ONLY
SIGNATURE OF SUPR.ELEC' Date: CY /
LICENSE NO.
•• .•39.4175 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 Applicatl CE'IVEj FOR OFFICE USE ON 1
City of Tigard Received GMAIM �, 11 / �^
Date/B : 0 Permit S: �f 5-�to 111 tei
111 q 13125 SW Hall Blvd.,Tigard,OR 9��� 0 Plan Review
• Phone: 503.718.2439 Fax: 503.5 .9 a0 2 5 Date/B : Related Permit q:
-
Inspection Line: 503.639.4175 Ready Date/By: Jens: ® See Page 2 for
TIGARD Internet: www.tigard-or.gov CIr%()P' rif;ACH Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
❑New construction $1 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 stones.
❑ Demolition 0 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 0 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
prc /, , ❑Addition of new motor load of system.
Job#: l Job sit address: /6 44f 7/ I00HP or more.Ci /State/ZIP: �' a f/ G ❑Six or more residential units. occupancy.
ty t ��� ❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: I Project name: u IJ(�er) e�,1,{,'I'r 7 ❑Hazardous locations.e0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
Description I Qty. I Each I Total I .
New residential single-or multi-family dwelling unit.
Subdivision: 1 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 I
D CRIPTION OF WORK i ,, ` Limited energy,residential 75.00
,i / (with above sq.ft.)
. A 3 7V Ye' Clef ii-14c 'mu/ a / )ten Limited energy,multi-family 75.00 J
residential(with above sq.ft.)
Renewable Energy _ ❑ See Page 2
❑ PROPERTY OWNER ❑ TENANT Services or feeders installation,alteration,and/or relocation
Name: 200 amps or less 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 30L04 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 1 59.36 i
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 _
Owner signature: Date: 401 amps to 599 amps 168.54 2
❑ APPLICANT 1 ❑ CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: above service or feeder fee,
7.42
each branch circuit
•
Contact name: B.Fee for branch circuits without
Address: service or feeder fee,first / 0, o
branch circuit 56.18 2
City/State/ZIP: Each add]branch circuit /� 7.42 gg,* 2
Miscellaneous(service or feeder not included)
Phone:( ) I Fax: :( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email: Reconnect only 67.84 2
. _. ' 'tt 4.t i.,. � � ' -"` -i-'•• Pump or irrigation circle 67.84 2
Business name: ` ,�j �r—Si or outline lighting 67.84 2
Signal circuit(s)or limited-energy
Address: /0 +f"� .� e f, �P19/ . • panel,alteration,or extension. ❑ See Page 2 2
City/State/ZIP: ��r ��� Each additional inspection over allowable in any of the above
�� Additional inspection(1 hr min) 66.25/hr
Phone: 3 ) 7 Fax:$.03 ) �e — ?26 Investigation(1 hr min) 90.00/hr
Emai1:�M 3e/Lc I/ Lo' M Industrial plant(I whhr ich min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.:P4 28 lectrical Lic.: ` Suprv.Lie.: � l!, specifically listed(Y hr min) ,
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: _, of„........f Subtotal: ' 7 7.4 Y
Print name: i y) _- /7 0 Date:/► 20 / ❑Plan Review Required(25%of permit fee): •----
State surcharge(12%of permit fee): g.yl
Authorized signature:
TOTAL PERMIT FEE: g'7i'S
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.
l:/Building`Permits ELCPermitApp_ELR_ERE.doc Rev 06/17/2015 440.46151(11/05/COMWEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL,yypRK ONL, FEE SCHEDULE
Fee for all residential systems combined: $75.00 ne (.), •i,. E„ch total
y Renewable electrical energy systems:
Check Type of Work Involved: s kva or less 100.70
5.01 to 15 kva 133.56 _
❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 _
Wind generation systems in excess of 25 kva:
1 1 Burglar Alarm 25.01 to 50 kva 301.04
50.01 to 100 kva 552.26 2
n Garage Door Opener* >100 kva(fee in accordance
with OAR 918-309-0040) 552.26
n 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 6625/hr
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifical■ listed(':hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Subtotal(Enter on Page 1):
Fee for each commercial system: $75.00
*
(SEE OAR 918-309-0000) Number of inspections allowed per permit.
Check Type of Work Involved:
❑ Audio and Stereo Systems
n Boiler Controls
1 Clock Systems
Data Telecommunication Installation
U Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
17 Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
1:\Building,Permi ts,ELC_PermitApp_ELR_ERE.doc Rev 06/I 7/2015
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
9855 SW WALNUT PL, TIGARD, OR, 97223
Commercial - Electrical
199 Electrical final
PASS - No C of O
ELC2015-00667
Jeff Grove
Violation Summary:
Inspector Contractor