Permit (242) CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2018-00032
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/16/2018
tCa1i8'L) g Parcel: 251026D01601
Jurisdiction: Tigard
Site address: 9855 SW WALNUT PL
Project: DAVIDSONS TIGARD CAR WASH Subdivision: FREWING ORCHARD TRACTS Lot: PTS E&
Project Description: Adding(2)branch circuits for lighting and outlet.
Contractor: A&A ELECTRICAL CONTRACTORS INC Owner: DAVIDSONS TIGARD CAR WASH LLC
1588 SKY TERRACE 8915 SW COMMERCIAL ST
SALEM, OR 97306 TIGARD, OR 97223
PHONE: 503-949-3193 PHONE:
FAX: 503-378-9085
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo/Purchase 01/16/2018 $63.60
Specifics: Service or Feeder
1 ea 12%State Surcharge- 01/16/2018 $7.63
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $71.23
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 aw requires y•u to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR %-00)>�• O. Yoay obtain a co- of the rules or direct questions to OUNC by calling 503.232,1•• t. (:00.332.2344.
Issued By: .(� /' Permittee Signature: _ 1.
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 r 1r�
- - 4.4.E
FOR OFFI( ►, l:S►:O\►.l
City of Tigard Received
I Ill 13125 SW Hall Blvd.,Tigard,OR 9722V\N 16 2018 Date/B : 1 ,
' _ Phone: 503.718.2439 Fax: 503.598.1960 Plan Review _
Related Permit#: ' /.
Inspection Line: 503.639.4175 I (" u/`� //3
T 1 G n K D .. 151. 2'3:;, Ready Date/By: kris: H See Page 2 for
Internet: www.tigard-or.govNotified/Method:
,{{�� Supplemental Information
TYPE § O ? I i d I Si if t'
PLAN REVIEW
❑New construction 0 Addition/alteration/replacement Please check all that apply pp y(submit 2 sets of plans w/items checked):
0 Demolition ❑Other: 0 Service or feeder 400 amps or more 0 Building over three stories.
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 .tfrt ommercial/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
Job#: I Job site address: 0 Addition of new motor load of system.
. S sit)l Ulu,(,..,„ 4 V I' 100HP or more. ❑..A» .<E» ..1 2»..1 3„
Clty/State/ZIP: �--/n _ 1� ��
❑Six or more residential units. occupancy.
1 vt,i v�
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: I Project name: 0 Hazardous locations. 0 Supply voltage for more than
Cross street/directions to job site:
❑Service or feeder 600 amps or more. 600 volts nominal.
`l FEE SCHEDULE
f� �' t �.tt i l/ '1 ' A. Lig)
Description I Qty. Each I Total 1 *
Gjl/ I KKK+++-X� f r J I. New residential single-or multi-family dwelling unit.
Subdivision: I Lot#: Includes attached garage.
Tax map/parcel#: 1,000 sq.11.or less 168.54 4
DESCRIPTION OF WORK Ea. sq.ft.or portion 33.92 1
Limitedited energy,residential
2. C i 4..4 (;)IA c t. c.)-yue (J ILLA (with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00
residential(with above sq.ft.) 2
Renewable Energy 0See Page 2
0 PROPERTY OWNER I 0 TENANT
Name: Services or feeders installation,alteration,and/or relocation
200 amps or less 100.70 2
Address: 201 amps to 400 amps 133.56 2
City/State/ZIP: 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Phone:( ) I Fax:
( ) Over 1,000 amps or volts 552.26 2
Email: Temporary services or feeders installation,alteration,and/or
Owner installation:This installation is being on property that I own which is not made2000 amps
a pon
mps 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
PLICANTNTACT PERSON Branch circuits—new,alteration,or extension,per panel
Business name: A.Fee for branch circuits with
above service or feeder fee,
Contact name: each branch circuit 7.42 2
B.Fee for branch circuits without
Address: service or feeder fee,first /
branch circuit ! 56.18 2
City/State/ZIP: Each add'l branch circuit f 7.42 2
Phone:( ) I Fax: :( ) Miscellaneous(service or feeder not included)
Each manufactured or modular
Email: dwelling,service and/or feeder 67.84 2
Reconnect only 67.84 2
CONTRACTOR
Pump or irrigation circle 67.84 2
Business name: ,,,t C' `c r` 4� S � —
nSign or outline lighting 67.84 2
Address: ( (j Signal circuit(s)or limited-energy
0 y ` --i�Gt c e S - panel,alteration,or extension. 0 See Page 2 2
City/State/ZIP: Set /(°4'1. e_179.-f.-91,
. Each additional inspection over allowable in any of the above
QQ 1 ��c,� �� Additional inspection(1 hr min) 66.25/hr
Phone:^l/.3) 9 C; 3 Fax:(573 7 7 ! e tJ
,� .� Investigation(1 hr min) 90.00/hr
Email: Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
CCB Lie.: /5-3✓7/ 1 I Electrical Lie.: 36 3 Ic I Suprv.Lie.: : 7�CJ's specifically listed('/z hr min) 90.00/hr
Suprv.Electrician signature,required: _
IELECTRICAL PERMIT FEES
4 nioy
Subtotal:
Print name: Date: 0 Plan Review Required(25%of permit fee):
d/h
State surcharge(12%of permit fee):
Authorized signatr�ar \ - TOTAL PERMIT FEE:
IPrint name: I This permit application expires if a permit is not obtained within 180
I Date: days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\BuildingTermits\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:
TIAL'
.WORK'ONLY; 7,,: .<
Description I QtY• I Each I Total I * :
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
5 kva or less 100.70 2
Check Type of Work Involved: 5.01 to 15 kva 133.56 2
❑ 15.01 to 25 kva 200.34 2
Audio and Stereo Systems*
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
❑ Garage Door Opener* >100 kva(fee in accordance 552.26 2
with OAR 918-309-0040)
❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System* Each additional kva over 25 7.42 3
❑ >100 kva—no additional charge 0.0 3
Vacuum Systems* Each additional inspection over allowable in any of the above:
❑ Other. Each additional inspection is 66.25/hr 1
charged at an hourly(I hr min)
Inspections for which no fee is 90.00/hr
specifically listed('h hr min)
„n
n ELECTRICAL PERMIT FEES
Cp1��1VIE-RCIA �'OQNLY.? . .a .
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:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
n Data Telecommunication Installation
n Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
n Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015