Permit (62) CITY OF TIGARD ELECTRICAL PERMIT
11111
COMMUNITY DEVELOPMENT Permit#: ELC2018-00770
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/29/2018
T t ° Parcel: 1 S 1260000300
Jurisdiction: Tigard
Site address: 9724 SW WASHINGTON SQUARE RD F06
Project: Din Tai Fung Subdivision: None Lot: None
Project Description: Sign lighting for(1)exterior wall sign.
Contractor: DWAYNE DONALD PURCER Owner: PPR WASHINGTON SQUARE LLC
16409 SE DIVISION#216 PO BOX 847
PORTLAND, OR 97236 CARLSBAD, CA 92018
PHONE: 503-816-8463 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 11/29/2018 $67.84
Specifics:
1 ea 12%State Surcharge- 11/29/2018 $8.14
Electrical
Type of Use: COM
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $75.98
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specia Co•es - • all othr 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 issu. ce, • w•rk suspended for more the 180
days. ATTENTION: Oregon law requires you to follow th -d by the Oregon Utility Notifica io C h rules are s- •• '
• , AR
952-001-0010 through OAR 952-001-0090. You..- •• -in a copy -ct•uestions to OUNC by calling 50 3 ;8 1• 0.Al2.234.
Issued By: Permittee Signature: AVAIL /-`
'ter -
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 ro►z 0141( I, I S►:Oy1.1
' -^ f 'i t Received
•
City of Tigard nate/B : % / /1 „vA1r�
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
C Phone: 503.718.2439 '�� 2 Date/B : Related Permit#: /"- ,
Email: TigardBuildingPermits@Tigard or.gov Ready Date/By: ❑ See Page 2 for
I I G A R D
Inspection Line: 503.639.4175 Int
p Hvw,ligapd orpv.; Notified/Method: �� Supplemental Information
TYPE OF gowniNG gown( DIVISION PLAN REVIEW
❑New construction 8.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 ❑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 xi Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
/� ❑Addition of new motor load of system.
Job#: 1 Job site address: 7Z IA .,,W ke-(i 100HP or more. ❑"A","E","t-2","I-3",
❑Six or more residential units. occupancy.
City/State/ZIP: 1-1( /)\-/—.> .Q-
Q73 5
n ` 2.- 0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt. "CI, J �� ry#: ( Project name: + FlN
/ 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 I Qty. I Each I Total I *
New residential single-or multi-family dwelling unit.
Subdivision: I 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
S (with above sq.ft.) 75.00 2
X" ` "e-1 L. f"/�,t r -t S 1 6/..i — �� 1.—/ T 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 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:( ) 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
Branch circuits-new,alteration,or extension,per panel
0 APPLICANT ❑ CONTACT PERSON
IA
� n A.Fee for branch circuits with
Business name: tv\(. cora'. above service or feeder fee,
7.42 2
' / \--'1-
� each branch circuit
Contact name: h l (--F` ; —(-1" eLa ) B.Fee for branch circuits without
sAddress: -� S,3 ('-{. t. SGS S ervice or feeder fee,first
branch circuit 56.18 2
City/State/ZIP:SLr ,\Y t lam- c--v x. 0( 3`.IP Each add'I branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(C)() 'Z &"-- (7 Each manufactured or modular
Email: �s�N . . dwelling,service and/or feeder 67.84 2
.. /tomjLL € \AQ S S42-'\ j_Ccs f`(, Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: ‘,,,...41,...24,2_....outline lighting 67.84 N 2
gnal circuit(s)or limited-energy
Address: l to Li 0 C§ i� s Lo� panel,alteration,or extension. 0 See Page 2 2
City/State/ZIP: t �((c-� �f' / �j , Each additional inspection over allowable in any of the above
�0 1"r S`) ( 4. V( �Z. (r Additional inspection(1 hr min) 66.25/hr
Phone:(� ) C�I b , %L / '� Investigation(1 hr min) 90.00/hr
Email: c t b 1/11
/11()CZ- 3/4� Industrialspetoplant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.:( a Electrical Li -. Suprv.Lic.: c, specifically listed(%hr min)
L ' :I ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal: C 7.A:11
Print n /�
ame: i" P U,1` Date: 1 ❑Plan Review Required(25%of permit fee):
� State surcharge(12%of permit fee): e, l i
Authorized signature: / TOTAL PERMIT FEE: 75.7'1 ir
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 10/26/2017 440-4615T(l l/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,SCHEDULE
Description I Qty. I Each I Total 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
El 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:
❑ 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('/hr min)
COMMERCIAL WORK ONLY:
ELECTRICAL PERMIT FEES
SubtotalEnteron Page 1):
:
y
Fee for each commercial system: $75.00 Y * Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
n Clock Systems
n Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
El Landscape Irrigation Control*
❑ Medical
El Nurse Calls
El 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_ELRERE.doc Rev 10/26/2017
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9724 SW WASHINGTON SQUARE RD F06,
TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Electrical ELC2018-00770
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor