Permit '':('1 CITY OF TIGARD ELECTRICAL PERMIT
y r,
- COMMUNITY DEVELOPMENT Permit#: ELC2015-00921
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/24/2015
t. Parcel: 2S101BA00101
Jurisdiction: TIGARD
Site address: 7500 SW DARTMOUTH ST 120
Project: Great Clips Subdivision: WEST PORTLAND HEIGHTS Lot:
Project Description: Sign lighting for(2)wall signs.
Contractor: E S &A SIGN&AWNING Owner: WAL-MART REAL ESTATE BUSINESS TR
89975 PRAIRIE RD BY PROPERTY TAX DEPT STORE 5935-00
EUGENE, OR 97402 PO BOX 8050
ATTN MS 0555
BENTONVILLE,AR 72716
PHONE: 541-485-5546 PHONE:
FAX: 541-485-5813
FEES
Quantity Description Date Amount
2 ea Sign or Outline Lighting 11/24/2015 $135.68
Specifics:
1 ea 12%State Surcharge- 11/24/2015 $16.28
Electrical
Type of Use: COM
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $151.96
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 law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 throu�h OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332 2344.
Issued By: 1 L� h 1 O �Alt /` Permittee Signature: /e5-----....
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.
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(2)0-VA 5/.6)0 5
R C EOVED
•Electrical Permit Application NOV 1 0 2015 FOR OFLICE USE ONLY
City of Tigard Received l m �� I����!}�
ate/By Permit No.. LC
i.. 13125 SW Hall Blvd..Tigard.OR 9722 jI `O' TIGA IQj
ill
Phone: 503 718.2439 Fax: 503.598t79[>ItILDIIVG DIVIS Other Permit.
•��IIJJ '
TIGARD
Inspection Line: 503.639.4175 NA e5 eady/Ry: Jour ® Sec Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
'New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked below)
0 Service or feeder 400 amps or more 0 Building over three stories
❑Demolition ❑Other: where the available fault curl em 0 Marinas and boatyards
CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 130 volts or 0 Floating buildings
less to ground.or exceeds 14.000 0 Commercial-use agricultural
❑ I-and 2-fmily dwelling NCommercial/industrial ❑Accessory building amps for all other installations buildings
❑Multi-family ❑Master builder ❑Other: 0 Fire pump 0 Installation of 150 RVA or
0 Emergency system larger separately derived system_
JOB SITE INFORMATION AND LOCATION
0 Addition anew minor load of ❑"A""I '"I =' "I t"
Job no.:2 �N lob site address: O e L�y� IwwoIP or more. occupancy
I S w �5 w J ,0 Dar-I 1 '/a)1-1/ ❑Six or more residential units ❑Recreational vehicle parks
_ 1 1{� �] ❑Health-care ratio es ❑Supply voltage for more than
Cih'/State/`LIP:' n 1 %/�)�Z q 71 3 S Ut Il' I O ❑Hazardous locations 600 volts nominal
Suite/bldg./apt.no.Y44N tJVV �/Project name; —\ nips- 0 Service or feeder 600 amps or more.
—r FEE SCHEDULE.
Cross street/directions to job site: y t°� /, Derrription l 9n. I Fee. I real I •
Dar' 7-0,nC _ New residential single-ormulti-family dwelling unit.
Crw,"} `'2L "r"- rt-t/� Includes attached garage.
Subdivision: Lot❑o.: LOOII sq ti.or less 168.54 4
—
Ea.add'I500sq II or'poi lion 33.92 I
Tax map/parcel no.: Limited energy.residential
75.00
DESCRIP'T'ION OF WORK (with above sq.Il.)
//�� t LLL - Limited energy.nudtrftmtily
�S ICA,( ( •1 5C. 0.9c-- / 1 r4/7 .( residential(with above sq.11.1 75 011
� ,( �J� l Renewable Energy El Page 2
le- L'( , Services or feeders installation,alteration,and/or relocation
0 PROPERTY OWNER 0 TENANT
200 amps or less 100 70 2
20I amps to 4110 amps 133.56
Namt- _ 401 amps to 600 amps 200 34 2
Address: 601 amps to 1.000 amps 301.04 2
Over 1.000 amps or volts 552.26 2
City/Stale/"LIP: Temporary services or feeders installation,alteration,and/or
relocation
Phone:( ) I Fax:( ) 200 tulips or less 59.36 I
Owner instaIlati•.. tis installation is being made on property that 'i which is not 201 amps to-loo amps 115.08 3
intended fo ., e,lease.rent.or exchange.according to ORS 447.449.670., • 701. aol amps to 599 amps 168.54
Own r signature: Date: Branch circuits-new,alteration,or extension,per panel
_J 0 CONTACT PERSON A.Fee for branch circuits a idr
its above service or feeder fee. 7.42 2
Business name: G 5 -, ,c----751 -- r 11 c _ each branch circuit
H.Fee for branch circuits nitro,
Contact name �a'�' CCn f' t service urfeeder tee.tirst 56.18
branch circuit
Address: 81,'7-S Li Prot "1 C Each add.]branch circuit 7.42 2
City/State/LII': (j(u !C� ()I 41—(-1 0 Each Miscellaneous(service or feeder not included)
t manufactured or modular
67.84 2
dwelling,sit vice and/or feeder
Phone:(5c1I ) - aS Fax::(SL() ) � S -<G1� ti..
Reconnect only G7 84 '-
E-mail: S d eS S 2
���� �e t (!�/].S•Ct?✓� Pump or inigalion circle 67.84
CONT RACTO Sign or outline lighting 67.84 1354,5) 2
t Si mal circuit(s)or limited-ener' See
Business name: S Jr 1 e/ -i Aryl;n l/ g E>'
t! / panel,alteration,or extension. Page 3 2
Address: 5"9 i I5 {)(ut`, e I f) Each additional inspection over allowable in any of the above
Additional inspection I I he min) 66,251hr
City/Stale/ZIP: "'Li ele, c, q-74O•Z Investigation)I hr rain) 66.25!hr
Phone:1 591 , s-(,,, Z 3 D s Fax:(54( ) (_ S"'S — 5 ( 3 Industrial plan)11 hr mins 78.18/hr
Inspections Ibr which no Ice is 90.00/hr
CCB Lie.: I6,3y .10 Electrical Lic.:a( 5y ((S Su v.Lic.:51+{ S I 6._ specifically listed Cit hrmin)
ELECTRICAL. PER:\IIT FEES
Supn'.Electrician signature.requiredSubtotal: i 35 , (,,',6
(� Plan review(25%of permit tee): �.
Print name:6_0(^01,_‘ CR:1)5C 5�' �U - Date: `U - yS'-�s
State surcharge(12%ofpermit tee): �(�•��
Authorized signature: "TOTAL PERMIT FEE: `•j G <o
/ _ "Phis permit applicat' expires if a permit is not obtained within 180
Print(tame: ?,a.514.1 is-t/`�
Date. U-- 5 clays after it has been accepted as complete.
• Number of inspections allowed per permit
r?nudldin,\Penuirs\F.II'_Pennir,pp_EI R_EREdoc Re,05/21200 44s-10Is'I'OI I%vliCONIAVEB
A
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
Fee for all residential systems combined ... $75.00 Description I Qtr. I Fee 1 Total I
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
I I Audio and Stereo Systems* 15.01 to25 kva 200.34 2
Wind generation systems in excess of 25 kva:
I I Burglar Alarm 25.01 to 50 kva 301.04 2
n G• arage Door Opener* 500110 100 kva 552 26 2
>100 kva(fee in accordance with 552.26 2
OAR 918-309-0040)
n Heating,Ventilation and Air Conditioning
Solar generation systems in excess of 25 kva:
System* Each additional kva over 25 7.42 3
n V• acuum Systems* >100 kva-no additional charge 0.0
Each additional inspection over allowable in any of the above:
I I Other: Each additional inspection is 66.25/In 1
charged at an hourly(1 hr min)
Inspections for which no tee is 90.00/hr
specifically listed('A hr min)
COMMERCIA[ WORIC',ONI Y ':s '=°"'3 ELEcTntc ;FE AL PERMITS ' •
Fee for each commercial system $75.00 Subtotal.
(SEE OAR 918-309-0000) Plan review,if required(25%of permit fee):
State surcharge(12%of permit lee):
Check Type of Work Involved: TOTAL PERMIT FEE:
This permit application expires it'll permit is not obtained within 180
I Audio and Stereo Systems days alter it has been accepted as complete.
Number of inspections allowed per pet init.
n Boiler Controls
n C• lock Systems
Data Telecommunication Installation
I I Fire Alarm Installation
HVAC
I Instrumentation
n Intercom and Paging Systems
I I Landscape Irrigation Control*
n Medical
n Nurse Calls
I Outdoor Landscape Lighting*
I I Protective Signaling
,1<1 Other I S
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I\t3te klieg\Penults\ELC_Pcnn0App_ELR ERE doe Re,05/21/2013