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Permit (67) CITY OF TIGARD ELECTRICAL PERMIT N ■ COMMUNITY DEVELOPMENT Permit#: ELC2016-00853 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/03/2016 T I c,A I+.I7 9 Parcel: 1 S126CA01000 Jurisdiction: Tigard Site address: 9009 SW HALL BLVD 170 Project: Lee Gel Nails Subdivision: None Lot: None Project Description: (1)sign lighting for new wall sign Contractor: GRAPHIC D'SIGNS LLC Owner: CAFARO NORTHWEST PARTNERSHIP 9125 NE SANDY BLVD PO BOX 422 PORTLAND, OR 97220 FLORHAM PARK, NJ 07932 PHONE: 503-256-2064 PHONE: FAX: FEES Quantity Description Date Amount 1 ea Sign or Outline Lighting 11/03/2016 $67.84 Specifics: 1 ea 12%State Surcharge- 11/03/2016 $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. 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 r le are set forth in OAR 952-001-0010 throu.•• . R 952-001-0090. • •.- .btain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2 4 . -...m.„.....Issued B 'i . ,.L - �►�_— Permittee Signature: k!� _C=1it,tl` tl 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 Applicaign UE1VED FOR OFFICE (SEO"��1.‘ City ofTigard Received ©fferi Permit#: G'_e: ZIP- '3 9 Date/B : NI 13125 SW Hall Blvd.,Tigard,OR 9 Plan Review _ Phone: 503.718.2439 Fax: 503.59 60 0. 3 2016 Date/B Related Permit#: le,-oey/ Inspection Line: 503.639.4175 Ready Date/By: Juris: ® See Page 2 for 1 I G A R D Internet: www.tigard-or.gov C rrv7 OFffDIVISION TI GA1 [) Notified/Method: Supplemental Information TYP s i t WC PLAN REVIEW ❑New construction ❑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. 0 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. 0 1-and 2-family dwelling ❑Commercial/industrial ElAccessory 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 0 Addition of new motor load of system. Job#: Job site address:00 p(J� Cj' . \ R' 100fP or more. ❑"A","E "l-2 "1-3 City/State/ZIP: °`i 0 Six It more residentialac . units. occupancy. Y 1~, ❑Recreational vehicle parks. 1 i l l R. 0Healthcare facilities. Suite/bldg./apt.#: Project name: t' 0 Supply voltage for more than / ( cid,n � ❑Hazardous locations. 600 o g `j,74 1✓I!(,I, ❑Service or feeder 600 amps or more. volts nominal. Cross street/directions to job site: + f'�� �t{ , C FEE SCHEDULE / �i Description I Qty. I Each I Total New residential single-or multi-family dwelling unit. Subdivision: 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 75.00 2 l l r (with above sq.ft.) OYl/ KAA (o W/si �` (VW) da/r-L Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Renewable Energy 0 See Page 2 0 PROPERTY OWNER I 0 TENANT Services or feeders installation,alteration,and/or relocation Name: 200 amps or less 100.70 2 201 amps to 400 amps 133.56 2 Address: 401 amps to 600 amps 200.34 2 City/State/ZIP: 601 apps to 1,000 amps 301.04 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 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: 59.4_, C^z-GA" e.A.da of pry f Date: 401 amps to 599 apps 168.54 2 0 APPLICANT 0 CONTACT PERSON Branch circuits-new,alteration,or extension,per panel A.Fee for branch circuits with Business name: C (Z i t /-5 1 c'T`IV.S LLC above service or feeder fee, 7.42 2 each branch circuit Contact name: N_) c)7.��1• t. B.Fee for branch circuits without Address: service or feeder fee,first 56.18 2 branch circuit City/State/ZIP: Each add'I branch circuit 7.42 2 M(S )2 0 ( ) Each laneouu or(serviceor feeder not included) Phone: Fax: : Each manufactured or modular dwelling,service and/or feeder 67.84 2 Email: Reconnect only 67.84 2 3 , iCONTRACTOR Pump or irrigation circle 67.84 2 Business name: Cry...4k?k-411� 1) "St 6r Sign or outline lighting f67.84 (e7. ��2 ttt tt' YY 1 Signal circuit(s)or limited-energy Address: oti s \tk- ,v0,, f,ki panel,alteration,or extension. 0 See Page 2 2 Each additional inspection over allowable in any of the above � City/State/ZIP: q)09719-4.110 Additional inspection(1 hr min) 66.25/hr Phone:(A )gS -c�lJ, Co 4 Fax:( ) Investigation(1 hr min) 90.00/hr } YIndustrial plant(1 hr min) 78.18/hr Email: aN` AL, `J':1-. �' � Inspections for which no fee is specifically listed(Vs hr min) 90.00/hr CCB Lic.: 1 44 i�� Electrical Liar A rI` �/f uprv.Lic.:` .7 A i [ `� ELECTRICAL PERMIT FEES •Suprv.Electrician signature,required: .-v) ,n Subtotal: e07, Tc/Print name: k T Date:/1 / o' / 4 c 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): �.1�. Authorized signature: L/ Vn� '9Csi-4 ` TOTAL PERMIT FEE: 7 5.98 This permit application expires if a permit is not obtained within 180 Print name: PIA(zit Nk �H t ,`�j"/ 4 Date: 1 I " days after it has been accepted as complete. * Number of inspections allowed per permit. l:\Building\Permits\ELCPermitAppFt RERE.doc Rev 06/17/2015 440-4615T(11/15/COM/'EB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: . l ..� SIDEI�TTIAL''V�? 0�; � �� -� � � � :�n. t FES � `,a Fee for all residential systems combined: $75.00 Description ( Qty. Each Total y Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 2 5.01 to 15 kva 133.56 2 ❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 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 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 mm) 'ttti xlimjitECTOICAL PERMIT FEES 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 ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:\Building\Permits\ELCPermitApp_ELR_ERE.doc Rev 06/17/2015