Permit CITY OF TIGARD ELECTRICAL PERMIT
INs COMMUNITY DEVELOPMENT Permit#: ELC2016-00776
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/22/2016
TIC;,ti It.T_� g Parcel: 1S136DCO2504
Jurisdiction: Tigard
Site address: 7275 SW DARTMOUTH ST 120
Project: Bollywood Eyebrow Threading Subdivision: None Lot: None
Project Description: New 20"x 18'illuminated wall sign located on the west facade.
Contractor: VISION SIGNS LLC Owner: AMERICAN INDUSTRIES INC
16127 NE THOMPSON ST 1750 NW FRONT AVE STE#106
PORTLAND, OR 97230 PORTLAND, OR 97209
PHONE: 503-442-1195 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 10/10/2016 $67.84
Specifics:
1 ea 12%State Surcharge- 10/10/2016 $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 -• •- ; ith 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. ENTION: Orego law -quires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-00 -0010 through OAR 952 •.1-00•f. ou may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800��3 2.2344.234.
Issue.By: �t
.. / ‘i . / Permittee Signature: il�
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: / /
C---. .A\
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 FOR OFFICE FSE ONLy
� �' zw. "' � "'eceived
Ipi RI City of Tigard w %/4.,', -
13125 SW Hall Blvd.,Tigard,OR 97223 � " 1" �bateB : /a I(P //� -
$ Plan Review `i/
Phone: 503.718.2439 Fax: 503.598.1960 Date/B !: Related Permit#: ' ,/(d 'O.041
Inspection Line: 503.639.4175 a �r 16 Read DateB : See Page 2 for
TI G A R D Internet: www.tigard-or.gov `�t' (f `�(� Notified Method: w` Supplemental Information
E it : 1TYO r GA D , 7!iiilnIPNEU:EigiiiEidSi#t*ii::;:: eeillijiiiiieejiiiieligiliiiiiliiiiiiiliiiiigil
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I__I New construction ❑Addition/alter „opip4l Please check all that apply(submit 2 sets of plans w/items checked):
J ? A � a u >, 0 Service or feeder 400 amps or more 0 Building over three stories.
Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
;T Q, , __tI11 exceeds 10,000 amps at 150 volts or 0 Floating buildings.
❑ 1-and 2-family dwelling Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
Multi-familyMaster builderamps for all other installations. buildings.
❑ 0 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
L , 0 Emergency system. larger separately derived
Job site address: �� 4 i, ❑Addition of new motor load of system.
Job#:
105/ l z �Gl f.tynn oil 1 4 I OOHP or more. ❑"A„ ..E„ ..1 2„ «1.3„
City/State/ZIP: }� `J 0 Six or more residential units. occupancy.
6112 6� /t / ❑Health-caze facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: f t Project name: Se.)
it 1t�i(r$if So �;ten, ❑Hazardous locations. 0 600 holt voltage forlmore than
❑Service or feeder 600 amps or more.
Cross street/directions to job site: r
Q rJ '] /y r Description I Qty. I Each I Total 1 "
✓ WI / �'� a !/rf)GIN'�1 New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
Tax map/parcel#: 1,000 sq.ft.or less 168.54 4
Ea.add'I 500 sq.ft.or portion 33.92 1
R ION IE1r1C_ 1imiwillioI Limited energy,residential
75.00 2
t -�t/Jbdh�t Y/feas � �S`< 4'/k1 �7 t LYr Limited(with above sq.ft.)
energy,multi-family
,i residential(with above sq.ft.) 75.00 2
- -.- Renewable Energy See Page 2
:!:',. ..1..„-.;!.,-• • •• • i _ T 1 Services or feeders installation,alteration,and/or relocation
Name: ?,ti,]?� f4R ' .C in' 200 amps or less 100.70 2
Address: q, , " F .lila�� s.fr 201 amps to 400 amps 133.56 2
4/r 401 amps to 600 amps 200.34 2
City/State/ZIP: P c p.//air'€t 0 R 472 3 li 601 amps to 1,000 amps 301.04 2
Phone:(ie.3) its H 7 C r 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: Date: 401 amps to 599 amps 168.54 2
7: t Branch circuits-new,alteration,or extension,per panel
A A.Fee for branch circuits with
Business name: th S lc 441 ( . �' ) 'L above service or feeder fee,
7.42 2
y / each branch circuit
Contact name: /G/Pi p„j 1- B.Fee for branch circuits without
Address: ie
/02
1 /I f ` 1 (6� branche or feederstfee,first
� ,v C 6 f'js'1{� � � branch circuit 56.18 2
City/State/ZIP: f7�,.R If f dtip G: ez / 4 7.2 3 /q Each add'I branch circuit 7.42 2
l7 (.� Miscellaneous(service or feeder not included)
Phone:c 3 ) 442 — // 4 5 Fax: :( ) Each manufactured or modular 67.84 2
�- dwelling,service and/or feeder
Email: rE e.,,,, ,,./5„, 4 f ( Trym Reconnect only 67.84 2
" ; ''`` Pump or irrigation circle 67.84 2
Business name: V iSie / 44, i / Sign or outline lighting V 67.84 �' 2
/ /� G Signal circuit(s)or limited-energy o
Address: rzflye Cpanel,alteration,or extension. El See Page 2 2
�} Each additional inspection over allowable in any of the above
City/State/ZIP:
Pc f7 17 A,il` 4i (iQ 7,g 3 0 Additional inspection(1 hr min) 66.25/hr
Phone:(&"-t3) .9 I/ 7 0 Fax:( ) Investigation(1 hr min) 90.00/hr
[7� f Industrial plant(1 hr min) 78.18/hr
Email: (C/m ( Sc, s. C emu. Inspections for which no fee is
j / a specifically fisted %hr min) 90.00/hr
CCB Lic.: /7( Q t7 Electrical Lic.: cC Suprv.Lic.: s (
tx .. 0I 1' EEE
Suprv.Electrician signature,required: Subtotal: 6,7-IN
avic,Print name: Li„,..,,a g et Date: j A/3 //A, 0 Plan Review Required(25%of permit fee): y—
State surcharge(12%of permit fee): p'/rf
Authorized signature: ` TOTAL PERMIT FEE: P 7
wt This permit application expires if a permit is not obtained within 180
Print name: 11 / Date: days after it has been accepted as complete.
s Number of inspections allowed per permit.
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
7275 SW DARTMOUTH ST 120, TIGARD, OR,
97223
Record Type:
Commercial - Electrical
Inspection Type:
199 Electrical final
Result:
PASS- NoCofO
Comments:
Violation Summary:
Inspector
Tel: 503.718.2439
Inspection Date:
Record ID:
ELC2016-00776
Inspector:
Chip Barnett
Contractor