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Permit - CITY OF TIGARD ELECTRICAL PERMIT ` 2 COMMUNITY DEVELOPMENT Permit #: ELC2010 -00074 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/12/2010 TIGARD : Parcel: 2S112DA01400 Jurisdiction: Tigard Site address: 6650 SW REDWOOD LN 210 Subdivision: Pacific Corporate Center Lot: 0 Project: NuScale Project Description: (10) branch circuits for TI Owner: FEES PACIFIC REALTY ASSOCIATES Quantity Description Date Amount 15350 SW SEQUOIA PKWY #300 PORTLAND, OR 97224 10 crt Branch Circuits 02/12/2010 $122.96 wo /Purchase Service or PHONE: 503 - 624 -6300 Feeder 1 ea 12% State Surcharge - 02/12/2010 $14.76 Electrical Contractor: JOHANSEN ELECTRIC INC 10984 SE VALLEY VIEW TERR HAPPY VALLEY, OR 97086 PHONE: 503 - 698 -3417 FAX: 503 - 698 -2486 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Total $137.72 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 through 0 952- 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. i nature: OW /' -/ Cf51 Issued B Permittee S g s y 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 603.639.4175 by 7:00 a.m. for an inspection that business day. 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. f Lk. pir I: „ ; ., , CITY OF TIGARD ELECTRICAL PERMIT a ' COMMUNITY DEVELOPMENT Permit #: ELC2010 -00074 T [ GAR Ia 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/12/2010 Parcel: 2S 112 DA01400 Jurisdiction: Tigard Site address: 6650 SW REDWOOD LN 210 Subdivision: Pacific Corporate Center Lot: 0 Project: NuScale Project Description: (10) branch circuits for TI Owner: FEES PACIFIC REALTY ASSOCIATES Quantity Description Date Amount 15350 SW SEQUOIA PKWY #300 PORTLAND, OR 97224 10 crt Branch Circuits 02/12/2010 $122.96 wo /Purchase Service or PHONE: 503 - 624 -6300 Feeder 1 ea 12% State Surcharge - 02/12/2010 $14.76 Electrical Contractor: JOHANSEN ELECTRIC INC 10948 SE VALLEY VIEW TERR HAPPY VALLEY, OR 97086 PHONE: 503 - 698 -3417 FAX: 503 - 698 -2486 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Total $137.72 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 0 R 952 - 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By: ClIaLOS Permittee Signature: 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' App Date: LICENSE NO. 'J Call 503.639.4175 by 7:00 a.m. for an inspection that business day. 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 RECEIVED relit (Iht,c 1. l ;h u•1., City of Tigard Received FEB 11 2010 DatelB o2 /a /0 ,tom Permit Eu2a /o - 40,07 A : . �- 13125 5W flail Blvd Tigard, OR 97223 Plan Revie Phone: 503.639.4171 Fax: 503.598.1960 �B other Pemtit� (,�,� p/p - pp0A 4, I- . Inspection Line: 503.639.4175 CITY OF TIGAR Date Ready/By: Jan r - IB See Page 2 for O � DIVISIO www tigard or gov C Dg'� C I® I Notificd Method. (S Supplemental Information ill"' i , ; 1 1-1411 .1 4 t t I iv .0- ' I r y pip, �4S ra ! T. !. !! ,l f ifi'.r- t }' I {4 :Ttiz t l..L'• - _ J. :. I. -. . 4 : • r . �I k1 .... _i ,- i.0 ° 7!e- nA ' W .,. .. I, . 1. (ti rq ? .I . 'J: . .lit. _ i, .. _� t, • i'. .i t ..- ,; .Y11.9.ri ❑ New construction . Addition /alteration/replacement Please check all that apply (submit 1 sets of plans w /items checked below) 13 Service or feeder 400 amps or mot ❑ Building over three stories. ❑ Demolition ❑ Other: where the available Sault current ❑ Marinas and boatyards. Ill i ,}N .., ,-� t ■l" 4;1'14:4)4 Wit rl tie l ./(tr - �,., #,} r t 'r' .w ' , f t', ' ,,4.-: !,11.,;', exceeds 10,000 at 150 volts or Float' buildings � -.,., il l i •.', 14: lesa creeps ❑ tag s & ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ 1- and 2- family dwelling Z. CommerciaVindustrial ❑ Accessory building amps for all other installations. buildings. ❑ Mu lti- family ❑ Master builder ❑ Other. ❑ Fire pump. ❑ installation of 75 KVA or nI 'I. 1 r { t i t if y i t ll ❑ system. larger separately derived system. 'Ii 3 I G 'I' 'C r4 #lt41} i 1.. t "' T. . , .�y ��� c . 4 `` , II .. ; II� , .�'' .�4�1.��!14A' ' ' (; 11. � ❑Addit i Emergency on of new motor load of ❑ "A ". "E "• .. 1.2 .. , .•1 -3 ", Job no.: 1 Job site address: (_ (415(j V)Occj in 100HPormore. occupancy. ❑ Six or more residential units- ❑ Recreational vehicle parks. City /State/ZIP: ❑ 1 te allth -care facilities. ❑ Supply voltage for more than In Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: 0 Project [tame: is) ti,ScAt. in Service or feeder 600 amps or more. ' Cross street/directions to job site: neseripaaa 12x. I Fen 1 Toad I • New residential single or multi- family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4 Tax map /parcel no.: Ea add'I 500 sq. ft. or portion 33.92 1 Limited energy, residential 111.. ' it i ( , H it1 t - frP 'i , Ii,# (with above sq. fi.) i it :1 11 #� ! j1la f IIti 'I )1 ".RS {T1 9 VQH I ' t 67.84 2 Limited energy, multi - (amity Te-no A (11 -\) )4/ei residential (with above sq. It) 67.84 2 " Services or feeders installation and/or relocation 200 amps or less 100.70 2 i } t: i j iI • 't.n , • '�.. , i1 11 ,•' d It 4,Ii II ,I itli ' l8I ;...- '4T1 t�I - i k 201 amps to 400 amps 133.56 2 Name: 401 amps to 600 amps 200.34 2 60i amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 City/State /ZIP: Temporary services or feeders installation, alteration, and /or relocation _ Phone: ( ) I Fax: ( ) 200 amps or less 59.36 l Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 _ 1 2 Owner signature: Date: Branch circuits - new, alteration, or extension, per panel r rr�� A. Fee for branch circuits with t, :>; i�irl {1 -1i• (�i. f i � 1 ',EC i1 l i 1 1 .. . ��'dl P 7i tt i'4 :i>kt ±,. +.i. .'4.' above servioe or feeder fee, 4 each branch circuit 7. 2 2 Business name: Johansen Electric Inc B. Fee for branch circuits Contact name: Charlynn Leifsen without service or feeder fee, , 56.18 540. IS 2 first branch circuit Address: 10948 SE Valley View Terrace Each add'I branch circuit .9 _ 7.42 (,p(i;ie 2 Miseetlaseous (service or feeder sot included) City /StateiZJP: Happy Valley, OR 97086 Each manufactured or modular ( 67.84 2 Phone: (503) 698 -3417 I Fax: : (503) 698 -2486 dwelling. service and/or feeder Reconnect only 67.84 2 E -mail: Pump or irrigation circle 67.84 2 i l"li 1..1 '11 1,5 i•sr /.stifle :k r•.• a r,i I r il•ti'r .zI." Si Or ou tline li tt CQN[iaAi�:llfll� . 1Jua i, I .i. 1� :� ;'•. .� '- ''�'t� � � �g 67.84 2 Business name: Johansen Electric Inc Signal circuit(s) or limited- energy panel, alteration, or Address: 10948 SE Valley View Terrace extension. Describe: Page 2 2 City/StateiZ IP: Happy Valley, OR 97086 Each additional inspection over allowable in any of the above Phone: (503) 698 - 3417 Fax: (503) 698 - 2486 Per inspection 66.25 Investigation per hour (1 hr min) 6625 q✓CCB Lic.: 51539 L, Electrical Lic.: 3 -243C I./ Suprv. Lic.: 2053S . industrial plant per hour 78.18 UU �' i li { .. ji•'Ir I * I tt ' L '411"),14,1': d � Suprv. Electrician signature, require v Z .. Subtotal: 1 2 Print name: Carl Johansen Date: I I I Plan review (25% of permit fee): m State surcharge (12 % of permit fee): 14 .71 Authorized signature: » .,..`� TOTAL PERMIT FEE: 13'112. Print name: nn Charl y Leifsen Date: 2.I I i! Zip This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete- Nrinrber of inspections allowed per permit. 1 ■BuildiagPerautslELC- PernutApp doe 10/01/09 440. 46157(11 /05 /CO.MIl4EB E • Cl XU3 13C?I3SH1 dH WdEi : I 0102 T T clad