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
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