Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2010 -00188
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 04/21/2010
TLGA'RD; g Parcel: 2S112DB00300
Jurisdiction: Tigard
Site address: 7233 SW KABLE LN 500
Subdivision: Lot: 0
Project: Nuance
Project Description: Fixture work, tenant improvement
Owner: FEES
PACIFIC REALTY ASSOCIATES Quantity Description Date Amount
15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224 2 ea Services or Feeders - 200 04/21/2010 $201.40
amps or less
PHONE: 503 - 624 -6300 40 crt Branch Circuits w /Purchase 04/21/2010 $296.80
Service or Feeder
12 ea 12% State Surcharge - 04/21/2010 $59.78
Contractor: Electrical
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 $557.98
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 rules are set forth in OAR
952- 001 -0010 through OAR 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: • . 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' Date:
LICENSE NO.
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.
v + AUeed - /p d / i ' Wfr
Electrical Permit Application ,.a lf ' '' '" '1r4 ` ''f y 1.4 �` A' lad
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M City of Tigard Permit No : /L L r� ^
Crate./By: G ,),Of () _to /Se
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
o. :4 Phone: 503.639.4171 Fax: 503.598.1960 APR 2 0 201 r teBy' Other Permit:
i. �.7 ' 1 . 1 7 r / Inspection Line: 503.639.4175 Date Rea lull See Page 2 for
Yu0. Internet: vrww.tigard or.gov Notified/Method: SuppkmentalInformation
a iPa
Il' -,t ^t ;4S r'jl "t r9'17' �1lwtm i i • - . rp s -1{r 14' . .. 1! - : r. n s
J i W �h l ie _ r p r - ,, / r6t� r. 1 + . �.,�
,1: .. 'h)ttt 1 hltn sttu_ a 'Q tea daflii 1. j•. -P tt 1!S .! ' ffi ... -! v " w. , . + „tli �� ilr:.,..r r lira r.,tk mrE ' Lai r,k•� nar:r aU �. a I •: • ❑ New construction ddition/alteratio r ep -cement
Please check all that apply (submit = t sets of plane w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories
❑ Demolition ❑ Other:
where the available fault current ❑ Marinas and boatyards.
1 L.7,,17.5 t' ' € • - - °9F..F” r r c Mta,6N n r 1 v-P t o 00 exceeds 10,0 am sat 150 votes or Flo • t: 1 : . _ .e w .... . ; ;a ., ..a.v '' `It• .,H, ai ,.. t11 "' _ 41 a il rle' S ., - .;:1'h2 , nfk,;4 1,:J P ❑ sting buildings.
less to ground, or exceeds 14 000 ❑ Commercial agricultural
❑ 1- and 2- family dwelling SI Commercial/industrial ❑ Accessory building amps for ell other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ installation of 75 KVA or
',NZ-MI. '', ,, r - to r t M1 gu .. ❑ Emergency system. larger separately derived system.
... iaii: i . r. , .:! ?t { l i . d i i e + - ' . Xittil �`r� � m��J isi cis ii �r i i i n ., � .... f 1ti.'. i
#t ❑ Addition of new rmtar load of ❑ °A .. "1.2 . t_3 ,.
Job no.: Job site address: 72.3 LA). I00HP or mare. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State/ZIP: ❑ Health -care facilities- ❑ Supply voltage for more than
m
❑ Hardous locations. 600 volts nominal
Suite/bldg. /apt. no.: an,, I Project name: Reim ❑ Service or feeder
p� 6600ain s+�roor,�more. i
'' f it !t `1/( I i Rilk1'k' 1 xs if:li t °}' ,:� 'r;'.
Cross street / directions to job site: Description 1 00' ( Fre. 1 Total I •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft or less 168.54 4
Ea. add'l 500 sq. R. or portion 33.92 1
Tax map /parcel no.:
x ? ^ tt Ira t r(V
:;, at9 _ ilIr r s ,, t s i Limited energy, residential
4sI ",, ,, - W�IM11 �nsv l u i ► a :c�t:t r lx.f�i, I .!,_ [fd with above: .ft. 67.84 2
•
H i / Limited energy, multi- family III 11
���1 /r residential with above s.. 0. 67.84
Services or feeders installation, alteration, and /or relocation
200 amps or less 2_ 100.70 214 • • 2
,01,:is tt. m x1.7,1 lt 111 talIpr ,• rl t it hiitr
t. ' I. iWN'i, 1 .� iial ;ntwc ;..:!w i litdani r :il i' .� -, .. r t l t , a _ - 201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 200.34 2
601 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
relocatio n
Phone: ( ) I Fax: ( ) 200 amps or less 59.36 1
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 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
I,ir.:7 1fitI r!te a r .'s l ,.i.... ' 1;',';,,:'
,r � t i' a , 1., �, a c �.if.l ` ,d.,. > " I' above service o f fee, Id 7.42 ilts 2
each
Business name: Johansen Electric Inc circuit
$. Fee for branch bbranch ci rcuits
Contact name: Charlynn without service or feeder fee
ynn Leifsen first branch circuit 56.18 2
Address: 10948 SE Valley View Terrace Each add'1 branch circuit 7.42 2
Miscellaneous (service or feeder not included)
City /StateiZIP: Happy Valley, OR 97086 Each manufactured or modular 67.84 2
Phone: (503) 698 - 3417 Fax: : (503) 698 - 2486 Rec lonnnnee ct t ice and/or feeder
Rec 67.84 2
E -mail: Pump or irrigation circle 67.84 2
V,�f
# l l I 1 .. 'D t,uMl.J� !�I.il Tii . a irt .,In i' s Sign or outline lighting 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/State/ZJP: Happy Valley, OR 97086 Each additional inspection over allowable in any of the above
Per inspection 66.25
Phone: (503) 698-3417 Fax: (503) 698 - 2486 Investigation per hour (I hr min) 66.25
CCB Lic.: 51539 I Electrical Lie.: 3 Suprv. Lic.: 2053S Industrial .Iant per hour 78.18
Suprv. Electrician signature, required: ` 9 -
�da./ • Subtotal:
/ Plan review (25% of permit fee):
Print name: Carl Johansen Ddfe: V/20/(4)
State surcharge (12% of permit fee): 5 e Z 77
Authorized signature: - TOTAL PERMIT FEE: 557, 98'
Print name: Charlynn Leifsen (� J Date: g) This permit application expires if a permit is not obtained within 180
�/ days after it has been accepted as complete.
* Number of inspections allowed per permit
t: Building \Permits\ELC- PormitApp.doe 10/01/09 440 - 46157(11105 /COIWWEB
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