Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
`.' 0 _; COMMUNITY DEVELOPMENT Permit #: ELR2010 -00108
Date Issued: 06/11/2010
T tGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S110DB00500
Jurisdiction: Tigard
Site address: 15336 SW PACIFIC HWY
Subdivision: Lot: 0
Project: Sonic Drive -In Restaurant
Project Description: Low voltage for irrigation control.
FEES
Owner:
MWF TIGARD LLC Description Date Amount
2123 NW ALOCLEK DR #1203 Restricted Energy Permit 06/11/2010 $67.84
HILLSBORO, OR 97124 12% State Surcharge - Electrical 06/11/2010 $8.14
PHONE: 503 - 617 -0175
Contractor:
NEW GROWTH LANDSCAPE
PO BOX 1571
BEAVERTON, OR 97075
PHONE: 503 - 848 -2404
FAX: 503 - 848 -2408
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio & Stereo: N Boiler Controls: N
CCTV: N Clock Systems: N
Data & Telecommunications: N Fire Alarm: N
HVAC: N Instrumentation: N Total $75.98
Intercom /Paging: N Landscape /Irrigation: N
Required Items and Reports (Conditions)
Landscape Lighting: N Medical: N
Nurse Calls: N Protective Signal: N
Security Alarm: N Other: N
Other Desc:
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 ma obtain a c. • • the rule- or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: i Perm ittee Signature:
7 i
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.
CaII 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.
CITY OF TIGARD ELECTRICAL PERMIT
Ip
c > COMMUNITY DEVELOPMENT Permit #: ELC2010 00108
:? Date Issued: 03/09/2010
T t GARD. 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S112DD00701
Jurisdiction:
Site address: 15858 SW UPPER BOONES FERRY RD
Subdivision: OREGON BUSINESS PARK II Lot:
Project: AMEC
Project Description: Add /alter (8) branch circuits.
Owner: FEES
PACIFIC REALTY ASSOCIATES Quantity Description Date Amount
15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224 8 crt Branch Circuits 03/09/2010 $108.12
wo /Purchase Service or
PHONE: 503 - 624 -6300 Feeder
1 ea 12% State Surcharge - 03/09/2010 $12.97
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 $121.09
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 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.
i I I
Issued By:� — tilt. .I ' �.. . - _ 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' Q 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.
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Electrical Permit Application' Kw OFFICE t: Usti U.x,t.l
City of Tigard nn Received • * ' =51 IMP
; : i . 13125 SW Hall Blvd., Tigard, OR 9722M 4R 0 8 2013 Plan Review Other Permit:
g Phone: 503.639.4171 Fax: 503.598.1960 Date /By:
T 1 c .; I; 1', inspection Line: 503 639 4175 Date Ready By: frfn ® See Paget for
Internet: www tigand - ' [ c.� NotiSed/Mcthod: Ins) Supplemental Information
.
] l (,7 ^;p ,� r 1.11 N ,}H i w ..i , l ii 311 1 ? 'I {e - i l y i 1 ✓ l � r I. _ `1 : i ('u , .. ,# .t lj i O lf' i
iF4in„Tll .y'.,. i � •, ,li .f i{ : 4 lit t; : �; _ i 1.01, {1 11 � f L.1.[ ,o_ ,ii :- {.k ? i . >.I I . I1 .. i 7 4 Y. 4. 1 1 . .d' 1ir :i 111
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❑ New construction &r-Addition /alteration/replacement Please check all that apply (submit1 bets of plans wlttems checked below):
❑ Service or feeder 400 amps or more ❑ Building over duce stories.
❑ Demolition p Other: I t� 1 .T i li .:c.id1 I ' where the available fault current ❑ Marinas and boatyards.
1i� [ l ll!:; '� of F? s-7' 4?' s.n., + 9 x11 ' Ii� ;: 1,1 ii r ..i. ., i : A •' , : ;,
! exceeds 10,000 amps at 150 votes or 13 Floating buildings.
;l ; ;!i.,. v' .,
- � a less to ground, or exceeds 14,040 El Commercial-use agricultural
❑ 1- and 2- family dwelling ' 'Comrnercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi family ❑ Master builder ❑ Other. ❑ Fire pump. ❑ Installation of 75 KVA or
i n , ik f' i I' � �
�� r � : Y 1 s s.'i' t { a $ ,.. 14 , 4 ❑ Eme system. larger separately derived system.
�1I ; ., e � .,,
14, 111 s1 l 11 It.:
; I:i., I,i , ,ii ,,irt1v.igt, tr,.pQ1 4 1 .. t -.:,{:1,1r.
.,sJ, 9f .. K „l ❑ Additionofnew mover loadof ❑ A' i 1 -2” 1.3
Job no.: I Job site address: 1 �,, ' � . �\ W V R 100HP or mare
&Dam El or more residential occupancy
units. ❑ Recreational vehicle parks.
City /State/ZIP: + ❑Health - care facilities. ❑ Supply voltage for more than
❑ Hazardous locanons. 600 volts nominal.
Suite/bldg./apt. no.: I Project name: ' ►t "`C, ❑ Servrce or feeder600 amps or more.
_'ill
nut �, d tY , 'nil r' ?sl n `i i, t 1, N � l1 �, F*. • U -1 r „- luf ,r . lf'.
T�''
Cross street/directions to job site: 1 peseriptian Orr. I Pee 1 Total 1
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'I 500 sq. ft. or portion 33.92 - 1
Tax map/parcel no }� �yt Limited energy. residential 67.84 2
E {. i . 1 ii. P ,i. t. : -1. .1 ii r . ib n f. „ la�i. k a,tP if"V -.. °i � , i h t li l r � :1 : r ti' u ; i , { (w above sq. ft.) . ■
lt Y/I I"I 1 1 1 1? 4.fTl.frr t'T Limited energy multi -family
v 67 84 2
r r 1 residential (with above sq. ft) 1
Services or feeders installation, alteration, and/or relocatio
200 amps or less 100.70 2
lJ � �'l`i. ,! dl ' v d' e i a (. e ,, i :4 1 r :h o f 1 )l filth , ZS it 1 Ih'.. ^ � 201 amps to 400 amps 133.56 2
401 amps to 600 amps 20D.34 2
Name:
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
City/State/ZIP: emporary services or feeders installation, alteration, and /or
15 : relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 1
Owner installation: This installation is being madc 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
1ttti'' ( r° ""' it r 1 l . i ji I( ' ,� iJl t';''1! r + " -i: t :, ! above service o f f
HN.'.:>, ;5, �1 k e i , s 1 c:r.: 7.42 2
each branch circuit
Business name: Johansen Electric In B. Fee for branch circuits
without service or feeder fee, 56.18 2
Contact name: Charlynn Leifsen first branch circuit
Address: 10948 SE Valley View Terrace Eachadd'l branch circuit 1 , 7.42 51 . 2
Miscellaneous (service or feeder not included)
CitylState /LIP: Happy Valley, OR 97086 Fach manufactured or modular 67.84 2
dwelling, service andfor feeder
Phone: (503) 698 - 3417 I Fax: : (503) 698 - 2486 Reconnect only 67.84 2
E-mail: ( ui( tt� '" #.#t tj ' Pump or irrigation circle 67.84 2
f...irli ' �a .3.!Jr �1"1f't= i'i.-. ,;,1If' i,::.'�H� %�trn }ltiii"t;f It a Ili (14u.. h.+� i -T l_ Signor outline lighting _
, a
energy panel, 67.84 2
Business name: Johansen Electric inc Signal p a n e l( l e r limited -
tcrat:on, or
Address: 10948 SE Valley View Terrace extension. Describe: Page 2 2
City /State /ZIP: Happy Valley, OR 97086 Each additional inspection over allowable in an , pf the above .
Per inspection 66.25
Phone: (503) 698 -3417 Fax: (503) 698 - 2486 Investigation per hour (1 he mil)) 66 25
CCB Lie.: 51539 Electrical Lic.: 3 -243C Suprv. Lic.: 2053S Industrial plant per hour 78.18
;u 13 �-. j t o " }� i� w , 5 ," P
Suprv. Electrician signature, required: of .1.. 0;,17_
Print name: Carl Johansen Date: y Q», 'v (12% Plan review (25% of pe mu fee): i2 •.‘11 CJ S tate su rchar ge (12 of permit fee):
Authorized signature: a t e TOTAL PERMIT FEE: + z I • 0 q ,
This permit application expires ir permit is not obtained within 180
Print name: Charlynn Leifsen Dale: �(� t1 days after it has been accepted as complete.
��(( t • Number of inspections allowed per permit.
1:' 4Bwldng 'ternutslELC- PemulApp.ern 10/01/09 440- 4615T(11/05/CO.Ml'PD
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Electrical Permit Application �-1 FOR OFFICE USE ONLY
,J 1 ` Received
City of Tigard + C,�I DateiB / ��J Pe No.: C LL A f), vC
• - Phone: 503.639.4171 Fax: 503.598.1960 11 7 - ° 13125 SW Hall Blvd., Tigard, OR 97223 Pla Review
t Date/By: I Other Permit: " 1.1 fix t --, �u...- 0 n 1
Inspection Line: 503.639.4175 AU t Date Ready/By: Juris: H See Page 2 for
TIGARD Internet: www.tigard a r g 4 tified / Method: ll Supplemental Information
® l y
�� F -
TYPE OF WOWORK Cl 1 PLAN REVIEW
Q
WORK _
Please check all that apply (submit 2 sets of plans w /items checked below):
® New construction ❑ Addition /alteration /re�
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 volts or ❑ Floating buildings.
less to ground. or exceeds 14.000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑Fire pump. ❑ Installation of75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A "E "I -2 "I -3 ",
Job no.: Job site address: 15300 SW PACIFIC HWY 100HP or snore. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: TIGARD, OR 97224 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: Project name: TIGARD SONIC DRIVE IN ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street /directions to job site: Description 1 Qtv. I Fee. 1 Total 1
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'I 500 sq. ti. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) 67.84 2
Limited energy, multi- family 67 84 2
IRRIGATION CONTROLLER BOX residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
® PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2
Name: MWF TIGARD, LLC 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: 2123 NW ALOCLEK DRIVE SUITE 1203 Over 1,000 amps or volts 552.26 2
City/State/ZIP: /State /ZIP: HILLSBORO OR 9 7124 Temporary services or feeders installation, alteration, and /or
Y + relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 1
Owner installation: This installation is being made on property that 1 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
® APPLICANT ! ❑ CONTACT PERSON above service or feeder fee, 7.42 2
each branch circuit
Business name: NEW GROWTH LANDSCAPE LLC B. Fee for branch circuits without
service or feeder fee, first 56.18 2
Contact name: MIKE KOLODZIEJCZAK branch circuit
Each add'I branch circuit 7.42 2
Address: P.O. BOX 1571 Miscellaneous (service or feeder not included)
City/State/ZIP: BEAVERTON OR 97075 Each manufactured or modular 67.84 2
Y � / dwelling, service and/or feeder
Phone: (503) 572 - 2628 Fax (503) 848 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E -mail: TERESAF @NEWGROWTHLS.COM
Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s) or limited- energy
Business name: NEW GROWTH LANDSCAPE LLC panel, alteration, or extension. I Paget 67.84 9
Each additional inspection over allowable in any of the above
Address: P.O. BOX 1571 opt)
Additional inspection (1 hr (1 ) 66.2 / hr min) 66.25/ hr hr
City /State /ZIP: BEAVERTON, OR 97075 min
Industrial plant (1 hr min) 78.18/ hr
Phone: (503) 848 -2404 Fax: (503 - 848 - 2408 Inspections for which no fee is 90.00/ hr
specifically listed (' /z hr min)
LCa Lic.: 7425 J Electrical Lic.: Suprv. Lic.: _
/ ELECTRICAL PERMIT FEES
361 I Subtotal: 67.84
Suprv. Electrician signat re, required:
Plan review (25% of permit fee):
Print name: Date: State surcharge (12% of penult fee): 8.14
TOTAL PERMIT FEE: 75.98
Authorized signat e' This permit application expires if a permit is not obtained within 180
/�� /� days after it has been accepted as complete.
Print name: M /�� „a L Date: FED / //' //� * Number of inspections allowed per permit.
1 : Building Permits ELC- PermitApp.doc 1 0 0 1 09 v � 440- 4615T( 1 105 COM WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RE SIDE NTIAI: WORK ONLY: ,
Fee for all residential systems combined $67.84
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener
❑ Heating, Ventilation and Air Conditioning System"
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORKONLY: ,
Fee for each commercial $67.84
system.
(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
111 Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1:\ Building \ Permits lE LC-Perm 9 App .doc I0 0 1/09