Permit IN CITY OF TIGARD
ELECTRICAL PERMIT
n
COMMUNITY DEVELOPMENT Permit #: ELC2009 -00538
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 10/08/2009
T i G FORD Parcel: 2S112DC00500
Jurisdiction: TIGARD
Site address: 15895 SW 72ND AVE 210
Subdivision: OREGON BUSINESS PARK III Lot: 40
Project: Spec Space
Project Description: Add /alter (6) branch circuits.
Owner: FEES
PACIFIC REALTY ASSOCIATES Quantity Description Date Amount
15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224 6 crt Branch Circuits 10/08/2009 $93.28
wo /Purchase Service or
PHONE: 503 - 624 -6300 Feeder
1 ea 12% State Surcharge - 10/08/2009 $11.19
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 $104.47
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 R 952 - 0034100. 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: act ` Q i I �)3 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:
` op CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Q ., Date:
LICENSE NO. � J(y , J `V �/
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 ApplicatiolOCEt\
' Dti
City of Tigard eceived
r , c Pen
zpZ9 it Date/BPeru No' : 1.C.z.)o 9 .
I
I . 13125 SW Hall Blvd., Tigard, OR 97223 n i. 1 kr 0 Plan Review
Phone: 503.639.4 171 Fax 503 598.1960‘ pat Other ilei a lin
Inspection Line: 503.639.4175 I1CIP'"-IX° •• Date Read y/By: Jurw El See Page 2 for
Internet: www.tigard CAri ° .0 piN ISD1\ Notified/Method: 1 i c—i Supplemental Information
it u
i f**001-r i lr i ,l 1 :_,..-7' 11 .'''''''il i ti''i•ltl: - } 1, =::;' li'i ',- ':'::'''• - ":1' ,, 4:1 ;••• `;:
,,,,,,,,,-„-;:,- •-• -,. :I- ,,, g;••, , ,N.N.,,,,,...:... '. 01 ,; . .. .. . . ,....„ . - - ,:.,-,.•,•,. ,, .: ;;.,;', ..., : , " ..1.• '; ,,, .• •'. .,-,,, , . - - . . -
D New construction nAdditionialterati on/replacement Please check all that apply (submit 2 sets of plans wirtecos checked below):
0 Service or feeder 400 amps or more 0 Building over three stories.
0
Demolition 0 Other: where the available fault current El Marinas and boatyards.
- sr - k. ,•-`, ■••.:1: 4 , r
oGot.w004010441 -.'.4 ::::::.„, exceeds 10,000 amps at 150 volts or 0 Floanng buildings.
less to ground, or exceeds 14,000 0 Commercial agricultural
E 1 - and 2 dwelling El 0 Accessory building amps for all other installations. buildings
El Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 75 KVA or
1 a k ... .i •, :. l i ., , • , -.1 , -• i ,,,,,,,, . 0 Emergency system. larger separately derived system
611 ' 1: tli' l'40 ***** ° J E i40: 4 *: . :4 ) ... 1 Ati,. 11 iftli i•I'. !1 0 Addition of new motor load of
Job no.: Job site address: 15sci 54As 90 4 9 0 m
1001-1P or more
Six or are residential 'Ina 0 s. occupancy
Recreational vehicle parks
City/State/ZIP: ID Health-care facilities. 0 Supply voltage for more than
0 Hazardous locations 600 volts nominal.
Suite/bldg./apt no.: 2_10 Project narne: v atcy\clic ;
- 0 Senioe or feeder 600 amps or more.
"it : •I,, :: ..;::i'.v, ',,,,:;;;:i4‘i(Ottitittittjftlii 'l•IlL'''..F.I.F11.144;11l'1.1
Cross streetldirections to job site: Description I Oly. I Fee. I 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
1 Ea. addl 500 sq. ft. or portion 33.92 I
Tax map/parcel no
Limited energy, residential
1 "'"`‘ . ' 4isofoilitisi: 0. :1,';:. . ' . 4.1 , , ..iii• !:i':' ','.: , (with above sq. IL.) 67.84 2
-
Limited energy, multi-family
0 J/ ettit_ V\ tiN VA_ C&J\ C& Gen. CR, res:dential (with above sq ft.) 67.84 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 1 2
!!t'' ' i pp I1 '1 '•..' . ' 1 .H.ii...ii,di'ii •, „. .1:1..1i1 i. 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 1 552.26 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 1 59.36 _ 1
i
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. 1 401 amps to 599 amps 1 16834 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date:
A. Fee for branch circuits with
! I,: :x.,;; . :',,i 1 ,' .1,:.IM:Xiii•aitliftir,::',Vri , 4 ' !' ir dit40 above service or feeder fee,
7.42 2
each branch circuit .
Business narne: Johann Electric B. Fee for branch circuits
t ,
Contact name: 10948 SE Valley View Terrace
without or feeder fe 56.18 gv it 2
first branch circuit
Address: Happy Valley, Oregon tt i086 Each add'I branch circuit _ 5 7.42 31,) o 2
— CeBlt - rat539 1 Miscellaneous (service or feeder not included)
City/State/ZIP: d E w ac e h llin m g anu s factu ice re an d o
67.84 2
Phone: ( ) I Fax: : ( ) I Reconnect only d .
67.84 2
E-mail: Pump or irrigation circle 67.84 2
1:1'1' 1 l f,...:::TT: l ' I : 1 1'''Okle1R1401:111t' :” : il,:1,, i: 1! 1:'.•,114; ii :' tli a, Si or outline lighting 67.84 2
. -
Business name: Johansen Electric Signal eircuit(s) or limited-
energy panel, alteration, or
Address: 10948 SE Valley View Terrace extension, Describe: Page 2 2
Happy Valley, Oregon 97086 -
City/State/ZIP: ((R # 51K19 Each additional inspeedon over allowable in any of the above
Per inspection 66.25
Phone: (53) 6,ig—..(4)-1 F a x : ( ) Coqg —20g6, Investigation per hour (1 hr min) 66.25 I
CCB Lic.: 51.3q Electrical Lic.: 3_ iii3e.._ Suprv. Lie.: 2.-1).53S . Industrial plant per hour ., ,,_ , , 78.18
Suprv. Electrician signature, required: ait'd itfrtC004., At 41 T; - ' 'agOtRIC4: 4 0'
Subtotal:
Print name: Ca,(1 - 3 -- Ohmst i o ..,....„ _.... Date: ID 1 )bel Plan review (25% of permit fee):
State surcharge (12% of permit fee): I I , ic)
Authorized signature: a...„..../......- TOTAL PERMIT FEE: / 0 V.147
, -.
This permit application, expires if a permit is not abtaised within 180
Print name: (_ hadrtt/j VII tit 4-St--fl Date: 101(0itill days after it bas bees accepted as complete.
" Number of inspections allowed per permit.
Piaui ldiqg \ Permits \ EIX-PermitApp doe 10(01 440.461 5T(1 1,05/COMAVER
E XIdd 13rd3S1:11 dH WILIOI:OT Gooa 90 400