Permit CITY OF TIGARD ELECTRICAL PERMIT
° PERMIT #: ELC2008 -00676
COMMUNITY DEVELOPMENT DATE ISSUED: 12/16/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 112 DA -01400
SITE ADDRESS: 15350 SW SEQUOIA PKWY 190 ZONING: I -P
SUBDIVISION: PACIFIC CORPORATE CENTER LOT : 002 JURISDICTION: TIG
PROJECT: DIANA HARRISON CPA
Project Description: TI.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 1 W /SERVICE OR FEEDER: 10 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 0 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
PACIFIC REALTY ASSOCIATES JOHANSEN ELECTRIC INC
15350 SW SEQUOIA PKWY #300 -WMI 10948 SE VALLEY VIEW TERR
PORTLAND, OR 97224 HAPPY VALLEY, OR 97086
Phone: Contact #: PRI 503 - 698 -3417
FAX 503 - 698 -2486
FEES
Description Date Amount Reg #: ELE 3 -243C
[ELPRMT] ELC Permit 12/16/2001 $146.80 LIC 51539
[TAX] 12% State Surchar 12/16/2001 $17.62 SUP 2053S
Total $164.42 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You ies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: �,� �/� • ermittee Signature: �Q / L.4475r-
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'N: 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.
W
Electrical Permit A lice i O
pp t O � � FOI((11'I I( . 1- . 1 .ti F. U�L■
City of Tigard ®!` (O .
Received
13125 SW Hall B1 Ti ® ■ ��s Date/13 : /fo �j� (a
- ® C\ Plan Da Review Other Permit .
• Phone: 503.639.4171 Fax: 3. 19Cp ` 99 O` r m e : t: J , 4 •
. 1 , , . t , Inspection Line: 503.639.4175 �`(� �` ` r am Ready/By: '
yy w or.gov `` `� Notified/Method: ,y� 1W ��
Internet:
;fl: ' x t . El I �@ I Lc I "�� . rlti:{ii69i e..!tA (,. A'R ,l j� t + p ��{ a � a ��ilti 0 ;11 :•.11flaltedhl', .,�W. � INEF. d
l m,. 1iC 4t. .� LL� 7 / - �- ••1 �1 rw, { 1 1.1'
❑ New construction ®Addition/alt n \ cement Please check all that apply (submit l sets of plena atitema checked below
❑ O
❑ Demolition Other: T7` ❑ Service or feeder 400 amps or more 0 Building over three stories.
i 7 d �l> ; 4pta l trpn n:mnurpPx:s l �,,. where the available fault current 0 Marinas and boatyards.
., ,PAIT 1� �l�r' ';�`t.1=`,:;, ;.ir' a i '1 : �: r�� • : exceeds 10.000 ompe at 150 volts or 0 Floating buildings.
El l- and 2-family dwelling less to ground, or exceeds 14,000 0 C nurse dal -use agricultural
Y g ® Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. 0 installation of 75 K VA or
+l�t,f .� •g s y sn� t rc calls e N Esc .�,• Il ergerwparaoelyde i ayaem
• ai �
in 1�!r � &;t: +try r,t'a iL'lia au:: �'( W " t ., ❑E 1
r. i .a ad3;n au,aaa! :�:dtiu i ua Baal rl sr 1 Iff �^ ❑ Add itio n of new motor bad of 0 °A_, 'B ", "1.1" "I_7
Jobno.: Job site address: 15350 SW Sequoia 1o011Pormom. OQ11pancy.
City/State/ZIP: 0 Ha � or residential units. 0 Recreational vehicle parks.
Supply voltage for more than
0 Hazardous locations. 600 vole manna.
Suite/bldg. /apt. no.: 19 0 I Project name: Diana Harrison 0 Scrvice or feeder 600 amps or mere. ((
Cross street/directions to job site: 1 • • - • a' -'
Daterhaden Orr. Pea Total •
New residential single- or mild- family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 000 sq. ft. or less 145.15 4
Tax IMP/parcel no.: Ea. edd'I 500 sq. ft or portion 33.40 1
I1 i.: �} s a �: L7 (:II t a Limited energy, residential
1 r J,1ENI d r; ice t inn„ •o ff}..t�i '"j. k 'rJi '!i ll Il ly " >r'uE... (with above a4. es 75.00 2
Limited energy, multi - family 75.00 2
Tenant Improvement residential (with above sq. ft.)
Services or feeders installation alteration, and/or relocation
�,- - 4
I;L T.�u:F••"+,{�tilY. ; ='ua� 111,,...1 ,!- 1 s 200 amps or less 1 80.30 80.3c 2
•
K 1 ' :ell . ,u r;1.ili?i nt 31jii ,ii� , N{'- � , p,': ;k(L"a '�"�' .0 Ft I . r r`.. Ica 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
Address:
601 amps to 1.000 amps 240.60 2
Over 1,000 amps or volts 454.65 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
I relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps I 1 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
t .. r A. Fee for branch circuits with
u °`' „f7 n!�on��.. II :add � `� a bove service or feeder fee, I f
- ....�� . �. �. :,1l�Fe�t.u:i�rr�,�'�iD1iR�'��� t e r ` V 6.65 e ito 5
Business name: Johansen Electric Inc. each branch circuit
B. Fee for branch circuits
Contact name: Charlynn Leifsea without service or feeder fox, 1 46 • 85 2
first branch circuit
Address: 10948 SE Valley View Terrace Each add'I branch circuit 6.65 9 • 8 5 2
Miscellaneous (service or feeder not included)
City/StaleJZIP: Happy Valley, OR 97086 Each manufactured or modular
Phone: (503) 698 -3417 I Fax; : (503) 698 -2486
dwelling, service and/or feeder 90.90 2
Reconnect only 66.85 2
E -mail: johanseneleet@msn•com Pump
„a i IN rsatf l i t R :VOV'KI .,.�.,, ..... or irrigation circle 53.40 2
i
, 18 EC 'ps i l} illo; 7TI .7: ?, galia .na i EM Sign or outline lighting 53.40 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/ZIP: Happy Valley, OR 97086 • Each additional inspection over allowable in any of the above
Phone: (503) 698-3417 I Fax: (503) 698 -2486 Per inspection 62.50
Investigation per hour (1 br min) 62.50
CCB Lic.: 51539 I Electrical Lic.: 3 -243C I Suprv. Lic.: 2053S Industrial .lent • how 73.75
Suprv. signature, hire t a b l� l i
!i' ;f 'rg1 l '71� t ii '! .,
S rv. Electrician signs required: Cat/ K jell? 4.i49844 { x i u "?�; - { t 0
4f(o
Print name: Carl K. Johansen Date: 12/16/08 . - Plan review (25% of permit fee):
State surcharge (12% of permit fee): 2 2 . 4 4 17, (vr)-+
Authorized signature: C.,- ■,_ TOTAL PERMIT FEE: 2 0 9 . 44 `'oti i3O
Print name: Charlynn J. Leifuen I Date: 12/16/08 This permit application eepu'n if • permit is not obtained within 180
days after it MN been accepted as complete.
I: 1 8uil�ng■PemidlEt ,OF4tmitgpp.doe 07!13/06 • Number of inspections allowed per permit.
440 . 4615 T( 1 1105/COMN✓Ila
1 ' el Xdd 13C213S131 dH WbO I : I i 8002 91 cal
'.::CITY OF TIGARD
33UILDING DIVISION PERMIT #: ELC2O00.00676
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1211 woos
Phone: (503) 639- 4171r'�I�*
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 1/-13/2009 TIME: 7:OOAM PAGE: 7
SITE ADDRESS: 15360 SW SEQUOIA PKWY 1!:10 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: Q02 TYPE OF USE:
PROJECT NAME: DIANA HARRISON CPA
DESCRIPTION: TI.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: JOHANSE.N ELECTRIC INC PHONE #: 603-69a-3117
Inspection Request Scheduled For: Date: 1/13/2009 Pour Time:
Code # Inspection Description /Con ri m #N • Contact # Message
199 Electrical final 079640 -02 � 603-91a5262 N
Corrections /Comments /Instructions:
0 PAS n PARTIAL APPROVAL CANCEL n NO ACCESS
• ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: L.0 Date: 1 • 1- 3 ' Phone #: (503) 718-1./11-g)
CITY OF TIGARD 4 .
BUILDING DIVISION PERMIT #: 8...C2008-00V/6 13125 SW Hall Blvd., Tigard, OR 97223 DATEISSUED: 12/16/2008
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 '''l
INSPECTION WORKSHEET FOR DATE: 1/2/200c1 TIME: 7:01Am PAGE: 16
SITE ADDRESS: 13350 SW SEQUOIA µ1W r 190 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: 002 TYPE OF USE:
PROJECT NAME: DIANA HARRISON CPA
DESCRIPTION: Ti.
OWNER: PACiFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC: PHONE #: 503 - 598.3417
Inspection Request Scheduled For: Date: 1l7J2009 Pour Time:
Code # Inspection Description - Confirm # Contact # Message
130 ".oiling cover LI19335.01 503 - 969.5262 N
Corrections /Comments /Instructions:
l
li
' !
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL El CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G IV 66 ■ Date: 1 ' j 1 Phone #: (503) 718- 1-9
CITY OF TIGARD
.BUILDING DIVISION co PERMIT #: ELC200B 00676
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1211E42008
Phone: (503) 639 -4171 /6, ,
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 12/230008 TIME: 7 : 00Al PAGE:
SITE ADDRESS: 15350 SW SEQUOIA PKWY 190 CLASS OF WORK:
SUBDIVISION: PACIFIST CORPORATE CENTER LOT #: 002 TYPE OF USE:
PROJECT NAME: DIANA HARRISON CPA
DESCRIPTION: T1
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503 -69 &3417
Inspection Request Scheduled For: Date: 12/2:312008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
125 / ---------- cover 079193-02 503-969 -5262 N
Corrections/ . - -- - s ructions:
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
7 FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date/ .2_ —2 -,j) Phone #: (503) 718-