Permit 1
CITY OF TIGARD ELECTRICAL PERMIT
° PERMIT #: ELC2008 00600
li fil
° COMMUNITY DEVELOPMENT DATE ISSUED: 10/24/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S113AA -00400
SITE ADDRESS: 16260 SW 72ND AVE B2 ZONING: I -L
SUBDIVISION: OREGON BUSINESS PARK I LOT : 018 JURISDICTION: TIG
PROJECT: AMSOIL
Project Description: Electrical 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: 2 W /SERVICE OR FEEDER: 20 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 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 10/24/2001 $293.60 LIC 51539
[TAX] 12% State 10/24/2001 $35.23 SUP 20535
Total $328.83 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 to in •AR 952 - 001 -0010 through OAR 952 -001 -0100. You may obtain copie of these rules or direct questions to OUNC at
503.246.6 9 or 1.800.
■
Issued / I iL■1 Permittee Sig - ,, . 1.17 _ / /�--
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:
• NTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' • : Ilk_ . . d1- .XSTMJJ7 .4)---------- 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.
.-
Electrical Permit Applicat� C�E O 1.()R ()r, ,( 1 s,; (,., ,
City of Tigard I� Received
Date 13125 SW Hall Blvd., Tigard, OR 972¢(3] . 1 .. e7 2. Plan Review .0-3 U ,, Permit No.: it_ ,,, ^'�/ � dli
0 ' Phone: 503.639.4171 Fax: 503.598. F9bD Date :: Outer Permit:
1 , -., t r Inspection Line: 503.639.4175 0016 w, Dam Ready /BY Ito See Page 2 for
Internet www.tigard- or.gov ant VI ' ISION Noti6ed4Netbod: Supplemental Information
h t .?r•'Ut� r ��,'I ' . 4: i'tr4x911 t, { 7.' �' I I 'y " "it t i i " 7 "iluk't} °vcm rye• sa r e
:iFJldt-t Y "„ . ' .cis �L ir�1 111f it M :du ri ng .€ di 9 a a 1 as i"' i 3 t�{h . } ! i '4
' ° rA..). `a�eceaxhSi.a a � � .. . .. bat .. , .wl\ -.1 - � .. t � '.11kei 7 t � y � er
❑ New construction IS Addition /alteration/replacement Please check all that apply (submit asets of plans whams checked below):
Demolition ❑ Other ❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑
o where the available fault current ❑ Marinas and boatyard&
t l r a fit. �+1 t �(1 � n tty tzr+w74:e ?t ; u i�c rn a j .._
MM L° t,1 M mi <',�e 23 �r ,i, t uF+ c� Ei17117a j i t 1 r A t,I 4$71;,1 I' exceeds 10.000 amps at 150 volts or ❑ Floating buildings.
❑ 1- and 2 - family dwelling ®Commt:rcial / industrial less m ground, a exceeds 14.000 ❑ Com,nercialvee agricultural
❑ Accessory building amps for all caber installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
ns T" nwTtitl�n,�t x�e ir-�e a tp�aF e ` a ^ t rv tek. }�d� ❑ larger separately derived system.
- �.-- a •' s "' C mfr +� y J a a , 3 t uy I g lE • �l' r4 a l r
� Il { � 2 ❑ Additio Emcgexroy n of rww sY or load of mot ❑ •A E , 1 -Z l_3
wlttt< tai.d mhikas:ksl�er:.l�td. V .o-rtlilir'.l.it,.tt�rad' .
Job no.: Job site address: 16260 SW 72nd 100HP or more. occupancy.
❑ Six a more residential twits. ❑ Recreational vehicle parks.
City/State/ZIP: lg lieatth - care facilities. 0 Supply voltage for now than
['Hazardous locations 600 volts nominal.
Suite./bldgJapt. no.: 1 Project name: AMS011 0 Service or feeder 600 amps or more.
ctr� r. • �� .- . ••!, wearq� :r..,e,a.k a.-c c n; f tv y �
p `t111! ?,'1.+4ItJUltt tf''Z -t:t =+n` k a, i li t } i;l ,3 L• t t':��l7tk°!- rat
Cross street/directions r ; r,6e. 04v. x::,:. street/directions to job site: neseriptloa o4. Pet. Total •
New residential single- or malti- family dwelling emit.
Includes attached garage.
Subdivision: 1 Lot no.: 1,000 sq. R or less 145.15 , 4
Ea. add') 500 sq. ft. or portion 33.40 1
Tax map/parcel no.: Limited energy, residential
I'WRr uR°Illii { ;. i t�i } rtn trns: r t mt( r , wbT l,:
i >tetl r� $ •' i I..,4.118.iittai.. ',. it(81tsc.,eiFle y .,i, ' .1e .,1 . % 'ct .t> � �� t ; 1 1 i (with above so. E) 75.00 2
Limited energy, multi- family 75.00 2
Tenant Improvement residential (with above sq. ft.) _ ,
Services or feeders iavtallatioo and /or relocation
' 1' rtc �t tr r.c a}} rs.ut4in} null^ 1il9Pfi 11 r { ssewu tt 6 200 amps or less 2 80.30 6 0 . 6 2
ll * l� util r#.3;:1;i1�3crLi i r� i� li_1 (ItihHI N 128 ; ` li�1,' ° f,`�i,, , . t srl j{ it i 201 amps to 400 turps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City / State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 I 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 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
�n 7 A. Fee for branch circuits with
.361 'R�' 't U'� -:.- t ' ` ' l 7 `k, ;cii im fi , `I'•*,:s iLaep . riF, . ir ..� ., ,
`,t .r.- ' 12.. f ##1(k it lltit ti. )a;5: k:} i. hl tea. i.4 � t.,i I' t above service or feeder fee
awrW ti.t,.. each branch circuit 20 6.65 133 2
Business name: Johansen Electric Inc. B. Fee for branch circuits
without service or feeder fee,
Contact name: Cbarlynn Leifsen first branch circuit
46.85 2
Address: 10948 SE Valley View Terrace Each add'l branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City /State/ZIP: Happy Valley, OR 97086 Each manufactured or modular 90.90 2
dwelling, service and/or feeder
Phone: (503) 698-3417 1 Fax: : (S03) 698-2486 Reconnect only 66.85 2
E -mail: jobansenelect (gmsn.com y; 3�;., y�{[t l ;.g.�p Pump or irrigation circle 53.40 2
r, n its •}! t l J of r II g `� f � c A 7 . Ar:.}f 821§ D"T36.ag"�f O
Irrli� ��t. Freel_ �. Il !1����lILl1L*tt.�.+_ °� -Jba' �.. . �� � 1 t;�r d 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
Per inspection 62.50
Phone: (503) 698-3417 Fax: (503) 698 -2486 Investigation per how (1 hr min) 62.50
CCB Lie.: 51539 Electrical Lic.: 3 -243C 1 Suprv. Lic.: 2053S 'Industrial Plant per hour 73.75
•. f l . ,. ! •vew r . t n ,
1 ... "Fw I :::.:' i.-_5 . 1' r, :: �ii`t.i:.:.'l'.1 IZZAT; i
Suprv. Electrician signature, required: ( t (I4 �( Subtotal: • , • it
Print name: Carl K. Johansen Date: 10/23/08 Plan review (25% of permit fee):
State surcharge (12% of permit fee): 3 5 . 2 3
Authorized signature: TOTAL PERMIT FEE: 3 2 8, 8 3
Print name: Charlynn J. Leifsen Date: 10/23/08 This permit application expires if a permit is not obtained within 180
days after It has been accepted as eosuplete.
t: lBwIdingPermitatELC- PenaitApp.doc 05/23/e6 440.4615T(II/OS /COM/WEB • Number of inspections allowed per permit.
•
T Xdd 13rN3S1d1 dH WdL :T 8002 E2 400
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2008-00600
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/24/7008
Phone: (503) 639 -4171 I�I
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 1/7/2009 TIME: 7:01AM PAGE: 11
SITE ADDRESS: 16260 SW 72ND AVE B2 CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK I LOT #: 018 TYPE OF USE:
PROJECT NAME: AMS011
DESCRIPTION: Electrical TI
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503698 -3417
Inspection Request Scheduled For: Date: 1/7/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
138 Electric:al final 079471 -01 50:3 -969-5262 N
Corrections /Comments/ Instructions:
�\ J
YV
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: N 6e I.ar Date: • 1- 1 Phone #: (503) 718- allYv
CITY. OF TIGARD
BUILDING DIVISION PERMIT #: ELC2O0B.00600
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10124/2008
Phone: (503) 639- 41711�
Inspection Requests (24 Hrs.): (503) 639 -4175 _! 'I_I�
•
INSPECTION WORKSHEET FOR DATE: 12/22/2008 TIME: 7:OOAM PAGE: 3
SITE ADDRESS: 1€260 SW 72ND AVE 132 CLASS OF WORK:
SUBDIVISION: (.)R 3(aid BUSINESS PARK I LOT #: 018 TYPE OF USE:
PROJECT NAME: AIVISOIL
DESCRIPTION: Electrical TI
OWNER: PACIFIC REALTY' ASSOCIATES, PHONE #: •
CONTRACTOR: JOI-IANSEN ELECTRIC INC PHONE #: 503-698-M17
Inspection Request Scheduled For: Date: 12/2212008 Pour Time:
Code # • •ectio. a -scription Confirm # Contact # Message
130 Ceiling cover 079/8601 503 - 969.5262 „ • N
Correct • - ents /Instructions:
•
- 15KSS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: • [1i 4 Phone #: (503) 718-
CITY OF TIGARD
... --.
BUILD IVISION . PERMIT #: ELC2008-00600
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/24/2008
Phone: (503) 639-4171 Affidtw
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 1218/2008 TIME: 7 oam PAGE: 13
SITE ADDRESS: 16260 SW 72ND AVE B2 • CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK I LOT #: 018 TYPE OF USE:
PROJECT NAME: AMSOIL
• DESCRIPTION: Electrical TI
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 603-698-3417
Inspection Request Scheduled For: /Date: 12/8/2008 Pour Time:
,
i
Code # Inspection Description onfirr
Contact # Message
126 Wall cover 078856-01 \ 603•969-5262 N
Corrections/Comments/Instructions:
/
\---___---
M 0 eAl 01 cerracc___
PARTIAL APPROVAL E CANCEL E NO ACCESS
n FAIL n CALL FOR INSPECTION E ADDITIONAL FEES ASSESSED
• Inspector: G'. 6 I S 8 Le Date: 1 IA Phone #: • (503) 718- _AA__