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Permit CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2007 -00804 _' COMMUNITY DEVELOPMENT DATE ISSUED: 11/28/2007 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S 101 AD -03200 SITE ADDRESS: 12909 SW 68TH PKWY )96"/' ZONING: MUE SUBDIVISION: TIGARD TRIANGLE CENTER LOT : JURISDICTION: TIG PROJECT: BENEFICIAL FINANCIAL Project Description: (15) branch circuits. 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: W /SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 14 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 CLACKAMAS, OR 97015 -000 Phone: Contact #: PRI 503 - 698 - 3417 FAX 503 - 698 -2486 FEES Description Date Amount Reg #: ELE 3 -243C ELPRMT] ELC Permit 1 1/28/200' $139.95 LIC 51539 I [TAX] 8% State Surcharge 11/28/200' $11.19 SUP 2053S Total $151.14 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 may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344. Issued By: � �� �, Permittee Signature: Q ' ) . 1 G_ 1 g o ' ; (- A llL 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. Electrical Permit A heat CByED rt ,R. (n,: i. l ( L 1 l (,-.1 ., City of Tigard 13125 SW Hall Blvd., Tigard, OR V 2 8 / • I' 17 / /..." i s,. i Plea Review • ir+' Phone: 503.639.4171 Fax: 503.598. I frspection 503.639.4175 c f ry ©f II (211A9 By. 9D Date Ready/ Other Permit Internet: vvvwv tigard -or.8a p i NoeSed/Method: 2 for V i Li r Supplemental Information � i ����y -� i�� I!� �(1��! I�bl �if1� 1 I 1 C•nl�'LL r y4. -.� , �' f t�.�! �11f�pp� pf.I L �' f � 1 �� ;c� &� qvi . 4faimi! I. f„1i 9113 1�,(�•1.W tY qq y11yy 1 { t11ltuflC=.��Rt.atc .., c 'F!! tit �� ti I 7 n! y r , 7 t , .7[ lalitiilM�lii:tGLld,a)lit L i I y 4 " -' i�l_�i` t� �t[ / , l / , C �{I�� {y 1,Y21��iSl � �1t� H!• i 411,...f:�a�.a'i'?�, f ��..w,rff:i {t�3:llf��l�:r..��11_ I ❑ New construction ® Addition/ alteration /replacement Piano chedf all that apply (submit j seta of plans writcma dieeked below): D ser.ioe « feeder 400 amps or more ❑Building over Stave stories ❑ Demolition ❑ Other: • ?' when the available fiwlt currant ❑ Marinas and boatymdf. +)l�li 2'Ygt'1?.)f( , '7C,�3. � 1� � �fr4 -Rr: 9Jtya K.+1 ::•:aka; ";;•�wz t>Aw.t <emN �tf h �f ,.b lag �..i;s ;: 0 .., -!!zw..� vas i.,bc .. :•.t, . 7 f„•s?e�:�t' f I ry fL�ta i,^ si?'r'i .:. exceeds 10,000 sumps at 150 volts or 0 Floating buildings. El and 2-family dwelling ® Cotnmerciallindtlshial spry building less m ®found, or exceeds 14.000 0 Comroarciat � teultral ❑ Multi - family ❑ Master builder ❑ Other: g CI Fire pump. ha for all other installations. building!. J ❑ tallarica of 75 KVA or pp r �f� w•'at4`f� {�If1�LpaNy 1hY1h�p(�l ��Yt 'Wn. t c nyL' ED SrA:I 019ia i'�!::iil, �' 7' ' p j a : t t 1 �+ 1 I t Sit a'�tH,� fg ❑ esgcnoy �6ICIO• ' X50. 4u.11,__`-,fs" ,- ., .;",utdz...: ..,,.aHl •mot, „ ( !S.1YI i3Ir �; t4 ; E' ; .f ❑ Ad ofnew motor bad of Or separately derived system f Jab no.: Job site address: 1 2,q q ( i 40 1001 ar Store. occupancy. r ❑ Six or more residential units. ❑ Recreational vehicle perks. City/State/ZIP: 0 Health -care &vilifies. 0 Supply voltage for m«o than no.: I'( 0 Haardooa locations 600 volts nominal. Suite/bldg./apt. I Project name: �yl G Q ❑ serv;ao « reader 600 amps «more. Cross stneet/directions to job site: J �^ ` I `.} I � � u'se u ` N _ 4 _ � mili f New residential single. or maraca- family dwelling unit ' Includes attached garage. Subdivision: I Lot no.: 1,000 sq. ft. or less 145.15 4 Tax map/parcel no.: Ea add' 500 sq. R. or portion 33.40 l F °lull el FI 'Fl "'S �} s q .�. ar !Bu 7y.�cTU. rlLLt t ) i.! !EMI Limited energy, residential t3 ".'u ?1743".isa :lb.i!'es'" 5 14: .:Ih c. ;t' .Zl:�lu .k xl�+ i 1n i E4 f�fw '6� .:�ti ',l[ (with above sq. 8) 7500 2 J411. O/f1I>s nu b b y Limited ide tial (, th above emily -rr1 !�"���/urt.Nta residential (with above aq. R.) 75.00 2 Services or feeders installation alteration. and/or relocation „�l (s•"`u .. ex rr Q,.,w. ya4-m �.^tt i-cti rm: nn v ft's �u.n ,�r _ 200 amps or less 80.30 2 Iii' <� 1 lu�4ly 4 !��f l ' 1 �p1 �r vu P a .nmi:a!�Lrlaii.�tti9,�4inn�,... l i. �v'"l. 31��1 ., tiLllll.` Uzu i'�? ?si ikNifiS'•" 201 amps 10 400 amps 106.85 2 Name: P, g, 401 amps to 600 amps 160.60 2 Address: p 1R3 s� � Qti )l( ill /3.x,0 Over 1,000 amps psD amps 240.60 2 / • ! � /P�/ %I/ Over 1,000 amtrfpe fn volts 454.65 2 - 2Z� Temporary services or feeders Installation, alteration, and/or City /State/Z1P: *,-Ha O� 9 Phone: ( ) r /- j Q Fax ( ) 200 amps or less I 66.85 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 maps J 133.75 2 Owner srgpature Date: Branch circuits - new, alteration, or extension, per panel 1.41111174a341;.-7.1b2 a , ,��,,,_.,.. , ,,. , t � A. Fee for branch circuits wick - ' .._.:�z 1+rSfjljirf>t�l iit �kthnJ iltllfftllL...I 1, P s Er '71M111 1 s l.� �i � ,� � i �� ..' i s ' , o , o ' above service or feeder fix, ,�',:.:$,..• �� � 6.65 2 Business name: Johansen Electric Inc. each branch circuit B. Fee for branch circuits Contact name: Charlynn Leifsen without service or feeder fee, first branch circuit 1 46.85 ,gs •2 Address: 10948 SE Valley View Teri. Each add'1 branch circuit (tf 6.65 13.10 2 City/StateJZip; Clackamas, OR 97086 Miscellaneous (service or feeder not 'minded) Each manufactured or modular 90.90 2 dwelling Phone: 003) 698-3417 1 Fax: : (303) 698 -2486 service and/or feeder E-mail johanseneketQa men nom React only 6685 , 2 ��i�lht�!f7�t�a ., f`' If+Tf.�i s %�� 'a ��l c.l r r; �v -n.�y! �u _ Pump or irrigation circle 53.40 2 "� ss a .t ..reran "?ftt�''!il _,af.,.:.�, „"�,... L,ti is I i 3; 1 /Main. . . _ 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 Teri, extension. Describe: Page 2 2 City /State/ZIP: Clackamas, OR 97086 Each additional inspection over allowable in an elite above Phone: (503) 698.3417 I Fax: (503) 698-2486 Per inspection 62.50 . - investigation per hour (1 hr min) 62.50 CCB Lic.: 51539 I Electrical Lic.: 3 -243C Suprv. Lic.: 2053S ind��ustrial lsr per hour 73.75 . Suprv. E %if ilfduitifilar ✓li .T r . �, :r:r.f tN•.;y. _.,i...f 1 ir. 0i uprV Electrician signature, required: ar-t k :.�.i:�..: •. Subtotal: ��JJ �s I ,1 'R;.t ,'. kl�� ..:ice'.:' •:;,t5i �i�:fl I 9.- / - Qy/ Subtotal: f 39 . ' 5 Print Warne: Carl Johansen / ► • e: 1 8 �7 Plan review (25% of permit fix): Authorized signature: ti State surcharge (8% of permit fee): 1 1. I q TOTAL PERMIT FEE: IS 1 • ty Print tannic: Charlynn Leifsen Thin permit application expires if • s Date: I1 11D? aml permit is within 180 t days after It kw been a c c e p t e d as complete. t:\BuildinglP rnitOEGC- PertmtApp.doo 07/23/06 440.1615T(I t /07/COn4/WEB , Number of inspections allowed per permit E'd X133 13fb3Sd1 dH WdEE :2 L002 82 AOW CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2007 -00604 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/2e/20o7 Phone: (503) 639 -4171 Avp Inspection Requests (24 Hrs.): (503) 639 -4175 - ° 111. INSPECTION WORKSHEET FOR DATE: 1/3/2008 TIME: 7 :00AM PAGE: 29 /Da SITE ADDRESS: 12909 SW 68TH PKWY3(f CLASS OF WORK: SUBDIVISION: TIGARD TRIANGLE CENTER LOT #: TYPE OF USE: PROJECT NAME: BENEFICIAL LIFE INSURANCE DESCRIPTION: (16) branc :h circuits. OWNER: PAaFIC REALTY ASSOCIATES, PHONE #: CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503 - 698 -3417 Inspection Request Scheduled For: Date: 1/3/2008 Pour Time: Code # Inspection Description / c;onfir) Contact # Message 159 Electrical final 062488.01 503 969-5262 N Corrections /Comments /Instructions: % PAS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Cr (' Le Date: 1'1 61 Phone #: (503) 718 - Z-`f'Ttp CITY OFTIGARD BUILDING DIVISION PERMIT #: ELC2007- 00804 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/28/2007 Phone: (503) 639 -4171 1 1 , II Inspection Requests (24 Hrs.): (503) 639 -4175 p:_.. INSPECTION WORKSHEET FOR DATE: 12/27/2007 TIME: 7:00AM PAGE: 10 p0 SITE ADDRESS: 12909' SW 611TH PKW CLASS OF WORK: SUBDIVISION: TIGARD TRIANGLE CENTER LOT #: TYPE OF USE: PROJECT NAME: BENEFICIAL LIFE INSURANCE DESCRIPTION: (15) branch circuits. OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: CONTRACTOR: JOIHANSEN ELECTRIC INC PHONE #: 5036913417 Inspection Request Scheduled For: Date: 12/27/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 130 Ceiling cover 062210 -01 503-969-5262 N Corrections /Comments /Instructions: PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL , ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: G'n Y vY L' Date: 1141' 01 Phone #: (503) 718- IVk_ CITY OF TIGARD BUILDING DIVISION PERMIT #: Et_C2007 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11128/2007 Phone: (503) 639-4171 Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 12/7/2007 TIME: 7 :00AM PAGE: 22 /CO SITE ADDRESS: 12909 SW 66TH PKWY 19tr CLASS OF WORK: SUBDIVISION: TIGARD TRIANGLE CENTER LOT #: TYPE OF USE: PROJECT NAME: BENEFICIAL FINANCIAL DESCRIPTION: (16) branch circuits. OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503- 698-3417 Inspection Request Scheduled For: Date: 12/7/2007 Pour Time: Code # Inspection Description _Q oifirm # Contact # Message 12b Wa1I cover •61066 -01 503-669-8341 N Corrections /Comments/ Instructions: PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: C' V Date: Q1 Phone #: (503) 718- 7.11'07