Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2008 -00099
COMMUNITY DEVELOPMENT DATE ISSUED: 2/25/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 101 AD -03200
SITE ADDRESS: 12909 SW 68TH PKWY 200 ZONING: MUE
SUBDIVISION: TIGARD TRIANGLE CENTER LOT : JURISDICTION: TIG
PROJECT: ACE INSURANCE
Project Description: Add (2) 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: SIGNAUPANEL:
MANF HM/ SVCI 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: 1 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: 503 - 624 -6300 Contact #: PRI 503 - 698 -3417
FAX 503 - 698 -2486
FEES
Description Date Amount Reg #: ELE 3 -243C
EELPRMT1 ELC Permit 2/25/2008 $53.50 LIC 51539
[FAX] 12% State Surchar 2/25/2008 $6.42 SUP 2053S
Total $59.92 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All
work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for
more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions " to � OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: Permittee Signature: QA/ /9"," L/ e;4
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF. SUPR. ELEC'N: DA./ /9 I/ 770 '1 DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
}
f ��E� Electrical Permit AnolicatEC , (,,; ,,,:,:,, I. I. ,, (1\1.'1
City of Tigar �: . , p
13125 SW Hall Blvd., Tigard, OR 97213 FEB %2U,;';''3 Date/11 : e a d � gi�� -' . No.:�C� eaeo B ®p
r- Phone: 503.639.4171 Fax 503.598.1960 0tlurPermitie1/'o7O Icf000r
, , , ,, , Inspection Line: 503.639.4175 D� ll ��® pate Rmldy/By :
� See Page 2 for
Internet: www.tigard- or.gov �y Supplemental information �' ' t :ri . tr$ _rl'i5fu6 jZ;' 1 •1 1 i{�.1 A1feftdd3Sl�lJit1 ; 1L{t' ir i'd ttitbA.. Er - w • ;i:i`I:702 o ld i ''
❑ New construction ® Addition/alteration/replacement Please check a0 that apply (submit 1 sets of plans w /itetm checked below):
❑ Demolition ❑ Other.
❑ Service or feeder 400 amps or more ❑ Building over three defies.
1 ll ifi'� x Kk� #� 7�>: � � �wu��{',,r`;r garunu sv rwmi •u where the available fault currant ❑ Marinas and boatyards.
Irmi • °� wre i{ii,i'.�kr`ow"�'a^; i4 b ` �. to i xrt , G ` ii ,
s r�ii io....' a:. ^•, r w -i 1m exceeds
srow0 amp at 1 0 volt or ❑ Float* il
buildings.
sgnculturd
❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building amps for an other installations. building..
❑ Multi-family ❑ Master builder ❑ Other: ❑ Fie pump. 0Instillation of 75 KVA Of
1 � »'�i q rfi}r'�t' }iii{ n � gut '1a Tie ::Mi ?n3 t 'r ❑ FinaBeacysystem. lags separately derivedsystem,
c a l e3.:::.h xa , dlniil;t� : c;�a " t l razyiLlll�;di:i f s ❑Addition of new motor load of
Job no.: Job site address: 12909 SW 68th, 2 0 0 100HP or more. occupancy.
0 Sts or norm residential units. 0 Recreational vehicle parka.
City/State/ZIP: ❑ Health -can facilities. 0 Supply voltage for more that
❑ Hazardous tombola. 600 volts nominal.
Suite/bldg. /apt. no.: 200 I Project name: ACE USA ❑ service or feeder 600 amp .
s or more
Cross street/directions bons to job site: i ;l 7. y ..
�✓' a J I1l , �o ' It F
oest a ow. t P M y Total •
New residential single- or multi- fiemtly dwelling unit
lodudes attached garage.
Subdivision: I Lot no.: 1.000 sq. ft or less 145.15 4
Ea. add'I 500 sq. ft. o :portion 33.40 1
Tax map /parcel no.: .
filyc; �,. Limited energy, residential
5 �� # ffi64 �� r r^ w: ' t r ' �i 75.00 2
:..„ r_. _�t il i..-.' " ': °'a .MINR.1 § q Z IA; with above se. ft.)
Limited energy, muhi- family
Tenant Improvement residential (wilt above so 8 75.00 2
Services or feeders installation alteration, and/or relocation
, fg llj mu 4 c s :.r w,a.eE �m9 fi l - 200 amps or less 80.30 2
3, t� 1 rleu'i.�,�:,N�:o: t w 1ii'.E�.�t63v._; 1 3 I T EIS M11, 'l! . o 201 amps to 400 amps 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: ( ) I Fax: ( ) 200 amps or Tess 66.85 I I
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:
Branch circuits - new, alteration, er extension, per panel
�M ill.:' ,-.`. t ' `• l llEt�l EM=1 „ '1;::;;�m s.�l„ mY� a=�s ii;� tll1il Vi A above service f ice or feeder e. /
a m t. a r1� �k « !1t:Y�a : e ;1}191:. ; °°, 6.65 2
each branch circuit
Business name: Johansen Electric Inc. B. Fee for branch circuits
Contact name: Charlynn Leifsen rrirlmra service or feeder fee, 1 46 46. 852
first branch circuit
Address: 10948 SE Valley View Terrace Each add'I branch circuit 1 6.65 6 . 65 2
City/State/ZIP: Happy Valley, OR 97086 Miscellaneous (service or feeder not included)
Each manufactured or modular 2
dwelling, service and/or feeder
Phone: (503) 698 -3417 I Fax: : (503) 698 -2486 Reecmnect only 66.85 2
E -mail: jobanseneleet®msn.com Pump or irrigation circle 53.40 2
,k `I : , .. at i` 1 'tl a '�i�1 iffia :i : f'.; ;y re!!.i I ;1rSPA ' IMA 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 eoctension. Describe: Page 2 2
City /State/ZIP; Happy Valley, OR 97086 Each additional inspection over allowable in a . of the above
Per inspection 62.50
Phone: (503) 698-3417 I Fax: (503) 698 -2486 _ Investigation per hour hr mm) 62.50
CCB Lic.: 51539 I Electrical Lic.: 3 -243C / 1 Suprv. Lic.: 2053S Industrial .lent per hour e- " 73.75
Suprv. Electrician signature. required /� / = , '„ ' l � pAs ',." f d .. fr :ter �:!', L '
Subtotal: •
Print name: Cad K. Johansen v l Date: 2 22 08
Plan review (25 °/a of permit fee):
Authorised signature: State surcharge (1 rA, of permit free . „4.....243--4,. ya.
TOTAL PERMIT FEE: 5 7. %a c °l,
Print name: Charlynn J. L e i f s e n I Date: 2/22/08 � ' p e r m i t ��on expires if • p e r m i t b not .. r1... -. within 1 +�
days after it has been accepted as complete.
• Number of inspections allowed per permit 4
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CITY OF TIGARD •
BUILDING DIVISION PERMIT #: 200/.0601
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 :moot
Inspection Requests (24 Hrs.): (503) 639 -4175 �..
INSPECTION WORKSHEET FOR DATE: IN." ...6 TIME: PAGE:
SITE ADDRESS: 125M6 W S$ PKw'y Zoo CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION: `i I
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date3" 1 - Q 4 Pour Time:
Code # Inspection Description Confirm # Contact # Message
Corrections /Comments/ Instructions:
'fA 1\
�
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G L* Date: 3' Q' V o Phone #: (503) 718- VA.
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2009.00099
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/25/2008 •
Phone: (503) 639 -4171W
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 3/14/2008 TIME: 7:OOAM PAGE: 48
SITE ADDRESS: 12909 SW 618TH PKWY 200 CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE CENTER LOT #: TYPE OF USE:
PROJECT NAME: ACE INSURANCE
DESCRIPTION: Add (2) branch circuits.
OWNER: PACIFIC REAL :fY ASSOCIATES. PHONE #: 503624 -6300
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503698
Inspection Request Scheduled For: Date: 3/14/2008 Pour Time:
Code # Inspection Description n irm # Contact # Message
109 Electrical final - 466694 -01 503 - 209 -3917 N
Corrections /Comments/ Instructions:
�L P &Z•1 1OE 6,LL l - pOIVI Q S. Alt! <<■( 3 (i'■
•
❑ PASS ❑ PARTIAL APPROVAL El CANCEL ❑ NO ACCESS
c FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G N 68 Date: 3• - Phone #: (503) 718- 1
•
CITY OF TIGARD • _ ,
BUILDING DIVISION PERMIT #: ELC200B•00099
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/25/2006
Phone: (503) 639- 4171iAIIlI
Inspection Requests (24 Hrs.): (503) 639 -4175 . �!,
INSPECTION WORKSHEET FOR DATE: 2/27/2008 TIME: 7:00AM PAGE: 56
SITE ADDRESS: 12909 SW 68TH PKWY 200 CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE CENTER LOT #: TYPE OF USE:
PROJECT NAME: ACE INSURANCE
DESCRIPTION: Add (2) branch circuits.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: 503 -G24-6300
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503 -690 -3417
Inspection Request Scheduled For: Date: 2127/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
125 Wall cover 065680 -01 503 -969 -5262 N
Corrections /Comments/ Instructions:
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
F ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G- -N N 66 Le Date: 2.11 • DA Phone #: (503) 718- 2"1tk
CITY OF TIGARD . , _ -
BUILDING DIVISION PERMIT #: EL.C2008.0O099
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/25/2006
Phone: (503) 639 -4171 / w '■
Inspection Requests (24 Hrs.): (503) 639 -4175 "'' I..
INSPECTION WORKSHEET FOR DATE: 2/27/2008 TIME: 7:00AM PAGE: 9
SITE ADDRESS: 12909 SW 60TH PKWY 200 CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE_. CENTER LOT #: TYPE OF USE:
PROJECT NAME: ACE INSURANCE
DESCRIPTION: Add (2) branch circuits.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: !iO3 -624 -6300
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503 -698 -3417
I
Inspection Request Scheduled For: Date: 2/27/2003 Pour Time:
Code # Inspection Description Confirm # Contact # Message
\
) 130 Coiling cover N O657413 -01 503-969.5262 N
Corrections/Comments/Instructions:
■, PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
• • ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Cr A ( 4- 6 L ' Date: ?/ L7' Y% Phone #: (503) 718 - -4L v