Permit /\" CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2002 -00481
qa DEVELOPMENT SERVICES DATE ISSUED: 9/17/02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S101AD -03200
SITE ADDRESS: 12909 SW 68TH PKWY 400
SUBDIVISION: TIGARD OFFICE BUILDING ZONING: MUE
BLOCK: LOT : JURISDICTION: TIG
Project Description: Revisions Of Offices On 4th Floor, South End Of The Building
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: SIGNALIPANEL:
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 TERRACE
PORTLAND, OR 97224 CLACKAMAS, OR 97015 -000
Phone: Phone: 503 - 698 -3417
Reg #: LIC 51539
SUP 2053S
ELE 3 -243C
FEES Required Inspections
Type By Date Amount Receipt Elect'I Final
PRMT CTR 9/17/02 $139.95 2720020000(
5PCT CTR 9/17/02 $11.20 2720020000(
Total $151.15
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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -6699 or 1 -800- 332 -2344.
Permit Signature: % ' Issued By:
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 639 -4175 by 7:OOpm for an inspection the next business day
From: Charlynn J. Leifsen To: City of Tigard Date: 9/11/2002 Time: 3:10:46 PM Page 3 of 5
r•
Electrical Permit Application t 11 11 "\i,
l
,. ! T. t tN +i, ± Date received: Permit no. • '' - 0 V
- City of Tigard �- , �, Ptojecdappl. no.: Expire date:
City of ord Address: 13125 SW Hall Blvd, T OR 97 223 Date issued, ay. Receipt _
Phone: (503) 639 -4171
Fax: (503) 598 -1960 SEP 1 1 2(102 Case file no.: Payment type:
Land use approval: Q:ki I. Oa £u.15.0 J
1 1 PI 4)1 VI RIIII
0 1 & 2 faintly dwelling or accessory �e'tommercial/induatrial U Multi - family 0 Tenant improvement
0 New construction 0 Addition/alteration/replacement 0 Other: 0 Partial
Job address ) (p Bldg. no.: Suite tier: Tax map /tax lot/account no.:
Lot: Block: Subdivision:
Project name: Z1) e(1 Ol'i I Description and location of work on premises: reA451 an of bai (QS al Or egj
Estimated date of completion /inspection: q 131 •
Job no: Fee Mao
Business name :.1`O j - E lt.C�' -%t ' 1r1 r - . ° Q ty. (s.) Tom ae. la.p
Address:
Flaw tsldedld- �eeeamdt}feadly
liCiyO - t�l Ui T r. direlingmh.fatiades attached garage.
Cit C 12 -r_ka r -5 ta z�(cIS Ser.leetlei/eds
Phone: e, 0}N - I Fax: , -z I Ema il: r 1000 sq. R or less 4
CCB no.: p,it E lec. bus. lic. no: 9 _- .— additional 500 sq. R or potties thereof
Limited energy. residential 2
City/metro bc. no.: (O Limited energy, s id 2
. G ()Z Each manufactured home or modular dwelling
s i o t! }14 } Date Service and/or feeder 2
Sup. Idea name ( k [rimers on: .5 d a
Sevvioorfeeders- lanaHdh,
�� aNeradoeorrenaideo:
200 amps or less 2
Name (print): 201 amps to 400 amps 2
401 Mailing address: 601 amps to to 600 1000 2
amps to
City: [State: I ZIP: Over 1000 amps or volts 2
Phone: I Fax: I E -mail: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary Darden or famine -
which is not intended for sale, lease, rent, or exchange according to O '''' d° '' O " dOe ' dO ■ `
ORS 447, 455, 479, 670, 701. 200 amps or less 2
201 ernes to 400 amps 2
Owners s :., titre: Date: 401 as 600 •s 2
1 N(.1 \I 1 It Brandi chain - mew, alteration,
or extension per paced:
Name: 4- Fee far branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: I State: 1 ZIP: B. For for branch circuits without purchase
Phone: Fax: E -mail: of service or feeder fee. first branch circuit 1 1 41/.05 1 40- ' 2
Each additional branch circuit: i 1 6.l.4 43•I8;
Mho. (Santee er foam notieelaiedk
O Service over 225 amps.eomm ecial O Health - earn facility Each pump or irrigation circle 2
O Service over 320 amps rating of l&.2 O Hazardous location Each sign or a lighting 2
family dwellings O Balding ova 10,000 square fed four or Signal clrenil(s) or a limited eoegy panel.
O System over 600 vole nominal more residential units in one structure alteration. or mansion* 1 2
0 Building aver three stories 0 Feodas. 400 amps aware •Desaippon: ,
O Occupant bad ova 99 persons 0 Manufactured sanctum or RV park Each aitldsad bMpecdoe over the allowable V say of the above:
O Egresdlighring plan. 0 Other: Per inspection I i 1 1
Sabath _ sets of plans wilts stay order above. Investigation fee '
The above are toot applicable to temporary eo4aslroefioa service. other
Notice: This permit application Permit fee $ • 1
- expires if a permit is not obtained Plan review (at _ %) $
within 180 days after it has been State surcharge (8%) $ 11 • 24)
accepted as complete: TOTAL $ 1.51.1 &
4404615 (6/00/COM)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 ' .
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received G Date Requested /Z - 1 / AM PM BUP
Z- 5
Location / 7 O y 2 < Ykw Suite cG MEC
Contact Person // Ph ( ) 6f? 3q/7 PLM
s
- Contractor �7?7 Isen CL£c'>f1"Ic, Ph ( ) SWR
BUILDING Tenant/Owner A.N.0 PU ? /. ELC 1-GU '($l
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling 1)/
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
.
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Fina Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
Et Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date C o 1 1 Inspector : • _ Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL