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Permit CITY OF T I G A R D• ELECTRICAL PERMIT 404. 1 PERMIT #: ELC2003 -00598 DATE ISSUED: 9/25/03 v i DEVELOPMENT SERVICES 4I I 13125 SW Hall Blvd., Tigard. OR 97223 (503) 639 -4171 PARCEL: 2 S 112 D C -00100 SITE ADDRESS: 15605 SW 72ND AVE SUBDIVISION: OREGON BUS. PARK III ZONING. I -L BLOCK: LOT : 002 JURISDICTION: TIG Project Description: Electrical TI, install /alter (25) branch circuits. Job No: 8323 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/ 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: 24 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: Phone: 503 - 698 -3417 Reg #: LIC 51539 SUP 2053S FEES ELE 3 -243C Description Date Amount Required Inspections [ELPRMT] ELC Permit 9/25/03 $206.45 [TAX] 8% State Tax 9/25/03 $16.52 Rough - Elect'I Final Total $222.97 • 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 -00_ -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- . ,. ,. Issued y: 1. ..t Permit Signature: L XJpp ,g / 6-��) 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: LX9 O . ed DATE: • LICENSE NO: A,06 Call 639 -4175 by 7:OOpm for an inspection the next business day nn J. Lei en To: City of Tigard Date: 9/23/2003 Time: 9:48:28 AM 4P Page 2 of 3 y y v.. k q �y�0 t l! '��,(..Ir'Q 14 ut MIS [" I ' . ;; : �� C 11 f i r Fermi: ...:4-51,-,c.'.7- . _ . 1 , , r l t� ar D y : r ,. Eleefri ' I i • _.� B : o3 ..... : Perntit•NO Fcg�n3 Q-�71 Ti lanning • pp mval Sign City m# '� tgard SEP 2 3 2003 Datcniy: Permit Na.: 3125 SW Hall Blvd. Plan Review Other Tigard, Oregon 97223 DAY: • ... Pernik No.: Phone: 503- 639 -4171 Fax: 503 A 7. WO,. host -t vieiv Land use Internet www.ci.tigard.or.us BUILDING DIVI � . ;`fir; ' ;Ij;jh Darcy: Case No.: - - - -T ____ - * t �1."At,, Contac Jurls .: ?It 'See Page .2far 24 -hour Inspection Request: 503 -639 -917.5 13ame1Mcthod / ^ c Supplemental information. • .. r .. .p - - J I : ��. .::.. ..::� t�• r:.. .,:.< . : „,,_.,.- ,�� : qy:- � { y ., D � }�Mw.:� t[ll ;�� �: •AV -. q,�i � {'t�'N i. �: . . , :i:a•. •''R,..,. '^ AE_' f 01YY 1 F .. ` . •, +A . /.. .sit _ ] •� - {,• =; : g lg: - .,t/ r� , . , iitg r trio '.rlia s .�_ —�w.�- • II New eonslruction Demolition ■ Service over225 amps- A 'Health -,rare facility. commercial 0 Hazardous location © Addition/alteration/re lacement Other: ❑ Service ove;320 amps - rating or ❑ Building.ovcr ),(),000 square feet, 4 , ":.` :: • M four s •'N'' A'A��N `Y �.'. 1 ':'(' ” f. D.�„l"°•lt_';. �;':�. ?'`.z "s ":.. . F & 2 family dwellings fou or more residential units in i [U 1 & 2 Faniil dwellin, © Commercial/Industrial 0 System Over 600 volts nominal one structere. 0 Building over three stories : 0 Feeders, 400 amps or [ngri {� $ Accessory Building_ U Multi Family _____ ❑ L esvAightw 1 ❑ Occupant to-ad d over 99 persons • 0 Manufactured structures or RV part IN } f Master Builder 0 Other: 0 s plan Other ••;...::.: _ . _ __j2L..� 4 Ah 4iia^ 01 . V O ^ , : ^YINl , ,, i ; 4ti y ± submit sets of plans with arty of the above. �, Y 6__iA'i[�.r:M -1+.� fyF 'F ±.ae�e' ...�. {cli� l� +,� -. T ^ ... - - Thc ova are not s, . livable to rem � 4rary ..construction ser vice 15605 SW 72nd � Job Site r$dciress. � ��N �r=; �:'� ff.�V`�`; «��x- �•;�,'w _ _ {a Suite #: Bldg. /Apt. #: Number of ins , ectlons r r emit' allowed Project Name: Swiftview . Description Qty fee(ra.) Total New residentinl-single or mul.tbfarally per Cross street/Directions to job site: dwelling unit. Includes ftUseIted garage I I Service included: . WOO sq. ft or less • 145.15 • . . 4 — Each additional 500 so. ft orportion thereof i • • 33 AO I — " Limited enere, residential 75.00 2 Subdivision: I Lot #: umited nonresidential 75.00. 2. Tax ma reel #: — Each manufactured home or modular dwelling y a• � RI >. r.•.g ., °-:;s +? : scrvire.ond/or feeder 90.90 2 AtY.F� L ''�'u.. .F .- 9Js�"' %t�t.. }. .. .. :- :1�V {:J- ..LA{� . "lYfAY I . SPlL•10E6 or feeders - InstaIIatloa. abcration'or relocation; • • 201) amps or kss 80.30 i 2 201 amps to 400 amps 106,85 w 2 • . 401 amps to 600 amps .: 160:40 z 2 e .p m�„ a :.s iv no: , : ; r -,:if, 7.4 .: z 1 601 amps to 1000 amps . •� as4 is . Over 100.0 amps o �roks � f Name: •f�C .t / ��� —___. I Reconnect ('685 • 2 Temporary services or feeders - installation, • • • .. Address: alteration, or relocation: City/State/21p: • 200 amps or less 66.85 I F 201 amps to 400 amps 100.30 2 Phone: , , E 401 to 600 amps , , . 133.75 2 ?���"0g1�t� +� �Y:< e �,,r• ;; :. , > ..� '• ' { { }� �y - - ' i ; A circuits- new alteration, or Name Johansen Electric Inc. . extension per panel: . . A. Fee for br?nch•c'ucuits with purchase of Address: 10948 SE Valley View Terr. service or feeder fee, each branch circuit 6 - r 2 City /State/2;i : Clackamas, OR 97015 B. Fee Mr branch circuits without purchasr3 of • I • - 4 6 • 5 as.as 2 service or feeder fee, first branch circuit 2 6 65 15 9.60 2 _ Phone: (503 698 -3417 1 Fax: (503) 698 -2486 .Each. additional branch circuit aol t J ohansenelec.com Misc.jService or feeder notincl uied): )E- rrlail: "� Johansenelect@aol.com Alt - c r ° n East . • ., ar irr lion circle _._ 53.40 2 • .. :• 2 ;r.; {�j .eu.,•...'. °.cl�l•.. M �. "x:;..,•.::. 1. �' -. �:';,� E lighting 53.40 J No: 8323 Sigml cireuit(s)Rr a limned energy panel, - alteration, or estrnsion Page 2 2 Business Narn.e: Johansen Electric Inc. Description: Address; 1 0948 SE Valley View Terr. . Each additional Inspecfionover thealtowable in an •ofthe above: City /State /Zip: Clackamas, OR 97015 i'sr inspection per,hour(min. 1 hour) MN 62 .x ._ Phone: (503) 698 -3417 Fax: (503) 698 -2486 lmmstigattonfce Other_ 111111 CCB Lic. #: 51539 Li o. 243 f 6' rx4.. a A •�ii I s �...�, �,;� Supervising electrician , ,r t',. - ._ ,, f :. Suhiotal . .5 206:4.5 signature required: < — . . Plan Review C25 Pernlit Fee : -. ;$... . • r [Print Name: Carl K. Johansen Lic. # : State Surchare. .... ' o f Permit H�� $ 16.52 k � I'O Al PERMIT F Lei $ 97 _I Authorized " /, 9/23/03 Notice: This permitapplicatdon. explresfrfa permit is not obtained within Signature: �, Y `� . ''� a e . - - -. 180 days after tthas been accepted as complete. *Fee methodology set by Trt- County B u i lding Industry Service Board. Charlyn . Leifs-n 1 —. (please print norm/ _ . . . iAD stsiPermitForma \PioPermitApp.doc 01/03 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: ' (503) 639 -4171 MST //-(0 / BUP Received _ Date Requested (P AM PM BUP Location / 5 e OS 7 oZ Suite MEC Contact Person � -�G -� tAA1 -- Ph ( ) ' 7 0 y'' 5-34 PLM Contractor ►� Ph ( ) -3G 0 -6 01 SWR BUILDING Tenant/Owner ELC - - 40 S Footing ELC Foundation Ftg Drain Access: ELR 3 - o Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation C .� Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling 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 ELECTRICAL , J � O U 3 a 3 S5 Service Rough -In 40 d 3 O D 3 I _ UG/Slab Low Voltage Fir Alarm Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PART FAIL SI Please call fo • reinsp -ction RE: gl Unable to inspect — no access. Fire Supply Line 1 / ADA Date Ins actor �, - I /dam / i�a — Approach/Sidewalk P Other: Final DO NOT REMOVE this Inspection record fro the Jo . site. PASS PART FAIL