Permit U CITY OF TIGARD ELECTRICAL PERMIT
Permit ELC2010 -00599
COMMUNITY DEVELOPMENT Date Issued: 10/26/2010
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S113AB01400
• Jurisdiction: TIGARD
Site address: 7352 SW DURHAM RD
Subdivision: Lot: 0
Project: Tax Services Inc
Project Description: (10) branch circuits for TI
FEES
Owner:
PACIFIC REALTY ASSOCIATES Quantity Description Date Amount
15350 SW SEQUOIA PKWY #300 10 crt Branch Circuits 10/26/2010 $122.96
PORTLAND, OR 97224 wo /Purchase Service or
PHONE: 503 - 624 -6300 Feeder
1 ea 12% State Surcharge - 10/26/2010 $14.76
Electrical
Contractor:
JOHANSEN ELECTRIC INC
10948 SE VALLEY VIEW TERR
HAPPY VALLEY, OR 97086
PHONE: 503 -698 -3417
FAX: 503 -698 -2486
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $137.72
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 the 180
days. ATTENTION: Oregon law requires you to follow the 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 a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: Permittee Signature:
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' Date:
LICENSE NO.
Call 603.639.4176 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 Application RECEN I l>1: 1 tt 1 1, 1.1 >1 0\1) .
City of Tigard Dais /0/26/,0 r Permit No 6Ze -- O 05
111 11
13125 SW Hall Blvd., Tigard. OR 97223 r T 6B �° '10 1 plan Review
r' Phone: 503.639.4171 Fat: 503.598.1960 OC 1 B DateBy: Other 44 o -CVs a 7
1 :: ., 1 . L , Inspection Line: 503.639.4175 • . Ready/By: 7ud. El Ste Page 2 for
www.tigard-or.gov ww.tigard- or.gov 1 OF TIG AR! otifed/Method: Supplemental Information
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❑ New construction ® Addition/alteratio replacement Please check all that apply (submit 1 sets of plasm w/itane checked below):
❑ Demolition ❑Other: ❑ Service or feeder 400 amps or more Building over three stories.
when the available fault current ❑ Marinas and boatyards.
fl' t ' Fn '' r t q ' . 1 w ! 1 e '- t �r� t *r , � •,• � , • • t b ' •' • ` exceeds 10 .000 amps at 150 volts or Q Floating buildings.
e .i�rk1 � lgtr >. e l `. �.i..l .. :` F' ,, 5 ..,... . .,
'� : °•° - � • has to ground, or exceeds 14,000 in Commercial-use agriniltarrl
❑ 1 - and 2- family dwelling. ® Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ FFire pump. ❑ Installation of 75 KVA or
s ', /' .- I / W {.�ffia }A.�il 3 � 117 l' J I,•l �! zM`', tt ._a tl ` ' 1:i i Em•cy &S'Btem, larger separately derived system.
• • ILr' - . eslizi+nutwtP rsi.:- ..zol.is.tintustaar4s is u siixb iti ., f.1 7 1'`alk.v ', t ❑Additioe of new tamer load of ❑ ••p....E.. «I- 2- .'•l•3 ".
1
Job no.: Job site address: 7352 S W Durham or amore. artcy.
❑ Six x or or momore Recre
residential units. ❑ Recreat vehicle petits.
City /State/ZIP: ❑ Health -cam facilities. ❑ Supply voltage for more than
❑ Hazardous locations 600 volts nominal.
Suite/bldg!apt.no.: I Project name: Tax Solutions ❑ Service or feeder 600am
b:
Cross street/directions to jo site: • l)e ow, re. Taal •
New residential single- or multi -famly dwelling unit.
. Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 168.542 4
Ea. add'I 500 sq. ft. or portion 33.92 1
inap/parcel no.: Limited erne residential
it.:' i , u+r A na t sett, w� u,x p s t t : 7 . •, - t• above sq. ft.) 75.00
x 2
y '. „: i e j . _ e 4 , . ,d , �+ li0'st?+n . . :r'1uN1 . ,' l' . (with above
'�¢3l�ii aoioalu t t�l a hi+l ,.a.t
Limited energy, multi- fhraily
Tenant improvement residential (with above sq. R) 75.00 2
Services or feeders Installation ,alteradou, and/or relocation
200 amps or less 100.70 t 2
v lag ,7 7 r Til /
,s t' l r e ' i, i 1 s""57 4 „S' C. 201 133
to400 .56 2
,i i , A i- :758<.44.ii � �� • l 'I's r- r' 27. ,? t ! . . .Ill'u. al ,' . , ..`f i t . , .
at strw4,�,. d-
Name' 401 amps to 600 asps 200.34 2
601 amps to 1,000 amps 3DI.04 2
Address: Over 1,000 amps or volts 552. 2
City/State/ZIP: Temporao ' services or feeders installation, alteration, and/or
Phone: ( ) • 1 Fax: ( ) 200 amps or less 59.36 1
Owner installation: This installation is being made on property that I own which is not 201 t0 amps 125,08 2
intended for sale, lease, rent; or exchange, according to ORS 447, 449, 670, and 701.
401 amps to 599 amps 168.54 2
Branch circuits - new, alteration, or extension, per nand
Owner signature: Date: A. Fee for branch circuits with
.c ; MAP *!�l"N n ;x, above service or feed fee,
y. cE ; <d�::.iRw •3 IIt' i ' ■ '1a fea'v ,,A vt , s.. each branch circuit 7.42 2
L
Businessrlame Johansen Electric B Fee for branch circuits without CC''--
service or feeder Cie, first I 56.1 B . , •) S 2
Contactname: Charlynn Leifsen branch circuit
Each add' I branch circuit R 7.42 t'.'1 g _ 2
Alress: 10948 SE Valley View Terr miscellaneous (servieeor feeder not included) _
Each manact or City/State/ZIP: Happy Valley, OR 97086 dwelling.s 67 2
Phone: (5 0 3) 698-3417 11:.(503)698_2486 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E - mail:
�ltp!3�r pia t p r e'• �,_ -,_. ! n�uel + + � �- t 4• + Sign or outline lighting 67.84 2
• irt iratillei 7 tAUlfSFi1+41. i t ..".' t ora3) .) :e�,'.:NtE�lil EZE '�� ' si cit >cuit(s)orlimiled'energy
Business name: Johansen El ectric panel, alteration,Oi°�'sion. Paget - 2
Each additional Inspection over allowable la any of the above
Address: 10948 SE Valley View Terr Additional inspection (I hr grin) 66.25/ hr
City /State/ZIP: Happy Valley, OR 9 7 0 86 I p (1 1 min) 78.1 hr
Ppy y r Industrial plant (1 hr min) 78.181 hr ,
one: (5 0 3 ) 698-3417 9 8 - 3 417 Fax: (5 0 3) 698-2486
Inspections for which no fee is �/
4 - - . - Beall listed 'h hr ruin hr
CC Li c. . 51539 3 9 I Electrical Lic.: 3 Suprv. Lie.: 2053 S i 5 ° t ► ^' .; ' 11 rt:1MWTNI f °
L.a_,.�. µ#1_t: :...
/ Subtotal: z q1,
Suprv. Electrician signature, required: l .� �• i e , , 0 e,. ' Pien review (25% of permit fee):
Print name: Carl hans en te: 10/25/10 State surcharge (12% of permit fee): / �, 7/,
TOTAL PERMIT FEE: /,?'7. . ✓
Authorized signature: This permit application expires if a permit is not obtained within 180
• days after it has bees accepted as complete.
, , Punt name: Charlynn Le i f s en Date: 10/25/10 • Number of S i m i allowed per permit.
1 1BuiIdiegtPern t*.ELC- PersutApp.doc 07/01110 440-46/ 57(1 1ro5/COM/WEB
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