Permit CITY OF TIGARD ELECTRICAL PERMIT
' o COMMUNITY DEVELOPMENT Permit#: ELC2010 -00605
I G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/28/2010
T
Parcel: 2S113AA00300
Jurisdiction: Tigard
Site address: 16316 SW 72ND AVE B3
Subdivision: OREGON BUSINESS PARK I Lot: 0
Project: A & I Distributors
Project Description: Replacing transformer.
Owner: FEES
PACIFIC REALTY ASSOCIATES Quantity Description Date Amount
15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224 1 ea Services or Feeders - 200 10/28/2010 $100.70
amps or less
PHONE: 503- 624 -6300 1 ea 12% State Surcharge - 10/28/2010 $12.08
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 $112.78
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 • - 001 -0100. You may obtain a toles or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. •
e- 111111.
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 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 lie do ECEIVED 1'[)1:1 11( 1. I ,1. (i.
City of Tigard OCT Received 13125 SW IIa11 Blvd., Tigard. OR 97223 " 2010 D: - : , D AI f Pecmit No.: 7 r es a _ 6) , p S
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 gat other Permit: 6Vs r ,,f 0 - 4
-., ; ., R i , Inspection Line: 503.639.4175 CITY OF TIGARD Data Ready/By. . Supplemental 2 for mitba
Internet: www.tigard- or.gov Notified/Method:
1 i .1
i •w+ err, i ary k rvlmse{dye,k. d �,.. h�nr ,, ht' f i r1 eE, :r;
...yt{�fM' i I 1•, y.�,}} I 11 tri 1 1•. • {� ::�i,n .,� a l r3ii'lil� uLUr1�.t¢''�.v.a nt2/ : �"'.��tr. ,, l; :Ig 11 , : ti , .: � St ,7. .' .�r`.e� :J�•.d.d:�' [:: � �1 • .�: �4 ,'nrjli �1 "_ «"T:
❑ New construction In Addition /alteration /replacement Please check all that apply (submit 2, acts of plans w/itema checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories
❑ Demolition ❑ Other:
oary
,� :: : ,,.., � �� whore the available fault current ❑Marines and bards.
., r '; ' ; '' C ' + .� Y" ?' l]n a.i,ksn[Mii!>::. 4 111 7 e blM , ,s;!' iii•I n " pn ,I° < r.iii' '' ' rr.; :tH (','i exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
{•. �, t 7 '
12 1- and 2- family dwelling t:2 Commercial/industrial ❑ Accessory building a m s ground, of or exceeds 14,000 ❑ Commercial -use Agricultural
amps far all other installations. buildings.
❑ Multi-family ❑ ' Master builder ❑ Other 1:j FII pump. ❑ Installation of 75 KVA or
A � r l i4,1 111 ! x ° ; ` ( t u i , ^ .c�. lh eureat t{ it ' :ii ii" r ., ❑ Fmcy sy°tem. larger separately derived system
eee� s.Az 6.1 .:_ a s.,- ❑ Addi erreo tion of new motor load of ❑ A , •E , °1 -2 "1 9 ,
I0OHP or more. occupancy.
Job no.: Job site oddness:
16 316 sw 72nd ❑ Six or more residential units. ❑ Recreational vehicle parka.
City /State/ZIP: ❑ Health -care facilities. ❑ Supply voltage for moos than
I ❑ Hazardous locations. N 600 volts nominal.
Suite/bldg. /apt. no.: Project name: A& I Distributors ❑ Service or feeder 600 amps or mace.
Cross street/directions to job site: '' ``" n atv . Fee. M.W. C. t ,. F r' : .
ee. Total •
New residential single- or multi- family dwelling unit
j+ includes attached garage.
Subdivision: 1 Lot no 1,000 sq. R or less 168.54 4
Tax ma / 1 Ea. add'I 500 sq. ft or p ortion 33.92 1
p parcel no..
1 li t , •i. ,,:,:i l L'iG Limitedener , sq. r f; v++'' w.rl.pun r i 75. 2
�t: °', ;. � ,, , � N r: t a � e � ���ll� (with above sq. It)
- - Limited energy, multi - family 75.00 2
Replace transformer residential (with above sa • ft)
Services or feeders instafatioa and/or relocation
'��j� ntr: }y 200 amps or less 1 100.70 )OC•70 2
r ', .? ill lea.I[� err ITl t e1��(� lfI,F t II ``'', wt + „ y r iv _ ' n r -'i
.sd ��!h�na.rr�airwai)Su "�„� + k�i... riftl.: i .: t �: o:: .. �., 201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
City /State/ZIP: Temporary services or feeders iastaWtioa, alteration, and/or
relocation
Phone: ( ) 1 Fax: ( ) 200 amps or Tess 59.36 1
1
201 amps to 400 amps 125.08 I 2
Owner installation: This installation is being made on property that I own which is not
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 168.54 2
Branch circuits - new, alteration, or extension, r panel
Owner signature: Date: A. Fee for branch circuits with
i e i , s i' 1 �� u �t r�tv�, 1. r . :•-4,l above service or feeder fee,
+ , l , _ �; n ._ ; r' r:' i'' ; r , ' :... 3L�ldlg�,F'w tE r? : a 1. . •: each branch circuit
:L s.iA,io.: wt r,� .• r , 7.42 2
Business name: B Fee for branch circuits without '
= Johansen Electr service or feeder fee, first
56.18 2
Contact name: Charlynn Leif sera branch circuit
Each add'I branch circuit 7.42 2
Address: 10948 SE Valley View Terr Miscellaneous (service or feeder not included)
Each manufactured or modular
City/State/ZIP: Happy Valley, OR 97086 dwellinrt, service and/or feeder 67.84 2
Phone: (5 0 3) 6 9 8 3 417 I Fax:: (5 0 3) 698 Reconnect only 67.84 2
E - tnst7: Pump or irrigation circle 67.84 2
e Sign or outline lighting 67.84 2
v � 1 ,: fz F , �t k lf „ ' .y k. 1�, �i + [` •:>�,•,'
1 ' Signal circuil(s) or limited- energy
Business name: Johansen Electric ate, alteration, or extension. Pane 2 2
Each additional Inspection over allowable la any of the above
Address: 10948 SE Valley View Terr Additional inspection(lhrmin) 66.25/la
City /State/ZIP: Happy Valley, OR 97086 ndu
l stigation(]hrmin) 66.25/ hr
Industrial plant (1 hr min) 78.18/ br
Phone:(503) 698 -3417 I Fax:(503) 698 -2486 Inspections for which no fee is
s , - ificallv listed N, hr min 90.00/ br
CCB Lic.: 51539 I Electrical Lic.: 3-243C I Su Lic.: u' �l. I, `p - 71 `"' .
Suprv. 2 0 5 3 5 �. { �zo1.` iI �:.: �_ r+���'g.e� +.,.� "�;�'.i�f` a
:
Syprv. Electrician signature, required: /� �' Subtotal: Q�, 70
{ _., fi g' Plan review (25 °.b of permit fee) :
Print name: Carl Qhansen I e: 10/28/10 State surcharge (12%ofpermit fee): IL, CS
g / TOTAL PERMIT FEE: 2 7g
-Authorized signature ✓ This permit application aspire ifs permitis not obtained within 180
drys after it has been accepted as complete.
Print name: Charlynn Leifsen Date: 10/28/10 • Number oinspectors allowed per perms.
1:1BuildintePemriME LC. PemutApp doc 07f01/10 440.46151(11107/COM'WEB
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