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Permit CITY OF TIGARD ELECTRICAL PERMIT Is • COMMUNITY DEVELOPMENT Permit #: ELC2010 -00609 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/29/2010 Parcel: 2S113AA00300 Jurisdiction: Tigard Site address: 16320 SW 72ND AVE B3 Subdivision: OREGON BUSINESS PARK I Lot 0 Project: SERVICE PARTNERS Project Description: TI Owner: FEES PACIFIC REALTY ASSOCIATES Quantity Description Date Amount 15350 SW SEQUOIA PKWY #300 PORTLAND, OR 97224 6 crt Branch Circuits 10/29/2010 $93.28 wo /Purchase Service or PHONE: 503 - 624 -6300 Feeder 1 ea 12% State Surcharge - 10/29/2010 $11.19 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 $104.47 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 ob : copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. •i i / / 1 Issued By. . -vs _ _ 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. CaII 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. • CiriVED Electrical Permit Applica i 1 1 / ) k 1 I i i i t 1 1 I t\ 1 City of Tigard 8 Received 13125 SW Hall Blvd., Ti �C 2 20�� Datc113 : 0 t. �.r hanittfo - :.1 - - 0 to MOO to Tigard, OR 972 3 Plan Review Phone: 503.639.4171 Fax: 503.5 Date/B : Other Permit Inspection Line: 503.639.4175 �I "OF TIGARD Date Ready Internet: www..ttiganl-or.gov a �1�� : ILDING DIVISION Notified/Method: 4p ?(�i b� 1! rV t y r if ' - 1[ W , ._ i !, ., [ `t Y,i, EMI 1, i llrtx l '1 � �( �j I IR�'I•i�nlrb�;�%Ugtl07�i11�� a{ � Ji: -�,•i �,: RM "� P t�; •c. 2" 11�1L�)E�'.f�{�dlS,Lud��o .z.3.,tl�i�'S!1�.� ^'iry,�7i�p. �.��' "i) -' ❑ New construction ® Addition/alteration/replacement Please ehedc all that apply (submit a acts of plans wfnems chocked bdow): El Demolition ❑ Other: current Service a feeder 400 an or more ❑ Building ova ihr©e works. 1+7.a .i (h sr:gym .,hzur r. � - rhWS�;uau u + 5 , { where the available fault curnt ❑ Marinas and boatyards. ' ' ii r wy3 mituar�w8.. -.- i:a... alhk• fir. e' ::.,..mi rl,i lw-i . h r:" ti. less ground, or 4,000 ❑ Commcc b icultural ❑ 1 - and 2- family dwelling ® Commercial/industrial ❑ Accessory building amps for ell other installations, buildings. ❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Instal1adon of 75 KVA or Y : t !� uhk cmaw an, a� r t -wur rslr, + ru : t -+t yu e� „.c? ; irg . ' t, .. S , •.,td ❑ Emergency system. larger separately derived system. . F4 �e Yn "r L4,1ilx: 0.ataN iii! 1 r • 41is4i,aalalia � } +-; a [" +i ❑ Addidonof new wormbedof ❑ "A. E», 1.2. t -3 », , i k - iz. t r. rt F? . e! t o : t: & l Job no.: lob site address: 16320 SW 72nd ❑ Six o or r or more. occupancy. poccupancy. on. more residential unite. ❑ Recreational vehicle parka City /State/ZIP: ❑ Health -care facilities. ❑ Supply voltage far more than ❑ Hazardous locations. 600 volts nominal. Snite/bldgJaptno.: I Project name: Service Partners NW ❑servicem fe 6 er 600 mapserrmares Cross street/directions to job site: , .r EEt . r .: i` .�' � .��'%•' e'. E i' ( 1Czltt SI' 11 ;e' .A New residential single- or multi- family dwelling unit. Includes attaehed garage. Subdivision: I Lot no.: 1.000 sq. ft. or less 168.54 4 Tex Wrap /parcel no.: Ea add'l 500 sq. ft. or portion 33.92 1 �7{�� l r'iF l ulh:yrr zuhx ~ maa r n . s , : Limited enagy, residential 75.00 2 F+i � i ` i8 u. t .l�i :•�. ° . lair' ' i � le : • t hin!! if it! Itilf : (with above sq. ft.) Limited energy, multi- family 75.00 2 Tenant Improvement residential (with above °Q ft.) Services or feeders installation, alteration, and/or relocallon 200 amps or less 100.70 2 w�.7�;.Y p . . r ai l;:Y a �ret`(ab�4`°yyy c}'c j td ten M l{r �1 ur' 1 .! 201 anip o400 ' amps 133.56 2 �� .,. 1st, rM9aeel�..x!iirl2!3l,.4 :.ze�cn: e. 13 ilrrtt -.- .LC' r � a'r .+yt, �_ I !Yarns: 401 amps to 600 amps 200 2 • 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 City /Srate2 Temporary services or feeders installation, alteration, and/or relocation Phone: ( ) I Fax: ( ) 200 am ps or less 59.36 I l Owner installation: This installation is being made on property that I own which is not 201 amps to 400 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 panel _ Owner signature: Date: A Fee for branch circuits with 1 i ,. . k• f r !naa �r 77•�� °�.a 1 r r r 9� (�r� w ++ •y+:a• above service or feeder fee, 7.42 2 : .1�+i1S:F1Y "}Y.l. :..' 1 >sm 6 c'Ita.tAn.thrft +i ...., a Y t each branch circuit Satinets name: Johansen Electric B Fee for branch circuits without service or fader fee, first Contact name: Char lynn Leif sen branch circuit 56.18 5-4, al 2 Each add'l branch circuit Jr 7.42 01, /0 2 Address: 10948 SE Valley View Terr Miscellaneous (service or feeder not indadedi Each manufactured or modular 67.84 2 City/State/LIP: Happy Valley, OR 97086 dwelling, service and/or feeder . Phone: (5 0 3) 698-3417 I Fax:: (5 0 3) 698-2486 Reconnect only 67.84 2 E - mail: Pump or irrigation circle 67.84 2 r p1}gtq��',t , a . y , .,,a��. w a ,r, i r Sign or outline lighting 67.84 2 ilelIM' t.EMIZIMa{I SOME, :7�' 1 n ..h!� » : ( Signal G1c ills) or limited -energy r 1 siness $u Warne• Johansen Electric panel, a l i seed extension. Pelee 2 2 I Each additional iosprce8ou over allowable in any of the abov Addis: 10948 SE Valley View Terr Additional inspection (1 hr min) 66.25/hr Investigation In min) 66.25/hr City/State/ZIP: Happy Valley, OR 97086 Industrial plant (1 hr min) 78.18/ to Phone: (5 0 3) 698-3417 Fax: (5 0 3) 698-2486 Inspections for wbidt no fee is 90.00/ hr ificall listed ' % hrmin CCB Lic.. 51539 1 Electrical Lic.. 3 Suprv. Lic.. 2053 S q- ,,1 1 i' 'i4`5 _;.:',., ti t"':: ik g i ri', ;.: "1'' ') ` ;;,'.. Subtotal: Sage Suprv. Electrician signature, required: ( f 4 / L a . 7 `. Plan review (25% of permit foe): foe): Print name: Carl J h ns en Date: /0 Z.f State surcharge (12% of permit foe): //V? II TOTAL PERMIT FEE: /(f f/, 97 Authorized signature: This rmit application if a t is not obtained within 180 a avp Qa a Print name: Cha r l ynn Lei f s �Dat : 10/28/10 • days o it has been accepted as complete. Numborofiffipectimu allowed per paffit. L•1Buildi eenniat6LC- PermitApp.doc 07/01/10 440.4613T(1I/05/COMM'BB T •d X43 13rd3Sd1 dH WdS27.I 0102 82 400