Permit I
'I ELECTRICAL PERMIT
CITY OF TIGARD
" PERMIT #: ELC2007 -00514
° COMMUNITY DEVELOPMENT DATE ISSUED: 7/26/2007
TIGARD
13125 � Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 113AD - 01900
SITE ADDRESS: 72ND AVE ZONING: I -L
SUBDIVISION: OREGON BUSINESS PARK I LOT : 009 JURISDICTION: TIG
PROJECT: VERIS
Project Description: TI - (2) services & (20) branch circuits.
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: SIGNAL/PANEL:
MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 2 W /SERVICE OR FEEDER: 20 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 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: Contact #: PRI 503 - 698 - 3417
FAX 503 - 698 -2486
FEES
Description Date Amount Reg #: ELE 3 -243C
[ELPRMT] ELC Permit 7/26/2007 $293.60 LIC 51539
[TAX] 8% State Surcharge 7/26/2007 $23.49 SUP 20535
Total $317.09 REQUIRED ITEMS AND REPORTS
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 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: A i_ 64A0 , J Permittee Signature: y y 0 icy2 j 0 ' t 8
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 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.
• Ci 22Ss 1 Tigard rd. T 97 ' 7 07 dr�1 Penh No.: 7-Qb
Phone: 503.639.4171 Fax 503.5N i1 n,, ,�
Plea Review
Inspection Than 503.639.417 ' . 114- • 1 I' D s Other Permit 1a10n t: www.d.tigad.or ms �' "; Dote steady /ay: lsu< 18gam laformat oa
, NaaiBedlM�Od;
❑ New oonstruction
® Addego� 4ltastl0o/reP.1ent Please check alt gut apply:
❑Demolition ❑ e ' ,, ' ,';?¢ ?0k Mervin over 225 amps,00mm'1 ONaawdoualocaion
Service over 320 amps - rating Q13u over 10,000 sq. it.,
❑ Accessory of 1- and 2-family dwellings 4 or more new residential
CI 1- and 2- t'ismily dwelling ® Commercial/industrial building QSysaan ova 600 volts nominal mute in one antenna
❑ Mnld Simil ❑ Master builder [1001a: °Building over dues stories OFecdere, 400 amps or more
DOnapant ,... ptaeaahe a
bad over 99 nfeclured
RV part
lob no.: rob site address: fl SW 72nd °Htnitih -cave facility tic
� J lD y V Sabath ,. sets of plans with any of due shove.
The above are not applicable to try construdioa soviet
Suitelbldgfapt. no.: Project name: Veris Industries
osetpler Qty. r.. Tsui
Cross steeet/direaaiona to job site: New reddened Slagle. or add-fondly dwdlhag unit
ledges. attached garage,
1,000 sq. R or less 145.15 4
Subdivision: Lot no Ea. midi 500 sq. 0. or portion 33.40 1
Tax map/parcel no.: Limned energy, residential 75.00 2
Limited energy, non-residential 75.00 2
Each manufactured or modular
Tenant Im • rovement trier 90.90 2
Services or feeders Iastallattea, alteration, and/or relocation
200 amps or less 2 80.30 160.6 2
t amps to 400 amps 106.83 2
Name:
401 amps to 600 amps 160.60 2
601 amps to 1,000 amps ' 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City/State/ZIP:
jp
Reconnect only 66.85 2
Temporary services or feeders IseleBngoa,abandon, and/or
Phone ( ) Fax: ( ) relocation
Owner installation: This installation is being made on property that I own which is not 20 amps to 00.30 1
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 201 to 600 amps 13 2
401 sups to 600 seeps 133.75 2
Owner
Date: !trench circuit,- new, alteralon, or extension, per panel
A. Fee fbr branch circuits with
Business name: Johanna Electric Inc. branch circuit a
ae 20 6.66 133 2
Contact tune: Merlyn, Lana B Fee for brtuucb circuits
without service or keder fite 46.85 2
Address: 10948 SE Valley View Tarr. each branch chart
Each WI branch circuit 6.65 2
City/State/ZIP: Claclaaeu, OR 97015 Miscellaneous (aervlec or feeder not inela led)
Phone: (503) 6984417 Fax:: (503) 698-2486 Pump or irrigation cicala 53.40 2
Sigp or outline lighting 53.40 2
E -mail: johaeaeaeleetliasa.cosn Signal cIait(s) or limited-
energy paid. alteration, or
Business name: Johansen Electric Int. aetehnsioa Deaazfe« Page 2 2
Address: 10948 SE Valley View Tear. Each additional iep
neeton aver slaw/able ble In nay of the above
Pa boon 62.50
City/State/ZIP: Clackamas, OR 9701.5 Investigation per hour (1 br win) 62.50
Phone: (503) 698 -3417 Fax: (503) 6984.486 Industrial hour 73.73
CCB Lic,: 51539 Electrical Lie.' 3-243 ' ,, .1 . Lir : 20533 Subtotal 293.60
Suprv. Eleexrldan signature, required: ' rev -' j r� .
Plan review (25% of permit bbe)
Print name: , State surcharge (S of permit fee). 23.49
�- �.,i : 7/25/07
Authorized signature: f, ;
/ r TOTAL. PERMIT FEE 317.09
�� -s. '1M' pm* aPP Ctrs u a pmteN Is pt ottorreea wtftile too
days after Nike bees accepted as complete
f Dete: 7/25/07 • Fee aa;ffiodolo
Print name: / kiwi' " t of d pm Tri-Cmusly allowed. 8 lathing Sarviee Bond
mo h>Maf 44046hs1Yt
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CITY OF TIGARD
BUILDING DIVISION -. PERMIT #: ELC2007.00514
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/;)5/2t107
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/2/2007 , TIME: 7:p1AM PAGE: 49
SITE ADDRESS: 16180 SW 72ND AVE CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK I LOT #: OOD TYPE OF USE:
PROJECT NAME: VERIS
DESCRIPTION: TI - (2) services & (20) branch circuits.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503 - 698.3417
Inspection Request Scheduled For: Date: 11/2/2007 Pour Time:
Code # Inspection Description Confer Contact # Message
199 Electrical final 058902-01 503 - 969.5717 N
Corrections /Comments /Instructions:
\—i . Apc ( s) AtIp D1 mot:. "co
K�L PAN 0�t ! outsblici 6g\iS
1
N b R•Ctj r ? ' i (,kKL ,
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G** x 8 Date: It • 1! (S1 Phone #: (503) 718 -100
CITY OF TIGARD
BUILDING DIVISION .. PERMIT #: FLC2007- 00514
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/76/2007
Phone: (503) 639 -4171 I I�
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/1/2007 TIME: 7:02AM PAGE: 33
SITE ADDRESS: 16480 SW 72ND AVE CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK I LOT #: OOD TYPE OF USE:
PROJECT NAME: VERIS
DESCRIPTION: TI - (2) services & (20) branch circuits.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503- 698 -3417
Inspection Request Scheduled For: Date: 11/1/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 058803-01 503 - 969 -5717 N
Corrections /Comments/ Instructions:
P A Ail- co 6 c 'w 6 / N ' 4-fe mti' PPL. S c.R.e'1 A / -
wkerit, Pal 4 L (,) ,fib Mp:ri ) D to; 2'l tN►$ *V!)
kl tto v I Oa b •: " tom (4 6 -. g I •A • l
1
N (tVC
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: '• Nu) LG Date: I • J • � Phone #: (503) 718 - m