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Permit C ITY OF TIGARD. ELECTRICAL PERMIT PERMIT #: ELC2003 -00622 01/4. DEVELOPMENT SERVICES DATE ISSUED: 10/8/03 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2 S 113AA -01000 SITE ADDRESS: 16562 SW 72ND AVE B -09 ZONING: I -L SUBDIVISION: OREGON BUSINESS PARK 1 BLOCK: LOT : OOC JURISDICTION: TIG Project Description: Install 200 amp service. 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: SIGNALIPANEL: MANF HM/ SVCI FDR: 601 +amps - 1000 volts: MINOR LABEL (10): SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: 1 W /SERVICE OR FEEDER: 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: Phone: 503 - 698 - 3417 Reg #: LIC 51539 SUP 2053S FEES ELE 3 -243C Description Date Amount Required Inspections [ELPRMT] ELC Permit 10/8/03 $80.30 [TAX] 8% State Tax 10/8/03 $6.42 Elect'I Service Rough -in Total $86.72 Elect'I Final This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699 or 1-800- Issued By: . L _ '. , Permit Signature: an C ppiC6A OWNER INSTALLATION ONLY / ' The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY • SIGNATURE.OF SUPR. ELEC'N: &r 'tom DATE: LICENSE NO: c" Call 639 - 4175 by 7:OOpm for an inspection the next business day From: Charlynn J. Leifsen To: City of Tigard Date: 10/7/2003 Time: 12:00:44 PM Page 2 of 3 • Electrical Permit A FOR OFFICE E 'ertiiit E ONLV . _ ;. : i Recetvod 3 ... 'P.teCerieal // --�� Date(By: / e 3 .. : C '' ' . t� 2 Planning A p .val Sign City o� Tigard � �`� E® Planning Date/By: permit No.: 13125 SW Hall Blv Plan Review Other r� "1:iigard, Oregon 972 D> y: PemiitNqF 3- 00. �/ Phone: 503- 839 -1171 503 5 4 1 4 ),b0 H Post Bellew • Land use - -- ' : ^, 4 5 „ Datr1B ': Case No.: _ Internet: www.ci.tigard, 11Mi' '' F t �t : A , J l J� ' Contact Jtnis. :�: See Page 2 [or 24 -hour Inspection Request: 503,..- ^M Name/Method: /14 Supplemental Information. G1r O p1VIS \O N - UiLDIN .. .. n . :. :.i.. :_ :, •.... .,. .i .,. A.. , .. :.rV . . ,.+.. :.-N A. •, , 5 ;'y- .. 1 +VIE . _ 7 . Srn ..IiCkti'd _ 1$t "t1 - • New construction 1p Demolition it Service over 225 amps- • • • A Ream-care facility:' commercial ❑ Hazardous location I© Addition/alteration/1 •lacement • Other: ❑ Service over 320 imps- rating of ❑ Building over 10,000squure feet, :. , 4 . , .O' + :O., 7 ; i, . ` a ozs r ,,.; :; : :; "', , :: s ., ,. 1 & 2 family dwellings four OT mare residential units in • 1 2Fanuly dwelling_ _ Commercial/Industrial © System over 600 m in molts nominal vne structure �-•-- ❑ Jiuilding over truce stories ❑ feeders, 400 ::rstps of more 01 Accessory Building ■ Multi - Family ❑ tie upant load over 99 persons ❑ Manufactured structures or RV park , ■ Master Builder • Other: ❑ eve..W �ltwig plan • ❑ Other: ..; .- .. ; • 4 - 1 `4 s i - r . ,,� , . A '. •' Submit sets of plans with any of the above. _ :.,.,.. cat r Et +..1E. •gad 8'� .M. +.rc . r n:Vructton sorvice. '� Tltc.above are not applicable to tempo arY � , • ; ;F�:,. ;-�,:•l ,: ;. �' �l.x.�l�� . Job site azIdress : 1656 2 SW 72nd - - -...r1 �, ..:i Suite #: Bldg./Apt. #: Nunibet of Inspections put •pertttit a11ow_ed Project Naine: Dcstription i Qty fee (ca.) Total } ( . Kew residential-slngle or mul.tbfandly per Cross street/Directions to job Site: dwetting unit. Includes attached garage, . Service tocluded: 1 . 1000 sq. ft c r less I 145,15 • . 4 Each additu,rual500 sit. ft orportion thereof . i • 33.40' - -- -... _... 1 --- -----• -- — tirnited energy. residential i 75.00 2 Subdivision: I Lot #: .-- . i.,united non residential _.75.40. _. .. 2. Tax Ilia r • reel A 1 l # : v . • • 1� .• _ �e/;e sacra and/or manufactured feeder home or nodular dwelling • A'' F , T 4: }7,,$".,, . Y tly3:. . : ,i 7,2 L .4 : 13F . �! .. •, 5ervkes or feeders - Inswlladoo, alteration or relocation: 1 80.30 80.30 2 . 200 am less .... ... . .. 201 amps to 400 amps 106.85 i _ 2 1 401 amps to 600 amps • • . 160:40 t 2 j ., ii C v.. IF l' rr vy 60:1 am to 000 a mps 2 f - ps 1 t � v im "d 61ae s,C ,.h -1 a7 "y `: �" :' � ! e54.65 . ' Over 1000 amps or volts Milne: . .Reconnect 66.85 2 Address: Temporary services or feeders - installation, alteration, or relocation: 1 Cit /State/Zi • : 200 amps or less 66 1 1 201 snips to 400wp 100.30 2 Phone: Fax: i 401 to 6+00 amps 133.75 2 �g " =""di r�• ' ,,, . r� ei i P a :, iT, lit: t , ,, 4, rt, 1_ .. .` ,4 ..A � LL ,; f ( ilfaneb c new, a or Name: Johansen Electric Inc. _ revision per panel: A. Fee for tauch'circuils with purchase of j l Address; 10948 SE Valley View Terr. sertice or feeder fee, each branch circuit 6 .ti 5 I 7 7_ C /State/j? Zi : C lackamas ' , OR 97015 • • Th. Fee for branch circuits without purchase ' service or feeder fee, fast branch circuit 46.85 2 Phone: ( 698 -3417 J Fax- (503) 698 -2486 Each additional branch circuit . - E II1311 Johansenelect@aol.com Micc.(Scrvice or feeder ROT included): 54 . • ,x Each pmr� or brigatwn circle _ 53.40 2 • . a' 'z - , • - J . . •-o ;...� ti ✓ '•• - F h ,g "' r • "` .. ""; .. - r ._ 53.40 2 - i'� %� € ?t Y'.• * :: Each signor • Job No: 8924 Signal eircutt(a)vr a limited energy panel, S alteration, or extension Page 3 2 Business Name: Johansen Electric Inc. Bests-tenon: Address: 10948 SE Valley View Terr. • Clackamas, OR 97015 FACh additional Inspceliun the allowable in an •oftheabove: Citvr /State /Zia : _ p e r 1 hour 62 "50 .—' Phone: (503) 698-3417 Fax: (503) 698 -2486 1m'cstlga:ion - -- 51539 L2c. #: 3 -243 other -- aki ��. .r• -fit 113 tl1ti 1i7laT3estl in 4( r -.. ' Supervising electrician ` Subtotal. .S 80.30 signature required: / • Plan Review (25% of Ptrnvt Fee)•:- . $ .. I Print Name: Carl K. Johansen Lic. #: 2053S - State Surcharge {8%of Permit Fee) $ 6.42 TOTAL PERMIT 6rE 8 .72 1 Authorized /� q � I Notice: This permitapplicatloncxplresJf a permit is not obtained within Signature: C 1 r FUit. (< e;_ 190 days alter!ties been accepted as complete. *fee methodology set by'frI- County Building Industry Service Board. Charlyn . Leifshn / (Please print name) is \DstsTennitFor1 ' IoPermitApp.doc 01033 CITY OF TIGARD 24 -Hour BUILDING Inspection Line (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 - 4171 MST BUP Received Date Requested J O —/ 0 AM PM BUP Location 1 ( D S(e A- Suite MEC Contact Person Ph ( ) PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC 3 - tW (o Footing ELC Foundation Ftg Drain Access: ELR Crawl Drain - - Slab Inspection Notes:— — SIT Post & Beam -� J�-�'� Shear Anchors qZ, g_ �.. J / Sheath/Shear Int Sheath/Shear 90—AAU � J f Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof 6 7'11 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 Service Rough -In UG/Slab Low Voltage Fir: larm ASS PART FAIL fl Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SITE ❑ Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk D Le d 3 Inspector Ext Other: final DO NOT REMOVE this Inspection record rom the job site. S PART FAIL