Permit C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00029
• DEVELOPMENT SERVICES DATE ISSUED: 1/24/03
13125 SW Hall Blvd., Tigard. OR 97223 (503) 639 -4171
PARCEL: 2 S 113AD -01900
SITE ADDRESS: 16640 SW 72ND AVE B -10
SUBDIVISION: OREGON BUSINESS PARK 1 ZONING: I -L
BLOCK: LOT : 009 JURISDICTION: TIG
Project Description: Job No. 8065
Tenant Improvement - located at engineering lab
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 TERRACE
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 1/24/03 $293.60
[TAX] 8% State Tax 1/24/03 $23.49 Elect'l Service
Elect'l Final
Total $317.09
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: p-- Permit Signature: / ! J ,�
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 639 -4175 by 7:OOpm for an inspection the next business day
1
From: Charlynn J. Leifsen To: City of Tigard Date: 1/22/2003 lime: 12:40:42 PM Page 3 of 3
Electrical
Date teeeisett ' ! •. ,
City o[ ' ord f ('�� Project/eat
C ( (1 Address: 13125 E # E.B7223 pate lamed: By: Raceips ace:
Pbonee (503)
Fax: (503) 598 -1960 Com m° m: Pam type
aProv Land. tJ AN 22 2003 134P a .., oo 4 7.a.,
0 1 at 2 smny dwelling or aooeaWLD 0 Mu ti- irod1y 0 Tenant improvement
0 New oolts>tuction O Adddioulatteratiotheplacernat O Other. 0 Partial
lob eddlesa 16640 SW 72nd Bldg. no.: Suite no.: Tax mepflax lotlaeooaot no.:
Loa Block: !Subdivision:
Piujoaname: Veris 'Description and location of work on premisar work at Engineering Lab
Estimated date of - • - • 1/24/03
i i i .. 1 lf,i 1 ,1'1•1 It \11 111 X1 1111)111
Jab sae 8065 Thin lin Johansen Electric Inc. $1..4i as Qty. fog Teeth m`ic..
r_ od all -ido.m mar
Addeess: 10948 SE Valley View Terra
City: Clackamas !SIam:OR I ZIP: 97015 Sarle.11dsae!
Phone 503 - 698 - 3417 I Fex:503-699 -24861 B-mal: Ja,e cor+ Tana .y. a or m.. , 4
CCB no.: 51539 I Elec. bus. lie. no: 3-243C Meth addiaood 100 e4 a or patios those
l.iailad doom mmidamtal 2
4898 idea cosy, ocossoithoeith 2
1/22(03 Each oloschethrod broth w mohair dae]liag
81,puae or eledrieiaa (mgoissd) Dm Smeim :Wow read 2
Sop. dna - kids Carl K. Johansen (Jean mix 2053S Rd_
eueromiesereweemec
200 sopa or has le e9.40 IOW 2
201 meow b 400 lops 2
Name (prim): 401 raps Co 600 math bfeiliog address: 601 amps b 1000 mess 2 ,
City: I Stale' ZIP: ova moo mop of mole 2
Mee: 'Fax: lemma only 1
Owner inna!b11icn The installation is being made on property 1 own Ta+aaf aa.lee arflomaor-
whirl is not intended for sale, lease, rent, or exchange according to 0 oe •
ORS 447, 45S, 479, 670, 701. 201 air Q 1 2
zol sips a 4011 00 map: 2
Or„OOfs Dm: 4oi b Goo 2
ILmmraefe des- men,ia.11ra,
Name:
or Mood= pm puck
A. Fos for booth abase with pars of n '•
Address: ravine s feeds fee, e.m booth y0 W.0 I 2 ,
City: 1 State: I ZIP: B. Fee Orr boom drabs whim punter
Pimp: Fax: E mnnY. of service at bake f.q Tim laaom eine* 2
Each riditioad booth dm.! 1 I 1
111114.(therthooththodloroattheloda&O
0 ss.ie. ass 225 ..p. e.aemdd Q 1401114eaa hoer Each pomp or Wisdom aide 2
0 S.nima ow 320 =awdi� of IOl 0 Heads= bodes Each #m or thaw urea 2
1ss7y drdTmga 0 9o'(a'lo war WOO .9ara het lbw or Siomd theta(.) or • laded amp part.
0 System over 6011 sold haled mat reoldcothd sibs fo m lace aaenli.s_ w odomoam• _ 2
f,7 dhaiaa over lime lens O Feadma, 400 amps or me •D a &
0' Pmt load over 99 poxes 0 mirmho ed amr4ss ar RV pat net m -a-llrlmdrawer dmaftemble r mgafalsaMw:
0 esmalWtibthis isi 0 Oder. Per iatpmda• 1 1 1 1
SEWN ads .fpbr !dal way ail ie.e. msempuom fee
11e — are use applicable te erapwary taaslf edl a genies Oder
'Noe.aimi3afo.r .plu plum li+iadtiiowfor mare .*__ ._ Neiioe This prod appliemtim �Initfoe.... ...._.. .:..i 2 VU
O via O Mare Call owing if a pima L not o6efaed Pia" review (at — %) S
moll...a amt= _ —1-1--- widen 180 days afters has ban Slam mucilage (876) .._.S
f° accepted as complete. TO'PAL ......._........ . t Tj 1 +(
_.. _ t.om. orardalar ...rr.n on milk aged
s
Orkbativ .iarme /moat M0461S (6I06WCOM)
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