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Permit CITY OF TIGARD ELECTRICAL PERMIT ° PERMIT #: ELC2007 -00090 ° .` COMMUNITY DEVELOPMENT DATE ISSUED: 2/8/2007 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S113AD -01800 SITE ADDRESS: 16650 SW 72ND AVE B12 ZONING: I -L SUBDIVISION: OREGON BUSINESS PARK I LOT : 011 JURISDICTION: TIG Project Description: Johnston - Electrical TI 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: W /SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 1 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 2/8/2007 $46.85 LIC 51539 [TAX] 8% State Surcharge 2/8/2007 $3.75 SUP 20535 Total $50.60 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 r s are set = h in OAR 952 - 001 -0010 through OAR 952 -001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503. 6.6699 or 1.800. 3 .. ; �' • Iss ed By: / / edi / ./ , 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: NTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: , . 0 797 /7----- -___ l 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. Feb 08 2007 11:08RM HP LRSERJET FAX p.1 Electrica Permit Application, i , i i; , , 1 1 H 1 , I (, . I ■ City of Tigard . i . CF nI t® Received 13125 SW Hall Blvd, Tigard, OR • ..�' Rao � ���1 mil a: CC - .• 0 II Phone: 503.639.4171 Fax: 503.598 F 0 8 2007 a >,: Odin. Permit: Inspection Line: 503.639.4175 .1,1 •) i� Ready/By: )nits Int r rww.d.d www.d.cigardar.us .us Pam 2 far F i aiAR® la &mplemenW bformeden ❑ Ncw consgvctioaa El Additirm/alteralion/replacement Please check all that apply: ❑ Demolition ❑ Other. ❑Service ova 225 amps, comm'l [Waved= location - ❑S etv[ee over 320 amps - rating ❑ ft Buildng over 10,000 star of 1- and 2- family dwellings 4 or more new residential ❑ 1- and 2- family dwelling ® Conunercial/industrial ❑ Accessory building ❑System over 600 volts nominal unit in One atrucnme ❑ ['Building over three stories axiate. 400 amPa at moo Multi ❑ Master builder CI Other: p Pa„t persons CIManutactured structures a ❑Eg essnighting plea RV park Joh no.: Job site address: 16650 SW 72nd ❑Health -care facility ['Other: Submit g seta of plan with any of the above. City/State/ZIP: The above are not applicable to temporary construction service. Suite/bldg./apt. no.: Project name: Johnstone Description Q4• rear Tan Cross street/directions to job site: New residential single -or multi-finally dwelling Walt. Includes attached garage. 1,000 sq. ft. or less 145.15 4 Subdivision: Lot no.: Ea. add'1500 sq. 8. or portion 33.40 1 Taos map/parcel no.: Limited energy. residential 75.00 2 _ Limited energy. non-residential 75.00 2 Each manufaeoned or modular Tenant Improvement dwelling, service and/or feeder 90.90 2 Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 ,_ t amps to 400 tarps 106.85 2 ;.. 401 amps to 600 snips 160.60 2 Name: 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 434.65 2 City/Stale/ZIP: only 66.85 2 Temporary services or feeders installation, alteration, and/or r Phone: ( ) Fax: ( ) relocation 200 amps or less 66. ' 1 Owner Installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2 Owner signature: Date: Branch dreulta per - new, alteration, or extension, _ A. Foe for branch circuits with service or Ibeder fee, each Business name: Johansen Electric Inc. bench circuit 6.65 2 B. Fee for branch circuits Contact name: Charlyan Leifer without service or feeder fa, each branch chant 1 46.85 46.85 2 Address: 10948 SE Valley View Tarr. Each add'I brunch circuit 6.65 2 City /State/ZIP: Clackamas, OR 97015 Miscellaneous (gervtce or feeder not included) Phone: (503) 698.3417 Fax: : (503) 698-2486 Pump or irrigation circle - 53.40 2 E -mail: johanseneleet@msn.eom - Sign 73.40 2 Signal l circuit(s) outline lighting or limited- - ::.. -. a Peed, altersion, a Business name: Johansen Electric Inc. Dascnbe: Page 2 2 Address: 10948 SE Valley View '1'err. Each additional inspection over allowable in amt attic above Per on 62.50 City /State/ZIP: Clackamas, OR 97015 Investigation per hour (1 >a min) 62.50 Phone: (503) 698.1417 Fax: (503) 698 -2486 industrial lam per hour 73.75 CCB Lic.: 51539 Electrical Lit.' 3 -243 S . Lic.: 20535 Subtotal 46.85 Suprv. Electrician signature, required: I. � / ^ ' sr Plan review (25% of Kermit fee) Print Warne: Date: State aeraterse (8% of permit fee). 3.75 i i /.._24 2/8/07 TOTAL PERMIT WEE 50.60 Authorized signature: 1 ,.. . �, Ttds permit application spices ifs permit is rot obtained Kehla 160 ����� days after It Ms been steepled as come plate Print name: / : / ; / �/ %w° .. Date: 2/8/07 • Fee methodology set by T„ -Coaary Building radnsny Service Ooird •• Numbs of inspections per permit allowed. imMsaingWends.Wi.0 -rninu Men 1 am- 4615T(10/00/COWWm CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2007-00090 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/13/2007 Phone: (503) 639 -4171 14 Inspection Requests (24 Hrs.): (503) 639 -4175 .�� I.. INSPECTION WORKSHEET FOR DATE: 2/12/2007 TIME: 7 :05AM PAGE: 35 SITE ADDRESS: 16660 SW 72ND AVE 1312 CLASS OF WORK: SUBDIVISION: OREGON BUSINESS PARK I LOT #: 011 TYPE OF USE: PROJECT NAME: JOHNSTONE DESCRIPTION: Johnston - Electrical TI OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503 -698 -3417 Inspection Request Scheduled For: Date: 2/12/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 196 Misc. inspection 043267 -01 603- 704-1634 N Corrections/Comments/Instructions: { v c E©.v ►,�, P MYwi - vYr 1acz► `S6 Z N Iq5 1 $ SAN L c r3 _ A PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 1'v Date: (21- 12d "O Phone #: (503) 718 - 1446