Permit CITY OF TIGARD ELECTRICAL PERMIT
•
• COMMUNITY DEVELOPMENT Permit #: ELC2010 -00668
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/01/2010
Parcel: 2S113AB01400
Jurisdiction: TIGARD
Site address: 7312 SW DURHAM RD
Project: Protection One Subdivision: Lot: 0
Project Description: TI
Contractor: JOHANSEN ELECTRIC INC Owner: PACIFIC REALTY ASSOCIATES
10948 SE VALLEY VIEW TERR 15350 SW SEQUOIA PKWY #300
HAPPY VALLEY, OR 97086 PORTLAND, OR 97224
PHONE: 503 - 698 -3417
PHONE: 503 - 624 -6300
FAX: 503 - 698 -2486
FEES
Quantity Description Date Amount
4 crt Branch Circuits wo /Purchase 12/01/2010 $78.44
Specifics: Service or Feeder
1 ea 12% State Surcharge - 12/01/2010 $9.41
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $87.85
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 wit 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 • • - '52- 001 -0090. You may obtain a co• = les or direct questions to OUNC by calling 503 11987 or 1.800.332.2344.
Issued By: fQ Permittee Signature: 4+-��P
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.
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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.
Electrical Permit APphcatIO C , 9%.\% Received ,�0 I lit O1 1. i . . I Sl Ov 1.1-
City O Datela
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0 `J g g . \ t J / NLL' Permit No.: E ,,,a, ` y.
Ci of Tigard , -
13125 SW Hall Blvd, Tigard, OR 9722
'' tan Review
g ' Phone: 503.639.4171 Fax: 503.598.1960 ` A P -,, Date/13 Other Permit:
r , r ,\ R ;i Inspection Line' 503.639.4175 O 1 Date Ready/By: g1 See Page 2 for
fn � �a� V G n. )A r SupplementalLnformatioo
` Int ernet www.tigard-or.gov or gov C . - � Notified /M ethod
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1:I New construction ® Addition/alteratio replacement Please check all that apply (submit 2sets of plans w /items checked below):
❑ Demolition ❑ Other: where Service or feeder 400 amps or more ❑ Building over three stories.
7s 1d 4 o o where the available fault current ❑ Marinas and boatyards.
z
- t 0 'f� x c i litis., u = ro s atu'r* I . ahv7 4 , ' 6 1 , ll` II , chip 1 � , r{ � 1 1 V..H t ' ..a, s z exceeds 10,000 sumps at ISO volts or ❑ Floating buildings. . less to ground, or exceeds 14,000 El Commerc -use ag
❑ I- and 2- family dwelling ®COminerciallindustrial
❑ Accessory building amps for all other installations. buildings.
❑ Multi -family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
` r (,,, ,mot - :hE t d7 l l t, i t . r i „ Emergency system. larger separately derived system.
-P a,: x : a liiuoitl r 1 � . 'sl u s 7 s ;,47111 ..(1 yI sr I , ,:al ❑ Addition of new motor load of
Job no.: Job site address: I00xPormore. occupancy.
7 312 sw durham ❑ Six or muse residential runts. ❑ Recreational vehicle parks.
C itylState /Z IP: ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt, no,: I Project name: Protection One ❑ Service or feeder 600 amps or more. �
11. r -;;,I A U`t W -' x ; 1 Ye 174
Cross Cross street to job site: Description ply, roe, Total
New residential single- or multi - family dwelling unit.
Includes attached garage.
rr
Subdivision: I Lot no.: 1,000 sq. ti. or less 168.54 4
Tax map /parcel no
Ea. add'( 500 sq. ft. or portion 33.92 1
1 7 n . i l rum r t : mil Limited energy, residential
�, e 4 t f; e 6 d 4i I Y I a ,l4 at t
tart .. , II.'ii .1• :v rc„xr .. � 1 1' �). ,F.. �ul,f E . ()�71i�111ii , . '� (wit above sq. ft) - 75.00 2
Limited energy, multi - family 75.00 2
Tenant Improvement residential (with above sq. ft.) _
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
n,,Il }r r_ ,$$,, It 201 am P �:�� ,j r��d� x�f� 1� �.$�ltil x k �1 r;" 1 er.'+S - {t 1�t6 , .. Ps amps 133.56 2
Name: 401 amps to 600 amps 200.34 I 2
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
City /State /ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) I Fax: ( ) 200 amps or less 59.36 1
201 amps to 400 amps 1 125.08 I 2
Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701_
Branch circuits — new, alteration , or extension, per panel
—Owner signature: Date: A. Fee for branch circuits with
list,
.;`; - .; ±,^ ', ;e:alo , 1 1 I # 01ka0;i e' s. 6 7 :x above service or feeder fee, 742 2
Min r,t ^ ' s �'" s each br ci rcui t
Bu,si_ness name: Johansen Electric B. Fee for branch circuits without
service or feeler fee, first
Contact name: Charlynn Lei f sen branch circuit 1 56'18 5� j g 2
Each add'1 branch circuit 3 7.42 22, 2 6 2
Address: 10948 SE Valley View Terr Miscellaneous (service or feeder not included)
/ State/ZIP: Each manufactured or modular
h Happy Valley, OR 97086 dwelling, service and/or feeder 67.84 2
City/State/ZIP:
Phone: (503) 698-3417 I Fax: : (5 03 ) 6 9 8 - 2 4 8 6 Reconnect only 67.84 2
E -mail:
Pump or irrigation circle 67.84 2
a r 1 r 7 a! 7 r141 I 1u Sign or outline lighting 67.84 2
,» , a ,.; a ' I l • 1 Lit l Ii , : • ', } l : ii:i lln ,I. t 'it
Signal circuits) or limited-energy
Business name: Johansen Electric panel, alteration or extension. Paget 2
Each additional inspection over allowable in any of the above
Address: 10948 SE Valley View Terr Additional inspection (t hr min) 66.25/ hr
Investigation (1 hr min) 66.25/ hr
City /State/ZIP: Happy Valley, OR 97086 ,
Industrial plant (1 hr min) 78.18/ hr
Phone: (5 0 3) 6 98 - 3 417 I Fax: (5 0 3) 698-2486 Inspections for which no fee is 90.00/ hr
s. citcally listed '/r hr min
CCB Lic.: 51539 Electrical L - t h 3 — ?4 / C S rv. Lic.: 2053S N¢il__`2' - g; �,sw- 4 i:, ,I!
Subtotal r
-. Suprv. Electrician signature, required; Plan review (25% of permit fee): y
Print name: Date: State surcharge 12% of permit fee): C J o h ansen 11/30/10 �( p ) 1:/r
(
TOTAL PERMIT FEE: f7, 5�
-- Autllorized signature: ( This permit application expires if a permit is not atilt within 180
days after it has been accepted as complete.
Print name: Charlynn Leif Date: 11/30/10 t Number of inspections allowed per permit.
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