Permit V CITY OF TIGARD ELECTRICAL PERMIT
Ci COMMUNITY DEVELOPMENT Permit #: ELC2010 -00713
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/23/2010
Parcel: 2S112DA01400
Jurisdiction: Tigard
Site address: 15350 SW SEQUOIA PKWY 300
Project: Pacific Realty Subdivision: PACIFIC CORPORATE CENTER Lot: 0
Project Description: (1) feeder and (20) branch circuits for office remodel.
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
1 ea Services or Feeders - 200 12/23/2010 $100.70
Specifics: amps or less
20 crt Branch Circuits w /Purchase 12/23/2010 $148.40
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 12/23/2010 $29.89
Electrical
Type of Const:
Occupancy Grp:
Total $278.99
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 will 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 copy of rue •r direct questions to OUNC by calling 503.23 or 1.800.332.2344. •
Issued By: 'i" 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:
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.
3 ,
Electrical Permit Apulicatio ni �� �,_, e �r 1 O11.r( 1• I ■I: ( Osl.)
City of Tigard RE eived
D , No.: �" • 13125 SW Hall Bvd, Tigard, OR 97223 DEC 2 2 2010 _ /�
L
Phone: 503.639.4171 Fax: 503.598.1960 DateB : Other Perron: ! 1.1 0 a 0 - O •
7 i,,,. 1, 0 Inspection Line: 503.639.4175 CITY OF TyGARD Date Ready/By: Si see : age 2 for
Internet: www tigard or.gov ' s ; N , Noiified/Mathod: CM Suppiemeaht Information
1 t. , t tih h �r;l i t t.,1,. t.,1,. r I i, ✓- 4ry?1 II $ l sax ii istlIV- a N i 7 `; CJ' F,
i1 'dill6r�Iallihl +�r. ,N,,l 41,1,,,,14,1. ISrial ¢ , 1,1,,,. ..... ,' �...• l &,II.. :Tug, � e... .. , ,t I m r,t rplig ' 1 4 � �4 ii;41k „
❑ New construction ® Addition/alteration/replacement Please chock all that apply (submit 3 sets of plans w (items checked below):
El Demolition El Other: ❑ Service or feeder 400 amps or more ❑ Building over three stories.
where the available fault current ❑ Marinas and boatyards.
r` Rl i t . :- ¢ F ` ` ¢j j , ,' M 1 t ' t I tfu , ee 1 q ' ° 7 !} ' F �1; exceeds 10.000 amps at 150 vohs or ❑ floating buildings.
romi a • x; rim i 1:1 1 : ;” j �. u - less to ground, or accords 14,000 ❑ Commercial
CI 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building agricultural
amps 811 other install Mims. buildings.
❑ Multifamily ❑ Master builder ❑ Other ❑ Fire pump. ❑ Installation of 75 KVA or
r c I ' 1,,) .4. Y 1 , r , ❑ ❑ Emergency system larger separately derived system.
I ;,1.'c��s s .rsul :, eL i1. :1 • : 12" 4 ' !ILIA . "t4Lfitiii r /i'; .& .n: ! ,.,
Addition of new motor load of ❑ "A ", "E ", "1 -� , °l -3 ",
1_, / Ai /V' I00HP or more. occupancy.
Job no.: Job site address:
/ _ .. w ❑ Si or more residential units. ❑ Recreuimlal vehicle perks.
City /State,/LIP: ❑ Health - care fiscilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: I Project name: Pa c / ' W ❑ Service or feeder 600 amps or more.
Cross street/directions to job site: r s i > ". . I Fee. T
,rk� r ,,,
Dnerl I Qq'. I Fee. � Total
New residential single- or multi -family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft orless 168.54 4
fax map/parcel no : Ea add'l 500 sq. ft. or portion 33.92 1
1(
it - ', Limited energy, residential
i I.1r 6,! 1416 -`;t ,+5, , d1 i F'' : , n I Ed t! IiRr Jt< , 1 r 1,r l I d 75.0() 2
d,s,�,.,ute,, 9
,°1 (with above sq. ft )
L imited energy, multi - family 75.00 2
ore residential (with above sq. ft.)
Services or feeders lnstallation`lteratioo, and/or relocation
200 amps or less ' 100.70 'corm 2
ll iil'i4al{ri`r 1' 1. ", ia,-„ fi ) I►I .f111YI1t gi `'s tia,'i r n,, iN! a to 400 am 3.56 2
i16 ,�K'�?tt47lsn�k�I :sr �� i �. tit.,q+TtitEr!! 1,7'1 U {� 201 � � 13
Name: 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
City /State /Z IP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) I Fax: ( ) 200 amps or Tess 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.
Owner signature: Date: A. Fee circuits —
circuits alteration, or extension, per panel with
kilt e` 7 r ,� i�r tilt }. , :. , `(1 ' ' j `d J �Iti�at. ^�initi �, 0 . 1 4 - . R ,.. _liv � '�:_, above service or feeder fee,
.r- 1�dY;I,�+'�t3�7Mi�i - ��trlg4k.11a Itx! l `I - !'a.. Ira. 7.42 n1/i
each branch circuit 7 . rt,ye, 2
Business name: Johansen Electric B . Fee for branch
feede rrcuits without
service or feebler fee, first
56.18 2
Contact name: Charlynn Leifsen branch circuit
Each add' l branch circuit 7.42 2
Address: 10948 SE Valley View Terr Miscellaneous (service or feeder not included)
CitylState/'ZIP: Happy Valley, OR 97086 Each manufactured or modular
PPY Y dwelling, service andfor feeder 67.84 2
Phone: ( 503) 698 -3417 Fax: : (503) 698 -2486 Reconnect only 67.84 2
E - mail: sir Pump or irrigation circle 67.84 2
)t�t i ll [ )flig, ith ll�'il ` YIP ..: r :+ 1, �,7l ru I k 1 ,t as k l N 1i1 " 11:b.itiN ya i „ 0 `.]I.1 s ignor outline lighting l ing 67.8 2
J +' -tr4r , �b , Signal circuits) or limited - energy
Business name: Johansen Electric panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: 10948 SE Valley View Terr Additional inspection (1hrmin) 66.25/hr
City/State/Z]P: Happy Valley, OR 97086 Investigation (1 hr min) 66.251 hr
Industrial plant (I hr min) 78.18/ hr
' Phone: (5 0 3) 698-3417 Fax: (5 0 3) 698-2486 Inspections for which no fee is 9000/ hr
• tficall listed 4 hr min
CCB Lie.: 51539 I Electrical Lie.: 3-243C II Suprv. Lic.: 2053 S 'I4
I . , . t: P.:' :i , fl „i ',11 , I ,tt .,I .t N
'' Suprv. Elec signature, required: aer4i /° Subtotal: '. ��
Plan review (25% of permit fee):
Print name: Carl J ansen 12/22/10 State surcharge (12 %ofpermit feu): 0 A 9 d i
( 611 Authorized signature: TOTAL PERMIT FEE: 2%O
This permit application expires ifs permit is not obtained within 180
days after it has been accepted as complete.
Print name: Charlynn Leifsen : - 12/22/10 • Number of inspections allowed per permit.
LIBuildin \PertnitsIELC- PermitApp.doc 07/01/10 440 - 461ST( I I /OS/COM/WEB
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