Permit CITY OF TIGARD ELECTRICAL PERMIT
`"� " COMMUNITY DEVELOPMENT Permit #: ELC2011 -00044
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/19/2011
Parcel: 2S113AC00103
Jurisdiction: Tigard
Site address: 7244 SW DURHAM RD, BLDG# M
Project: RSD Refrigeration Subdivision: PACTRUST BUSINESS CENTER Lot: 0
Project Description: (1) service and (12) branch circuits for 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
1 ea Services or Feeders - 200 01/19/2011 $100.70
Specifics: amps or less
12 crt Branch Circuits w /Purchase 01/19/2011 $89.04
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 01/19/2011 $22.77
Electrical
Type of Const:
Occupancy Grp:
Total $212.51
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 acco • • - 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. ATTE ION: Oregon , requires ou to follow the rules adopted by the Oregon Utility Notificatio Center. Those rules are set forth in OAR
952- 001 -00 r throw. h OAR 952 -00 l+•0. Y u ay obtain a copy of the rules or direct questions to OUNC by ca ,.__ *3.232.1987 or 1.800.332 344.
Issued B : �r / ` % �� ' Y Permittee Sig
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: / q ///
LICENSE NO. 7c / ///
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 Applicat " , r . I s
1„,...- City of Tigard JAN 18 2011 Received m�� ,
h' g DaI � Permit No �� c. o t � . = 0�0
13125 SW Hall Blvd., Tigard, OR 97223 plan Review /� /�
Phone: 503.639.4171 Fax: 503. ` F TIGa, " (: Datr/B ; ° (7r
r PffrniL .( POIOII'Ot6iO
.. I .. , inspection Line: 503.639.4175 Date Ready/By: Luria' El See Pa 2 for
w DUIL DING DI V I Si
Internet:
ww.hgard- or.gov Notified/Method Supplemenpsl
,;�1" �, l ieu lh�n zk" . Gi l uri•. ,
yYy��� ppy�g y{ y, t �.W .1 'LK y yt� f ICE ic.: [
,77 V.N 'a� ii;1 uo + t+h�{l.ifre• iiNigpul� "; 7 ".ilt lrs �I�4 -1', iltJ1 ' -, .11 taM j i.�a4t :.:.r'
• ❑ New construction ® Addition/alteration/replacement Please check all that apply (submit j sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
. '' -y:
rt ■ltt ■ a ey�gsy u t IPT1 , s, yli T exceeds 10 000 amps at 150 volts or ,
t it l .,,qr, . 4 oi .11 t t?t f: �lka 1 .. it s i a , r i • ' a .,
' a 1• ., . t, t ustsindmdaitts -+ ', ., I ri a ,,,,,, ..' r iltt u t� 'a- ,'' leas to ground, or exceeds 14,000 ❑ Floating buildngs.
❑ 1- and 2- family dwelling E Commercial/industrial Accessory building 8r ❑ b i1 ings l -use ag rictdtttral
❑ A ry g amps far all other installations. buildings.
❑ Multi -family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
"' nal t+-�'7 ;.t'y1 p ;t ,l' i 33 ❑ Emergency system. larger separately derived system.
.4e* , ila lm t 8 t ;ript I r 1.$,i 14:. t
� { , ?�G,�� i t.��::t- �timr.5t�� lui afadu>adt thy h2 �: ,�,;,,._, k.: � ` - � ' ( r `a ,_ ❑Addition of new motor toad of ❑ "A" "E" "I.2" "I.3"
100HP or more. occupancy.
Job no.: Job site address: 7244 SW Durham, 500 r ❑ Six of more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: I Project name: RSD Refrigeration ❑ Service or feeder 600 amps ormore.
tNl lilt .ittl { >t it ii, { 1 "1 1 "4
Cross street/directions to job site: t'l Desninnea 44 Pee. Taal -
New residential single- or mu16- family dwelling snit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'I 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
a - �. .�iiVNlINtrr e' t�rt I k = me [ a
a i :.a , . 'iii L r '•i, `•.'' i eu i 1 ' = n TM ?:. " t 4 (with above sq. ft)
75.00 2
Limited energy, multi- family
75.00 2
Tenant Improvement residential (with above sq. ft.)
Services or feeders installation, /ration, and /or relocation
�ql . r . .'11 tut t 1 t a 200 amps or less 1 100.70 /A,� 2
il3sl2tS(d i Gl .,t a s r..l i ' r _ _ a i h' l olb9 � r. ' 201 amastc 133.56 2 •
' 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 /ZIP:
Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) I Fax: ( ) 200 amps or less 59.36 I I
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 16854 2
Branch circuits - new, alteration, or extension, er panel
Owner signature: Date: A. Fee for branch circuits with p
n NV:1' ;IF ,I, 'i t t 1 rp'" & it ,w !,:o l , ; . a nt €i s r <a ..- �' 1 ' s I t s . ll la' l above service or feeder fee, /
°t"' itt 'diem' s ' ' r each branch circuit 7.42 gig r 60/ 2
Business name: Johansen Electric B. Fee for branch circuits withow
service or feeder foe, first
Contact name: Charlynn Leifsen branch circuit 56.18 2.
Each add'l branch circuit 7.42 2
Address: 10948 SE Valley View Terr Miscellaneous (service or feeder not included)
City /State /ZIP: Happy Val OR 9 7 Cl 8 6 E ach in se rv ic e ado / r modular 67 84 2
PPY Y r dwelling, service and/or feeder
: Phone: (5 0 3) 698-3417 Fax:: (5 0 3) 698-2486 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E-mail:
• rr , ii Sign or outline lighting 67.84 2
u1,l :•,, �. a. r t i �i ,,, ' r r
e 4 f- "I �, , c
_ y- s, � ": _ t -, t� , � -� !' � ..- :� . �� „ Signal circuit(s) or limited- energy
B usiness name: Johansen Electric panel, alteration, orexlertsion. Page 2 2
Each additional inspection over allowable in any of the above
Address: 10948 SE Valley View Terr Additional inspection (1 hr min) 66.25/hr
City /State/ZIP: Happy Valley, OR 9 7 0 8 6 Investigation (1 hr min) 66.25/ hr
Industrial plant (1 hr min) 78.18/ hr
Phone: (5 0 3) 698-3417 Fax: (5 0 3) 698-2486 Inspections for which no fee is 90.00/ hr
s. liken. listed 't4hrmin
1 ,1 CB Lic.: 515 3 9 I Electrical Lic.: 3 2 4 3C Suprv. Lie.: 2 0 5 3 5 't.Pl 1 -u ;°'',' t: l T t e n '� 0104 e
Suprv. Electrician signature, required: Subtotal '.
_ - A Plan review (2S% of permit fee): of fee):
State s `
Print name: Carl J nse per 54' e. surcharge (12 °.0
Authorized signature: � ►►��" " TOTAL PERMIT FEE: 4 !
This permit application expires if a permit is not obtained within 180
Print name: Charlynn Leifsen I Date: 1/ 18 /11 days after it has d been accepted as complete.
• Ntmtber of inspecnans snowed per permit.
I. \BuildingTennitsIELC-PerrnilApp doe 07/01(10 440-4615T(I 1/05/COM'WED
I'd Xdd lArNASFJ1 dH WdSS: T I TOZ Elf nee