Permit CITY OF TIGARD ELECTRICAL PERMIT
1111 COMMUNITY DEVELOPMENT Permit #: ELC2011 -00114
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/01/2011
Parcel: 2S112DB00300
Jurisdiction: Tigard
Site address: 7233 SW KABLE LN 900
Project: Nuance Systems Subdivision: Lot: 0
Project Description: Electrical 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
20 crt Branch Circuits wo /Purchase 03/01/2011 $197.16
Specifics:, Service or Feeder
1 ea 12% State Surcharge - 03/01/2011 $23.66
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $220.82
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 0 • r 952 - 001 -0090. You ma ob .. • • • the rules oi irect questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
O
Issued By: � , = s 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.
Electrical Permit Application 1 (Hz ill 1,9 1. 1 •l I>\I
City of Tigard Received f
., gar, Date/13 : ifJ �'
II -,,A 13125 SW Hall Blvd Tigard, OR 97223 Plan Redew
I. Phone: 503.639.4171 Fax: 503.598.1960 p other Pernik: : ` , i 04 - 1.1
j , , , Inspection Line: 503.639.4175 Date Ready/By; 0 See Page 2 for
Internet www.tigard- or.gov Notified/Method: SapplememlalInformation
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❑ New construction E Addition /alteration/replacement Please check all that apply (submit 2, sets of plans w /itenss checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition El Other:
t `t "' 11119 r e p rITII nr 0 ua�ep where the available fault 150 volts ❑ Marinas and boatyards.
l tl'' i t . a w s 1e c. �1 1ai ra 7I 41 exceeds 10 000 snips. at 150 volts or ❑ Floating btutdinga
r.i,,, , t �a less to ground, or exceeds 14,000 ❑ Cotmnereaal -use agricultural
❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
T. ,,.a i . ; It l t t % ' rat Pg lamer .e e� p e erne "s r , li . ` . " i ❑ Emergency system. lager separately derived system.
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...,�,. -aft ii latY',�aui alu,ia" aES.:Rlh..t�l��t9rlt tat.dt• ;le c ...,d ". ,:: ,t 1'1sf
❑ Addition of new motor load of ❑ "A" "E^ "1.2" "I.3^
Job no.: Job site address: 7233 SW Kab1e Ln, 54)-0-- Iac or tres Recreational vehicle parka.
City /State /ZIP: ❑ Health -care facilities. [l Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: it.'s f Project name: Nuance ❑ Service or feeder 600 amps or more
1 'y ' i „ )11 E 7 r! i'EI t 7 j;
Cross street/directions to job site: oa,e,;pn.a Qty. Fee. That •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: 1 Lot no.: 1,000 sq. ft. or less 168.54 4
Tax map /parcel no.: - Ea. add'l 500 sq. ft or portion 33.92 1
II1 +' o„ ; : t t � t Limited energy, residential 75.00 2
n ittf . g t,L a li uasr's,la et t o 4iflpl at. ', ..,a l till . (with above sq. ft )
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
s.- t+ t ZI,; Ike ' t ° Ill f ,ow.4r , ' '1 I t i ll .t t ,' tai) t y y ,' i l o `t lltl ilia 4']!!1 � ° 201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 200.34 2
601 amps to 1,000 turps 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: ( ) F ax: ( ) 200 amps or less 59.36 1
Owner installation: This installation is being made on property that I own which is not 201 amps to coo amps 125.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 j 2
Branch circuits - new, alteration, or extension, per panel _
- Owner signature: Date: A. Fee for branch circuits with
1 ;e440 e t 'V','' p E7.71461,11' - s VTrw a n6 x , cu t 111 above service or feeder fee,
"" tit ` ± ' : a 9s , .at a .„' rat e ach b r an ch c ircui t
I��rd' t .,.. a t w seua� b 7.42 2
BuSinessnarne: Johansen Electric B. Fee for branch circuits
service or feeder fee, first 1 56.18 56- 18 2
Contact name: Cha r l ynn Le i f s e n branch circuit
Each add'l branch circuit 191 7.42 14 0. 913 2
Address: 10948 SE Valley View Terr Miscellaneous (service or feeder mot included)
City/State /ZIP: Happy Valley, OR 97086 Each el ing , sfr v i c e a or and/or 6784 2
dwelling, service andJor feeder
Phone: (5 0 3) 698-3417 I Fax:: (5 0 3) 698-2486 Reconnect only 67.84 2
E-mail:
Pump or irrigation circle 67.84 2
1 ymm.t 11" t t Sign or outline lighting 67.84 2
.3 11iiii Eie.1 "''G trill.= a s 1...1 LBEi a I Ili rF } l E(I . s i I igi
, Signal circuit(s) or limited-energy
Business name: Johansen Electric panel,alteraton,orextension. Paget 2
Each additional inspection over allowable in any of the above
Address: 10948 SE Valley View Terr Additional Inspection (lbrmill) 66,25/lir
City/State2iP: Happy Valley, OR 97086 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 foe is hr
s. cificall listed '1 hr min �/
CCB Lic,: 51539 Electrical Lic.: 3 - 243C Suprv. Lic.: 2053 S ha 's'; thlt""�'>:`6' " `�• `' "�-F �° ""� " `_ lr� '
'1,•, .tie -� �>� ...1.:.,;, u:.� ?
..,$,uprv. Electrician signature, required: Ar Subtotal •7.16
.tZ - / Plan review (25% of permit fee): f
Print nalne: Carl Johansen Date: 2 / 2 8 / 11 State surcharge (12% of permit fee) - / S (G 4
�j n `/ - f s en TOTAL PERMIT not 2 3 within Authorized sigsignature: �`i/ ab O1
�
This permit application expires if a permit is not hied within 190
Print name: Char 1 nn Le i days after it has been accepted as complete.
Y Date: 2 / 2 8 / 11 . Number of inspections allowed per permit.
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