Permit t � CITY OF TIGARD ELECTRICAL PERMIT
"' I ' COMMUNITY DEVELOPMENT Permit #: ELC2011 -00214
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/26/2011
Parcel: 2S112DD00200
Jurisdiction: Tigard
Site address: 15500 SW 72ND AVE 200
Project: JP Morgan Chase Subdivision: PACIFIC CORPORATE CENTER Lot:
Project Description: (6) branch circuits for new tenant.
Contractor: JOHANSEN ELECTRIC INC Owner: PACIFIC REALTY ASSOCIATES LP
10948 SE VALLEY VIEW TERR ATTN: N PIVEN
HAPPY VALLEY, OR 97086 15350 SE SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 624 -6300
HONE: 503 - 698 -3417
FAX: 503 -698 -2486
FEES
Quantity Description Date Amount
6 crt Branch Circuits wo /Purchase 04/26/2011 $93.28
Specifics: Service or Feeder
1 ea 12% State Surcharge - 04/26/2011 $11.19
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $104.47
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 i ordan - , ith 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. ENTION: Orego law • ires you to follow the rules adopted by the Oregon Utility Notification Cen er. Those rules are set forth in OAR
952 -0 1 -0010 through OAR 95 • .1-00* 0. iu may obtain a copy of the rules or direct questions to OUNC by • k .w •87 or 1.800.332.244.
Iss d By: ■ I / L ! r t L ( Permittee Sign. i ?4r e � / --
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' - il l - �4 �. Date:
LICENSE NO. 471 5
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.
* ** *NEED TODAY IF POSSIBLE * * **
Electrical Permit ApplicationRECEIVED i ell: (►1 i ie l 1 Sr (r'j 1
City of Tigard pp 6 D 1t Received / � PermuNo.: tt C e/ - Z �
e 13125 SW Hall Blvd., Tigard, OR 97223 A r R 2 v 2011 plan Review
a Phone: 503.639.4171 Fax: 503.598 1960 Dne/g Other Permit,
Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: fists Q! seepate2 for
Internet www rtgard or gov 1 I �r ,� r Nonfied/Method Supplemental Informattoa
t t s ,, ttik� l{ "" -ti. 4 , " M t �" � , - "'" a 3' � �t as>SS� ,� lx �e': ' S t ' d ,� t o rr • aro - ,�e!r 7 � 1., l i
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❑ New construction ® Addition/alteration/replacement
sax check ,all that apply (submit Z Beta of plans w / items checked below)
❑ Demolition ❑ Service or feeder 400 amps or more ❑ Building over dune stories.
❑ Other: where the available fault current ❑ Marinas and boatyards.
1M1119 I "
13 ;ititirt'Eiriitcn u „*v ''� <. . .. ! # ' „ q 4 e� r . y '8 '' a '' . ; : u'.tt ' exceeds ground, amps e s 1 volts or ❑ C l mme buildings.
` ` "` less to ground, or exceeds 14,000 ❑ Commercial-use agricultural
❑ 1 - and 2- family dwelling ® Commercial/industrial ['Accessory building amps for all other installations buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ fire pump ❑ lusuliation of 75 KV A or
tp ry °fir r ..- , s� ' ' . 1 1 reti,l. i)ti: ❑ Emergency system. larger separately derived system.
. l i11,:- Z,ells iI'1'sr'*v" i . j* ** 614 „i�
,,„ i( �r. !c s&wt_i+fd: ax 4 4A— ' ❑Addition of new motor load of ❑. ..E.. , .1.2 „ . '1.3 ..
Job no.: I Job site address: 15500 SW 72nd, 2 0 0 ❑ ]00� more. ❑ Recreational vehicle parks.
Six or more residential units.
City /State/ZIP: ❑ Health-care facilities. ❑ Supply voltage Eu more than
❑ Hazardous locations. 600 vats nominal
Suite/bldg, /apl.no.: 200 I Project name: JP Morgan Chase ❑ Service or feeder 600 amps ormore.
: era, _ 9 Y = t
as{gB tr'
Cross street/directions to job site: Desedetlon O "' 7 k�.
Qty. Fee. Total
New residential single or multi - family dwelling unit.
Includes attached garage.
Subdivision: I Lot no,: 1,000 sq. ft. or less , 168,54 4
Tax map/parcel no.: Ea add'1500 sq. ft. or portion 33.92 I
FI)Ial It f " l h1 T181 dA11lI3 It Limited energy, residential 75.00 2
�li llyl ' , p'' 1 li . p .l s ir`I "i t (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
°mot ` ' :` qy . c , , tj �b ittglt ! + :' ' :o i , r4 l l'`pi -;' 201 amps to 400 amps 133.56 2
u� a dtnu l kid. s 9
Name: 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 imps or volts _ 552.26 2
City/State/ZIP: /StatC /ZIP Temporary services or feeders installation, alteration, and /or
ty : relocation
_Phone: ( ) I Fax: ( ) 200 amps or less 59.36 I 1
201 amps to 400 amps 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
K , ( " t rata. , , :` r 1 4?i u� . above service or feeder fee, 7.42 2
X13 u tip rarsa inn �� a, , , ;� ^ each branch circuit
Business name: Johansen Electric B . Fee for branch circuits without
service or feeder fee fast 1 56.18 56 _ 18 2
Contact name: Charlynn Le i f s en branch circuit
Each add'l branch circuit 5 7.42 37 . 1 2
Address: 10948 SE Val ley View Terr Miscellaneous (service or feeder not Included)
City /State/ZIP: Happy Valley , OR 97086 dwel m g, service a or modular 67 84 2
dwelling, service and/or feeder
Phone: (5 0 3) 698-3417 I Fax: :(503) 6 9 6 - 2 4 8 6 Reconnect only 67.84 2
E -mail Pump or irrigation circle 67.84 2
re cc wept t_ , sign or outline lighting 67.84 2
... r ' , " ;i ;�: ':.«&s1 ` n as�' .9 . _ 1 11..1E i t',? i.; Signal circuit(s) 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 (I hr min) 66.25/ hr
Investigation (1 hr thin) 6615/ lir
City /State/Z[P: Happy Valley, OR 97086 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
, cificall hated 'V hr min
CCBLic.: 51539 I Electrical Lic_:3- 2433 I Su rv.Lie.: 2053S rat' , ; „11-'r,�„�,' B:;I; 1p� 42s lj ;ii;a`t'1. r
,% Subtotal: 93.28
Suprv. Electrician signature, required: ✓ Plan review (25% of permit fee):
Print name: Carl Johansen ate: 4 /26 / 11 State surcharge (12% of permit fee): 1 1 . 19
Authorized signature: /i// e
TOTAL PERMIT PEE: 104.47
I'C �t'C Thu permit application expires its permit is not obtained within 1210
Print name: Charlynn Leif I Date: 4/26/11 days after it has been accepted as complete.
• Number of inspections allowed per permit.
E1Buildng1Pemtits \BLC- PerntitApp.doe 07/01/10 140- 4615T(11 /05 /CONS/WEB
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