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Permit CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2011 -00328 'TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/16/2011 Parcel: 2S 101 AD03200 Jurisdiction: Tigard Site address: 12909 SW 68TH PKWY 270 Project: Spec Space Subdivision: TIGARD TRIANGLE CENTER Lot: Project Description: (6) branch circuits for TI Contractor: JOHANSEN ELECTRIC INC Owner: PACIFIC REALTY ASSOCIATES 10948 SE VALLEY VIEW TERR ATTN: N PIVEN HAPPY VALLEY, OR 97086 15350 SE SEQUOIA PKWY #300 PORTLAND, OR 97224 PHONE: 503 - 698 -3417 PHONE: FAX: 503 - 698 -2486 FEES Quantity Description Date Amount 6 crt Branch Circuits wo /Purchase 06/16/2011 $93.28 Specifics: Service or Feeder 1 ea 12% State Surcharge - 06/16/2011 $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 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: egon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 thro h OAR 52- 001 -0090 You may obtain a copy of the rules or direct questions to OUNC by calling 503. .1987 or 1.800.332.2344. Issued By: (/1 Permittee Signature: C / -' G " 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: Gldr,/ LICENSE NO. 4Dc 3 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. RECEIVED Electrical Permit AppticatiotON 1 5 2011 hcalz on. I `l. i :1 h: (`,., City of Tigard ClY OF TIGARD �/ C Y OF TIG[�RD Daw iR ; , ti I Pcmnit No' ih�?o!! 61 • 13125 SW Ball 13lvd., Tigard, ( �JG DIV ISION Plan Review n ' ' Phone: 5f13.G39.4171 }'ax: Date/B : Other Poling: tit C AO //— OD g 5 7 I r ; ,\ R I ' , Inspection Line: 503.639.4175 Date Ready /By: NM !a Set t'age 2 for Internet: www,tigard- or.gov Notitiod /Method: Supplemental Information TYPE' ib>a. WORZ I?MN 13t�VClCw El Ncw construction In Addition/alteration /replacoment Ploam check all that apply (submit 2 sate of plena w /hulas chucked below): ❑ Demolition ©Other: In Service or feeder 400 amps or more ❑ Building over throe stories. whore the available fault current ['Maims and boatyards. C i It o s'iaaa • exceeds 10,000 amps et 150 volts or ❑ Floating buildings. • lass to ground, or exceeds I4,00o ❑ Cimtmerclnl•uaa agricultural ❑ 1- and 2- family dwelling ® Commercial /industrial El Accessory building ,antis for all nthar installations, huildinge ❑ Multi- family ❑ Master builder ❑ Other: Cl Pirc pump. ❑ Installation of 75 I;VA or ' . F,merye icy system, larger separately deriv system. ' . lXil'ORISPs Ofi. LOCATION; ❑ Addition of now motor load of 0"A", ., epar . Job no.: Job site address: 12 g 0 9 SW 6 8 tr h 2 7 0 10011P or mono. R r ❑ Six or more residential unites. ❑ Rccrcatioaal vehicle parks. . City /State/ZIP: ❑ Health -care facilities. ID Supply voltage for more then „1,../ ❑ Hazardous locations. 600 volts nominal. Suite/bidg. /apt. no.: 270 Project name: Vacancy ❑ service or feeder KO ititr or mom. Cross street/directions to job site: Ihaorl5tba 1 (RT.. 7 - Fre. I tow 1 , "" New residential single- or multi - family dwelling unit. Includes attached garage. • Subdivision: l 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,: 75 UO 2 Limited energy, residential Lin ' . a tyWfly 1(. _(with above sq. fl.) - Limited energy, muhi• family 75.00 2 Space Improvement residential (with above sq. ft.) Survives or feeders installation, alteration, and /or relocation ( OPPR'flt OW1� . ., .. .. . .,... ,,., amps to a 133,56 2 2 tuns t loss ' � �' Amor 20l amps to 400 amps I33,56 2 Name: 401 amps to 60(1 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 ` 2 City /Slale/ZIP: Temporary services or feeders Installation, alteration, and/or -- relocation Phone: ( ) I p ax: ( ) no amps or loss 59,36 I Owner installation: This installation is being made on propetty that I own which is not 201 amps to 400 amps 125.08 2 intended for sale, lease rent, or exchange, 601 amps to 599 amps 168.54 2 rttl}rC, aceotdzng to ORS 447, 449, 670, and 7 Branch circuits.. new, alteratlonor extension, pSer navel Owner signature: Date: A., lee for branob circuits with above service or feeder fee. . LJCA1�1 #( ,41"AON each branch circuit 7,42 2 Business .name: Johansen Electric 11, Fee for branch circuits without -- • service m fcndar fcc, licit 1 56 .18 5 6.18 2 Contact villas Charlynn Le i f e en branch circuit — Each add'l branch circuit 5 7.42 37.10 2 Address: 10948 SE Valley View Terr Miscellaneous (service or feeder not Included) City/State/ZIP: Each manufactured or modular t3 Happy Valley, OP. 97086 dwolinx, serviceand /orfeede_r 67'84 2 Ci • Phone: (5 0 3) 698-3417 1 Fax:: (5 0 3) 698-2486 R0otnneet only 67.84 2 E-mail: Pump or irrigation circle 67.84 2 Sign or outline lighting 67.54 2 • • ' ' • (O MOR • Signal cirouit(s) or limited- energy )3usinesgnamc: Johansen Electric ponol,a I uxtottsiolt. PaRa2 2 Each additional inspection over allowable in any of the abov Address: 10948 SE Valley View Terr Additional inspection (I hr min) 66.25/hr Investigation (I hr min) 66.25/ hr City /State /ZIP: Happy Valley , OR 9 7 0 8 6 lneiuntrinl p ant (l hr min) 75.18/ hr Phone: (503) 698 -3417 1 Fax; (503) 698 -2486 Iospectioes rot whiuhno feu is 90.00/ hr p specifically liatc E s t hr data moor, Fr CCB Lic.: 5153 9 Electrical .Lie.: 3 — 2 4 3 0 Sunni, Lie.: 2 0 5 3 5 ' Suprv. Electrician signature, required: . / , , , . Subtotal: 93,28 Plan review (25% of permit fee): Print n ame: Carl Jo ansen I Date: 6/15/11 . state surcharge (12% of permit ice): 11 , 19 Authorized signature: A.., ____,--,. TOTAL PERMIT FEE: 10 4.47 . .. T his p ermit application expire; it a penult is not obtained within 1110 days after It has been accepted as complete. Print name: Charlynn Leif seal Date: 6 /15/11 • Number of inspections allowed per pemtil. T: 1Tlui ldini \Pcrmitettt.C- PermitApp, dse 0illt /l0 440 ..161 S'I'(I 1 /OS/COMiwsn 8 /L . aDVd 98VZ869£05 98i7Z8696O9 'Darla MESM1HOr IOW L5:60 TTOZ.9T