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Permit CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2011 -00336 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/21/2011 Parcel: 2S112DA01400 Jurisdiction: Tigard Site address: 6650 SW REDWOOD LN 220 Project: Archibald Subdivision: PACIFIC CORPORATE CENTER Lot: Project Description: (10) 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 SW SEQUOIA PKWY #300 PORTLAND, OR 97224 PHONE: 503 - 698 -3417 PHONE: FAX: 503 - 698 -2486 FEES Quantity Description Date Amount 10 crt Branch Circuits wo /Purchase 06/21/2011 $122.96 Specifics: Service or Feeder 1 ea 12% State Surcharge - 06/21/2011 $14.76 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $137.72 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 160 days. ATTENT Orego law -quires you to follow the rules adopted by the Oregon Utility Notificatio• Center. Those rules are set forth in OAR 952- 001 -001 hrough OAR 952 •'1 -009'. You may obtain a copy of the rules or direct questions to OUNC by calFc i.' .232.1987 or 1.800.3 2.2344. _ I Issued B / ... P Permittee Signatu ' ! ' //I/SW 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: ��/ / �✓� /LC D. (�--- Off/ LICENSE NO. dO 5 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. Electrical Permit Applicati t C D roll I;ti n(1'.,I. tit 0.1., City of T igar d A' 2 t1 Received Purmll h1U�: n a 13125 SW Hall Blvd,, Tigard OR 97 22�'Y 21 Date /11 ; �� ea X10 -a, ' Phone: 503. 639. 4171 Fux: 503.598.1960' Millnillill. Other Permit: : I./ M e w- i v /,? l ,,,-,,•,.,,, Inspection Line: 5103.039.4175 CM OF TIGARD Date Ready /Hy: tun M Sec Page 2 fur Internet: www.lignrd- or.gov RIM Mc ptViSiAIV Notitind /MethoJ: Supplemental hdn anatimr , u : x woate . PiAN REVIEW.. . Pl yrae check nn the) apply (tuhntil 2 xnl� of plans w /lteffla checked below): ❑ New construction ® Addition /alteration /rcplaccment ❑ 4arvice or tiwdar 4110 amps or morn ❑ building over throe stories ❑ Demolition ❑ Other; whore the available fault ourreni ❑ Marinas and boatyards. ' ' .CAATEGORV• OF CONSUIXTiON • • cxctxds 10,000 amps at 150 volts or ❑ Floating building.. • •' ° lens 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, ❑ Inxtnlhrlioii of iS KVA Or ' . - ❑ Emergency system. larger separately derived 4yttom. .. n�r Mt SITE ORM T M D x . 10 Addition of new motor load of ❑ "A" "E" "1-2", ' 1 Job no.: Job sile address: 6 6 5 0 SW Redw 10014P or a rest Recreational 1 ❑ Sir or mars residential hairs. CI Rccrcetional vehicle parks, City /State /ZIP; 11nnithoare fu ilitia +. ©Supply voltage Ihr more than ❑ Hazardous locations. 600 volts nominal. Suite/bldg./apt. no,: Project name: Archibald Relocation _❑ service or feeder 600 amps ormore, - - • Mt SOMME Cross street/directions to job site: ' nenrr tine i Qty, I Mee. 1 1'eml " New residential single- or multi - family dwelling unit. includes attached garage. Subdivision: Lot no,; 1,000',4. n. or lent 168.54 _ 4 I s. add'I 500 xy. ft or portion 33.92 1 Tax map /parecl no.: Limited energy, residential 75A0 2 '': 7 . fitSCR l.'EO1'i. OF WORE (with above ail. fl.) ' Limited energy, multi - family 75.00 2 Tenant Improvement reiiidetitiid (with above sq. ft.) Services or feeders installation, alteration, and /or relocation 200 amps or less 100.70 2 tj kty1 R"1` ' . Q '.'ll` NAtif'1i' .:. 201 amps to 400 amps 133.56 2 Name: 401 amps to 000 amps 201) 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 i nstallation, alteration, and /or relocation Phone: ( ) Fax: ( ) 200 amps or less $9.36 1 201 amps to 400 amps 125.08 1 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 _ 168 2 Branch circuits- new alteration, or extension, perrumel Owner signature; Date; A, Fee for branch airouits with i A. 0 • • CO1Vt CT •'P O , • oaclt b r a ri circuit ircuit or fender cue, 7.42 2 • . oech branch c Business name: Johansen Electric 11 Fee for branch circuits without . service or feeder foe, first 1 $6,1856 .18 2 Contact name: Char lynn Leif s en brunch circuit Each add'I branch circuit 9 7.42 66.78 2 Address: 10948 SE Valley View Terr err Miscellaneous (service or feeder not included) City/State /ZIP: I ld Valle OR 9 7 0 8 6 d uv e t mta, ncrvie or modular 6784 2 ppy y Valley, dwelling, service rind /or feeder Phone: ( 503) 698 -3 417 Fax; : (503) 698-2486 Ra oal 67.84 2 Pump or irrigation circle 67.84 2 _ q" or Sign outline E -mail: CC31v i itACFOR e 67 84 • RiMnn! cirouit(s) or IimilnJmnergy d Business name; Johansen Electric parrol, alteration, orextension Papo2 2 Each additional inspection over allowable in any of the above Address: 10948 SE Valley View Terr Additional inspection (Ihr 66.25 / lit Investigation (1 hr min) 66,2S/ hr City /State /ZIP; Happy Val , OR 97086 industrial plant (I hr min) 78.18 / hr Phone: (503) 698 - 3 417 Fax: (503) 698-2486 Inspections for which no fee is 90 .00/ he specifically listed !q be min) CCB Lie,: 51539 Electrical Lie.: 3 -243C Suprv. Lic.: 20539 • : , V'tE O1AAr .Pti.,011T Bilitg ' "' 7 7::' Subtotal: 122.96 Suprv. Electrician signature, required: ,k- Plan rovicw(25i%aof permit foe): Print name: Carl. .3 hansen Date: 6/20/11 suite surcharge (12 %ofpermit 14 - '76 TarAL in-Alvin: Ail: 137.72 Authorized signature; / This permit application expires If a permit is not obtained within 180 a.„...---\..........._ days after it has been accepted as complete. Print name; Char 1 yon Leif sen Dec: 6/20/11 r Number of inspections allowed per permit. 1;l t \Permits\8LC:- PermitApp.Mc 07801/l0 444615Ttivas/c'.Otvwt;a Z /T " 3DVa 98T7Z869C0S 98t7Z869CO5 IDEZH NESNVHO2 Na ZZ:ZO TTOZ- 0Z -unr