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Permit CITY OF TIGARD ELECTRICAL PERMIT ` COMMUNITY DEVELOPMENT Permit #: ELC2011 -00372 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/06/2011 Parcel: 2S112DA00800 Jurisdiction: Tigard Site address: 15115 SW SEQUOIA PKWY 110 Project: Integrated Services Subdivision: PACIFIC CORPORATE CENTER Lot: 2 Project Description: Electrical 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 - 624 -6300 HONE: 503 - 698 -3417 FAX: 503 - 698 -2486 FEES Quantity Description Date Amount 1 ea Services or Feeders - 200 07/06/2011 $100.70 Specifics: amps or less 40 crt Branch Circuits w /Purchase 07/06/2011 $296.80 Type of Use: COM Service or Feeder Class of Work: ALT 1 ea 12% State Surcharge - 07/06/2011 $47.70 Electrical Type of Const: Occupancy Grp: Total $445.20 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through OA: -001-0090. You may obtain a co. ules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: Perm ittee Signature: es/sa• OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease or rent. OWNER'S SIGNATURE Date: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC' Date: LICENSE NO. Call 503.639.4175 by 7:00 a.m. for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Electrical Permit Application �r,� 1 oitout WI•: 1, ti F ONO .l . il City of Tigard Received R 13125 SW Hall Blvd„ T i 1 r� Date/11 : ` O1/ �. Phone; 503,639,4171 Fax; r : 98,1960 ex(.3 v INAM otter Permit; .U i -0/0 / I n I InspectiOn line: 503.639.417 \`\ v Y y: Fier Page 2 for Internet: wwwligard- or.gov '\ Jv lC 0V Notified/Method: !t `PE uppiementat lunwn atirm tY iOF \qr., ° ;u_ t4 1 i® , :r 1%4 ^ ,VIEW \\ Please check all that apply submit 2 acts of plans w /itcuta checked below): ry , . cement pp • ( p ❑ New construction E Addition /al i 'f'' • 0 3erviee or feeder 400 amps or MOM 0 Inuilding Over throe umrics. © Demolition ❑ Other: ds �. r ava limit surreal [i Marinas and boatyards, w ____•,‘' ''CA ,' •,. cP COOstitiJ'G` `IO$ ). :,E exceeds10,000 amps nt 150 volts or ❑ Floating buildings, Isms In ground, or exceeds 14,000 El Comnmaroial. 1st tairicallural ❑ I- and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi- family ❑ Master builder Other: 0 fire pump. ❑ Installation of 75 KVA or I•:nla a y x . a ?' '.}y; l ' xlrltt' 1W .1" N 1!' t t,1±YI[St ,l rV41�..r'AQI 1l ratlr '4111511051y tiarivml syaletn, , ❑ Addition anew motor lend of 0 "A" "li' 1.2 Job no.; Job site address: I (i iE \ I V 1 or more. R cupancy. ,f 1;p © Six or more residential units. ©cereational vehicle parks. City /State /ZIP: ❑ Hcslth -care theilities. 0 Supply voltage for inure than ❑ liarardouk lescationa 600 volts nominal. Suite/bldg. /apt, no,: 1 ID Project name TyA - �+ ❑ Strvtcu or teedar 600 amps ire mr>re. 1' � J ► "� 'P& SrnftlE Cross strcot/dircctions to job site: 1i<.or, a ,,,, New residential single-or multi- family dwelling unit. Includes attached garage. Subdivision: I Lot no,; 1,000 sq. ft, or loss 168:54 4 - --- - Ea. add'I 500 Sq. ft or portion 33.92 1 Tax map /parcel no.: Limited energy. residential ' •. `. tAtwkor'XON+ , O1Q.W'ltic (with above ey. rl.) 75,00 2 Limited energy, multi- family 75.00 2 Space Improvement rasidmriiul(wilh above sq. 11,) Services or feeders installation,alteratlon, and /or relocation +'.g - „ = r_. ,,, .., >.., . , �., m a or less 100.70 200 a p � (� .7Q ✓ 2 : °? O ? ' ";'OWNE» �r , , 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200,34 2 Name; . 601 amps to 1,00D amps 301.04 2 Address: pear 1,000 amps or volts 552,26 2 Temporary services or feeders installation, alteration, and/or City /State /ZIP: relocation Phone; ( ) I Fax: ( ) . 200 amps or less - 73068 1 201 amps to 400 amiss 125. Owner installation: This installation is being made on property that 1 own which is not - 4111 amps In 50 imps 1115 „34 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits — new alteration or extension , er , and Owner signature; - _______-_-,-..--- _- ________ Date: ,.,.. -, .,...... A, Fee for branch circuits with above service or feeder foe, , Jw C�1'1 ' Cr i "t]IV X"+4 Ialti� l each brunc c 7.42 / _ to 2 Business name: 13 Fee for branch circuits wllhour 1I� (f11 Johansen EleGtxlC service or Moder Mc, first $6,111 2 Contact name: C harlynn Le i f s en brnmclt circ:nit -- Each add'l branch circuit • 1 C 7 W 2 Address: 10948 SE Valley View Terr lt5isceiluneuus (service or feeder not included) Each manufactured or modular 67.84 2 City/State/VP: Happy Valley, OR 97086 dwelling, service and /or feeder Phone: (5 0 3) 698-3417 I Pax:: (5 0 3) 698-2486 Rnaonnect only 67.84 2 Pump or irrigation oirelo 67,84 2 E -mail: -T_, T., Sign or outline lighting 67.84 2 • Signal cimrwiKs) or limited•etmorgy Business name: panel, alteration, or extension. Page 2 2 Johansen Electric Each additional inspection over allowable in any of the above Address; 10948 SE Valley View Terr Additionaliitspeetion - 66.25/ lit City/Statc /ZIP: Happy Valley, OR 97086 investigation (I hr min) 66,25/ hr Industrial plant (Ihrmin) 78,18 / hr Phone: (503) 698-3417 T Fax; ( 5 0 3) 698-2486 Inspections for which no fee is 90,00/ hr s ocilicull lislnd "/: hr min CCB Lic.; 61839 I Electrical Liee 33 � 3 C 1 Suprv. Lio.: 2053S $ iW,`, ""' T : , . O :777, :. ; ; ' , Suprv. Electrician signature, required: eett G r , a - Subtotal � �.50 Plan review (2S%ofpermit fee) Print name: Carl Johansen - -.�+_7 / 5 /1 1 State surcharge (12% of permit fee): 4 � , t1 O TO•!'Al. PERMIT F•II: y 45 ,mil Authorized signature': 0 �l /1 This permit application expires Wu permit is not obtained within 180 1 � / days altar II has boon accepted as complete. Print name: Charlynn Leif sen Date: 7/5/11 « Number of inspections allowed per permit • 1•Uln ildinalpev'ln \E:LC- IaarmilApp.d,e 07/01/10 4411- 4015T(11 /tS/OOKI VPII 6 /T -soya 98VZ869COS 986Z8692O9 ZOH'TE masmvHOr Na 8Z:£0 TTOZ'90'Tnr