Permit CITY OF TIGARD ELECTRICAL PERMIT
/
COMMUNITY DEVELOPMENT Permit #: ELC2011 -00402
Date Issued: 07/19/2011
T1G4AI3 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S113AC00103
Jurisdiction: Tigard
Site address: 7204 SW DURHAM RD 300
Project: Consumer Cellular Subdivision: PACTRUST BUSINESS CENTER Lot: 0
Project Description: (2) branch circuits 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
2 crt Branch Circuits wo /Purchase 07/19/2011 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 07/19/2011 $7.63
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $71.23
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 throug :AR 952 -00 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 50 */0/06./c-67-4 3..2332.199887 or 1.800.332.2344.
Issued By: (Jr., / - Permittee Signature: O/ �' /' A
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.
Jul . 18 . 2011 06:12 PM JOHANSEN ELECT 5036982486 5036982486 PAGE. 2/ 2
Electrical Permit
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City of Tigard : ,irliii perimiNo.C‘ec20// —,,:myo.
!p.-, . 0125 sw ilaill3lvd„ Tigard, OR lt. 1 9 2011
; _ 1 • Phone: 503.639.4171 Fax: 503.59 .1960 ' Ii Olher Penn i teie --./fee) 6,6'
• i t., A it ri Inspection Line: 503,63 9.4175 rirry OF TIGARD i)itte Ready/Hy: fi2 Sec Page 2 for
Internet: www,tigard.or.pnv CITY i Notified/Method: Ready/Hy: . Supplemental Information
':''::' , ':t+, •,,...‘ .. :. .,:,' ..:..•.',•:.,,..,.; ' `;.AXYLOWL:'-'.Y 4 ::,: . ,":.: , :;.'.':,:!,..;::. , 5.:. , .: :.•=',' r
.. ,....... •..• ..
0 New construction l Addition/alteration/replacement
Please check all that apply (submit 7 oak of ans f pl w/iterna checked below):
E
0 Service or feeder 400 amps or more 0 lull Ming over three stones.
ID Demolition CI Other: .
whore the available &Mt current 0 Marinas and boatyards,
'',7:; ' . .7....,". : 4 ,, ,:: . 2. , , :,. : :::•:,' . 7 .. exoeocts moo amps at 150 volts or 0 Floating buildings.
less to ground, or comet& 14,000 0 Commercial-use ItaliWittilli
Ell- and 2-family dwelling t's'l Commercial/industrial 0 Accessory building imps for all other installations. buildings.
0 Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 75 KVA or
larger separately derived system
,,:„! '7.:''... N ,„ • : ..,..,.,- . '.......! „.. .,.... . ,.,,,'-':..,' ','.-‘,..':,;',.,' ,••■...-',;';';..,.'`. ,':'. ' co Addition of waw motor Mad of 0"A",
100i11) or 11101 opoupanny.
Job no.: Job Site address: 7204 SW Durham, 300 0 six ormore residential units, 0 Recreational vehicle parks.
City/State/ZIP' 0 Health-care &citifies. 0 Supply voltage for Malt than
0 Hazardous locations. 600 volts nominal.
Suite/bldg./apt. no.: 300 Project name: COrilaUtner Cellular LI ..
SOMA/ VT limier 600 AMassist Of MOM.
........ ''''''' ' :j4E14:0110*.'57:::.i..';q:'::::':,;..:: .;..'.;:.:
Cross street/directions to job site: Description ' i Qty. I Ike.
New residential single- or multi-family dwelling unit.
Includes attached garage,
Subdivision: Lot no.: 1,000 sq. ft. or less 168,54 4
Ea. tidd'I 500 sq, ct, or portion 33.92 I ,
Tax map/parcel no.: Limited energy, residential
75,00 2
DES R1 o wo*K (with above sq It) - Limited energy, mulii.family 75.00 2
Space Improvement-phase 2 residential (with above sq. ft.)
services or feeders installation, alteration, and/or relocation
200 amps or loss 100.70 2
;'; ',.. :; •: - .. ' •. : . " . ; ; : ttit : R 0 0.0t,.*:4***! : ;;''' ' *'; ' ''' ,. ';',i (; ..(.,:' P' . P ,. 135,56 2
' 401 amps to 600 amps 200,34 2
Na tne: .„. ...
601 amps to 1,000 amps 301.04 2
Address: over 1,000 amps or volts J 552,26 2
Temporary services or feeders installation, alteration, and/o
City/State/ZIP: relocation
- • ...
phonc:( ) I Fax: ( ) 200 amps or lass I 59.36 1 1
201 amps to 400 amps i 125.05 2
Owner Installation: This installation is being made on property that I own which is not
I
Intended for sale, lease, rent, or exchange, according to ORS 447,449,670, and 701. 401 amps to 599 amps 168.54 2
Branch circuits - new, alteration, or extension,yer panel
Owner signature: — Date: A. Fee for branch circuits with
. ,:;.::.:..:;,.:..,.:.; : .; , 7 : ,. ..,., , - i . , .:,.. , ; , ... ,. . 2. ., :i.. ...•• cc o.to,*00* :: ,... , ...,,,., :. , . abo feeder fee. 7.42 2
Business name: Johansen Electric 13, pee for breach cirimits without
service or feeder Mc, first
1 56.18 ', 6 . 18 2
Ommdmme: Charlynn Leifsen Muncheimuit
Each add'I branch circuit 1 7.42 7 • 42 2
Address: 10948 SE Valley View Terr Miscellaneous (service or feeder not included)
Each manufactured or modular
City/State/ZIP: Happy Valley, OR 97086 67.84 2
dwell service and/or feeder
Phone: ( 503) 698-3417 Fax: : (503) 698 -2486 Reconnect only (17.84 2
Pump or irrigation circle 67.84 2
E-mail:
, .. ,,, .,..... , „ Sign or Oiltiirld lighting 67,84 2
i.' - :* : 'k:OPellkOtork: : :: , .::, : ,:. ; t.; '...,, , ':" ' .'! :Il.. :.':-,!.. r :• Signal circuit(s) or limiMd-onergy
Panel, altorntiort Of 6XteMiOrl. PaLe 2 2
Muitiossmirm Johansen Electric , Each additional inspection over allowable in any of the above
Address: 10948 SE Valley View Terr (1 h
l i
Additional (r min)
--- - 66.25/ hr
City/State/ZIP: Happy va.11ey OR 97086 ---- Investigation (1 hr min) 0:2:/ hr
Industrial plant (1 hr min) 78.18/ hr
Phot10: ( 503) 698-3417 IFfilc(503) 698-2486 lrispwliculs for which no fee is
00/
h
. apecitically listed ( hr mi9 90. r
et iZt03 Lie.; 51539 .. ,/Electrical Lie,: 3 -243C tAuprv. Lic.: 2053S
, . subtotal: 63.60
Suprv. Electrician signature, required:
Plan roviow (25% of permit fee):
Print name: Carl Johansen Date: 7/18/11 state sun (12% of porm it roc): 7 , 3
ToTAL PERMIT FEE 71 , 23
"
Authorized signature: (itel r_.,. • This permit i mpu ta ti on ev ii r m if a permit 11, not obtained within IRO
days after it has bccn accepted an complete.
hiaummCharlynn Le aen Date: 7/18/11 . Number or inspectimis allowed per permit.
1:11iluildingTermita \GLC-PsimilApp.dne 01/0 I /10 444.7-4615T(l1/05/COM/W113