Permit CITY OF TIGARD ELECTRICAL PERMIT
- COMMUNITY DEVELOPMENT Permit #: ELC2011 -00458
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/11/2011
Parcel: 2S113AB00600
Jurisdiction: Tigard
Site address: 16165 SW 72ND AVE
Project: Spec Space Subdivision: PACTRUST BUSINESS CENTER Lot:
Project Description: Electrical for TI.
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 - 698 -3417 PHONE: 503 - 624 -6300
FAX: 503 - 698 -2486
FEES
Quantity Description Date Amount
10 crt Branch Circuits wo /Purchase 08/11/2011 $122.96
Specifics: Service or Feeder
1 ea 12% State Surcharge - 08/11/2011 $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 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' • 2- 001 -0090 You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: i./ ✓_ _ Permittee Signature:
/TO j
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.
RECr",IVED
Electrical Permit Application FokIWFWvisvbNILY
City of Tigard
. ----% 13125 SW Hull Blvd., Tigatd, OR 97223
IN AUG 11 2011 isiganitivi
Pl ROVinV VI IMMINIIIIIMIRII
, i • Phone: 503.639.4171 Fax: 503.598.19641-Y OF TIGANU D iW ftieD : Other Permit:
../ I . A iz i ., Inspection Line: 503.639.4175
BUII DING DIVISIOti DNaotetifiR= mi , Sae Page l for
Internet: vvww.tigani-or,gov Supplcmcnini 1011)rmation
. ... . .‘ .. , .. . - .
1Y0.0t.WOX • .-:' . :..,::'.:.'.:..;' ..;:.,,. : ..'; ..,,%, '•,:.::.• '.'••',.'.'.)it0. v
0 New construction n Addition/alteration/replacement
Please check all that apply (submit 2 sets of plans w/iterns checked below):
i
0 Sorvice or feeder 400 amps or more 0 Buiiding over three stories.
0 Demolition 0 Other; where the available huh current El marinas and boatyanls.
':..', '1 `•.. :.:,',......',':..-...,: ;.:,:!..'"//: ',.:',,,.,'.'; . :,„...d, 10,000 amps at 150 voila Or 0 Floating buildings,
kss to ground, or exceeds 14,000 CI Commercial-us* exticullerel
El 1- and 2-family dwelling IN Comincreial/industrial 0 Accessory building ampa for all other installations. buildings.
0 muiti-ramily EiMaster builder El Other 0 Vire pump. 171 Inetallation of 75 KVA or
, 0 h:rpritgency system. huger separately derived system.
0 *C1 'Ei$ / :;,.:(::' ''.:' ''... ''!.....': 0 Addi6on of new motor load of 0"A" E "I - 3'',
■001-11 or more. occupancy,
Job no.; Job site address A A . AL,
,h CI Six or more rosidern lel 1111i1x. EIRecreational vehicle parks.
In Health-carc facilities,
011am:does locations, 0 Supply voltage for morn than
600 volts nominal.
Suitable:41qt. no.: Project name: t 0 Scrvice or feeder 600 amps or more.
7 :'; J' '''. ': : ScHitiAltitk ..:..''',.:',::,..,"'-:',,:. .,',; • 2, ;,.:..
Cross street/directions to job site: DotrIptInn Qty. Fee, Total '.
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision. Lot no,: 1,000 sq. ft. or less 1611.54 4
Fa. add' I 500 sq. ft. or portion 33,92 I ,
Tax map/parcel no.; Limited energy, residential
75.00 2
DESCR1:PflO1' OP WORK (wutlu above sq t't)
. '
Limited energy, multi-family 75.00
111111111111111111111111..111 residential (with above sq. tt) 2
Serdres or feeders instanation, alteration, and/or relocation
201) mnps.-loris 100.70 2
a 41i0iiiiiixkW,00,10.,::'::. ;.;..,:':,. :.,.., '1 ': ,":',':.: :.'.ti:ir , .' ,'' 201 imps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name; 601 amps to 1,000 amps 301.04 2
Address; Over 1,000 amps sir volt) 552.26
Temporary services or feeders installation, alteration, and/or
relocation
01111 Fax: ( ) 200 amps or less
59.36 1
201 amps to 400 amps t
125 06
Owner installation: This installation is being made on property that I own which is not { 2
p 1 1
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 ams 68.54
Branch circuits — new, alteration, or extension, per panel
Owner signature: - A. Fee for branch circuits with
,. . .... . . , .
conAo:yokoN ,...,,...:..,,.;: 11,Z,hvebrsuenr:ihcniorcrtficieder fee, 7,42 2
II Pee for branch circuits wirhour
Business tissue: Johansen Electric service or feeder fee, first
Omtactmime; Char). nn Leifsen brain:416mM'. 1 56.1g 2
1%
litiob iiikl'l branch circuit i 'l 7.42 6,6 g 2
Address: 1 0 948 SE Valley View Terr Miscellaneous (service or feeder not included)
Each manufactured or modular
City/State/ZIP; Happy Valley, OR 97086 dwelling, serviee and/or feeder 67,84 2
Phone: (503) 698-3417 Fax!: (503) 698-2486 Km:iron:et only 67.04 2
Pump or irrigation circle
67.84
Sign or outline li
67.84 2
2
':.:' . :
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coriTgCrOtt -...: ':•.:',...: I...,•'!. . ::':.;..; :. ' ' ; : ; .• ;•:: '• • Signal circuit(S) or iimitod-cocrgy
anal alteration or extension, Pale 2 2
Business name. Johansen Electric Each additional inspection over allowable in any of the above
Address: 10948 SE Valle View Terr Additional inspection (1 hr min) 66.25/ hr
mvestigution (I hr min) 66.25/ hr •
City/State/ZIP: Happ Valley, OR 97086
Industrial plant (1 hr min) 78.18/ hr
Phone; (503) 698-3417 Fax; ( 503) 698-2486 Inspections for which no fee is III
90.00/ hr IIM
a oceificall hated 14 hr min.
CC13 Lie.: 51539 Electrical Lie,: 3-243C Suprv, Lie.; 2053S -:: ....':.'•:...1'...: ''''ttriMtt : ; • It.: = :.:;..'...;.'......
Subtotal: 2,2,.
Suprv. Electrician signature, required: . '
Plan review (25% of permit foe):
111 *""e: Carl i4lansen / Date: 8/11/11 State surcharge (12% at permit fee):
Authorized signature: ,
TOTAL. PERMIT FEE: /3/0 72
rids permit application expires if a permit Is not obtained within 180
1111=11=21 Date: 8 / 11 / 11 Number o days after it has been scoptoii as complete
. f inspections allowed per pernlit.
11\fluilditteormaltPIC;.PurmitApp.4104 07/01/10 440
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