Permit rt CITY OF TIGARD ELECTRICAL PERMIT
I: g ;" COMMUNITY DEVELOPMENT Permit #: ELC2011 -00462
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/16/2011
Parcel: 2S 112 DA00800
Jurisdiction: Tigard
Site address: 15115 SW SEQUOIA PKWY 170
Project: Napier Subdivision: Lot:
Project Description: (2) 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
2 crt Branch Circuits wo /Purchase 08/16/2011 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 08/16/2011 $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 cordance ' . approved plans. This permit will expire if work is not started within 180 days of iss - • --, or if work is suspended for more the 180
days. A ENTION: Oregon a, requ es you to follow the rules adopted by the Oregon Utility No" - ion Center. Those rules are set forth in OAR
952 -001 0010 through OAR 95 001- 0090.' may obtain a copy of the rules or direct questions to OUNC b �rmc r 1.800.332 44.
Issue By: , e.M — — ` \ i Permittee Signa■ � '� .'4 _ ir
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' •/ - �; <-41■4, 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.
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Electrical Permit Applicatioq 6 2011 FOR 111 I SE ()NIA
HU LI I
City of Tigard
, ,- .1 13125 SW Ilea Blvd., Tiglik170R. i :.-) n
111111 Received Q , ..,„. , _.....
DatelEt : e tOA "lim""..
FESIMIlll (Mier Pamit; 4 - 4 - - ...../ 1 -- . ,
v.r."
: 0 •
ehorte: 503.639.4171 4:61: Li
i I ,..; A . iz. I , .111SpeCt1011 lino: 5034N2DING DIVISION ESEEM111111111. sr. Page 2. for
'Internet: www.tigard-or.gov Supplemental Infermuflon
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' Please cheek nil that apply (suhinit 2 sets of plans wincrus checked below):
0 Now construction E] Addition/alteration/replacement
El s or feeder 400 amps or more 0 Building over throe stOcies.
0 Demolition 1:1 Other: when: the available lush current 0 Marinas and boatyards.
,..;;:,:e*tiiiiwAg . ..:;• : . :: !.,:;::::::.., 4 ,-;;..• : ;?...:‘..; , '.. exceeds 10,000 amps at 150 v011s or 0 Floating buildings
. . • • • . ' ' . " • - • - " • - hem to ground, or =cods 14,000 0 Cominerciakisc agricultural
0 1- and 2-family dwelling gl Commercial/industrial 0 Accessory building amps for all other installations, buildings.
0 Multi-family 0 Master builder 0 Other: 0 Fire pump, 0 Instillation of 75 KVA or
.. , . ,,.., , , , .... , , 0 Emergency sysmin. larger %enamel} derived ayetan.
e ''.'; .: . :7 , 6 .. ; ; 7., ,, ' ,. - :: : :r•;, ,; if ' ,6:' :: a4.0;„ ' ,.,,fikA ii*,III..0Y4 :: .:'.'':' , :' , '„;;r, ',- 0 Addition „f„cw motor load of 0"A", "ir, "1.2" "1-3",
1001P or mare, occupancy.
Job no.: Job site address: 15115 SW s e qu 0 i a, 1 70 El Six or more residentini unit 0 Recreational vehicle mrkz.
City/State/DP: El Health-ore facilities. 1:1 Supply voltage for more than
0 Hazardous locations. 600 volts nominal.
Suite/bldg./apt. no.: 170 Project name: Napier InService or feeder 600 snips or MON.
tE)V.
Cross street/directions to job site! ficaerlptIon T WY. 1 Ike- I Tend I •
New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision; Lot no.: 1,000 sq. ft, or let: 168.54 4
Ea. add'I 500 sq. ft. or portion 33.92
Tax map/pamel no.: I .Oni lad energy, residential
75.00 2
'`...?:':: :. ., i : ....•'..',:i .!....;,"::. .: 0t$Cittt :WeilW '.:''.'• .': ' T ...::.1'. • :' (with shove ai , ft —
Limited energy, multi-family 75,00 2
Add 1 office residential (with above sq. ft,)
services or feeders installationodteratIon, andkr relocation
200 amps or km 100,70 2
,',.';';';','.':'..•:".:'' :;•.:',p',4s0 . 201 amps to 400 amps 133.56 2
—
401 amps to 600 amps 200,34 2
Name:
66i amps to 1,000 amps 301.04 2
Address: over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and/or
City/Slate/ZIP: relocation
Phone; ( ) I Fax: ( ) . zoo rungs or lose
— $9.36 .. 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
401 amps to 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. -
Branch circuits- new, alteration, or extension, per panel _
Owner signature: , ,, Dato: A. Fee for branch circuits .17h
ova •aarvice or feeder fee,
.4.#. •,1‘. O 04**0-OPi00': : e gbachb,....h.i.it 742 2
i •
Bm name: Johansen Electric — service Or limier fuo, first
H. Fee for branch oireuils wilhoui 1 36.1856.18 2
Contact name! Charlynn Leifsen branch circuit , .
'Each add'I branch circuit 1 7,42 7. 2
Address: 1 0 9 4 $ SE Valley view Terr Miscellaneous (service or feeder not included)
latch manutteturatl or modular
City/State/ZIP: Happy valley, OR 97086 awe ing, service and/or feeder 67.84 2
.,
Phone: ( 5 0 3) 698-3417 Fax; : (503) 698-2486 Reconnect only
67.84 2
Pump or irrigation circle 67.84 2
E-mail: - .
. , ,. ., si or outline lighting 67.84 2
:,-,, :;:' ': •'..' .T. .'"..::''.:.':.''':.:.!''.;;','''''.::..'''.: Signal eircuit(s) or limited-energy . .
panel, alteration, or extension. Pane 2 2
N Johansen Electric —
Each additional inspection over allowable In any of the above
Address: 10948 SE Valley View Terr ,., Additional inspection (1 hr min) 66.25/ lir ..
Investigation (I hr m)n) 66.25/ lie
City/State/VP: Happy Valley OR 9708 6 . .
Industrial plant (I lit min) 78.18/ lir
.,. -
Phone: (503) 698-3417 Fax: ( 503) 698-2486 Inspections for whieh nl fee i ii
,,,.Iii ii 0 hr lain) 90.00/ hr_
CCB Lie.; 51539 Electrical Lic.: 3-243 Suprv. Lic.: 2053S '::,, :- !E1410100,V;
.." . .
10;:iiirdi ' / Subtotal: ' n . ,o
Suprv, Electrician signature, required: .. .......
.■ Plan review (25% of permit fee):
. ..
Print name; Carl jo a seri Date: 8/15/11 state surcharge (12% of permit foe): 7, 63
...
TOTAL PERMIT PM: 71 • 23
Authorized signature; '
..., - This penrnIe application expires ifs porndt Is not obtained within IRO
days after it has been accepted 119 comploc
Print name: Charlynn Leifsen Date: 8/15/11 . Number of Inspections allowed per permit.
1Arteilemn\PermitAELC•Perm0App.dec 07/01/10 4404615TO 1105/COMME111
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