Permit III ,v CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2007 -00805
°. 1 : COMMUNITY DEVELOPMENT DATE ISSUED: 11/28/2007
11 � 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 101 AD - 03200
SITE ADDRESS: 12909 SW 68TH PKWY 340 ZONING: MUE
SUBDIVISION: TIGARD TRIANGLE CENTER LOT : JURISDICTION: TIG
PROJECT: MERIDIAN
Project Description: (1) Service
(30) Branch circuits.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 1 W /SERVICE OR FEEDER: 30 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
PACIFIC REALTY ASSOCIATES JOHANSEN ELECTRIC INC
15350 SW SEQUOIA PKWY #300 -WMI 10948 SE VALLEY VIEW TERR
PORTLAND, OR 97224 CLACKAMAS, OR 97015 -000
Phone: Contact #: PRI 503 - 698 - 3417
FAX 503 - 698 -2486
FEES
Description Date Amount Reg #: ELE 3 -243C
IELPRMT] ELC Permit 11/28/200' $279.80 LIC 51539
'TAX] 8% State Surcharge 11/28/200' $22.38 SUP 2053S
Total $302.18 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 952 - 001 -0010 through OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: Permittee Signature: B) � � -
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'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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 ,, A E { `- ' : i5 -
I t )ko 1 I(FI 1 \'I °h ,,I j c t
City of Tigard M )1 ; i
a 13125 S W Hall Blvd., 'Tigard, OR ' 'oa i Die ` 2� / r ��� Permit N;`/° �� ,` �/
I N
Phone: 503.639.4171 Fax: 503.598n1,96Q, 8 2007 P1mrRevre •
IVIlJ1 VV D ' Other Permit:
Inspection Line: 503.639.4175 2 (y DateRoad lB
Internet. www.ti d -or. ev N y y' hair
gar P otifiedidethad:
^alt • t . ■
? a I� t if ,l. nr �;rh� {� , r�a!r�.�g��.r y,�„,, 1 qy p��, _ � t,,y ��'`'" '' • .k ?� Y fii6f 1141 : t a i ," .I '.4. si"TekoSr.dSM {yi�t'tr! r 1�2- 4�E �jl�nt �,tT'• m �� p'.,,' "4,s .r2 �., r.. J h 5'a zs i� 2�. �i `raEr'-f�"..nfals:.�':.^�Lwbme
6 I.f - 1 _ L h,T, w •t:.l {Y"5z!!'�' +ed.. �.t.7.r�. ay.:.l:`iEt ?n'
O New construction ® Addition/alteration/replace:nen Pleaso check all that apply (submits sets of plena w /items checked below):
[11 Demolition fi ❑ Service or feeder 400 amps or more ❑ Building over three stories
where the available fault current
s �';" .. `��� `j� rte I"� �+'5'i `I�I� x a =+" , p „. ❑Marinas and boatyards.
^c 48af ar F L i'MC,`!{Si'.y„„ 1' „ n ih."'. ,'f`� exceeds 10, Flo
' "'°""' l ess 000 to amps at 150 �g buildings.
❑ 1- and 2- family dwelling ®CommerciaVindustrial El Accessory building f;< all of or exce 14 volts or ❑ ❑ c unrmerciel -use agricuttsral
amps for al l other ins buildings.
❑ Multi family _ Master builder ❑Other
y ,�; - ��i,� � ❑ Fite pomp. ❑ Installation of 75 KVA or
` G r ..E 5 Tit straw { tak+t!'� il t } t o o r fr ❑F�erg aysoem.
,
Eti l ;f. .., 3 e=11si!".nE�''rr MO.P,:a-i,g� .1 . ,' `' "A" "1 2". derived system
❑ Addition enc otoew motor load of ❑ "A" "E", ^1 -2 ". "1 -3"
Job no.: Job site address: t '�g 0 C t s t rF -laJt 1 2J11 T �1 100HP or more,
❑
occupancy eai o n
❑
I V Six or mote residential [mite, Recreational vehicle parks.
City/State/ZIP:
❑ Health-care facilities. ❑ Supply voltage for morn than
t J ❑ Hazardous locations 600 volts nominal.
O
Suite/bldg. /apt. no.: ` Project name: (J� T DB d �, j d ❑ Service or feeder 600 amps or more
Cross street/directions to job site. w+ I t I ; r 1" 3 � . n _, fi � e ...,,.1 #, MENI;. '' .. ,
t1 if .. Ji - . P,
Description Qty. iee Total
New residential single. or multi - family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 145.15 4
Tax map /parcel no.: Ea, add'I 500 sq. ft. or portion 33.40 1
f "' , • v r , lltfi ! �,�-. fi
. " �, h; �+`!`�•� , P�arry�eetrrntu• -, , Limited energy, residential
S d.., u,? fie {� u wuiilrl Err ®i gt i t. "x (with above sq. &J 75.00 2
Limited energy, multi - family
l + i (1 1 '�� = residential (with above sq. ft.) 75.00 2
1 ,
Services or feeders insta9ation, alteration, and /or rdocedon
It-,. l•� "+ter . 'a�tft�utp4 ;, ,t, 200 amps or Tess
` 80.30 6 2
S'iii.? .,_ hums �,r: !tiers. i ,� r . , s ` 201 amps to 400 amps 106.85 85 2
Name: T� 401 amps to 600 amps 160.60 2
Address: 1 �� � �` [!v �' Q Q j 601 amps to 1,000 amps 240.60 2
,,! is r (hV f Over 1,000 amps or volts 454.65 2
City /State/ZIP: t a-n ,.J p /' V i - I Temporary services or feeders Installation, alteration, and/or
/ - ( '? _ ` ) 200 i) 1C
Phone: ) {p 2 1f _ relocation / XJ +Fax: ( 200 amps mps or less 66.85 I 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps I 1 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. _ 401 amps to 599 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, r
, � j _ J ', k t �Wdta^t, ry I'-• s 1 , tygNl� ra i to team[ A. Fee for branch circuits with
t panel
, ,r.., L sY,: vi:�i:s .7.0 17 PA fZl�.u. T pl 1 1 y t ��u >W u,^ 15.
• 14,�,r .ss �,�+ above service or feeder fee, I
each branch circuit n _ p _ 6 65 19q Z
Business name: Johansen Electric Inc.
B. Fee for branch circuits
Contact name: Charlynn Leifsen
without service or feeder fee,
first branch circuit 46.85 2
Address: 10948 SE Valley View Terr. Each arid" branch circuit 6.65 2
City/State/ZIP: Clackamas, OR 97086 Miscellaneous (service or feeder not inehrded)
Each manufactured or modular
Phone: (503) 648~3417 I dwelling, service and/or feeder 2
Fax: (503) 698 -2486 Reconnect only
E-mail: johaneeneleetQman coin 66.85 2
� _ ��, .:tnhi � Pump or irrigation circle 53.40
.xt : '1 , . 1, r '7 9.., sir, ..arttU igiL I ,. , a:. :::'. i ' Sign or outline lighting 53.40 2
Business name: Johansen Electric Inc Signal circuit(s) or limited -
energy panel, alteration, or
Address: 10948 SE Valley View Terr. extension. Describe: Page 2 2
City/State/ZIP: Clackamas, OR 97086 Each additional inspection over allowable in an of the above
-
Phone: (503) 698 1 Fax: (503) 698 - 2486 Per inspection 62.50
Investigation per hour (I hr min) 62.50
CCB Lic.: 51539 I Electrical Lic.: 3 -243C - Suprv. Lic.: 2053S Industrial plant per hour 73.75
Suprv. Electrician signature, required l/ `i "s .� I tip 17 ' :;� nl, �" . �prs rr R
P� eQ.,e,. / subtotal. 2'q •Soto `
Print name: Carl Johansen Date: 1 (I ibbt 6 ,. y Plan review (25% of permit fee):
f � n l � !t State surcharge (8% of permit fee): it . 7�
/ ?3 .1 c Authorized signature: (` "� IaA
TOTAL PERMIT FEE: fL.1 g
Print name: Charlynn Leifsen I Date: 1 ( frQ.)((fl This permit applieation expires if a permit is net obtained within 180
days after it has been accepted as complete.
1 : 1auildinglPtmutslLLC•1'ermtApp. roc 0323!06
• Number of inspections allowed per permit.
440.46151(1 I /05 /C0M/WEB
I'd Xdd 13C213Sd1 dH Wd2E:2 L002 B2 AoW
CITY OF TIGARD
BUILDING DIVISION PERMIT #: FLC 2007-001306
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 1112W2001
Phone: (503) 639 - 4171 ?�
Inspection Requests (24 Hrs.): (503) 639 -4175 ! 1J..
INSPECTION WORKSHEET FOR DATE: 2/1/200B TIME: 7 :O2AM PAGE: 16
SITE ADDRESS: 12 909 SW 68TH PKWY 340 CLASS OF WORK:
SUBDIVISION: 11GARD TRIANGLE CENTER LOT #: TYPE OF USE:
PROJECT NAME: MERIDIAN TECH GROUP
DESCRIPTION: (1) Service
(30) Branch circuits. -
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 03-69B -3417
Inspection Request Scheduled For: Date: 21 1/2008 Pour Time:
Code # Inspection Description ' Con irf m #-.., Contact # Message
199 Electrical final ` 0643€4 -01 503-698-3417 N
Corrections /Comments/ Instructions:
1
\ \
\ \
\ —
i _ ,, \ \
Uyt
r& PASS ❑ PARTIAL APPROVAL Il CANCEL I I NO ACCESS
7 FAIL i I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Cr • 0%4 1 -e - Date: Z '1 " &A Phone #: (503) 718- -
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007 -00306
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/28/2007
Phone: (503) 639 -4171 �► ^' 111
Inspection Requests (24 Hrs.): (503) 639 -4175 s!r__..
INSPECTION WORKSHEET FOR DATE: 11312000 TIME: 7 :OOAM PAGE: 28
SITE ADDRESS: '12909 SW 60TH PKWY : o CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE CENTER LOT #: TYPE OF USE:
PROJECT NAME: MERIDIAN Thal GROUP
DESCRIPTION: (1) Service
(30) Branch circuits.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503 -69Q -3417
Inspection Request Scheduled For: / Date: 1/3/2038 Pour Time:
Code # Inspection Description Confirm_# Contact # Message
139 Electrical final 062488 -02 603 -969 -5262 N
Corrections /Comments /Instructions:
a `P Room i S it % cmrisTVE C
❑ PASS PARTIAL APPROVAL X CANCEL ❑ NO ACCESS
1 FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Nte Date: • 3' o$ Phone #: (503) 718- 1-44)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007- 0()306
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/28i2007
Phone: (503) 639 - 4171`�°
Inspection Requests (24 Hrs.): (503) 639 - 4175
INSPECTION WORKSHEET FOR DATE: 1221/2007 TIME: 7 :03Ai11 PAGE: ?pa
SITE ADDRESS: 12909 SW 6TH PKWY 340 CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE CENTER LOT #: TYPE OF USE:
PROJECT NAME: MFRlD1nN TECH GROUP
DESCRIPTION: (1) Service
(30) Branch circuits.
OWNER: PACIFIC REA[..TY ASSOCIATES, PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 603 -69 &3417
Inspection Request Scheduled For: Date: 12/2/ /2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
130 Ceiling cover 062020 -01 503.96615262 N
Corrections /Comments /1 structions:
vi 01 154* ei431
FLIA-v`\eir ik 116)0:WA-,
( ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: �+ Date: 7.4 16 6 ) Phone #: (503) 718 -2+1 "
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC7007.00605
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/200007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 12/4/2007 TIME: 7 :01AM PAGE: 53
•
SITE ADDRESS: 12909 SW 68TH PKWY 340 CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE ENTER LOT #: TYPE OF USE:
PROJECT NAME: MERIDIAN
DESCRIPTION: (1) Service
(30) Branc :h circuits.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503 -698 -3417
Inspection Request Scheduled For: Date: 12/4/2007 Pour Time:
Code # Inspection Description ( Con irm -# Contact # Message
12y Wall cover 060 83-01 503968.5717 N
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL NO ACCESS
❑
FAIL — CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: tT tbi, le - Date: 021'31 Phone #: (503) 718- ?-4116•