Permit •
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CITY OF TIGARD ELECTRICAL PERMIT
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COMMUNITY DEVELOPMENT Permit #: ELC2009 -00306
1 3125 SW H all Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/23/2009
TIGARD 13125 2S113AC00103
Jurisdiction: Tigard
Site address: 7204 SW DURHAM RD 300
Subdivision: Lot: 0
Project: Consumer Cellular
Project Description: 1 200 amp service and 36 branch circuits
Owner: FEES
PACIFIC REALTY ASSOCIATES Quantity Description Date Amount
ATTN: N PIVEN, 15350 SW SEQUOIA PKWY
#300 1 ea Services or Feeders - 200 06/23/2009 $80.30
amps or less
PHONE: 36 crt Branch Circuits w /Purchase 06/23/2009 $239.40
Service or Feeder
1 ea 12% State Surcharge - 06/23/2009 $38.36
Contractor: Electrical
JOHANSEN ELECTRIC INC
10984 SE VALLEY VIEW TERR
HAPPY VALLEY, OR 97086
PHONE: 503 - 698 -3417
FAX: 503 - 698 -2486
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $358.06
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 OAR 52- 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By:
p Permittee Signature:' 7 r�"�
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 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.
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Electrical Permit A ]1;C ><o nt� . :• , f )�`kv i 4i n r 11 111u' O i ik�l,. r.9 rt lh 4') I ti P' i h, ��',i i' 4 4
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City of Tigard w 9 7 5 1 Received' r` , i.'„ , ,... , 44 fir. Permit o f ` 7vP tia "4 == �� +.} t { 's
_ -� 30
Ih1 ' ' J • 13125 SW Hall Blvd., Tigard, OR`
g7223 ` D an Review
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jk . aw; Phone: 503.639.4171 Fax: 503.598.01960 .1, Date/Bv: Other Permit.
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.iT+a'i;; i ttc' Inspection Line: 503.639.4175 C •+�
' 1!_.n • Date Ready/By: Paris: Hi SceP e2for •
Internet: www.tigard elr.gov ,,, g i� r\°0 -,;.1i,--n,
4 Notified/Method: Supplemental information
ilNat � �+N,lr l 4 ^, t• 1 i?op ��: +j F 1}- II. !l W FGri�Nt) 'S
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, r "c11�dit tr IiFs iw j I J a ? ; t4 `q ��s $fig fili ,, Mi rF 1 �L1f A .:s ,7 ,R�I1 a 1
'�" a•t : ,•�i k',"- �.��r�U �1R. lay. # kl�" = !1'€yani >yp.v s!i�d�i�i.�!t� �,�. � •a ',t��{'N - FS {i1 . I .k� j,Ei � v t ��kt� ° .�?,. :I E :rPat '.. : + � Le
❑ New construction ® Addition/alteration/replacement Please check all that apply (submit j sets ofpiens w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current
�, � rir t� � 5 „ s .• �+ t 0 Marinas and boatyards. l l r ,. ? °a . ![,; ° ,'9 t l itit e a i 1 ..,4,./, " 1t. 3 S te , t ` i exceeds 10 amps at 150 volts or ❑ Floating buildings.
❑ 1- and 2- family dwelling ® Commercial/industrial , less s o o. or i n Calla ons ❑ cominarctal use agricult usl
❑ Accessory building amps for all other installazions. buildings.
❑ Multi - family ❑ Master builder ❑ Other: CI Fire pump. ❑ Installation of 75 KVA or
L,‘,„1, M v i ?gl
Nit -.-- 1 'r t alT m +:;p q ,7 ...r I, �410 '' le.,., El Emergency system larger separately derived system.
,- kz:: i i s s1, ,0,� ,.;. I , ',1;',.; s ° 1 a,.. Vi 1 1 .1,1 +5it#•t•.'-, ,i
�� �� .� � 4 tl a � � - +h;a, ❑ Addition of new motor load of ❑ "A" "E" "1 -2" °1 -3"
lo b no.: Job site address: 72 04 SW Dur 100HP ormore. occupancy.
0 Six or more City/State/ZIP: ❑ Heath F acilitisx, units ❑ Supply vehicle parks.
ty ❑ S y rage far more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: 3 0 0 I Project name: Consumer Cellular ❑ Service or feeder 600 amps or more
t 't i2 +,. '� n i @ 911 n IFi n ° t I; • t 1
Cross street/directions to job site: ° °' �" �' •�`, - :>
Description otr. Fee. 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'! 500 sq. ft. Or portion 33.40 1
is sA. : . ;,,,� t',,.� _• �� ,• m - a � y - testa , I :;,:$1 lsfi�i - Limited energy, residential 75.00 2
nt t _ � , , _ . .�. - +- t,fiir �+4Y . t _ . �`trr" „� � / n ' . ' , (with above $
( s4- )
Limited energy, multi - family 75.00 2
Tenant Improvement residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
t mli pq9 ttai, l 200 amps or less 1 80.30 gib .39 2
.. "fr '-tt ', : , r.,.`6 i ii' d , . , ;ha i1, . t - . R14 1 4i + uY t" . °�+': h 7 [I1� v.'.' 7 u �?It 1 i4I . l Wt.* 201 tamps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) I Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that [ own which is not 201 amps to 400 amps 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, per panel
5', A. Fee for branch circuits with
kl r " "t +p I, :r r ? f ',1: i ': t . u � 1 above service or feeder fee,
r i fi � �', a tsi. 9 u�YlI'••'P',.•� 22
r t r 1 irmiljelwar = di C - :iiol c udae4ht V I Sr #..1T, . c b ,r 6. 65 i ,tip 2
each branch circuit 7r
Business name: Johansen Electric Inc. B. Fee for branch circuits
Contact name: Charlynn Leifsen without service or feeder fee 46 85 2
fast branch circuit
Address: 10948 SE Valley View Terrace Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Happy Valley, OR 97086 . Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: (503) 698 - 3417 I Fax:. (503) 698 - 2486 Reconnect only 66.85 2
E -mail: jobansenelect@msn,eom Pump or irrigation circle 53.40 2
I +� a I l .11',alil 7 'll.i7 I id-- i" liraF . e ( ' f-, •lil`a t l r i 11l l ,� 4I. •; S in or outline li 9;�,�A '"' ,o<..�, i'til �.••I ilY9 :
,I0 ',..,4 B Bb B 53.40 2
Business name: Johansen Electric Inc. Signal circuits) or limited -
energy panel, alteration, or
Address: 10948 SE Valley View Terrace extension. Describe: Page 2 2
City /State /ZIP: Happy Valley, OR 97086 Each additional inspection over allowable in any_of the above
Per inspection 62.50
Phone: (503) 698 -3417 Fax: (503) 698 - 2486 Investigation per hour (1 hr min) 62.50
CCB Lie.: 51539 Electrical Lie.: 3 -243C Suprv. Lie.: 2053S Industrial plant per hour 73.75
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�..Wa.C. I�Ii • ids i ,, '.St'a_: I tf il 'w .-,..+ lin ^ . :1411 lg }
Suprv. Electrician signature, required: Subtotal / 9 ,70
Print name: Carl K. Johansen Date: 6/19/09 Plan review (25% of permit fee).
A State surcharge (12% of permit fee): 5g . 34, Authorised signature: Cr" '' TOTAL PERMIT FEE: 3 00
i
Print name: Charlynn J. Leifsen Date: 6 / 19 / 0 9 T� permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
' Number of inspections allowed per pemnt.
1 .1BUildingiPermits4•LC PemutApp doe 05/27/06 440- 4615T(1 i /05It2OM,WEB
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