Permit r il CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2009 -00416
13 125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/13/2009
TiG • g Parcel: 2S113AB01400
Jurisdiction: TIGARD
Site address: 7312 SW DURHAM RD
Subdivision: Lot: 0
Project: Spec Space
Project Description: (4) branch circuits for TI.
Owner: FEES
PACIFIC REALTY ASSOCIATES Quantity Description Date Amount
•
15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224 4 crt Branch Circuits 08/13/2009 $66.80
wo /Purchase Service or
PHONE: 503 - 624 -6300 Feeder
1 ea 12% State Surcharge - 08/13/2009 $8.02
Electrical
Contractor:
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 $74.82
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 throu OA13 952 - 001 -010 . You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6669 or 1.800.332.2344. ,� /
Issued By: Permittee Signature: �� PP& �� �� " "
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.
.
g Ec :iv:o (j : i 'ti (l; '
Electrical Permit Application ;i��,�llk l 1.1.1.1 1. ,
City of Tigard AUG 1 1 Received
,q. '0 Permit No •
11114 Date(B : V a . / oQ � 't
s . 13125 S W Hall Blvd., Tigard, OR 97223 °� P lae Review
• • Phone: 503.639.4171 Fax: 503.598.191)6' OF I IGA R p D ; orherPennit:
_ c .,s k ;,,' Inspection Line: 503.639.4175 '�- p '' pIVISiO Dace lteod} By: H See eaye 2 for
Internet: wtvw.tigard- or BUI Notified/Method: I MI Supplemental Information
n: w,.M - , " xt h a a.+r - aw :.,r,�.v _ i - _. - aliK, + -'.
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❑ New construction ® Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more 0 Building over three stories.
❑ Demolition LI Other: where the available fault current ❑ Marinas and boatyards.
l a. e'iii43 J P,r:o-t.-au A[.teY i- n .. "l iLrv + ..i�•:-A i .. •• :ll ` 2 41iN
:.a`[�kt�:s� r=' �,.. ����� {�{i`<��iR li>,iag +srt+elit':�' 1;,.:
..; ty exceeds 10,000 amps at 150 volts or ❑Floating buildings. ++v at�miitrinklit'li'ali lh(� aiiiac! 1. k!; :. �,,Oi rf'>i?Tt . ^ ;;,..,., ,E:af li6L,a:;1 less to ground, or exceeds 14,000 ❑ Commercial - use agricultural
❑ 1- and 2- family dwelling ® CommerciaUindustrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
.11°77 0 s ri aryl w ��Try � ',.f110',:: F_tnergency system. larger separately derived system.
g;" r f .p 11 . ,I� 1 4, Il I - `ea ,'•;, sa + l
� .. • .�.. y. L,A 0np ii� ,� �- , , .. t. tu4T � . ,. - s !' ' ,.t -,,:: i i $ I ❑Addition oftnw motor toed of ❑ `A" "E" "1 2" "I.3"
Job no.: Job site address: 731. 2 SW Durham 1001 -1P ortnore. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/ State/ZIP: ❑ Health - care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg./apt. no.: Project name: SpeC s ❑ Service or feeder 6C)0 amps ormnre
g a ',,, ., �, 3 , ' r
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Cross street/directions to job site: Description � Di/ Fee. Total •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map/parcel no.: Limited energy, residential
75.00 2
li,.i;�_.., I 1i° / -; '" tiv t _ - x£ t 9itllld (w
l tM above sq. ft.)
1iiNi a, ,. ,.::,, ,,.",. A- ki.f •:.:, = = + + rogr ;F . iill �3 G1°1 11Follioi fd! 11' `
Limited energy, multi- family 75.00 2
Tenant Improvement residential (with above sq. ft.)
Services or feeders installation and /or relocation
200 amps or less 80.30 2
li li il01!: {� r i - _ ..21 - _ - u h.: •..
. n .. - i)= ! t ti Ih�� . .I,. '' I 'ite f It' 1 gi �. a . 1 ,,. �tt, 001 4V. i 201 amps amps _
, , a , a3u 1 , } iq (, ��il � cYbf,`,r„ u. s to 400 am s 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 I 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
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
1 4 '' ` iar..: ;t &ra .. . ,..tdi ;L.1,;= 1 9gi{ a E r r �t t i' above service or feeder fee,
"'.. . :._. P., .„r .,,,,n,A,di 6.65 2
each branch circuit
Business name: Johansen Electric Inc. B. Fee for branch circuits
Contact name: Cbarlynn Leifsen
without branch service or feeder fee 1 46.85 4 6 . 8 5 2
first branch circuit
Address: 10948 SE Valley View Terrace Each add'I branch circuit - 3 6.65 1 9 • 9 b_ 2
Miscellaneous (service or feeder not included)
City /State /ZIP: Happy Valley, OR 97086 Each manufactured or modular 90.90 2 dwelli Phone: (503) 698 - 3417 l Fax: : (503) 698 - 2486 Reconnect only 61).65 2 -
E -mail: johansenelect@msn.com Pump or irrigation circle 53.40 2
ar. >v?,' :• X i I auie ; e
,,�t °a ali.: `I hr � 1 ? . lII11 O Si
,s.n., ,i ,, Ls„r,r:;�,<w4airit`�� � #rr '` 'tl ��:� ! -„�! I I i Si nor ou tline 53.40 2
Business name: Johansen Electric Inc. Signal circuit(s) 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 Phone: (503) 698 -3417 Fax: (503) 698 -2486 Investigation ga 62.50
` � nvn per hour (1 hr min) 62.50
CCB Lic.: 51539 (/ I Electrical Lic.: 3 -243C 1 Suprv. Lie.: 2053S I/ Industrial plant per hour 73.75
Suprv. Electrician signature, required: ( k , � Subtotal: 6
Print name: Carl K. Johansen Date: 8/11/09 Plan review (25 °/s of permit fee ):
State surcharge (12% of permit fee): a • UL
Authorized signature: TOTAL PERMIT FEE: 74.82 I ,/
Print name: Cbarlynn J. Leifsen l Date: 8 /11 /09 This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Number of inspections allowed per permit.
JABwld ,ag\Permi:s\ELC- PermitApp. 05/23/1)6 440-46151(11 /05 /CObt/WEB
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