Permit CI TY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 00259
DEVELOPMENT SERVICES DATE ISSUED: 4/15/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S113AC 00103
SITE ADDRESS: 07216 SW DURHAM RD P100 ZONING: I - P
SUBDIVISION: PACTRUST LOT : JURISDICTION: TIG
Project Description: 6 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: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 5 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 -W1V1I 10948 SE VALLEY VIEW TERR
PORTLAND, OR 97224 CLACKAMAS, OR 97015 -000
Phone: Phone: 503 - 698 - 3417
FEES Reg #: LIC 51539
SUP 2053S
Description Date Amount
ELE 3 -243-243
C
[ELPRMT] ELC Permit 4/15/2005 $80.10
[TAX] 8 %State Surcharge 4/15/2005 $6.41 REQUIRED ITEMS AND REPORTS
Total $86.51
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- 332- 344.
Issued By: � , �; � � � Permittee Signature: cF)'j ex104 Ca 't.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'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.
•
From Charlynn J. Leifsen To: City of Tigard -.- R 1%
-' : 11 ei Date: 4/14/2005 Time: 1:57:48 PM Page 2 of 4
5 '' , t
'Electrical Per Application "65 IUR OFrlt F 1 'I: n\I.V
L City of Tigard �� Date/B :
1z0ciVed Permit No. �05 - 00 Z, j; AMNION 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 or 1. J P ' • j" : • ' i i ` Date/Date/13 : Other Permit:
Inspection Line: 503.639.4175 Cl. s.. ;�. '2 � Date Ready/By: ta See Page 2 for
Internet: www.ci.tigard.or.us I G �I Notified/Metbod: Supplemental Information
': _ a i 'SR , # P # fit. qi ifI t T } =f a d5>' 7. i r 4 u' -._v .,.,. xE _..... .". .d ! x 1. ar,; " c: ff',l 3 i kn F'% : . i - ,. .� s ,°
.. . .. 1 ., ll M.4 ; , °rte ? . ., .� :,..,. :x,_ - c ,,....:s: "..'L :i :.. :",I� i X k di ' i .. r 1: -e`�y�
i:��'- ��5[�",� yw_� :r.,. .. a' _(. �. ',I �I' :,. �. .. :.., �...� :: ,_ _. ....,,.,, t xa :s.: :;tp�, .�. :... .;� �. ».. ".... _ : « :� . ���>. - ... , .,., ,,, ». r,. �r, l,... �i?y
[ New construction ® Addition /alteration/replacement Please check all that apply:
El Dmolltlon ❑Other OService over 225 amps, comm'l ['Hazardous location s
l e ` aI} 1fi } l+ #T " ' , "{ ,wirr $ m ❑Service over 320 amps rating ❑ Buildng over 10,000 q. ft.,
, tY " 'sue 1
of 1- and 2 -farm! dwellings 4 or more new residential
❑ I- and 2- family dwelling ® Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
El Multi - family ❑ Master builder ❑ Other: ❑Building over three stories ❑Feeders, 400 amps or more
t {� N; �« 4 x z . � ,, r Occu ant load over persons Manufac red structures or
❑ p 99 pe to
3#t :,;,_' 4 _.. . m ..(.' .. ,...`... s . tg ❑Egress/lighting plan RV park
Job no.: Job site address: 7216 SW Durham, 100 ❑Health -care facility ❑Other:
Submit 1_ sets of plans with any of the above.
City/State/ZIP: Portland, OR 97224 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: Project name: Newkirk ..
Description Qty. F. Total
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'I 500 sq. ft or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.: Limited energy, non - residential 75.00 2
sa t ea t a� r. ly, 1 x - .ram x I r a s te
:-w;
� v ' ` ...`. : ,„. t i,ao t .,� „i,, .(u.�.= .. . e s . : -V . - t k ,it +,l. :p Each manufactured or modular
Tenant improvement dwelling, service and/or feeder _ 90.90 _ 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
Y f l - �x~r fan s c a r k ,I , a � ?m - " 201 amps to 400 amps 106.85 2
'�!IlSs : :'..:..._.;, i : : , . :; 5. ;a , , a+.? ,Cie: ille.;i.,.i:• .t..`i_ ; B._ :• -Z :F " ".1, % ?1z� P amps 401 amps t o 600 am s 160.60 2
Name: Pacific Realty Associates 601 amps to 1,000 amps 240.60 2
Address: 15350 SW Sequoia Pkwy, 300 Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State/ZIP: Portland, OR 97224 Temporary services or feeders installation, alteration, and/or
Phone: ( 503)624 - 6300 Fax: ( 503 ) 624 - 7755 relocation
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 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
t3 1 5 f d 9 71{.ttA tl (1q(t # , idle.
ie4 �.. 7e$ { cg a :14 s, R.; : :: 5 sF t 9 1 1ilirvi ,al: .`_. � , A. Fee for branch circuits with
„ , _ .�.R � ,..... . . .. � .. , s erv ice or feeder fee, each
Business name: Johansen Electric Inc. branch circuit 6.65 2
B. Fee for branch circuits
Contact name: Charlynn Leifsen without service or feeder fee,
each branch circuit 1 46.85 46.85 2
Address: 10948 SE Valley View Terr. Each adds branch circuit 5 6.65 _33.25 2
City /State /ZIP: Clackamas, OR 97015 Miscellaneous (service or feeder not included)
Phone: ( 503 ) 698 - 3417 Fax: : ( 503 ) 698 - 2486 Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: jo hansenelect cr msn Signal circuit(s) or limited -
i com sri q pa
a a SS R;'QITR "3 �1 �fiSG�trrb,.« +Y' i �'F iMMSI t1 P .' energy Panel, alteration, or
,:.. .'?''- �`rM...- ,.. �'�.� _ , .... . �t f..t ..x, .;'mss'' diS. er•.r -..:
extension. Describe: Page 2 2
Business name: Johansen Electric Inc.
Address: 10948 SE Valley View Terr. Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State/ZIP: Clackamas, OR 97015 Investigation per hour (I hr min) 62.50
Phone: (503) 698 -3417 Fax: (503) 698 - 2486 Industrial plant per hour 73.75
INClitaligEORWAEUITZERTS:07
CCB Lic.: 51539 Electrical Lie.: 3 -243C Suprv. Lic.: 2053S Subtotal 80.10
Suprv. Electrician signature, required: / A , / Plan review (25% of permit fee)
Print name: Carl K. Johansen / Date: 4/14/05 State surcharge (8% of permit fee) 6.41
TOTAL PERMIT FEE 1 86.51
Authorized signature: a /3 LigllIllM This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: Charlynn J. Leifse, a Date: 4/14/05 • Fee methodology set byTri -County Building Industry Service Board
Number of inspections per permit allowed.
i.l Building \PermitelELC- PermitApp.dot I V03 440-4615T(10/0VCOM/WEn
• CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005 -00259
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/16/2005
Phone: (503) 639 -4171 m OpHuy�ii�6lti A\
Inspection Requests (24 Hrs.): (503) 639 -4175 �'
INSPECTION WORKSHEET FOR DATE: 4/18/2005 TIME: 7:14AIV1 PAGE: 63
SITE ADDRESS: 07216 SW DURHAM RD P100 CLASS OF WORK:
SUBDIVISION: PACTRUST LOT #: TYPE OF USE:
PROJECT NAME: NEWKIRK
DESCRIPTION: 6 branch circuits.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503 - 698 -3417
Inspection Request Scheduled For: Date: 4/18/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
125 Wall cover 004681 -01 503. 704 -1534 N
Corrections /Comments / Instructions:
!'
S i
a � .
)PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: Phone #: 503 P � � ) 718 -
TY OF TIGARD
,UILDING DIVISION PERMIT #: EL C2005 00259
':+125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/1 5/2005
one: (503) 639 -4171 �4jm�
spection Requests (24 Hrs.): (503) 639 -4175 L
INSPECTION WORKSHEET FOR DATE: 4/26/200, TIME: 7:10AM PAGE: 20
SITE ADDRESS: 07216 SW DURHAM RD P100 CLASS OF WORK:
SUBDIVISION: PACTRUST LOT #: TYPE OF USE:
PROJECT NAME: NEWKIRK
DESCRIPTION: 6 branch circuits.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503- 698.3417
Inspection Request Scheduled For: Date: 4/26/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 005371 -01 603 -704 -1534 N
Corrections /Comments / Instructions:
,PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: L�- 1 " '�"' �o/ Date: -26- 03 Phone #: (503) 718-