Permit CITY OF TIGARD ELECTRICAL PERMIT
• COMMUNITY DEVELOPMENT Permit #: ELC2009-00459
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/08/2009
Parcel: 2S113AB01400
Jurisdiction: TIGARD
Site address: 7324 SW DURHAM RD
Subdivision: Lot: 0
Project: Performance Systems
Project Description: (10) branch circuits for TI
Owner: FEES
PACIFIC REALTY ASSOCIATES Quantity Description Date Amount
15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224 10 crt Branch Circuits 09/08/2009 $106.70
wo /Purchase Service or
PHONE: 503 - 624 -6300 Feeder
1 ea 12% State Surcharge - 09/08/2009 $12.80
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 $119.50
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR - 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: Permittee Signature: e74) li L 77e s J
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Sep) 03 2009 1: 11P11 HP h T1 AX 4 p. 1
U It
SEP 0 3 2008
Electrical Permit Application (? qw � D l.ttk 01.1.1( 1.: 1'S : tiN1.1
City of Tigard C« OF TtGP1B Received _�• �/ ,�J/
�� a lI DlCV�.? N Vl v (I N Date/A : / Q .��� PerontNo. &C 0' I __009
1 Phone: 503.639.4171 Fax: 503.598.1960 Date/B . Other Pe SW Hall Blvd., Tigard, OR 97223 r y Plan Review D , d 0 �
Phone G[/ �
tt ,I) Inspection Line: 503.639.4175 Date Ready/By: I ' /`� 0 See Page 2 for
Internet: www.tigard or.gov Notified/Method: I Supplemental Information
4 '
-tea �� �
:.1.'' a� ?P .1 y !'v � e'ialV'i 4 -' ', 7 p .lr':s i:° G t% t i } a,tvu Q1 a,a rl m ; d ll
1 _.... .0 i' ! F 1!•„ tvS$ db'... Iarui. I, I .�.�� {e 37 Rcu.. e. .,.f, I t- �, i.a. r.� ✓ 71' 's:ry ^.' _ 6i 1 1 r ` �}
❑ New construction ® Addition /alteration/ replacement Please check all that apply (submit g sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other:
,�t� . T1 1 ' # where the available fault current ❑ Marinas and boatyards.
.. t, :
lhb r, 1r' ayel IllpU t +r. v�4i f n , - ,1� " fl i i,:= � exceeds 10,000 am
r } 4 r " � _ £ °, t �I luu d'3 z ,t 5 'il! Ps at 150 volts or 0 Floating buildings.
❑ 1 and 2 family dwelling ® CommerciaUlndustrlal less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: El Fire pump. ❑ Installation of 75 KVA or
e � �+ c w trats v a 1 I P e r . 12 Emergency s larger soparetoly derived system.
Job site address: 73
1 3: - i , 'ili�¢ � , . ,lra'�.t'. :s.® I li —c t„,,,„, .t ° 04 : , �I� , q'`
- .. ❑ Addition of new molar load of ❑ ., . E ,... l -2 ., . -3 ..
Job no.:
I OOHP or more. occupancy.
4 SW DuI`ha►y► ❑S ix or more residential units. ❑ Recreational vehicle parks.
rQ p-t�1 h a l l� t ,I. Q J ` Health-care facilities. ❑ S
City /State /ZIP: LA1(� lJ 1 f 1 l.J ❑ Supply voltage for more than
R ❑ Hazardous locations. 600 volts nominal.
Suite/bldg./apt. no.: Project name: • Service or feeder 600 stn or more
Per rrn C p_ P E: •
• Cross streetJdirections to 'ob site: 5 '1- • i `,1 •• dt "- "- ttti ! l i VT , L1
J Description Qty. Pee- Taal •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no 1,000 sq. ft. or less 145.15 4
Tax map/parcel no.:: -
Ea. add'l 500 sq. ft. or portion 33.40 1
Limited energy, residential
''f �� 1?a , 4-0.A. 11 " I l . ref a '+ .. � I I i a g „ cal , , ,, 4?^t y t € a., v, with above sq. ft 75.00 2
Limited energy, multi - family 75.00 2
Tenant Inn rovement residential (with above sq. ft)
Services or feeders installation, alteration, and /or relocation
IFry ,1 . 200 amps or less � 80 30 � 2
t9 -5 ..�'' 10 di a6rin I t� ti' � 1:r1:1 -ri 1' :,,'1 �*,`r� , ` ;''# 201 amps 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: ( ) j 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
Ott . ` ` e1 `.`� si! h 1 i ' d''` 1 i a c t tr$'t f - 1 ° "-! {~m1
x. *....- �,t �, �..31k' i ...... , 4„ . above service or feeder fee, each branch circuit 6.65 2
Business name: Johansen Electric Inc. B. Fee for branch circuits
turnout service or feeder fee, I 46, 2
Contact name: Charlynn Leifsen first branch circuit 46.85
Address: 10948 SE Valley View Terrace Each add'I branch circuit 9 6.65 59.s 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Happy Valley, OR 97086 Each manufactured or modular
90.90
dwelling, service and/or feeder
Phone: (503) 698 -3417 Fax: : (503) 698-2486 Reconnect only 66.85 2
E -mail: johansenelect@msn. Pump or irrigation circle 53.40 2
I r ru la, i' (i 49 tf1 t#„s p4) �' to ;re Cr# ia� ilia ” .l ( Si or outline lighting
'6dl, a •:::!iiltw -0�q`p "unpin fii.'�;R.! Sign 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 a , of the above
Per inspection 62.50
Phone: (503) 698 - 3417 I Fax: (503) 698 -2486
r —. Investigation per hour (1 hr mm) 62.50
CCB Lie.: 51539 t/ I Electrical Lic.: 3 -243C ✓ Suprv. Lic.: 2053S " Industrial plant per how 73.75
Suprv. Electrician signature, required: < 4x J7 /4_ , 3. Subtotal: I UP 70
•
Print name: Carl K. Johansen Date: Plan review (25% of permit fee):
State surcharge (12% of permit fee): i a - ' ('
Authorized signature: -`____ TOTAL PERMIT FEE: l 161 . 60
This p ermit application expires if a permit is not obtained within 150
Print name: Charlynn J. Leifsen Date: 3 - Q q days after it has been accepted as complete-
* Number of inspections allowed per p ermit,
1: 4 Building Tennil inELC- PenaitApp,doe 05/23N6 44046157(11I05/COM/WEB