Permit CITY OF TIGARD ELECTRICAL PERMIT
III �' PERMIT #: ELC2009 -00053
° COMMUNITY DEVELOPMENT DATE ISSUED: 2/5/2009
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S113AB-01400
SITE ADDRESS: 07358 SW DURHAM RD BLDG G ZONING: I -P
SUBDIVISION: PACTRUST BUSINESS CENTER LOT : JURISDICTION: TIG
PROJECT: CORAM
Project Description: TI.
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: 2 W /SERVICE OR FEEDER: 15 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 HAPPY VALLEY, OR 97086
Phone: Contact #: PRI 503 - 698 - 3417
FAX 503 - 698 -2486
FEES
Description Date Amount Reg #: ELE 3 -243C
[ELPRMT] ELC Permit 2/5/2009 $260.35 LIC 51539
[TAX] 12% State Surchar 2/5/2009 $31.24 SUP 20535
Total $291.59 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 P ermittee Signature: c ....: _Qs -4krip Ccli
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.
.., ._, .,
RECEIVED . _ . , , .
Electrical Permit Application . l I orr 1 l tit:. -001 .
it City of Tigard FEB 5 2009 R Received
a• 5 • 0Q
Permit No.:E. (q ,0605'3
111 ..- 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
i Phone: 503.639.4171 Fax: 503.5S�;1 6 OFTIGARD DateBy: Othcr Permit: 41,1P2008'0630
.i i - ; .,,,,,:; Inspection Line: 503.639.4175 BUILDING DIVISION Date ReadyBy: June id See Page 2 for
Internet: www.tigard Notfieesiethod: 'n (• Sapplenreatal Information
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❑ New construction N Addition/alteration/replacement
Please check all that apply (submit 2 sets of plans w /uems checked below
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault ounces ❑ Marinas and boatyards.
, 5 :x7 m. a9 a 131 m 5 -
, 6l. i 4 til l,g "Ill , a f , , .. a a rs, i , ayv %r i tor: exceeds 10.000 amps at 150 volts or ❑Float Floating buildings. buildings. rrlltt",� �t •:;: +wtlrnl� a...., - !::...:0 3. , .. - t ^^ .. :. acrd '�Y3Kt
` "� less to ground, or exceeds 14,000 ❑ Commercial-use agricuitaal
❑ I and 2 family dwelling ® Commercial/industrial ❑ Accessory building
amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
trl � • a .•�� r..,, ��= at a a+ i E,1.F ;. 'k fi l+ ❑ Emergency system larger separately derived system.
*- (.''ti 1'1 4 • ;., 11 .4, '. ' , 1
4v� .!,..4i 4 . • ? ❑ Add it i onofn w motorloadof
t•4tdlr i , 1 d Vti f , .. t IMn 4 7 i Y rI t,. e ❑
Job no.: 1 Job site address: 7 3 5 8 SW Durham 100HP of more. DCCupancy
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State,Z1P: ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal
Suite/bldg. /apt. no.: I Project name: Coram [Service or feeder 600 amps or more.
Ith r 74 '. `: s_ i', ..ci f ,r
H ' "c a .. r l l l 5 ,
Cross street/directions to job site: Deaeripbon oar. . r're. 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
Limited energy, residential
i r ": i; ` •. - ..iltri•tt gl . . *i ar :A %a ' '
ki t .. .. rel l `' 1 .,.. r, : +tu )7 i{ t 1 (with above sq, ft - 75.00 2
Limited energy, multi - family 75.00 2
tenant improvement residential (with above sc. ft)
Services or feeders installation, alteration, and/or relocation
: 1 ;,> a atmn 200 amps or less .j 80.30 1(,0 2
r ' r •, r o ' Ot t � , ,t r!` a� � �i +! C ' ` 201 amps to 400 am
i t ,,1 N m.. �„ r � ->,' t A' . 46 � ; �.tt -+!aTi ��s �;`. ,. „ :m•., g a,,,!e�'la.F�:Ii i r Ds 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
CitylState /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, . , .i v s ( it 'a . •'r� b v . t i t S " ;rte IEt' i
r ,� ...u, .K 1 ll `�l 1 ' p q 1 t ,t - < n1u above service or feeder fee, 15 6.65 Q$,`1S" 2
it .. f. �,, Il,t a t . .s.lr �1..: a.
each branch circuit
Business name: Johansen Electric Inc. B. Fee for branch circuits
without service or feeder fee,
Contact name: Chaaiynn Leifsen first branch circuit 46.85 2
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 90.90 2
Phone: (503) 698 -3417 I Fax: : (503) 698 -2486 Reconnect t onl and/or feeder
Reconnect only 66.85 2
E -mail: johanseuelect @msn.com Pump or irrigation circle 53.40 2
fit ''"i €ft, i *r_,rrr.,aJ3" ° :b: Lti _::°t " ;dr orb: ''E, l liild tin °Inv -„ Sign or outline lighting 53.40 2
Business name: Johansen Electric Inc. energy p anel , a) er or limited- o or
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 m rein) 62.50
CCB Lic-: 51539 Electrical Lic - 3 -243 C Suprv. Lie.: 20533 Industrial plant per hour 73 75
1511240i-1; 'P ' ,r ir,,., : ,..tt17 ,t'.' i ..E il,:l.. A,14:/ .
Suprv. Electrician signature, required: Subtotal: 24
Print name: Carl K. Johansen /-C 1 ,..- r. / / 0 9 Plan review (25% of permit fee):
State surcharge (12% of permit fee): 31 ••'i • Authorized signature: C /'- _-- TOTAL PERMIT FEE: 2,4 J , 51
Print name: Charlynn J. Leifsen Date: 2/5/09 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.
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