Permit CITY OF TIGARD ELECTRICAL PERMIT
! v COMMUNITY DEVELOPMENT Permit #: ELC2009-00171
Date Issued: 04/21 /2009
- TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503 639 4171
Parcel: 2S113AC00103
Jurisdiction: Tigard
Site address: 7228 SW Durham RD, STE# 0800
Subdivision: Lot: 0
Project: Brand Innovators -
Project Description: Install (6) branch circuits
Owner: FEES
PACIFIC REALTY ASSOCIATES Quantity Description Date Amount
ATTN. N PIVEN, 15350 SW SEQUOIA PKWY 6 crt Branch Circuits 04/21/2009 $80.10
#300 wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 04/21/2009 $9 61
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:
Class of Work: Type of Const:
Occupancy Grp:
Total $89 71
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 At work wit
be done in accordance with approved plans This permit wit 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 952- 001 -0100 You may obtain a opy of the rules or direct questions to OUNC by calling 503 246 6699 or 1 800 332 2344
Issued By: -. J, _ , /11 _ t .� �� Perm ittee Signature: I / 417 0 = Voir
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.
Electrical Permit Application .
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° City of Tigard APR 17 2009 p y. 4.[7. 0q Permit N T C 0c4 . cool
6- , 3 , ° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
1-
'r i el Phone. 503 639.4171 Fax 503.598 I .14Ty OF TIGARD Date/By Other Pernik.
! ; t£i- Inspection Line: 503.639 Date Read wr 0
1 See Pena 2 for gUlLDING DIVISION
Internet www Ggard - goV N Supplemental In formation
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❑ New construction ® Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /iteme checked below):
❑ Demolition ❑ Other:
ID Service or feeder 400 amps or more ❑ Building over three stones.
!!0 Demolition
j 't!" a.c.<;p° "• ,: •.•ii(;i la -fi t) , i113E3�yr 4 •p., :,.. ,. y }� exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
, where the available fault current ❑ Marinas and boaty'ards
.., ;t��I 1! I ,it 4s444' . i ,i , , 1?; iat li h �+ ! • sr il'll i i i ,. ' ,' 1 i ... P•W h, Sim i�
® Commercial/industrial less m ground, o or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling
❑ Accessory building amps for all other inatnllehons. bindings.
❑ Multi family ❑ Master builder ❑ Other: ❑ Fire pump ❑ Installation of75 KVA or
t 1. �_, n ao .•,.k _w Ya * , :: , s° w , iii ;r, r %+.,.. Emer enc s e m. larger
qq �ti 8 Y Y n u rge separately Y
r�l l fit i i w f .,: rlr+;,'rlr*,r t veils stern
?= {I, it tl 4u A iU� +i��+ ! `,� .t � >� „E . x �'�`'It :!.+i; �1!;�I!.' il�l 'a 'lFl(t11P 0 Addition of sew motor load of ❑ ..A ,. ..l- 2 "...1 -3
Job no.: Job site address: 7228 SW Durham I00HPormore 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.: 8 0 0 Project name: Brand Innovators ❑ Service or feeder 600 amps or more
µdtW �sateta a n �aea �z m o- ,a i9 t , 'H R.+ !k,
Cross street/directions to job site: Description 61 tt@ "i'21 'i :i .` 7 m' � 13i 6nJ d i l i'1 41 II l�l .
1 9b• I Fee. I Teo¢l 1
New residential single- or multi- family dwelling unit.
Includes attached garage.
I Subdivision: Lot no.: 1,000 sq ft. or less 145.15 4
Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
ar t 1 ll s aa+ Grp ; , t : „ p 1 gip t "S& ;. 75.00 2
it(i( {1' .. - .,; t h, IJI,I i , t .. 4 . irl. iii. q''. i ,9," k, o f t l i+ ( i l i~. (with above sq. ft.)
- -. ' AM�RIWr}1� ._ i("5{cf�'s., .< . l.k '� xry.+._'s +, if'
Limited energy, multi- family 75 00 2
Tenant Improvement residential (with above sq. ft.)
Services or feeders installation, alteration, and /or relocation
200 amps or less 80 30 2
0.4 ' iP, x, ; Y11 w ;.' 5 OiQl7.1 :7 ' ! e e x + t g „.' , i F1.1 V1. t +, 'i ls', amps amps
�� i °.• ; , 20 am to 400 am 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: ( ) l Fax: ( ) 200 amps or less 66.85 1 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
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
A. Fee for branch circuits with
' Iltl # r .s ' tI E M i I , r a - te �1 I;, t: Ith ilft I: Te l t ' -- -,. m ' T ....: 5t:.. pt' itllli5 11#i above service or feeder fee, 6 65 2
each branch circuit
Business name: Johansen Electric Inc. B. Fee for branch circuits
Contact name: Charlynn Leifsen without service or loader fee, ( 46 85 (�/ _2
first branch circuit SP
Address: 10948 SE Valley View Terrace EachadiYl branch circuit 5 6.65 7, .x; 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 Rec n n e t only e and/or feeder
Reconnect only 66.85 2
E -mail: johansenelect @msn.com Pump or irrigation circle 53.40 2
i - .,a . +_.i„, .,.t .,,..i, a 1 ' 8i' ilKAZOWii i7Z-'Z r i11;luyii ' ,. ll4d Sign or outline lighting 53.40 2
Signal circuit(s) or limited -
Business name: Johansen Electric Inc. 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
Phone: (503) 698 - 3417 Fax: (503) 698 -2486 Per inspection 62.50 • ` 4 QQ Investigation per hour (1 Munn) 62.50
CCB Lie.: 53 Electrical Lie.: 3 2 430: , S uprv. Li e.: 2I S t • LO Indust plant per hour 73.75
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tia
Suprv. Electrician signature, required: Subtotal ).$0, /0
Print name: Carl K. Johansen te: 4/17/09
Plan review (25% of permit fee)
} State surcharge (12% of permit fee) 9 .(�/
Authorized signature: I /}/A, C�
tY TOTAL PERMIT' FEE � 7 l
Print name: Charlynn J. Leifsen ` Date: 4/17/09 Tbis permit application expires ifs permit is not obtained within ISO
days after it has been accepted as complete.
• Number of inspections allowed per permit.
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