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Permit CITY OF TIGARD ELECTRICAL PERMIT ` " � 2 COMMUNITY DEVELOPMENT Permit #: ELC2011 -00569 Date Issued: 10/13/2011 TIGAR_D 13125 SW Hall Blvd., Tigard OR 97223 503 718 2439 Parcel: 2S112DC00500 Jurisdiction: Tigard Site address: 15883 SW 72ND AVE Project: Trane Oregon Subdivision: FANNO CREEK ACRE TRACTS Lot: 40 Project Description: Electrical for TI. Contractor: JOHANSEN ELECTRIC INC Owner: PACIFIC REALTY ASSOCIATES 10948 SE VALLEY VIEW TERR ATTN: N PIVEN HAPPY VALLEY, OR 97086 15350 SW SEQUOIA PKWY #300 PORTLAND, OR 97224 PHONE 503 - 698 -3417 PHONE: FAX: 503 - 698 -2486 FEES Quantity Description Date Amount 4 crt Branch Circuits wo /Purchase 10/13/2011 $78.44 Specifics: Service or Feeder 1 ea 12% State Surcharge - 10/13/2011 $9.41 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $87.85 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 952 - 001 -0090 You may obtain a co• of the rules questions to OUNC by calling 503 232 1987 or 1 800 332 2344 / l Issued By: _' L - Permittee Signature: - ,! i 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 the next available inspection date. 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 Applicatio E CE V Efl r()1Z( >r :1 til(clm.,‘ City of Ti OCT 1 3 2011 Received 1312 aril Ili SW Hall Blvd. OR 97223 Dnia /B , �� ir7 /� / MOr Phone• 503 639 4171 Fax• 503 598 19� 1 1 �/ OF �� Aj;p Other Permit' 61'1 r— — �' � � 1 t . n 1t I Inspection Line• 503 639 4175 v r :. See Page 2 for Internet. www.lignrd- or.gov BUILDING DIViSlQ Supplemental Information t „ „',. '!` .' . .', ' � '!'ci 1rO1. . .` '`, ._. '' ••,'i, ,1 I11''' Eirwrr,i7 .,,; .,' ,i' • Please shook all that apply (submit 3 seta of plans whims cheuknd below). ❑ Ncw construction EJ Addition /alteration /replacement ❑ Service or fbedcr 400 amps or mote ❑ Building over three stories, © Detnolition ❑ Other, where the available fault current ❑ Marinas and boalyatds •i , ,i: - ,i +a ` r'- A'I oir 0,04 0_ fl( !, , " " exceeds 10,000 snaps at 150 volts et In Fleming buildings less to gmund, a' exceeds 14,000 ❑ Commercial -use agricultural ❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps for all other installations buildings ❑ Multi - family ❑ Master builder ❑ Other ❑ Fire pump. El Installation of 75 KVA or t �.' '.'° t ❑ 1'. stnr5etwy sy ilnnb lorgar sensentely derived sy4Win ,'020."Olt; '0Q R , i T X O $ ' A r i r t L VATIQN, , , ' , ' , . • ` . ' ❑ Addition of now motor load of El "A" "Is' "•1.2", Job no Job Af to rrrldYeSA' p 10011P or mom occupancy, 15 8 8 3 SW 72nd ❑ Six or tiler residential units. ©Rccroatlonal vehirir parks. City /State /ZIP: ['Health-care facilities 0 Supply voltage fur more than ❑ Hazardous locations 600 volts nominal. Suite/bldg. /apt. no.. 1 Project name: Trane Co ❑ sorvtca or %crier 600 amps or more ' 'ICE 8Ca Dt ;, , Cross street/directions to job site I)rfcriptian I Qty. I V. I Total 1 • New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision. I Lot no • 1,000 sq, U. or loss 168.54 4 - - - - - -- - . _ . - - Ea add"i 500 sq ft. or portion 3392 I Tax CI no.: Limited energy, residential 75 00 2 .. , ,'' .f1'$tRfIQ14,. Q'E' WOO , with above sq ft ) Limited energy. multi -family 75.00 2 Tenant Improvement residential (with above sq. 11.) _ _ Services or feeders Installatlon,alteratlon, and /or relocation 200 amps or leas 100,70 2 d " "P t -, e?WN*k ‘ "1<° Na q's ':' v 201 amps to 400 amps 13356 2 401 amps to 600 amps 2D0,34 2 Name: 601 amps to 1,000 amps 301 04 2 Address; Over 1,000 snips or volts 552 26 2 City/State/ZIP: Temporary services or feeders installation, alteration, and /or relocation W Phone' ( ) I Fax: ( ) 200 amps or less 59.36 1 201 amps to 400 maps 125 08 2 Owner installation: This installation is being made on property that 1 own which is not intended for sale, lease, rent, or exchange, according to OR 447, 449, 670, and 701. 401 mop, to 599 am 168 54 2 Branch circuits - new, alteration, or extension, per panel Owner signature, Date' A. Fcc for branch circuits with 'PPO L p dNlr�Cf,� Iii _ ubovesvrviue ur l'ucdcrfee, 742 2 T La k R cacti branch circuit A , Nee for branch cirourt4 wt(huvr Busmcssname: Johansen Electric service or feeder fee, first Contact name: Charlynn Lei f sea branch circuit 1 56 18 6. 2 Each MC branch circuit 3 7,42 22.26 2 Address: 10948 SE Valley View Terr MIscellaneous (service or feeder not included) -- - Valley, e OR 9 7 0 8 6 Each manufactured or modular 67 84 2 City /Slale/ZJP; Happy Y dwelling, service end /or feeder Phono. ( 503) 698 -3417 Fax:. (503) 698 -2486 Reconnect only 67,114 2 Pump or tntiguuoa circle 67 R4 2 -mail: - - Sign or outlmc ghting li 67 84 2 - , , , �" ecIrrfRACTIDR :'< , • Signal circuit(s) or limited- energy Business name. Johansen Electric Pundl,nitnndion Pi' - 2 Each additional inspection over allowable in any of th shove - Address. 10948 SE Valley View Terr Additional inspection (Ihrmin) 6625/hr City /State /ZIP, Happy Valley, OR 97086 Investigation (lhrmi mi 66,25 /br Industrial plant (1 lir n) 78,18/ hr Phone. (503) 698 -3417 Fax: (503) 698 -2486 - Inspeutionsforwhiehnofeeis - 9000/hr R - >ecificallt listed ('F, hr min) C CB Lic.. 53,539 Electrical Lie., 3 - 243C Suprv, Lie.. 2053S ' , 'ET 1 Ai;' �'' fat4' ; ', Subtotal' 78. 4 4 Suprv. Electrician signature, required: ',.q p� (//� . _ � Qr Plan rovtcw %of penult fee) Printnanrc, Carl Jo nsen Date: 10/13/11 ln1e suxchargc(I2Yo of permit fee) 9 TOTAL PERMIT FEL 87 . $ 5 Autltonrod sigma-um; • This permit application expires if a permit 1s not obtained within 180 days after It has been accepted as complete" Print name: Char lynn L ei £ S en Date' 10/13/11 • Number of inspections allowed per permit I \HUildingV'ermits4,LC- Pei mltApp doe 07/01 /l0 440 4615T(1 I /05 /COM/WOA ? /T - RsVa 98t 869E09 9817Z869E09 'DEIE MESNVHOf PIll L0:60 TTOZ- CT -40O