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Permit
/)1/ y /P h ,e_r' f 7 ;ru6/64. c _ ( p6A/47 C, Ge-r )1—s CITY OF TIGARD ELECTRICAL PERMIT ` COMMUNITY DEVELOPMENT Permit #: ELC2011 -00578 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/18/2011 Parcel: 2S113AA00400 Jurisdiction: Tigard Site address: 16200 SW 72ND AVE B2 Project: Tufcoat Subdivision: ROSEWOOD ACRE TRACTS Lot: C Project Description: Install equipment. 12/14/11, REPRINTED permit to include (2) additional circuits. Contractor: JOHANSEN ELECTRIC INC Owner: PACIFIC REALTY ASSOCIATES 10948 SE VALLEY VIEW TERR ATTN: N PIVEN HAPPY VALLEY, OR 97086 15350 SE SEQUOIA PKWY #300 PORTLAND, OR 97224 P PHONE: 503 - 624 -6300 HONE: 503 - 698 -3417 FAX: 503 - 698 -2486 FEES Quantity Description Date Amount 1 ea Services or Feeders - 200 10/18/2011 $100.70 Specifics: amps or less 1 crt Branch Circuits w /Purchase 10/18/2011 $7.42 Type of Use: COM Service or Feeder Class of Work: ALT 1 ea 12% State Surcharge - 10/18/2011 $12.97 Electrical Type of Const: 2 crt Branch Circuits w /Purchase 12/14/2011 $14.84 Occupancy Grp: Service or Feeder 2 12% State Surcharge - 12/14/2011 $1.78 Electrical Total $137.71 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. 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 b the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through OAR 952- 001 -0090. You may obtain a copy of the rul• or direct qu- tions to OUNC by calling 503.232.1987 or 1.800.332.2344. r Issued By: _ __ Permittee Signature: • '/ 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. CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2011 -00578 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503 718 2439 Date Issued: 10/18/2011 Parcel: 2S 113AA00400 Jurisdiction: Tigard Site address: 16200 SW 72ND AVE B2 Project: Tufcoat Subdivision: ROSEWOOD ACRE TRACTS Lot: C Project Description: Install equipment Contractor: JOHANSEN ELECTRIC INC Owner: PACIFIC REALTY ASSOCIATES 10948 SE VALLEY VIEW TERR ATTN. N PIVEN HAPPY VALLEY, OR 97086 15350 SE SEQUOIA PKWY #300 PORTLAND, OR 97224 PHONE 503 - 698 -3417 PHONE* 503 - 624 -6300 FAX 503 - 698 -2486 FEES Quantity Description Date Amount 1 ea Services or Feeders - 200 10/18/2011 $100 70 Specifics: amps or less 1 crt Branch Circuits w /Purchase 10/18/2011 $7.42 Type of Use: COM Service or Feeder Class of Work: ALT 1 ea 12% State Surcharge - 10/18/2011 $12 97 Electrical Type of Const: Occupancy Grp: Total $121 09 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 rule •r direct q :stions to OUNC by calling 503 232 1987 or 1 800 332 2344. Issued By: — _ �_' Permittee Signature: � // _.`. - - - 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. t 4 a Electrical Permit Appiicatiion �`� City �� ° ►cI . L tJ' of Tigard � Date/By; PermitNo.! ts 6ir- _7s' w 13125 SW Hall Blvd., Tigard, OR 91 ‘,.._ ,C 1 • Plan Review a Phone: 501639.4171 Fax: 503.598 3 1" c,\ 17atd13y: Other Permit; r it I , Inspection Lino: 503.639.4175 C-' \ ., ''Date Roady /Uy: buss: 63 flee page 2 for w Internet: ww.tigard- or.gov o – l:' sailed /Method; f 2 Supplemental Information �. V ,.I l l I� 4 i �, 6 :':j `gr Y , „n i i l , R ', �� I : A , \ t` r 1 Z ' \ + i ,:.1” , PP+Y a '� p of rafts w/Irem iYt ♦,' "' rl ri \ ;Ii I T l ':1,,. .. �d „ rl ,. i, ,, ,r ., y P . ` „� -)�t)t � � � WOW): ❑ Now construction Addition/alteration /s t n s e t Cl iaa se choc a at a (,aub b s s c eo oc� ba o Service or feeder 400 amps o more 12 Building over throe stories. El Demolition ❑ W Other where the available fault current C] Marinas and boatyards. at; "1 10,;',k ' $ Ft•o ,`a 1i1l ' iii " I ti l "r; , vi ! r amps at exceeds 10,000 a at 150 volt or ❑ Floating buildings. ' ' ' I •• < '• ' t ` " ' ,;.. ,,, ,w - • . ' ,. ". „ °' ' ' . leas to ground, or esceeda 14,000 0 Commereial.usc agricultural ❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps for oil other installations. buildings, ❑ Multi - family ❑ Master builder ❑ Other; 0 Fire pump, ❑ Installation of 75 KVA or ©Entageecy syslnm. larger separately derived system. 9 g, 7 ;t, tt 4 -i» 4 . t . . .. 4 , .. ' 7 Y 4 !?"., . 6 :.'' .` ❑ Addition of new motto load of ❑ "A",17,-, .. 2.. "I-3". 100 /1P or mom• occupancy. Job no.: Job site Address: 16200 S W 7 2nd ❑ six or more residential units, ❑ Recreational vehicle park$. City /S1Ate/ZIP El llealth•caro facilities. El Supply voltage for more than . _ ❑ Hazardous locations. 600 volts nominal, Suite/bldg. /apt.no.: I Project name: TU fCoat El Service or foster 600 amps ormore. :r Cross street/directions to job site: Description Qty. Rao. T 0 Plow residential single- or multi - family dwelling unit. 1180100es attached garage. Subdivision: I Lot no.: 1,000 sq, ft. or Ices 168.54 4 Ea. add'] 500 sq, ft, or portion _ 33.92 1 Tax map /parcel no Limited energy, residential 75.00 2 ;; ,/ p p'4 /3 r P. 1 r .m, tI7 ,,,. 4'. err' 1 I (with ubovety.it) . , Limited energy, multi - Family 75.00 2 ** *ADD to •ermit l;LC2011 00578 residential (with abovosq.P.) Services er tbcdcts ihstallatton and /or relocation 200 amps or less 1(10.70 2 + >, v 6` v, t. ;i- %';'7a1.2.;'1,!,. v! y A < � { I ',o ✓ 7.n , . ,,j ' * g%N F'+ty 4 t ; rjE,i,' .a ry ,1 201 amps to 400 amps 133.56 2 401 amps to 600 amps 2(10, 2 Nye - 601 amps to 1,000 amps 301,04 2 Address: Over 1,000 amps or volts _ 55226 2 ' Temporary services or feeders installation, alteration, and/or City /State/ZIP: relocation _ Phone: ( ) I Fax: ( ) 200 amps or less 59.36 _ 1 201 amps to 400 amps 125.08 2 Owner installation: This installation is being made on property that I own which is not 599 intended for sale, lease, rent, or exchange, Acootding to ORS 447, 449, 670, and 701, 401 amps to 599 amps 168.54 2 Branch circuits —new alteration or extension , or.anel Owner signature:_____ Date: __ A. Fee for branch circuits with m ../....1.,....... a ova service or feeder tee, ?'! :; �w � ;.It;: ; , ;; i ^ r a y " ' tit > ; ic:c'' above ',. , !' ,' + � ' , _ I ? )..� , r' _� .C,, , J � ' ' ''' '' each branch oirouil 7,42 2 Business name: Johansen Electric B Peeforbranchof , i rsttltont 6erYFao or fegdar f oe, f rat 56,16 2 Contact naive: Charlynn Leifsen branch circuit Each Mill branch circuit 12 7.42 14.84 2 Address: 10948 SE Valley View Terr Miscellaneous (service or feeder not included) Euoh manufactured or modular 67.84 2 City /State /ZIP: Happy Valley, OR 97086 dwelling, service and /or feeder _ Phone: (5 0 3) 698-3417 I Fax:: (5 0 3) 698-2486 Reonnnect only 67,84 2 Pump or irrigation eirelo 67.84 2 e-mail! — :fiat <,r outline lighting 67.84 2 pa,. 9 'u !'. 1 M I` t "a f '.; t, ' .' �.'" J , , , . ' y � ..4a . ', , c , Signal circuits) or limited•e mergy Business name. �7a a� s en Electric panel, alteration, or extension. Page 2 2 Each additional insuctiun over allowable in any of the abov Address: 10948 SE Valley View Terr Additiannl inspection (lhrmin) 6625/hr City /Stat H � Vall OR 9 7 0 8 6 Investigation (I hr min) 66.25 / hr ppY Y r Industrial plant (1 hr min) 78,18/ hr Phone: (5 0 3) 698-3417 Fax: (5 0 3) 698-2486 Inspections for which no fee is ■ 80,00/ hr . s.eoiflcsli listed .%5 hr min CC33 Lie., 51.5 3 9 Electrical Lie.: 3 — 2 4 3 C Suprv. Lie.: 20 5 3 5 I ', ";Y ,' , , ; :, ejt' "T' ,' i; °; ; rr"t 7 Suprv. Electrician signature, required: Subtotal: X14 . 8 4 M ,C „ 6,j Plan review (25% of per fee): Print name: Carl J an s en . Date; 12 / 13 / 11 State surcharge (12% of permit fee): 1 . 78 TOTAL PERMIT FEE: 16.62 Authorized signature: This permit application expires ifs permit's not obtained within 180 days eaterIa has hem aeeept Print name: Charlynn Leifsen � - - -. Date: 12/13/11 " Numbers of inape>Cttnns allowed per permit, , as complete. 1:\ Baildsnalaermiu /GLC- Pe,mitApp.doe U7/0I /10 440.4615T(11/05/<' tM/WE➢ V /T •HDVd 9S7Z869£OS 98tZ869E09 103'IQ NHSNKHOf WI TZ =OT TTOZ•CT•3BQ ,ECENE Electrical ermit Application ACT 1 Received r(,tt t)l Fi(l t ti t ^ � I. , 72011 City of 'Tigard p ii 7.,- Of TtG O RD Date/By D / 13125 SW hall 131vc6, Tigard, OP. 97223 -rV t Plan Rev low N " Phone 503 63 9 41 71 Pax 503 590 19C,Ori 1 l boats , i t i „N izl Inspoction Lino: 503,639 4175 BthLDI�!G DIVI - Date Rcadv /By. row la Ski. Paw for - Internet: www,tigsrd•or,gov Notdied /Malbod, Supplemental Information . ,., "r'1!E: G QVoR , ;; - ^. + ,, '. `'i ,APT I VTR*, , -„ , , ❑ New construction ® Addition/alteration/replacement chock all that apply (subn+{t 2 acts of plena whtmna checked below); ❑ Sarvicn or feeder 400 amps or more ❑ Building over three stones, © Demolition ❑ Other' whore the available fault eurrenl ❑ Marinas and boatvarda - , "' - ' exceeds 10,000 amps at 150 volts or ❑ Heating buildings - loss to ground, or exceeds 14,000 ❑ ('ornn,arclabusc agricultural ❑ I- and 2- family dwelling E Commercial /industrial © Accessory building amps for all other installations, buildings CI Multi - family ❑ Master builder ['Other. ❑ Fire pump, ❑ Installation of 75 EVA or ••,a. '', ,;A , . • , ❑ Emcsgonay xystmn, larger separately derived syatcnn, ": 'J, - -, ,! �tMAT , ' ° M W ' l O . , , , ,,, ^ art "'. ❑ Addition of new motor load of ❑ "A" "E", "1 -2" "1-3", Job no.: Job site address: l (0� ) 0 ►i ❑ '(x or or n+nrc occupancy, Six ,x mare rozidenlial unit4 0 Rccrontionnl vnittulu narks, City /Stale /ZIP: IJ Ilnalih•earn facilities. ❑ Supply voltage for more than ❑ Hazardous locations, 600 volts nominal, Suito/bldg /apt.no.. I Project name. " 'v+ Cl/j' ❑ Surviuu oricuder600 amps ormore, ' ''' . FEE ^SClD , y R ' Cross strect/directtons to job Site. Description I Qty. F Iwi i raw, New residential single- ur multid'nmlly dwelling unit. Includes attached garage. Subdivision, I Lot no : 1,000 sq. ft Of less 168,54 it ^ Fu, odd' l 500 sy ft or portion 33,92 1 Tax map /parcel no ; i,umted energy, 'credential ,,,1 DE$<' QN,0F: W)K' , (with above .t. 0) 75.00 2 Limited unoray, malts -family I r $ t,ll l / D t `.� residential (with above sq. tt,) 75,00 2 - ! Services or feeders lnstallatlon and /or relocation 200 imps or less I 100.71) 100.1D 2 ''i,•', ,i, ` , , .' ' . 2 amps to 4 00 amps 139,56 2 Name: 401 amp% to 600 snips 209,34 2 . . . -- 601 amps to 1,000 ummps 301 04 2 Address, Over 1,000 snips or volts 552.26 2 Cat /$IAIf/ZIP' Temporary services or feeders installation, Alteration, an d /or Y relocation Phone: ( ) Fax ( ) 200 amps or loss ^ 59,36 1 Owner installation: This installation is being made on property that I own which is not 201 imps no 400 amps 125,08 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701, 401 imps to 59 °t imp 168 Sa 2 Branch circuits— new, alteration, or.extenston, s�crpanel Owner signature: _ _ vote: A. Pau for branch circuits with M ^ 14C . '� -� about service or tcedcr ace 7.42 2 each branch circuit B Fee for branch (Amite withotei Bnsinessmmo: Johansen Electric - service or fccdcrfoo,first ( 2 Contact name: Charl.ynn Le i f aen branch circuit _. Each add'I branch cirovtt 7 42 2 Address' 10948 SE Valley View Terr Miscellaneous (nervlcea feeder not included) • City /State /ZIP, Happy Val OR 9 7 0 8 6 Each in servi a or modeler 67 $4 2 ppy y r dwelling, service and /or feeder Phone: ( 503) 698-3417 Fax.. (503) 698-2486 Reconnect only 67,84 T 2 • --- i - Pump or irrigation circle 67 R4 2 E-mail: . .. Sign or outline lighting 67 84 2 Signet uiruui100 or limited -mime Business name: Johansen Electric panel, alteration, or extension I 2 Each additional inspection over allowable h t e nv of the above Address' 10948 SE Valley View Terr Additional inspection (I hr min) 66,25/ hr 70 18/ hr City/State/ZIP. Happy Val ley , OR 97086 Investigation (] hr mm) 66,25/ hr Industrial plant (l hr min) Phone: (5 0 3) 698-3417 Fax, (503) 698-2486 fl peenia fair wh,c1, no Pea as 90,00/ hr sroificnlly listed (' /t hr min) CCB Lie.. 51539 I Electrical Lie,: 3-243C � [ J"! Suuprv. 20535 , . ` . "' I a ' 1+G'� i Mt, . m '' ' C.:4 . /d Subtotal / R. /�J Suprv, Electrician Signature, required. �Ra� _. Plan review (25% of penult fee), Print name: Carl th a n e en Le' 10/17/11 State surcharge (12% of permit fee) 17,, .. TOTAL, PERMIT ht;l': 12/ • b i Authorized signature: ' This permit application expires if a permit to not obtained withlo tau days alter At Not been ',emoted as rnmplste. Print name: Char lynn Leif f een Date: 10/17/11 • Number of inspections allowed per permit, I lltraida,g \Peuniisibt - Pernti)App.doc 07101110 440 - 46151'(11 /05 /CCMlWDD Z / T • aDxa 98PZ869E05 9817Z869alg zOaga MasNKHOr WV ZS:OT TTOZ • LT •4DO