Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2011 -00649
T1GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11!17/2011
Parcel: 2S113AB01400
Jurisdiction: Tigard
Site address: 7376 SW DURHAM RD
Project: AMEC Environmental Subdivision: COUNCIL VIEW ACRES (LOTS 21 -44) Lot: 30
Project Description: (10) branch circuits
Contractor: JOHANSEN ELECTRIC INC Owner: PACIFIC REALTY ASSOCIATES LP
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
10 crt Branch Circuits wo /Purchase 11/17/2011 $122.96
Specifics: Service or Feeder
1 ea 12% State Surcharge - 11/17/2011 $14.76
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $137.72
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 09 952- -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503 .232..1987or1 /
Issued By: �✓ d'— Permittee Signature: 'A `/ or i-/ iC�77e' , V
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.
RE EEfl / f f 1 _
Electrical Permit Application NOV 1 4 , rt 0141( El - 1 ; tl\I.'
p
City of Tigard
lz�ei�ed ._ ;y—' - � Od � y-
lig .s C0 QC rl�DataB . 7 / l /�.�, YormitNn.: �/
13125 SW Hall Hlvd., Tigard, OR 97223 .plmt'Revicw 2Q Q 3
ti Phone: 503,fi39,4171 Fax: 503.598.1960 0 BU ILDIN> lDatdB OthurPnnnil :/�
Inspechun Lute: 503,639.4175 ®4%21:
Internet: www tlgard•olf,jlov 4up plemrtr brmarIon
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�•, I ° e "Yhtl %r1 n.t� ?, .�� �,,4; I �1 a �T' i' J'�' f „ '�`k. ,r '. r' _. k� :; ',. .rt ' ,•,. •1�4��''� :± n � i... -„ � ,y
❑ Ncw construction El Addition /alteration /replacement
Flew check all met apply (submit sntx of plaits wlitetna checked below)
['Service or feeder 400 amps or more ❑ Building aver three skates.
❑ Demolition ❑ O where the a vailable fault current s boatyards.
Other: t ❑ Marine and ba a
' ; ,∎ , yr r..9 1 4 ,fa;' ;: I ii ,44iji d ° r 1Ag � ,
,,' mcced810,0 amps at150 volts or ❑ Floating buildings,
, ,' , ,, , ; i, ,�, . �� ! c � . Inxs to ground, or exceeds 14,000 ❑ Commercial-use ngriouiturnl
❑ 1- and 2- family dwelling ® Commercial /industrial LI Accessory building amps for all odor installations, buildings.
0 Multi Tamil Y 0 Master builder ❑ Other: CI Fire Pump. ❑ Installation of 75 KVA or xyrd
r ' »„ „'r ; *" ' . ❑ Y.mn gsTLaJ syatam. larger separately derived um.
'y�. „n„ " . , ' !,:i.'.,:,,,7: m r r s o N 1 ° , i � ',, , i , t , , , , �! , i : ] Addition anew motor load of ❑ "A" "F" "1-2" "1 -3'
100HP or more. occupnaey,
Job no.; Job site address; 7376 Sw Durham Rd ❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State/ZIP: ❑ Health taoiIsI ❑ Supply v„Iwgc for more than
❑ Hazardous locations, 600 volts nominal.
Suite/bldg, /apt. no.: I Project name: AME C ❑ service Or feeder 600 amps or more. y�YYIIIrrrrrrA
Cross street /directions to job site; nrurtol on - f Qty. 11 Pee. 1 ?'etwt t "
- New residential single -or multi - family dwelling unit.
Includes attached garage.
Subdivision: t Lot no.: 1,000 sq. ft. or loss 168.54 I 4
Ea. add'l 500 sq. ft, or portion 33.92 W 1
Tax snap /parcel no,: Limited energy, residential 75.40 2
< " ;, r , i 7 , :. n.v;rfr, '-,, ., *: 4•t' " " i. ,.,,..', ", .. r.;h (with above sq, ft.) .,
),.invited energy, multi - tomtit' 75,00 2
work on Furniture residential (nth above ag. ft.) -
Services or feeders Installation, alteration, and/or relocation
200 amps or less 100.70 2
I,,> 'd 0' ° le � Y :
r "l 's'V I , 11 1 !'� rt
. 201 amps to 400 amps 133.56 2
c ' ' ° il ' . Y,' ' r %, , „ • `, t5 �r,�i
401 amps to 600 amps 200.34 2
Name; —
amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 15220 2
Temporary services or feeders installation, alteration, and/or
City /Statc/ZIP• relocation ,
Phone: ( ) `Fax: ( ) 200 amps or loss 59,36 1
tot amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that i own which is not 401 amps to 599 amp. 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 101. Branch circuits new, alteration, or extension, per pane
Owner signature; , . --"Pr'"',' Da te: - A. Coo for branch circuits wUh
„ {„ y , ta°M y above service or fealar foe, 7.42 2
`vi r , . ,•,,, p r , ', , . . ' ..,'
r ' . . °? A each branch c ` � _ .
Business name: Johansen Electric I3, Foe for breach circuits without
acrvicc or feeder fee, first 1 56.18 5 6.18 2
Contact name: Charlynn Lei sen brtatoh circuit
Each add'l branch circuit 9 7,42 6 . 7 8 2
Address: 10948 SE Valley View Terr ivlscellnneous (servlce feeder not lneluded) _
Each manufactured or modular 67 84 2
City/State/ZIP: Happy Valley, OR 9 7 086 dwelling, service and /or fonder _
Phone: (5 0 3) 698-3417 [Fax:: (5 0 3) 698-2486 Rcconneul only 67.84 , 2
Pump or irrigation circle 07,84 2
E-mail: c li hting ti7.84 2
a U r n ;; Si gn or g
;', i I i!0 f j ' „ „ Sipa! eircuit(s) or limited- energy
Business namc; Johansen Electric panel, nitent or i n sp e c i on Pie _ 2
2
Each additi Inspection over allowable in any of the above
Address: 10948 SE Valley View Terr Additional inspection (1 hr min) 66.25/11r
investigation (1 hr Min) 66.25/ hr
City/State /ZIP: H Valley, OR 97086 Industrial plant (1 hr min) 78.18 / hr
one: (503) 0 3) 698-3417 9 8- 3 417 1 Fax:( 5S03 ) 698-2486 In speetions far which no foe is 90.00/ hr
e fio
cctell listed i5 hr min
CCB Lie.: 51539 sr" Electrical Lic.: 3-243C " Lic.. 20538 1 ' rt1 ;�`l ' " • ..S:.1s.V. - 4 , a ' ; ?r / ; l
subtotal: _122.96
Suprv. Electrician signature, required: ] .. Plan review (25% of penult fee):
Print name: Carl Jo nsen t
o Date: 11 / 16 / 11 State surcharge (12% of permit fee): 14.76 /
TOTAL. PERMIT FEE: j 137.72 ,/
Authorized signature: This permit application expires It'll perms[ is not obtained within 180
days after It has beat accepted as complete.
Print name: Char l ynn L e i f s en atc: 11/16/11 5 Number of inapcctiona allowed per permit.
MbuildineorroW 07!01/10 444- 40151111 /05/cot. B
3 /T . HDia 98VZ869C09 98VZ869CO5 ZOara NasMraxor rya C0:50 TTOZ'9T'Aom