Permit _ ,, CITY OF TIGARD ELECTRICAL PERMIT
-- COMMUNITY DEVELOPMENT Permit #: ELC2011 -00689
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/07/2011
Parcel: 2S112DA01400
Jurisdiction: Tigard
Site address: 6650 SW REDWOOD LN 210
Project: NuScale Subdivision: 1996 -048 PARTITION PLAT Lot: 2
Project Description: (2) branch circuits 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
2 crt Branch Circuits wo /Purchase 12/07/2011 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 12/07/2011 $7.63
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $71.23
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. ATTENTI . on law
s/ /�requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -001 r ugh OAR 2 -0 0 . You may obtain a copy of rules or direct questions to UN by calling or of the dit ti OUNC lling 503. 32 1987 1.800.332.2344.
� _
Issued B : �_ P erm i ttee S
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' i % / r d , / `} J_ 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 Application ��� I(►1t Ol Elf p: t :`i: 1.1
City of Tigard �� 01\ AKM : P mil No': Ehe)o / "ClePg7
r 13125 SW Hall Blvd., Tigard, ()R 97223 c0 /� /�
i. * • Pion: 503.639.4171 Fax: 503.598,19E0 � a � :►: Other Permit: 61.1.. c2 w -et) a. •
u t > i Inspection Gins: 5£13.63 .4175 Q .C N + El Sec Palte 2 for
rte ct: www ti n 1 � `1 `,� Su matton
t m gt ni - or.6ov if ry , Supplemental Infbr
'.•.r. y,:�:.,,a�,r .•.. rh °., ..,.'.,r. •..,w ...,. r•. .1 ..n�;a,4F '41 ,,,5 /. .a,k... .: r� ; . 'C . e•. ;'F . '.,•. ,,, 4.:
�.f. , J: ,r:� " +� •,..,,• ;,t1,. '�`' :�ri.•.1. 'u..f r l'' .k.. �. . � 1�• ;
� � ..n. ... . i:;. .. J':. ,.�t1'.: .• ,, .' 1', :1.:. .i¢ �'v '(..� ` i c 1ti L s'h' ,u � , >a, -
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'�'! .�'l .�'eruA'� f. d( ��, ... J • : - t ,.r !ar„ tt''s :;, 1'�' ,, f.i; `., •:�:Y �
Please
ONewconstruction ®Additioln/alteration/i c31ent ��check all that appl submit rnisof w /itrma checked bolow).
8trvicc or feeder 400 amps Or more ❑ Building over throe stories.
Q Demolition 0 Other: where the available fault current ❑ Marinas and boatyards.
`'e g'='."T Y'A '''r4: ;;i,4r„?.., y .r^ „fines . :* , ° n " ,1 r 7 ?; J•aq.;r, L; :'', /;g:4: ;<•f excoc 10 000 atll s at 150 volts or ❑ Floating buildings.
i;,• h J u, ' " r 4 . • •��. + ,. Y .. e��� --,.. .. ' ": t ' h , '''' p g s.
6
I � ,; - � � ]ozs it' ground, Or exceeds 14,000 Q commercial-ow agricultural
0 1 - and 2- family dwelling IM Commercial /industrial ❑ Accessory building amps tor all other installations. buildings.
❑ Multi - family 0 Master builder 0 Other: ❑ Piro pump. 0 Installation of KVA Cl'
k, " ?;.c ; a '- ,. rid� "'ff� . . era ; + ,,, ,,�;., r ❑ Entarf;onuy zyslem. larger separately derived system.
!k,..' .1). , :':;tit l; •,i;1�^ ^^ :t; ,�,,_� *� /y*,� "..r ": r, :'
,rsr, ! <l�1��. • ;,61"1,1rr7 kA�!}}�� rr fl ',F�i lv �•���;: .; + �:... w motor <,A„ 'E", ,. �„
•�.•. .,�'.r,.til.,. „• ,. i �,. .�, ,., t:'�.'�e >bl�. A+. ,, . ,,,r r� / a:'� ^ %�`;'J� ❑A m0 ❑
10011P or more. Oteepancy.
;fob no.: Job site address: 6 6 5 0 S W Redwood d Sik or more residential units. ❑ Recreational vehicle perks.
Oily / Slate/ZIP: [l Health -care facilities. 0 Supply voltage l more ten
h
❑ Itarardnus locations. 600 volts nominal.
Suite/bldg. /apt. no.; 210 ` Project name: NuS c a l e ❑ service or feeder 600 amps or more
N'
Cross street/directions to job site: Da'errlatan Qt. fee total e
New residential single.- or multi-family dwelling unit.
includes attached garage.
Subdivision: ( Lot no,: 1,000 sq. R. or less 168.54 l 4
Tax m /areal no.: - - Ea, Odell 500 sq. R. or portion 33,92 1
app 1,. Limited energy, rosidential 75.00 2
!', • ' DE i ( /.' ,'i'; (with above sq. 1l.)
Limited energy, multi - family 75.00 2
Add new residential (with above sq. ft) .
service, or feeders installation, alteration, and /or relocation
200 amps or loss 100.70 2
7s+ {, } ^i? /,+,y'.'r:'. „ » ,,,+ /,, .:7,41';; ,roil,` ''S:'r?:ti1;j;;V,.i'' _ _ `,5'..7,; °t./•.. IV 201 amps to 400 am a 133.56 2
401 amps to 600 amps 200.34 2
Name:
601 amps to 1,000 amps 301.04 2
Address: over 1,000 amps or volts 552.26 2
City/State/ZIP: Temporary services or feeders i nstallation, alteration, and/or
relocation
^ Phone: ( ) ` Fax: ( ) 200 amps or loss 59,36 l
201 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 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. -
Branch circuits — new, alteration, or extension, per panel -
Owner signature: _ _ Date: A. Poo for branch circuits with
u d:': M_ ., ,:r; ". ` (c';,'. �. 1;1•':r r ' above service offoedor
'vi • s s ': _ 'rio ,, ., . i ...: . ;, ' , i ,: i ' 7.42 2
; a ... . • '�;'� ' :. ,. , , ,; ,l' ?`, ". , , "« ; ,; ; ,T,...., . , , ., • ,. . each branch Oitcuit
Business name: Johansen Electric B. Pee for branohcirlwits
service or feeder fen, first 1 56.18 6. 2
Contact name; Char Lei f sea branch circuit
F.ach add'i branch circuit 1 7.42 7.42 2
Address; 10948 SE Valley View Terr Miscellaneous (service or feeder not included)
Each manufactured or modular 67.84 2
City /State/ZIP: Happy Valley , OR 97086 dwelling, service and/or feeder
Phone; (5 0 3) 698-3417 J Fax :: (5 0 3) 698-2486 Reconnect only 67.84 2
Pump or irrigation circle 07. 2
E - mail' 6785 2
RR: , b'. . �: . i; -..: P:, !'v, rn•., y „... - �,: , .,, v ; ;•.rv,r . r , Ff: ' -
Sign or outline lighting 4
�,^0 •;: ∎.'qkt ; 'i 6C ' 0v ' is t.'r f, '9%'dv!:; ' -' � ` ..i':', . i .•
;','l ,r:. Vi i,.. :�� ��� ., oe. ,.,, Signmloirtntil(s ) orlimitod- energy
Business name; .7ohan8 en I' 1 !, c tr r Y c
panel, alteration, or extension. _ Pine 2 2
Each additional Inspection over allowable in any of the a
-
Address; 10948 SE Valley View Terr Additional inspection (l hrmin) 66,25/hr
City / State/ZIP; Happy Va 1 1 e , OR 97086 Investigation a p t min) 66.25/ hr
p�y � lndaslrialpl�nt( I hrmiu) 78.18 /hr
Phone: (5 0 3) 6 9 8 — 3 417 ( Fax: (5 0 3) 698-2486 In spectietna for which no fee is ■ 90.00/ hr
• s.coifcall Iisted th hr min
CCB Lie.; 5153 9 Electrical Lie.: 3 r Suprv. Lie.: 20538 ° "'v ;. a;;;.: L i 7 " : , 1i" 1 "t tr. :'"r "(�s',°;M '- sa':ca;: =.a;.'
3uhtotnl: 63.60
3.60
Suprv. Electrician signature, required: 0'4 - , W. ✓, 407 , Plan review (25% of permit fee): •
Printname; Carl t7S ansen I' Date: 12/6/11 Statcsurcharge(12% 7 , 63
l TOTAL PERMIT FE E: 71.2 3
Authorized signature: 7 � This permit application expires It a permit is not obtained within ISO
— "' days alter it has been accepted as complete.
Print name: Char Lynn Le if pen Date: 12 / 6 /11 • Number of inspections allowed Per permit.
1:\ 14uildinalPetmitx /Sl.C- P,mitApp,dur 07 /el /le 440 -46I ..r(I 1,r1/CATJWI111
9 /T - HsVd 986Z869E09 98t7869E05 'Darla MaSNVHor vsd Zb :EO TTOZ- 90.080