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Permit CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2011 -00717 Date Issued: 12/23/2011 TRGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S113AC00103 Jurisdiction: Tigard Site address: 7204 SW DURHAM RD 300 Project: Consumer Cellular Subdivision: COUNCIL VIEW ACRES (LOTS 21 -44) Lot: 25 -27,2; Project Description: Electrical for IT room. 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: FAX: 503 - 698 -2486 FEES Quantity Description Date Amount 2 ea Services or Feeders - 200 12/23/2011 $201.40 Specifics: amps or less 30 crt Branch Circuits w /Purchase 12/23/2011 $222.60 Type of Use: SF Service or Feeder Class of Work: ALT 1 ea 12% State Surcharge - 12/23/2011 $50.88 Electrical Type of Const: Occupancy Grp: Total $474.88 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 OA: •52 -001 -0090. You may obtain a co• of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued B /r. /� — j iti Permittee Signature: it14 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. Electrical Permit Application, r(11; In l It 1 I tih: i,�l l City of Tigard i R eceived 1� a . 7 r M 13125 S W Hall Blvd„ Tigard, OK Y � s Q�\ Dato : a Phone: 503.639.4171 Fax: 50159:I•;' + °° et4 0 j Other Permit; ?-cit • e ,� It 1 Inspection Line: 503.639.4175 t`C 0 .1151M1111 121 See Pago 2 for Internet: www.tigard -ocgov Q VP Supplementallnfonn agon v ' y a. ,,, . �' I ,r ti'1+ r ,. '. 1 r Ap,P, M�r 1 'e9 , ` \ W .. 1 .r IV ] ' : y' ; t l , ( F�„' a r 6'Ft �t� 5 A�.:�t 'ir ��Qt Absel, � „�� .., r �46 �' 9 . rJ +, 1, x. Jr s ] 1 t � C] New construction P9 Addition/alteration/r- lease shook all that apply (submit I sets of plans whams checked below): � nt 0 r ❑ Service or feeder 400 amps or more ❑ Building over three an toes. ❑ Demolition ❑ Other: whore the available fault current ❑ Marinas and boatyards, a.f; , S'4 . ;.� ir :i �, : �i% "r ^w'" exceeds 10,000 um nt 50 volts or Floating buildings. m f 4r r , 1 ]. ': " .Fb . '' s t' 6'''' O, ', ; y'' , , .' i ] ''' , less to around, or e 14,000 0 Commercial-use agricultural ❑ 1- and 2-family dwelling ®Commercial /industrial L] Accessory building snips for all other installations. buildings. ❑ Multi- fatnil ❑Master builder Ot D Fire pump. ©Installntioa of 75 KVA or 7 r.' u , ... r ❑ Emergency eyetcm. larger sepumtoly derived system. �L I k r, t.: ' F 1 �,{�y , a o f ,� a r i) ©Ad mk °,i ,d, I"k° ,'t,�,� }� r; <tt a dl liunofnewmOWrluudof ❑ „�„ „E,. "1-2” .,1_3 Job no,: 10b Site a 1001IF or more, occupancy. 7 2 0 4 SW Ijurham ❑ Six or more residential units. ❑ Recreational vehicle parks. City/State /ZIP' ❑ Health-care facilities. 0 Supply voltage for more than ❑ Hazardous locutions, 600 volts nominal. Suite/bldg. /apt.no,: 300 Project name: Consumer Cellular ❑ Service or feeder GOO annpsortnoro. Cross strect/dircctions to job site: azm p New residential single- or multi - family dwelling unit. Includes attached , ra:e. Subdivision, 1 Lot n0.: 1,000 sq. ft. or less .111111Q Tax map /parcel no.: Ea, add'1 500 sq. it, or portion NM 33.92 —Q y�ygEr yry� ] F'F u 4 ?*7ti , '�' ,. t r Limited energy, residential 00 l: >.., , ,l y e ,, �4:<'�,1 ,. . [ MO *:�°.•' 1 \ .',T , ,. Y'1., ,'F wit^ above.,. ft . Ell 75 °° Limited energy, mul fam work at IT room residential with above: .R. ■ 75,00 _ III Services or feeders installation alteration and/or relocation 200 amps or leas 100,70 O U El r r y ; }d All a a7 r A6y *,� r o : o , v ." �t ;. p ” a :, 1 , y +ail 201 ainps to 4(X) amps =I 133,56 - Name: 401 amps to 600 amps ME 200,34 — 60l amps to 1,000 maps = 3 01.04 Address: Over 1,000 amps or volts — 552.26 111111.1© • City/State/ZIP! Temporary services or feeders Installation, alteration, and/or r J relocation Phone: ( ) Fax; ( ) 200 amps or less IIIII 59.36 —Q 2(11 amps to 400 amps — ® —El Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps © intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Bnsneh circuits new alteration or extension er ■ and Owner signature: Date: feeder fee. wed A. Pee for branch circuits wrth — .'r§.', ;1' " i wx ,,, cod °S,. :; : ] 1 ;i v a " o t ' •rJ' !t , a 5 , , : above semee r ... i . each bnunuh circuit 111111 Business name: Johansen EleCtr� F1, savicc e rs 11111.1 Fee for or feeder fee, circuits without i Contact name: Charlynn Lea f sen bruncheirnit Each add'I branch circuit ME 7,42 — Address: 10948 SE Valley View Terr Miscellaneous service or feeder not included Each in; service or modular ■ � Ciry /StatcIZIP: Happy Valley, 017 97086 awclrn aervitce eand/or feeder Phone: (5 0 3) 698-3417 I Fax: : (503)698-2486 Reconnect only Pump or irrigation circle 1.1 67,84 IIINIE© E -mail: Sign or outline lighting =IEEE U c:rk .r. a,.;rt ^'r y; } :: :ar3' „ - , ,h';.M .1 , ;, 5 ?, ": a " R,e,l�r': ii:. •'', 4, i ..,-; ;':y ' ; ,: r , i r + : __ 7 : Sigiml circuit(s) Or limited.energy �© Business name: Johansen Electric ., el. alteration, or extension. Each additional Ins •ction over allowable in a of the above Address; 10948 SE Valley View Terr Additional inspection (1 hr min) 1111 66.25/hr _M City /State /ZIP: Valley, OR 9 7 0 8 6 ' Investigation (1 hr thin) 66,25/ hr � Happy y , , industrial plant (1 hr mat) _ 75.18/ hr MM. Phone: (5 0 3) 698-3417 Fax: (5 0 3) 6 9 8 - 2 48 6 laspeotiona for which no fee is 11111 • ificall listed 4 hr mitt CCB Lic.: 51539 Electrical Lie. 3-243C Suprv. Lie.; r g'il. `t c : > r`q C M'F 1 °" '. ,,; ..i , ;;, :3 -2 3C 20535 {..,,. <;;;rs�� ' .iG..�iir.� .,�.� i!.. arid Jj [s - Subtotal: ��' Suprv. Electrician signature, required: (,i(,� /� �� Plan review (25% of :runt fee): MUM Print name: Carl. JO ns en Date: 12/23/11 State surcharge (12% of penult fee): / �i . iril = i Authorized signature: .........------�-- This permit application expires If a permit is not obtained within 1180 days after it has been accepted as complete. Print name: Cha 1 ynn Leif s en T Date: 12/23/11 • Number of inspections allowed per permit. 1:1 Mehra \PemnitsU'I.C-Yermitnpp.d°c 07101/10 440 -46151Ui /OS /COM/WRA Z /T . asva 98VZ869CO5 9817Z869CO5 ioaga NaSNVHOr WV 6T:TT TTOZ'CZ'oeu