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Permit • CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2011 -00709 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/20/2011 Parcel: 2S101AD03200 Jurisdiction: Tigard Site address: 12909 SW 68TH PKWY 350 Project: Williston Financial Group Subdivision: WEST PORTLAND HEIGHTS Lot: 9 -25, PT Project Description: (2) branch circuits for office expansion. 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 crt Branch Circuits wo /Purchase 12/20/2011 $63.60 Specifics: Service or Feeder 1 ea 12% State Surcharge - 12/20/2011 $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. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules set forth in OAR 952- 001 -0010 through OAR 952- 001 -0090. You may obtai - • • • t ru es or ' ect questions to OUNC by calling 503.232 1987 or 1.800.332.2344. Issued Bye Lid Permittee Signature: - .1% .,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. A l pUd -d l' Electrical Permit ADD E E i l «'t OI I• I( 1,. NI.: ()NIA City of Tigard l r � (� R �,,r c° ; /R XDA i iD /1 e∎ 13125 si Phone: 50 6 94!171 Tigard, 5582111)" 2011 lialiESIZ I 1 i , ,\ i, I ) Inspection Line: 503.639.4175 luris: Ia See Page 216r Internet: www.ligard- or.go‘CITy OF TIGARD Supplemental Information k1 ^'. `\`i "Y':,s.'l�'^ :�4..`i.A.: F } ...f l ":1:.• {'N, ,.. h ^.i ,,. /: �. I , a ".A'. n�Tr,r,Ca: Fir Pf�f ^1C. 1Y ,.f.^ F",i..�",di �i(; ),w' Vi iI VRA ,t ' :'''!'� '', 40 a > d. f I$10P 'i ;V ) r t " , �i 1d� ei',,i`i 0 jP\''. 1 ; r � 1 , I, ''' `''.Il .i...': ^' . `} 'i 11A���'! ti I,t „1 ,1 rt 0 New construction a) Addition /alteration /replacement Please cheek all that apply (submit a sets o! plans wlitems shacked below): ❑ service or tbeder 400 runpa or mom ❑ Building over three stories. 0 Demolition 0 Other: where the available fault current ❑ Marinas and boatyanls. rr - 4,;SI, ' 1' ✓,,� d r!,'Y '1'' 1 ,,r, ," J ' : r. , A "' ' '! " ti" t''r ; +' F.,„ exceeds 10, amps al 150 volts or ❑ i'lnatin8 buildings, °' ':'' "" "" `` "' ` " ` ". ` "' ,' t' / '' ' .iii- '' l Icon to ground, or exceeds 14,000 Q Commorciai -uso agrieuluun1 Q 1- and 2- family dwelling ® Commercial /industrial 0 Accessory building amps for all other installations, buildings. 0 Multi - family © Master builder Q Other: ❑ Fire pump, ❑ Installation of 75 KVA or � +'V 4, tc', 17 Emergency system, large' separately derivedsyslem, -i 3 :10. , o- t ` dd I ' ' , i t I ' .1;Y t ( '; m Ir t ❑ Addition of now motor load of ❑ .. A ., A.F„ "1-2", "1 -3., Job no.: Job site address: 12909 SW 6 8th ❑ Six 8ix o or r more a residential s, occupancy, or unite. ❑ Recreational vehicle parks. City /State /ZIP: 0 Harem -eltre McItities. © Supply voltage fbr more than 0 Hazardous locations, 600 volts nominal. Suite/bldg. /apt. no.: 350 I Project name: Wi l l i s t On in Service or Rehr 600 amps or more, ,,:ti, �:`.•;'' r:''''g'.�i ∎:,�;.i%;,�'�irtC.', •,! �r1,', �.' ''`'j„.,:,^';T,f;.:;ry''4,i Cross street /directions to job site: !Description 1 Qty. 1 Pro. I Total 1 • " New residential single or multi - family dwelling unit. Includes attached are e. Subdivision, Lot no.: 1,000 sq, R. or loss 168.54 4 Ea. add'] 500 sq, ft, or portion 33.92 I Tax map /parcel no,: Limited energy, residential a ial 75.00 2 *,, j'a ;fw �� > u :a te ��� -.� s ` '. , withaboveaq.1k) . r , " Limited energy multi-family 75.00 2 ex , o ' residential (with above sq. ft.) Services or feeders installation, alteration, and /or relocation 200 amps or loss 100.70 2 ei {•.• pz,,., . r �,. ,,,.. ". , .,,..,., .qy>« t,Cn :, .t" i ty .!I'' T "A r; ;� yA..1g411"SR`; r „f � , ''.1�” , �7 „ Y r { wa ...', 't .., amps amps . A ' 201 am s to 400 am s iiS( 2 I Name: 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301,04 2 Address: Over 1,000 amps or volts 552.26 2 — Temporary services or feeders installation, alteration, and/o City/State/ZIP: relocation r Phone: ( ) I F ax: ( ) 200 amps or loan - 59.36 I 201 amps to 400 amps 125.08 2 Owner installation: This installation is being made on property that I own which is not f intended for sale, lease, rent, or exchange, according to OIRS 447,449, 670, and 701. 401 amps to $ amps 168.54 2 Branch circuits - new, alteration, or extension, per pond Owner signature: Date: A. Fee for branch circuits with •., "r' +; g ` i eTM” above service or feeder fee, .,ii: r t:, ,i -: , iGt'i -, ;: ° • ; : :`: 'i''' 1 :,! i' 7.42 2 :?.,t • . � . , �r ','���, , .." � ', .v�' - • �^ r ., �'`� �� ,'_ ' . .. each branch circuit Business name: Johansen Electric a Fee for home)) circuits without service or feeder fix, first 1 56.18 6.18 2 Contact name: Charlynn Leifsen - broneheirouit -- Each dd'l brunch circuit 1 7.42 / , 42 2 Address: 10948 SE Valley View Terr Mlscnllancous (service or (sede not Included) Flack manufactured or modular 67.84 2 City /State /ZIP: Happy Valley, OP. 97086 dwelling, service and/or feeder � Phone: (503) 698 -3417 Fax; : (503) 698-2486 Reconnect only - 67.84 2 Pump or irrigation circle 67.84 2 E x Sign or outline lighting 67.84 2 r,Ar • ;,,,, :•'Y , � :: :,4d', 1 : \_.'; ;rv.47 ` °+ ;� " f:..0 r',' � : . , �.' : „. "1-� " „ • . '1 71 k s �, , ..,5. A:',.'1'. fr7' , . 1 r :1 '.n ", ! f . .1 1 " ” � ... , Pi' , '' r ,a "' , Signal trircmil(s) t r limiled•naer$y Businessitalne: Johansen Electric prowl. alteration, or extension. _ Pusus 2 Each additional inspection over allowable in anv of the abov Address: 10948 SE Valley View Terr Additional inapcetion(1hrmin) 66,25/ hr City /State /ZIP: Happy Val l e OP. 9 7 0 8 6 Investigation (1 hr min) 66.25 / hr y r Industrial plant (1 hr min) 78.181 hr Phone; (503) 698-3417 I Fax: ( 503) 698 - 2 4 8 6 Inspections for which no fan ix 9o.o0/ hr s • ocificall listed '4 hr min CCBI.ic,:51539 Eleotrical Lie, :3 - 243C Suprv.Lie.:20538 , �r„�; !pols ',grt ? t':id' ( Subtotal: Suprv. Electrician signature, required: / �, / / • 4�^-'{ d�� ,111 .,t� F'�.. / Plan review (25% of permit fee): Print name: Carl J a n s en / late: 12/20/11 State surcharge (12% of perrttit fee): 7 . 6 3 TOTAL PEWIT FEE: '71.23 Authorized signature: This permit application expires Ira perndt is not obtained within 180 AN" Print name: nn Chart L e i f s en Date: 12 / 2 0 / 11 days aster it has been accepted as complete. v • y • Number of inapeotions allowed per permit, 1Aminidiog \P,rmilstnLC•PermitApp dot 07 /01/10 440- 4615Tp UM/OM/WC/1 Z / - '3DVd 98bZ869 €05 98172869 €09 'Darla N'3SNKHO2 Nd 65:20 TTOZ- OZ'oeu