Permit CITY OF TIGARD ELECTRICAL PERMIT
14 COMMUNITY DEVELOPMENT Permit #: ELC2011 -00722
TIGAR.D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/27/2011
Parcel: 2S 113AC00103
Jurisdiction: Tigard
Site address: 7244 SW DURHAM RD, BLDG# 600
Project: Tolt Subdivision: COUNCIL VIEW ACRES (LOTS 21 - 44) Lot: 25 - 27,2:
Project Description: Electrical for TI.
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
1 ea Services or Feeders - 200 12/27/2011 $100.70
Specifics: amps or less
15 crt Branch Circuits w /Purchase 12/27/2011 $111.30
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 12/27/2011 $25.44
Electrical
Type of Const:
Occupancy Grp:
Total $237.44
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through OAR 952- 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued B - / Permittee Signature:
`' j, r
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
RECEIVED
Electrical Permit Application / ttllti)hhlt 1, 1 tit•:ONI,1
City of Tigard 1tee0;vcd /ice /ii/ /� . ,
Y DEC 2 7 2011 Dacia ; a ....
• 3125 SW liali Blvd., Tigard, QR 97�7 plan Review
Phone: 503.639.4171 Palt; 503.59 OF TIGARD Dato/B
Inspection Lino; S U3,639.4175 BUILDING DIVISION err ,.� Su Sec Fago2lstr
nterttet: www•tigard- ar,sav pplcttterltal rntonnarton
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❑ New construction ® Addition /alleralion /replacement Please uhe k ,1I hat apply (submit 1 acts of plans whims chocked below):
0 Service or feeder 400 amps or more la Building over three stories.
❑ Demolition ❑ Other: vvhcro the available fault current 0 Marinas and boatyards.
::; ir. . ,Y. ;i , m,n,• ^y- i.. ,; >•!ti ,$,, v ❑ Floating buildings,
''i1' l” e 1 )i ";r r' . c °fir f i ' a 1''' ti 1 ✓ a P , less to ground, amps ee 1 oils or
5 "' 1�.. 4a 4 , K �� , , ! �; e ., �1', .., " ". �, , lommerc ;al -use agricultural
' less to groun or ex 14,04 ❑ >r
El 1- and 2- family dwelling IN Commercial/industrial ❑ Accessory building amps for an other installation buildings.
0 Fire pump. ❑ Installation of 75 KVA or
0 Multi-family ❑ Muster builder ❑ Other: .. r 0t'Anagaley system. larger separately derivtxt syetem,
r ; l'1 v r,tv i' ' s ,r..}' ':, Q + ' ' , a , :.i ? . , .!4 1 ,h DAdditionofnowmeter load al' 0"A", e " "I -2" "1 -3
Job no.; [Job site address: IOOHP or more, occupancy.
7 2 4 4 SW Durham o Six or more residential units, 0 Recreational vehicle parks.
City/State/ZIP: CI Health-care facilities, 0 Supply voltage for mom than
❑ Harerdous locations. 600 volts nominal,
Suite/bldg, /apt. no.: 6 0 0 I Project name. Tot t P 5
etvico or feeder 600 amps or more
f'. ire
Cross street /directions to job site: Description Qty. iice.'. Total •
' New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: I Lot n0.: 1,000 sq. 11. or less 168.54 4
. Ea. add'I 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
tl: ;e�c.; :; ^ ':k i " li " ' 7 " `:r' ;' "`�ri ;fS t l:t " "�; ' `,tic.' . • fii:•i V (with above 8g. ". 75,00 2
Limited energy, multi - family 75.00 2
Add receptacles residential (with above sq. ft.) - -
Services or feeders instailatton and /or relocation
5 200 amps nr lose 1 100.70 1 0. 7 0 2 • a l k .iKe I f" e • 11a'1",'' , r. y!! 1 i7 .' ,? ,il' , x A' 1 . : ; : , 201 amps to 400 amps 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
Temporary services or feeders installation, alteration, and/o
City/State/ZIP: relocation
r
Phone: ( ) J Fax: ) 200 amps or less 59.36 1
1 201 amp% 1. 40 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, lettSe, rent, or exchange, according to ORS 447, 449, 670, and 701. - Branch circuits — new, alteration, or extension, ear panel
Owner signature: Date: A. Fee for branch circuits with
(:i''' t;- x',, ;t�' . _ -n ^
ate,, , T''° ' ;,' ;;t 4 .. r: , F .,k . , 1 - 1. : ',, above service or feeder fee, 15 7.42 111.20
,.x; Gy ,.�' r'1 };��t ^ 'a i ' 'r `fl i' . ` i ' 1( ' i,i .• , :V. "�: iyi
v t, - � case branch circuit
B. Foe for branch circuits wttlrorel
Business name: Johansen Electric service> or fonder fee, find 56,18 2
Contaotname: Charlynn Leift�el7
branch circuit _
Each add'l branch circuit 7 42 2
Address: 10948 SE Valley View Terr Miscellaneous service or feeder not included
Cil City/State/ZIP: Each manufactured or modular 67.84 2
v Happy Valley, OR 9 7 0 8 6 dwelling, service and /or feeder
Phone: (503) 698 -3417 1 Fax: : (503) 698- Reconnect only , 67.84 2
. . Pump or irrigation circle 67.84 2
E -mail;
-Y•qn: ;• ,,r,.;,, . ,4i,6':'1`xf,i, * „�., , •,4. .,, ,,. X53.9. .n "r ?T,, ��.e:- ,. ,•.',r„'`,¢1' ;ti`?c':.:,sil.` ,4 Sign or outline lighting
„ 67.04 2
,l ,"i ; „I'l, ). ' ,f ,,.A,,,i, a �l� ? ] }A 64 , 1 w ii 'a o h ),, i n ` "+,, , „'. v'.. ' R' :' n ;r �,i � ,,' • ; Signal circuits) or limited- energy
panel, Business nome: Johansen Electric Each a dditi inn al inspection over allowable in a Papo2 - 2
-_ Each additional Inspection lty of the abov
Address: 10948 SE Valley View Terr Additional inspection (1hrmin) 66.25/ hr
Indust
City /State /ZIP: Happy Valle OR 9 7 0 8 6 r a (1 mm} 76. hr
p�y y � plant 76.1188 1 hr
Phone: (5 0 3) 698-3417 TFax: (5 0 3) 698-2486 , Vial
Indussl plan t (I l hr min)
for which no fee is 90.00/ hr -
a .ecifieall listed 1 hr min
CCB Lie.; 515 3 9 T Electrical Lie.: 3 — 2 4 3 C I Suprv. Lie.: 2053 S • a , !;, ;iF . "ti ?) ; ?, ? : 'tr y ; ,Y, > : , ;i , :
- Subtotal; 21
Suprv, Electrician signature, requited: ,414.' t 1 ^ /J t ! 11
C,414.' ^ Is—, Plan review (25% of pemlit fee):
Print name: Carl Johansen U Dec Dec 12/27/11 State surcharge (12%e of permit fee); 25.44
TOTAl. PRRMIT FEE: 237.44
Auth sign /G _ This permit application expires If a perndt is not obtained within 180
Print name: Charlynn Leif sen Date: 12/27/11 * dope ti orI a hasbepe penni edasranpkle.
Number of inspections allowed per permit.
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