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Permit
CITY OF TIGARD D ELECTRICAL PERMIT COMMUNITY DEVELOPMENT c a/ g /`�. 1 Permit #: ELC2012 -00027 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 6 Date Issued: 01119!2012 Parcel: 2S113AB00600 Jurisdiction: Tigard Site address: 16195 SW 72ND AVE Project: Option Care Subdivision: COUNCIL VIEW ACRES (LOTS 21 -44) Lot: 30 Project Description: TI. 2/8/12, reprinted to correct address from 16165 to 16195 SW 72nd Ave. Contractor: JOHANSEN ELECTRIC INC Owner: PACIFIC REALTY ASSOCIATES LP 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 01/19/2012 $100.70 Specifics: amps or less 20 crt Branch Circuits w /Purchase 01/19/2012 $148.40 Type of Use: COM Service or Feeder Class of Work: ALT 1 ea 12% State Surcharge - 01/19/2012 $29.89 Electrical Type of Const: Occupancy Grp: Total $278.99 Required Items and Reports (Conditions) This permit 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 n 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. TTENTION: Oregon "lqw •qu es you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -Of 1 -0010 through OAR 952-101-0090 ou may obtain a co y of the rules or direct questions to OUNC by callir. 2.1987 or 1.800.332.2344. Issue , Permittee Signa elf 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. ,, CITY OF TIGARD ELECTRICAL PERMIT 1 4 COMMUNITY DEVELOPMENT Permit #: ELC2012 -00027 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/19/2012 Parcel: 2S113AB00600 Jurisdiction: Tigard Site address: 16165 SW 72ND AVE Project: Option Care Subdivision: COUNCIL VIEW ACRES (LOTS 21 - 44) Lot: 30 Project Description: TI Contractor: JOHANSEN ELECTRIC INC Owner: PACIFIC REALTY ASSOCIATES LP 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 01/19/2012 $100.70 Specifics: amps or less 20 crt Branch Circuits w /Purchase 01/19/2012 $148.40 Type of Use: COM Service or Feeder Class of Work: ALT 1 ea 12% State Surcharge - 01/19/2012 $29.89 Electrical Type of Const: Occupancy Grp: Total $278.99 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 cosy of the r -s or dir- t questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: Permittee Signature: an. // �. 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. • EC E VE D E lectrical Permit Appli tuns ui i.i(ui i tir L► \I.\ City of Tigard JAN 17 2012 ,rip- 17 ° 13125 SW Hall Blvd., Tigard, OR 97223 f' Phone 503.639.4171 `ax: 503.5t1I1 bit) ®F�IGpti® Other Permit: I t r , A t; r i Inspection Line: 503.639.4175 w ill 15 Data Readyfily; 67 See Page 2 for Internet: www- tiger nr.gov BUILDING DIVISION Notified /Method: IFIAM 8upplemental , . ! p �. ' 1y, ,,; ,' y, 'i�t i, 4 r; , , ,I -� �, ,,, „ 64 f - 'f;.f �9 ( ,�C �., ��'.i, f f /'f,.rl ' W'�• �'1 / ``^ ❑ New eonslruetion ® Addition /a1teralion /replacement Please check all that apply (submit 2 Leis of plant w /hems checked below): 0 Sorvico or feeder 400 amps or rotas 1:1 Building ova three ounce. ❑ Demolition 0 Other: whore the available teals arrtent ❑ Mariana and boatyards, ,�'II, i�F c r i, a e , ,, ., y�, n t t r, ^, . ,/ �, f r; Y+ i/ :,,, ,�,`° �Y 4i,' ' ��" ` ,.. Ii,,1 v, �" : ,.t ,1• , month 10,000 amps at 150 volts or ❑ Floating buildings. • less to ground, or exceeds 14,000 0 Commorvial -uso agricultural ❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps for all other installations, buildings, ❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump, ❑Install of 75 KVA or ,! ,' 1 Y Y � r ! R ❑ Em system, system, larger separately derived s stem, a a F t , ,1 . , , ' � PI ^ G , tr ', � ,; L ,'r , Addition of new motor load of Job no.: Job site address; J / .' 100I4P or mOre. Rn oMancy. / `p [] six or more rasiflentlal units. ❑ Recreational vehicle larks. City /State/ZIP: ❑ Health• care facilitisa. ❑ Supply voltage for more than ❑ klu/arclous locations. 600 volts nominal. Suite/bldg. /apt, no.: Project nantc; 1)(i 7 ra j _e ❑ Sorvioa or /coda 600 amps or more. Cross street/directions to job site: samminimaimmormourvionstrinia New residential single - or multi- family dwelling unit. includes attached •, re: e. Subdivision: I Lot no.; ∎ ,000 sq. fl. or loss IIIIIEIEMMIIIIIIIIIIIU Tax map /parcel no.; Ea. ea 500 sq. a, or portion 33,92 �0 e m ,r � Limited energy. residential r,F t, , d W,4r , f ' wi th above s ft, 11 Limited energy, mu ltifamily 75 .0 0 7 a/7/ _iyj )rvyt'. iv4 residential wills above ro. ft. Services or feeders installation alteration and/or relocation 200 amps or loss r' 100,70 00, 4 Ei y : t ' ,y ,•, ' , � � ',' , F I , y + +e a•e q , d„ ,. .�tiFf�0 Y,�Yy!' ' ,' ' .,t'P'i�. ..';''ti�,',o'f, ,.,vi, ?Ol 133,56 � © Name; 401 amps to CO 0 umpa _ 200,14 - 601 amps to 1,000 amps IIIII 301,04 - Address Over 1.000 amps or volts ME 552.26 - City/State/ZIP: — Temporary services or feeders installation, alteration, and/or relocation Phone: ( ) I Fax; ( ) 200 amps or loss = 59.36 =Inn Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125 08 — intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps MIIIIIIMMIIIIIIIIII© 3'____ __leafs ____ r •.■'a.�:[Itu RUa- r��ai�fll� al's a Owner signature; Date A. Fee for branch circuila with c'::"' " ^ above service or feeder fee, ru0h hraauil O,rcpjl Business name: 3ohansen Electric B. foe for brunch circuits f without 11111 �wrviw or feeder fee, first 56.1 g Contact name; Chalyrin Lei f sen branch circuit Each add'I branch circuit = 7.42 —© . Address: 10948 SE Valley View Terr Miscellaneous service or feeder not include City /State/ZIP: Happy Valley, OR 97086 ISavh manufactured or modular ■E211111112 dwellin service and/or feeder Phone: (5 0 3) 698-3417 I Fax:: (5 0 3) 698-2486 Reconnect only MI 67,54 - E Pump or irrigation circle 11111 3111111111111U `:' %:wc i 0-.,. r;C'a i. Sign orotlinelighting 67,114 - ; r � . • ' r " " 4 ' q ` t a iT ' Y " ; �' �. Signet eircuit(s) or limited•ep erg_ � � Business name. Johansen Electric .: eel alteration or extension. Each additional ins action over allowable in an of the above Address; 10948 SE Valley View Terr Additional inspection (I hr min) _mmi City /State/ZIP; Happy Valley, OR 97086 Investigation (1 lir min) MI 66. hr —■ Industrial plant (1 hr min) IIIIIEXEM —■ Phone' (5 0 3) 698-3417 Fax: (5 0 3) 698-2486 Inspections for which no fee is .90.00 / hr - . a eciticull 1is(a4 t4 hr min COB Lie ": 51539 I Electrical Lie.: 3-243C Suprv. Lie.: 20535 ;,1„'TO"r'?I, Subtotal: ' /Q Suprv. Electrician signature, required: Plan review (25% of permit fee): Print name: Carl Johansen Dale: 1/16/12 Sta te surc (12% of permit fee): 2.9 •.i3`7 C TOTAL PERMIT FEE: IMPFAI k Authorized signature; /) / _ Tots permit application expires if a peon it is not obtained within ISO Gf / � .lays after It has been accepted as complete. Print name: Charlynn Le i f sen Data; 1/16/12 r Number of inspections allowed per permit. 1 m1luildinglammito \2i.C- PormitApp.doo 07/01/10 440.45157(5 t /05/:cMAWH1, Z /T 'aExa 98VZ869E05 98VZ869E05 'D3'Ia NasNzHor Na OV:ZO ZTOZ'9T'uPr.