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Permit iap r, ,' 41_e, -e- GNP Cl ,)-) C , a- ` CITY OF TIGARD ELECTRICAL PERMIT 11 11. COMMUNITY DEVELOPMENT Permit #: ELC2012 -00074 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/0212012 Parcel: 2S113AA00700 Jurisdiction: Tigard Site address: 16444 SW 72ND AVE B5 Project: Spec Space Subdivision: ROSEWOOD ACRE TRACTS Lot: D Project Description: TI. 2/14/12, reprinted to add (2) 200 amp or less panels and (12) branch circuits. Contractor: JOHANSEN ELECTRIC INC Owner: PACIFIC REALTY TRUST 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 02/02/2012 $63.60 Specifics: Service or Feeder 1 ea 12% State Surcharge - 02/02/2012 $7.63 Type of Use: COM Electrical Class of Work: ALT 2 ea Services or Feeders - 200 02/14/2012 $201.40 amps or less Type of Const: 12 crt Branch Circuits w /Purchase 02/14/2012 $89.04 Occupancy Grp: Service or Feeder 0 ea 12% State Surcharge - 02/14/2012 $34.85 Electrical Total $396.52 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 es o :'rect questions to OUNC by calling 503.232.1987 or 1.800.332.2344 Issued By: / ���� / ��-- Permittee Signature: 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. CITY OF TIGARD ELECTRICAL PERMIT ' COMMUNITY DEVELOPMENT Permit #: ELC2012 -00074 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/02/2012 Parcel: 2S113AA00700 Jurisdiction: Tigard Site address: 16444 SW 72ND AVE B5 Project: Spec Space Subdivision: ROSEWOOD ACRE TRACTS Lot: D Project Description: TI Contractor: JOHANSEN ELECTRIC INC Owner: PACIFIC REALTY TRUST 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 02/02/2012 $63.60 Specifics: Service or Feeder 1 ea 12% State Surcharge - 02/02/2012 $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 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 By1 . Permittee Signature: A / 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. ** *Add to permit ELC2012 -00074 Electrical Permit Application _t)t(l1 l l(l I. tit :9\I.t « City of Tigard b r °� �. Permit No,; t' d n° I Lvo P -7 -- ] 3125 SW Hull Htvd.,'figttrd, <) 9;13 3 Plan Review 3 , Phone: 503,639,4171 Fax: 503,598, 1960 Date /B ; Other Permit; 'I l , t „ It I y inspection Line: 503.639.4175 FEB C 1 201z 621 See Prase 1 Dal. inlet S upplementallnforwatlan Y 1 f 7 1 y �j�' t y j y � y ` �! y t , ✓ , y�y� , {,��,p1 • ❑ New construction ® Addition / te'dtiOrpro 3 el {t)1 1 I Please cheek rill thin ripply (submit 2, tints of p n. han. w /iln cheek 1)010w): J'' = ' ° • ■ • -" ❑ Service or feeder 400 amps or morn ❑ lluilding over throe stories. ❑ Demolition ❑ Other: whcrc the available fault current ❑ Marinas and boatyards, rr. exceeds 10,000 amps at 150 volts or [J !'lotting buildings, less to ground, or axcecda 14,000 ©Ctmtmarvial•nse aftticulWral 0 1- and 2•fatnily dwelling ® CAntntercial/industrial ❑ Accessory building amps for all other installations, buildings, ❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ installation of 75 KVA or ❑ rmm gmtcy nyxtenn. larger separately derived trystem, ,. , OIMA IOtc Jt11s111 T04Vtcli ' , ❑ Addition of new motor load of ❑ "A" "E" "1- 2 ", "1 -3 ", Job no.. `Job site addtess, 16444 SW 72nd romaro. atio ❑ Six Six o or more w rorsidcutie! am Recreational units. ❑ Raornttitmul vchial0 perks. City /State/ZIP; ❑ Health -care facilities, ❑ flspply voltage for more than ❑Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: f Project ratite: Vac ❑ Service or feeder 600 amps y o ,, rnrore, , . , Cross street/directions to job site: e r an I Qty. 1. Fa, I Total te: t reaerq ,t ul I New residential single. or multi - faintly dwelling unit. Includes attached garage. Subdivision: J Lot no.: 1,000 sq, fl or leas 168.54 4 Ea. add'! 500 sq. ft. or portion 33.92 l Tax map /parcel no.; Limited energy, residential ': D ON' •OF` Ot (with above sq. ft) 75.00 2 Limited energy, multi - family 75.00 2 Adds to permit #ELC2012 -00074 rosidMnial (with abovasq. Services or feeders lnsta latton, alteration, and /or relocation 200 amps or less 2 100.70 t1,40 2 , h++' 1i`illtt* **D4tt S 201 amps to 400 am 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 vole 552.26 2 Temporary services or feeders installation, alteration, and /o City /State /ZIP: relocation Phone; ( ) I Fax: ( ) 200 amps or less 59.36 l 201 amps Lo400smpx 125.08 2 Owner installation: This installation is being made on property Thal I own which is not qpl amps to s99 amp 168.54 2 intended for sale, Iease, rent, or exchange, according to ORS 447, 449, 670, and 7(11, . _ P . p. Branch circuits- new alteration, or extension, per panel Owner signature; Date: A. Fee for branch circuits with y,y q �y • y� above service or feeder foe, �:�, a! i ' , LJ : 66 , 1* P , +4i t"x OO each branch circuit 7.42 *EA ,t,(1 2 Business name: Johansen Electric R. Fee for branch ciruuita /Umut service or fouler fee, first 54,15 Contact name: Charlynn Le i f a en branch tirvuii. (inch ndd'i branch circuit L 7,42 1 2 Address: 10948 SE Valley View Terr Miscellaneous (service or feeder not included) Va 11 e OR 9 7 0 8 6 Pnch romuslllonlrod or modular 67.84 2 City /State /ZIP: Happy Valley, dwelling, service and /or fouler Phone:(503) 698 -3417 Fax: (503) 698 -2486 Reconnect only 67,54 2 Pump or irrigation circle E mall . Si or outline lighting 67,54 2 • ,. , _ . . ... •., Si c.,isn i(s) or limited-energy in Business name. Johansen Electric panel, alteration,orextension. P 2 2 Each additional inspection over aftow able, in any of the above Address; 10948 SE Valley View Terr Additional inspection (1 hr min) 66.25/ hr Investigation (1 hr min) 6625/ hr City /State /ZiP: Happy Valley OR 97086 ludustrialplant(I hr min) 78.18 /h r Phone: (5 0 3) 698 Fax; (5 0 3) 698 Inspections for which no fee is 90,00/ hr •teilicall listed '4 hr min CCB Lic.: 51539 1 Electrical Lic.: 3 C I Suprv, Lid: 2 0 5 3 S „ ERmyr.4 : ':'” :. ;.;:. r Subtotal: 1 q o . Li 4 Suprv. Electrician signature, required: ar <I. n Play] review (25 %of permit fcc): F Print name: Carl j anEl e��- — ,( Odle; 2 /13 / 12 St s urcharge ( 12% of p f ee) ' - 7 • t " � ~ Authorized signature: ~"^~ TOTAL �__..,... TOTAL PERMIT FEE: , 1 'fhts permit uppllatiun expires if a permit Is not obtained within 180 e v z Print name: Charlynn Le1,fsen Date; 2/13/12 days after it has been accepted a .complete. " Number of inspections allowed per pomtit, I:\ HuildingtPermiutHi .C- PormitApp.dne (17/0111a 440.46151 Z /T •HCVa 9861869009 9862869009 'Darla masISVEOr Ilia Lb =ZT ZTOZ'ST'aa3 Electrical Permit Applicatio, n Mit oath r t SP O\I.1 Pom,it No.. City of Tigard 1 �,0\r' 14eo6iv6d mare : ;,�� / • [.G.. i -..a..):::)7 13125 SW W Hall Alvd„ Tigard, 3 - c� g: Phone: 503,639.4171 Fax 50. 59 .196? 1 7:t 3 Iffillii - ... it t, Inspection Line 503.639.4175 [ - �\ C? O BJ Stu Fagg 2 err Inbomcl: www.liguni ar.gov 1 O \�� � Supplemremtai Information J( ",l�'2 K.,1,t1,;4', � er ;o , + " "`c P. : ^; + ;!'' �,t. ! i y v . i1 i4 ,('W 1 .. iI +,'.'' ." .,.'' ' r ' ❑ New construction Addition/alteratigflYt p lracement Please cheek all that apply (submit Z sett of plena wiitems checked below). sj ❑ Service or feeder 400 amps or more ❑ Building over three stories, 0 Demolition 0 Other: where the available fault current C) Marines and boatyards. ,'" Y.`' ;' : ; ells .es.'if :4i; , "' :; . I: ': , ,., , j`,C ;,,' c +;', YS P', r r.Y i 'r;;'; . ,9 exceeds 10,000 snips a t 15 J Floating bungs, , i •'•'� ;, �� / � 7 : ' • -; ^�� � � y �'i� - + - "' '" �° r,. , iP; Icsstn 0 volts or ❑Cv usattsr i c ultrrnd 0 1- fund 2- family dwelling ® Commercial/industrial ❑ Accessory building amps for ell other installations, buildings. D Multi- family ❑ Master builder ❑ Other: 0 Fire pump. 0 Installation of 75 Ks1A or ? ; ∎4 "'. ;a1. ; :.; ip' ,,." °i' ,.;.i',y?=',, ( Emergency system. larger separately derived system. jf;; tE ✓i ,r w,, . r , ';'',: ' t, 4' ;,, r ❑ "A" "E" "1 -2 - 1.3 . �° "'r' - „ -r . i . .., .- tt. ❑ Addition of now moire load of Job no,: 'Job site address: 16444 SW 72nd Six o r a more oecul�oY ❑ Six or more residential unite, [] Recreational vehicle parka. City /State/ZIP: is Health -care facilities. [] Supply voltage for more than ❑ Ilazardous locations. 600 volts nominal Suitc/bldg /apt, no.: f Project name: V IICy [] Service or facdor 600 amps or moro. Cross street/directions to job site: nncrtpnon Qty. F.. total ” New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: I Lel no.: 1,000 sq. ft, or less 168.54 4 Tax mfl /ptlrCOl no.: Ea. add'I 500 sq, ft. or portion 33.92 1 P ,. , imitedena v, residential 2 r t >' ,i' e r , "'r , t''I " "l,.i'� ^i.v' ;,; �a� ,. ., ; _ ,�{ ��}.t. ;i ; i... %r� "x "< "'0, :" y" with ab s m � ft. ', • limited energy, mufti - family 75,00 2 Lighting work residential (with 03ovesq, .—. - . - - - -- Services or feeders installatlon alteration, antifor relocation 200 amps or lass 100.70 2 w :+ ". 1 ta. +, /; Sll '�r As4... rc , .�., P c t ,, 2(11 amps to 400 amps 133,56 2 1 r � war, . , 401 amps to 600 amps 200.34 2 Name: 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 umps Or rolls 552.26 2 Temporary r services or feeders installation, alteration, and/or City/State/ZIP: Phone: ( ) I Fax: ( ) 200 atone or less 59,36 I 1 Owner installation: This installation is being made on property that I'own which is not 201 amps to 400 amps 125,08 -- { +( 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2 Branch circuits - new, alteration, or extension, per panel Owner signature Date: A. Fee for branch circuits with „" " t' ', i ': 'c " ^ . i o i; Dpi`: t i i.,:, aovosor • ' ' i ' l r � i � .', ., `� �+r� a . i� a r r e ach branch circui 7,42 2 t Ausiness learnt; Johansen Electric II Pea for branch circuity wI/hott! service or feeder foe, first 1 56.18 56 . 1 8 2 Contact name: Chanlynn Lei f seri branch eireuiI _ Each add'I branch envoi( 1 T_ 7.42 7.42 2 Address: 10948 SE Valley View Terr . Miscellaneous (service or feeder not included) City /State/ZIP: Happy Valley, 011 9 7 0 8 6 Each Mu, manufactured e a or r modular 67,84 2 spy yr dwollinR,.servico Phone: ( 503) 698 -3417 I Fax: : (503) 698 -2486 _Reconnect only 67.84 2 Pump or inigutirm circle 67.84 2 L'+ -mail: ,, . 'rn " „r,' :r ,,y :' ,. ,`. ;,,,.,tT,lyu''t•'yyyy T' � ;i' ;'” ?.1'c'- Tat''• ;;- `rr,' :.us:.;;a,e:'o,p Signoroutlirtolighting C7.R4 2 ;�, - • ,� `� � . Signal eirouit(s or limited mterBY }anol, alteration,orextension. Puget 2 FJusinessname: 'Johansen Electric Each additional ins action over allowable In , of the above Address: 10948 SE Valley View Tern Additional inspection (1 hr min) 66.25/hr City /State/ZIP: Happy Valley, OR 9 7 0 8 6 Investigation i ( l min) 78, / hr y y Industrial plant (l hr min) 78.18/ hr Phone: (503) 698^3417 Fax: ( 503) 698 -2486 hisperti for whirls tic, fec it III 90.00/ 111111 s.eeilicull listed ,h hr min CCB Lie.: 51539 Electrical Lic.: 3-243C �. - 44 3 C I Suprv. Lie.: 2053$ ,. '4.,. :r µ e ;h � I", ua�iq I ;' i ', Suprv. Electrician signature, required: c i S ,�. A Subtotal: 6 . • • . Plan review (25% of pa,rtit £cc): Print name: Car Johane en Date: 2 /1 /12 _ State surcharge (t2% of pennit fee): 7.63 t TOTAL PERMIT FEE: 71.2 3 Authorized signature:/ CC [[f� This permit application expires if a permit Is not obtained within 180 Print name: Char lynn Lei "" • ' Date: 2/1 / 12 • dop after la has been permit. a. complete. • Number of inspections allowed per potmit l: ulwldms \ermin11i1.C- PcnnitArp,doe now 0 440- 46157Yuro5 /COM/Wea t /T aura 981/Z869E05 98VZ869E05 z3HZa NESNVHO2 NI ET:60 ZTOZ.TO'aa3