Permit rir CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2012 -00195
1 3125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: Q4/05/2012
I1GA1tD Parcel: 2S113AA00600
Jurisdiction: Tigard
Site address: 16156 SW 72ND AVE B1
Project: Oregon Laminations Subdivision: ROSEWOOD ACRE TRACTS Lot: C
Project Description: (2) branch circuits in warehouse
• 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
•
2 crt Branch Circuits wo /Purchase 04/05/2012 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 04/05/2012 $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 0 952- 001 -0090. You may obtain a copy of the rules or direct questions I ling 503.232.1987 �or1.800.332.2344.
Issued By: ermittee Signature. TlO
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 503.639.4176 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 Annhic l r" iE shpt 011 1 Sl.: (I\l.\
City of Tigard nn pppp H s v o«mitNo':E7C 0/.2 - 00
ly
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Phone:
503 3 . 171 Tigard, 503.598.1%0 97223 O Plan Revio • l>dter Permit:
t , Inspection tine: 501639.4175 CITY OF TIGA ?D late Ready/By:
Internet: w �
" ww .tigmd- or.goV 1 Notified/Method: shod:
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❑ New cons/ruction ® Addition/alteration/replacement
lime check all that imply (submit goats of plan whiema checked below):
❑ tlervioo M feeler 400 nips or more ❑ Iluildittg over throe stories.
❑ Demolition ❑ Other: where the available fault currant 0 Marines and boatyards.
''= ,:,t)c -u 1,�a,�i; v � ` b j yY t ', +: H; c�}�: we : r,;; oxcends amps al150 voltaor (J Fielding buildings.
-< y'' ` loss to ground. or exceeds 14,000 ❑ Commercial -use agricultural
01- ' and 2- family dwelling ® Commercial/ industrial D Accessory building amps for all other installations- buildings.
❑ Multi - family ❑ Master builder 0 Other; 0 Fire pump. O Instellaa{m at 75 KVA or
❑ Emergency system. larger mast* derived system.
: -•, -.7-4i: ia � ' r. pw ... r e.� 1 : : ,. , ., , :. , ,,::,. ; : " "
z-ls? ;''�: � ; ..�- . ...,.,,,. k V :1 . � , r :_�. ; a u � . . .'• ... „a.' ., �' t's�•' Addlrlan of new motor load of O "A ". "1-3".
r
o more.
Job no,: Job Bite address: 16156 SW 72nd o of mos moore es oowvaer
Q Six residential unity. ❑ Nearmtltmal vehicle parks,
City/State/ZIP: ❑ Health -care facilities. Cl Supply voltage for mete than ,
CI Hazardous locations, 600 volts nominal.
Suite /bldg. /apt.no.: Project name; Oregon Laminations CI Service orfbcdtr600am urmore.
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Cross street/directions to job site: ' i mulsion r - I 7a m1 .. . ..
New residential single- or multi - family dwelling unit,
Includes attached garage
Subdivision: l Lot no.: 1,000 sq. R. or less 1613.54 4
Re. add'I 500 eq, f, or portion 3192 • t
Tax map/parcel no.: _ Limited energy, residential
� _z. R: i t ?"'T' tth above R, 7s.00 2
': ,.. y ..r�� : ''c^ °2k,, :.1.4.'• :. :.�.. ` -z.' : ' - ' . - “. ' S :.
� ij ; • : ' • .: . , )
l,imilul energy, multifamily 75.00 2
Add in warehouse space residential (with above sq. R.)
Services or feeders installation alteration, and/or relocation
200 amps or less 100,70 2
f f % •y 6i• q •i e :? ::',•r ?.', •t`c;.,, • :t' 'a*:` t i:; 0 j21., :f,i 201 amps w400anion 133,56 2
.
401 amps to 600 amps NNW 2
Name; 601 amp, to 1,000 amps 301,04 , 2
Address: o ver 1.000 amps or volts 552.26 _ 2
Temporary ton services or feeders installation, alteration, and/or
City/Side/ZIP:
Phone: ( ) Fax: ( ) 200 amps or loss 59.36 1
201 amps to 400 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, lease, tent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits - new, alteration, or extension, r panel
Owner signature: . Date: A. Pee for branch circuits with
�. .,,, • "a, , . : r ` a se rvice or fecdor fee
�y�. " > ; . :, : ; : '9" 742 2
?,:� :T ,, t y r � :�� := : �i� :. .: � 'a� . , a y'' :M ;: i, each branch oir0uit
Businessnama Johansen Electric 11
ruvicc or feeder C first 1 56.18 6.18 2
Contact name: Charlynn Le i f een branch circuit 1 7.42 7.42 z
Fech add'/ branch circuit
Address: 10948 SE Valley View Terr Miscellaneous jservlceor feeder not Included)
Each manufactured or modular 67,84 2
City/State/ZIP: Happy Valley, OR 97086 dwelling, service and/or feeder
Phone: (5 0 3) 698-3417 I Fax:: (5 03) 698-2486 Reconn0ct only 67.84 2
Pump or irrigation circle 67,84 2
E-mail: Sign or outline lighting 67.84 2
'••i4 : Y !. ' i 7, - .Cis ^�J aa { a ,' e'.:.l.,..,.� , „
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•€i1.r : : =.•: .{; >,N :.r"_ >�C•��;. �`:;h'' 5 i.';` i"; �" �:-' �•<� ° ;f, +�, :a :r�;.s;- ? "�r;;�� sips' eircui a or limited-en
Business name: Johansen Electric panel, a P Inan - 2
Each eddltioael inseaction over allowable In any of the above
Address: 10948 SE Valley View Terr Additional inspection (I hr min) 66.25 / hr
- Ci /StatetZIP: Happy Valley, OR 97086
Investigation dlplant m 78.1R/ hr
66.25/ hr
8 ' ppY Y r Induslriel pleat (i hr min) 78.I
Pho .(503) 698 -3417 I Fax :( 503 69 -2486 Inspections for whiuh fee is 9000/hr
jl7 a� listed tS5 hr mm
CB Lie.: 51539 E lectrical Lie.: 3-243 C Suprv, Lie.: 2053 S °': „, =' : `t'.`�' ": ` wt
/J �j �7 :'� : : . :1 Si�'1' ---!. '..1� r. j,oi.°Y) �,'�
-- �� x, , , /` su it fe e): 63.60
Suprv• Electrician signature, rcquvcd: Pl an review ('25a/o of fee):
Print name: Carl J ansen [Date: 4 / 4 / 12 State surcharge (12% of permit fee): 7.63
TO7'Al . Pl iRMIT FEE: 71.23 i-
Authorized signature: `^ This per„dt apps admr aspires if a penal is not obtained within 180
Leifsen f s en Date: 4 / 4 / 12 days sitar n has ban accepted as complete.
Print name: Charlynn
• Number Of Inspections allowed per peendt.
t, uruildis 'Pararitbvs.C- p«mtwrr.ma 07/01/10 440- 4e1e'7tl1/OS /CO /WEB
Z IT 'aUVd 98tZ869E09 9817Z869E09 ICTZ3 NESNVxor NV Z6:80 ZtOZ'b0'.dV