Permit CITY OF TIGARD ELECTRICAL PERMIT
1 1 1- - COMMUNITY DEVELOPMENT Permit #: ELC2012 -00200
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/06/2012
Parcel: 2S112DD00701
Jurisdiction: Tigard
Site address: 15838 SW UPPER BOONES FERRY RD
Project: Spec Space Subdivision: 1994 -006 PARTITION PLAT Lot: 2
Project Description: (2) branch circuits for warehouse lighting
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 04/06/2012 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 04/06/2012 $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 throu trOA -001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.33 /
Issued By: Permittee Signature: 0A/ /96' G/ r s- �O /
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.
RECEIVE
Electrical Permit AualicatkaIR 4 2012 I,m trrrtt,' t .sr. l,\1.\
City of Tigard I ER ii +/,�� - ,P /PA
13125 SW Hen Blvd., TigardaT9,SOF TIGARD Plan Rene • Other Permit:
■ Phone: 503.639.4171 ra Q3 cq8 Dan .
1 , , i: , Inspection Lira: 503.639. 5 fLtil: U l DI V �J�Q�'� Daro RadyNx ` See Pager for
!Memel: www,tigard- or.gov Notlflad&Modwd: �� Sus len ntallnformailon
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❑ New construction ® Addition/alteration/replacement Please cheek all that apply (submit 2 seta of plans wit twits chocked below):
D Service or feeder 400 amps or moro D Building over three stories.
❑ Demolition ❑ Other: ahao the available fault uurtdnt D Marinas and boatyards.
C.Y,,8.,•,: ' ;y, 'f. ,gym` ti r <_ : �.. ^ s. , y' •' ' •- e 14;.. ry _Qih%`r : exceeds 10,000 amps at 150 volts or CI Floating buildings.
• °�,'.;.%; , ri:. •z3., `l;� -„ .: k' ?!u'. . . �. L • �,sa , I a ' � ':'''14".‘ .'> .•: !:r '''' ' Ices (e grou d, erexceeds 14,110(1 ❑ COIIIIII01'elalilfe egriCUlmral
• ❑ 1- and 2- family dwelling ® Conunereial /industrial ❑ Accessory building amps for all other installations buildings,
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. D lnstallndim lit 7S KVA or
Y ';,; « ,': 4 ti� r � � ` • ` ' j' r•• Y'
- • • . :3:• � mtsr..: ❑ Finar system larger separately darived system.
a,•. x .,%:;s•.. A' �;,z ^,r a d ''a r. ' � . uyys .- -v,Ii' ..r'... .., :'.'!:,?', t" ❑ ..B,,. 1- 2". "1.3 "
' -`• •' , , '�„S,J' , ' ` •`' •i 7 ❑ Addltimn of new motor Mad of A ".
v lob no.: Job site address: 15838 SW upper Boone s Six or m mom. occupancy.
D Six or more residential uni te. 0 Roorenlh vehicle parka.
el City /Statc/ZIP: ❑ Health-4am facilities, 0 Supply voltage for more than
Q V
- D (hazardous locations. 600 volts ntxnlnal.
tr O BP I I ❑ Service or fbcdor600 a mps or MM. Suite/bldg. /apt. no.: Project name: ��
f , is a , , r• '� n C; ,.. ";" ^:
oss street/directions to job site: nmcripuon . 1 .,,„ ) Total ( '
ie �, . Include, attached garage. mnitl•tamily dwelling unit.
I ►, 0. or lam, 168.54 4
Subdivision: 1 Lot no.; 1.000 sq. p add'1500 sq. ft. or portion 33.92 1
Tax map /parcel no.: S //2 h O O 7 p / limited energy, residential
a�.wy. ;'.: >; r . ,�. �.... ,T!. ,ear 'f:'N 75.00 2
i ..;t: +c :x •. :.• ' '.''' 0�.� ,,yy,,�,�,��y �: ( ;::., ,. (withabovoaq.R.)
"'ti ,. •`•yr, 1 ;`+/�W4T :: .,,. :w- "'i::;.. s:.: ..l.imitedenergy,multi- family
Warehouse lighting replace residential (with above sq. fl.) __ 75.00 _ 2 ,
Services or feeders installation alteration, and/or relocation
200 amps micas I I 100.70 2
.; :' i s o al . d '.ck:; 4 Y - :'Al'!1 n 201 amps to 400 elope 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/or
City /State/ZIP: relocation
Phone: ( ) I Fax: ( 200 amps or low 59.36 1
Owner installation: This installation is being made on property that I own which is not 201 amps to woo 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 dreults - new, alteration, or extension, per panel
Owner signature:, Date: ,•„ A. Fee for breach circuits with
its wi
0 •_L9a'{'; °.,; `a� �.,�•�.,.., . .. .w"'. Ill .` ° :�"', +.4,�� .;.; z.::: Shove service mfeeder lea, 7.42 2
, .a .„ i x+' �c...... each branch circuit
B Fee for bmneh einseits without
Busiuessnamc: Johansen Electric serviee or feeder foe, first 1 56,18 6.18 2
Contact name: Cha r Lynn L e i f s en branch cirouil
Each add'( branch circuit 1 7.42 7.42 2
Address: 10948 SE Valley View Terr - Miscellaneous (service or feeder not included)
Each City/State/ZIP: Happy Valley, ey, dwelling, m uracbrrcd m modular 1 1 67.64 2
_ OR 9 7 0 8 6 service and/or feeder I
Phone; (503) 698 - 3417 I Fax: ;(503) 698 - 2486 Reconnect only 67.84 2
Pump or irrigation ciruto 67.84 2
E _ 67.8 2
. ar+:a t', , -.yr : ��.yy�� n. :.: F: :.k., :v "r 1 , t.t ,L 3,.
Sign or outline lighting
.i»at 4 3 is uv; ; _:�.:; <..• ;tir(j. air`! :^.. <,4..:ry '; ,,.:: <! •'.; Si8nai circuit(s)or limited-energy
Business name: Johansen Electric paacl, Inspection PIn a2 ny 2
Bach additional Inaptxdon over allowable in aqy otthe above
Address: 10948 SE Valley View Terr Additional inspection (1 hr min) 66,25/ hr
City /Stato/ZlP: Happy Val , OR 97086 invastigati R,21R/hr
pPY Y industrial pied (1 hr min) 7
Alone; (503) 698 -3417 1 Fax: (503) 698 -2486 Invasions for which no fee is 90.00/ hr
a• - •ficail listed 44 hr min
CCBLie.: 51539 I Electrical Lie.: 3-243C Suprv.Lie.: 2053S i'st ...,=b:= :; ;,rat'+ ~g r t t :a.:: "-.
63.-
Suprv. Electrician signature, required:
C. �' O�o�.. s4e
4 � - � . J %Now
P lan review (25% of permit fee)) :
Print name: Carl J t n s en v ......______,.......-- I Date: 4 / 4 / 12 State surcharge (12% of permit fee): ] , 6 3 •
TOTAL PERMIT FEi�' 71. 3
Authorised signature: This permit application espinb if a dente Ia not obtained whidn 180
- days after lt has been seeepted as complete,
Print name; Charlynn l ynn L e i f s en / I D ate; 4/4/12 per
1 • Number of inspections allowed Permit.
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