Permit CITY OF TIGAR� ELECTRICAL PERMIT
TIGARD #: ELC2006 -00481
�i �� DEVELOPMENT SERVICES DATE ISSUED: 8/29/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S136CD-00100
SITE ADDRESS: 11705 SW PACIFIC HWY * ** ZONING: C - G
SUBDIVISION: PACIFIC CROSSROADS LOT : JURISDICTION: TIG
Project Description: 27 branch circuits.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAUPANEL:
MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 26 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
PACIFIC CROSSROADS PROPERTIES, I JOHANSEN ELECTRIC INC
BY WYSE INVESTMENT SERVICES CO - 10948 SE VALLEY VIEW TERR
200 SW MARKET ST STE 345 CLACKAMAS, OR 97015 -000
PORTLAND, OR 97201
Phone: Contact #: PRI 503 - 698 -3417
FAX 503 - 698 -2486
FEES
Description Date Amount Reg #: ELE 3 -243C
[ELPRMT] ELC Permit 8/29/2006 $219.75 LIC 51539
[TAX] 8% State Surcharge 8/29/2006 $17.58 SUP 2053S
Total $237.33 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set
forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699 or
1- 800 - 332 -2344. /�
Issued By: 6 tlr
±i1 /� Permittee Signature: ` aV , L f/1
OWNER INSTALLATION ONLY i "��
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'N: DATE:
LICENSE NO:
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
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.
ji t ►. 25 2006 1:13PM Johansen Electric Inc. 503- 698 -2486 p.l
a
Electrical Permit Application
City of Tigard . Ritems
13125 SW Hill Blvd.. Tigard, OR JE CEIVED4 ' . • de '- C / ,B No d..aoo _ 'i
Phone: 503.639.4171 Fax: 503,598.1960 Plea a°N1
AUG 2 5 2006 der. Mar Permit
Inspection Line: 503.639.4175
' '�l NateR a Bas _ hr Internet www.citigard.or. us
I a TIGARD g I�ors>•
O New non ® Addition /altetationl eplaoement Please cheer all them
- may:
❑ Demolition ❑ Other: a over amps, comm'I D DHaxerdawlocation
aver
1 sad 2 —rig sing .000 . li
l 2- family dwelling
O - and ® Commadalimdustriel a - - fin' dvrellhmga 4 or over atote new reside
o - and ❑'�� Accessory building OSys� over 600 volts nominal unite in one sbuenus
MOM O Master bander ❑ Other. OBuilding over throe stories OPeedas, 400 amps or mar
ClOccupera load ova 99 pas= OManufictwod ages o
DEgressffighting plat) RV park
lob no.: Job site address: 11705 SW Pacific Hwy OHeawm facility Dotter.
City/State/ZIP: S Rak i, sets of plena with may! of the above.
The above me not applicable to temporary constraoa service.
Suite/bids/apt. no.: Project name: Pacific Crossroads
Cross street/directions to job site: °as `. New am. T ••
New residential single- or meal -fan icy dwelling unit
Includes attached garage.
1x000 eq. R orlon 145.15 4
Subdivision: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Tax mapJperpCl no.: Limited energy, reaidentlel 75.00 2
• Limited eaeam'. non- essidm�l 75.00 2
Each manufactured or modular
• = 6.= • • i • • • = :: • i• s: ■; a 1 • 1 1 lliW6 service and/or feeder 90.90 2
Servitas or feeders installation, dteratton, and/or rdoestIoa
200 an or ass
80.30 2
amps to 400 maps 106.85 2
Name:
401 amps to 600 amps 160.60 2
601 amps to 1.000 amps 240.60 2
Address: Ova 1,000 amps or volts 454.65 2
•
City/Stale/ZIP: only 66.85 2
Phone: ( ) Faye ( ) ntlon Temporary services or feeders imbibition, dteratloa, and/or reloca
Owner Installation: This installation is be' made on 200 amps or less 66.85 1
Intended for sale, lease, rent, or OR S Y that 1 two which is not 201 amps to 400 amps 100 .30 2
exchange, according to ORS 447, 449, 670, and 701. I 1
401 amps to 600 amps 133.73 2
Owner signature: - Date: Branch amens - new, alteration, or extension, per Pasel
A. Fee for branch circtdts with
Business name: Johansen Electric Ina servfe0 feeder foe each 6.65 2
brands circuit
Contact name: Chnrlynn Leiden B. Fee for branch cif
Address: 10948 SE Valley c branch circuit �` 1 ' 4 6.05 46.85 2
alley V iew Tarr.
Each add'l breach circuit 26 ' 6.65 172.E 2
City/Stete/2IP: Claclumas, OR 97015 Miscellaneous (service or [Ceder not included)
Phenix (503) 698-3417 Fax: : (503) 698-2486 Amami or angelica circle 53.40 2
E-mail: johasseael ssse.eom Sigo or °aline lighting 53.40 2
i. ,. Signal cheeks) or limited-
energy pad, alteration, or
Business name: Johansen Electric Inc. 2
a
Address 10948 SE Valley View Tarr. Each addlm all inspection over allowable In any of the above
Per inspestion 6230
City /State/ZIP: Clackamas, OR 97015
Investigation per tau (t >a ®) 62.50
Phone: (503) 698.3417 Fax: (503) 698 -2486 Industrial pee hour 73.75
CC13 Lie.: 51539 C=EIREMpi S .. . Lie.: 2053S subtotal 219.75
Electrician signature, r /,, 'Ar'' sw�• -
S
Wrv- gnature, required: Plan review (25% of permit fee)
g ` r,. -� % / . / Date: 8/25/06 ( ofpennit). 1 7.58
Authorized signature: ' T OTAL 237.33
/ /�-�. This permit appasatfon � Ifs grannie b am obtained wltbin 180
Print name: days after ft has bees.eopted at co
, : Data 8/25/06 • set by taeam, mplete seasoaaa
.
iMundireWmattAILOParndapp.doc IMO 4404.1 ST(tal•QlCOMIWES
,
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2006 -00481
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/29/2006
Phone: (503) 639 -4171 /ar Atoti( i
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 9/27/2006 TIME: 7:07AM PAGE: 15
SITE ADDRESS: 11705 SW PACIFIC HWY i' CLASS OF WORK:
SUBDIVISION: PACIFIC CROSSROADS LOT #: TYPE OF USE:
PROJECT NAME: PACIFIC CROSSROADS
DESCRIPTION: 27 branch circuits.
OWNER: PACIFIC CROSSROADS PROPERTIES, I, PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503 - 698 -3417
Inspection Request Scheduled For: Date: 9t27 /2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 037240 -01 503- 704 -1534 N
Corrections /Comments/ Instructions:
a PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: • . N U Or Date: cgs') 6( Phone #: (503) 718 - 2,4116+