Permit CITY OF TIGARD ELECTRICAL PERMIT
11111 al COMMUNITY DEVELOPMENT Permit #: ELC2012 -00227
T [ G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/20/2012
Parcel: 2S112DA00800
Jurisdiction: Tigard
Site address: 15055 SW SEQUOIA PKWY 100 '
Project: Pac Star Subdivision: PACIFIC CORPORATE CENTER Lot: 2
Project Description: Power to equipment.
Contractor: JOHANSEN ELECTRIC INC Owner: PACIFIC REALTY ASSOCIATES LP
10948 SE VALLEY VIEW TERR ATTN: N PIVEN
HAPPY VALLEY, OR 97086 15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 698 -3417 PHONE:
FAX: 503 - 698 -2486
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo /Purchase 04 /20/2012 $56.18
Specifics: Service or Feeder
1 ea 12% State Surcharge - 04/20/2012 $6.74
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $62.92
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 th = =ct questions to OUNC by calling 503.232.1987 or 1.800.332.2344..
Issued By: Permittee Signature: _ • —
Ai /
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.
Electrical Permit ApplicatiJ , : rlIt If I; 15l ()M.\
City of Tigard PR 1 2012 Received
Oatdlt - Mi �� ! 7
13125 SW Hall Blvd„ Tigard, Olt 02
p Phone: 503.639.4171 Fax: 503.598.1W Fairli Other Permit:
Inspection Line: 503.639.4175 CITY OF TIGARD
etntx: tanvw.tigrtd- or.goV DIVISION Notaed,Meeroa. l
Int
... . •: •', ,'.. a, :: " ;:. .. ', I SIO .r `r. ig `.',/ .:_ %;P: J.1 :i.3 ,,,,'; ?ti
ILDING VI
n? �%' �� i,l i � " ;��. .5 .i`: s r'rry: "• c:r`. t r .:� h'. e!. .'F. -• +
1101180 ohm* "; �ai� r. �V, . T .. vr., 5 ... +�,? .'' "- Y. f " ^: " 1�:i is ':_L� _ -_ �'
CI New construction ® ' Addition/altcetiotl/replacement M- • +. all that apply (submit 2 acts of plans w /items chocked below);
❑ Service or feeder 400 amps or more 0 Building over three stories.
❑ Demolition ❑ Other: where the available find' current ❑ Marinas and boatyards.
+1y - �, 1 c ?•t: "" ��;' +'. w : ` ; ,.;; ti 4 F f � C .nL� - t 'M� �, ds 10,0 so 0 Picturing buildings
;,'i',, - : ��i�`.a'.q::c- ;RM�r�a�r -' •"8=i. �'�j° �' . � ^'' , �: +r �a : ,.. ,:,, A' . rase cxcoc m gra m00d, or amps al 150 exaaeda 14.000 ils or ❑ Co mn wrv ialirso n6ri
O 1- and 2- family dwelling ® Commerciallmdusttial 0 Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other; ❑ Fire pump. ❑ Installation of 73 KVA or
❑ "A ",'B" "L -2" "1
•. , +;.. . , , '.". N' M ,4 i r - = .`, - � ,:t l . " u f • 'a. .- -;,:i, ❑Emergency system. larger separably derived system.
�:� ,;�°.�� 05,4;,. � : P , ., � '�.. . _ ':f g:'�` � ; mrw motor load of .3 ",
y .... �. < -, -., H'` �1'!. 1t?:. fi l� ,F� -: ..�.. .. "i•s�:, 4 fi`�. "_.: Add(6on of � ❑
Job site address: �.,/��+('�� 1 100HPormorre. occupancy.
Job no.:
/ ✓i,CJ.5 5 i) 09,4 »' �CQ ❑ Six or moo rosidonlicl unite. Q Recreational vehicle parka.
Cily/SII tetZlP: ❑ Health Wiliam. 0 S upply voltage for more than
❑ Hazardous locations. 600 volt, nominal.
Suite/bldg. /apt. no.: % ( Project name: p a . i - c ❑ service or feeder 600 am s CT more.
I • f� ii'1:'. {.�":a 8� ''. ::. :''A :;',* :, ' 4'.1
n
Cross street/directions to job site: ..rrl,aion 9 Fir. I tout
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. It, or legit 168.54 4
Ea. add'1500 eq. It or portion 33.92 1
Tax map /parcel no.: , energy, residential
_: r;;.:..,.:. h 75.00 2
I a'.i , ),:C pT'P�.Pu' Nf: Y:�l. W #i : "n!{� i; :... °l'. °.., (with above sq.ftJ
7 !
Limited energy, multi- family 75.00
� 3 ", r/v A � „ residential (with above eq. ft,)
d O W "�+t '�► Services or feeders inatullatlonoltereton, and/or relocation
200 amps or loss 100.70 2
.,.". , - scut a rr . '" .. i . vp s , r . . ,,.', . 133.50 2
.i•` ;': x srn ., " d:�A:t';, .... �_ •, tn , , ...
''. :; -,- : htl ;,,, .'t`7: . . r.` ` ya.lk 201amI+gw400ampa
L�..)�1.':, .,I', , y i .,n � ^ 1 ., i:. ."' ., ..l k.. :'�: lf. ;i':: . ,
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 552.20 2
Temporary services or feeders Installation, alteration, and/or
City/State/ZIP: .
Phone: ( ) [Fax: ( ) 200 amps or leas 59.36 1
201 amps to 400 amps 1 25.08 2
Owner installation: This installation is being made on properly that 1 own which is not 401 amps In 599 whips 168.05 2
intended for sale, lease, rent, or exchange, according to ORS 449, 449, 670, and 701. Branch circuits - new, alteration, or extension, Sher panel
Owner signature: Date: A. Pee for branch cirouits with
••,• , - +y+.... .4 .,- above service or (ceder fee, 7.42 2
i;f
'.. ,7 r ;wvr: "; ,. -. . • .`r. a48.,:
.::._" _,. p:
each branch circuit
Business name: Johansen Electric B service or r f ee , without
eervioo or feeder fee, flier
I 56.18 510 . if 2
Contact name; Charlynn Leifsen branch circuit -.-
Each edd'I branch circuit 7.42 2
Address: 10 9 4 6 SE Valley View Terr Miscellaneous (service or feeder not Included)
Each manufactured or modular 67,84 2
City /State2l P: Happy Valley, OR 97086 dwelling, service and/or feeder
Phone: (503) 698 -3417 I Fax; : (503) 698-2486 Reconnect only 67,64 2
Pump or irrigation circle 67.84 2
E - mail: sign or outline lighting 67 ^ ^ 84 2
�•r.;l1'_':'>.a: r1 •;. ;. ; ,•v��; .�
^� %}:: .. " "�i
O� *��•. :.. r.,:- .. . _ .. r'•�. • ,.. ..:.:. :', Signal circuit(s) or limited-energy .
Each alteration, orextension. paee2 2
Business name: Johansen Electric
Each additional Inspection over allowable in any of the alcov
Address: 10948 SE Valley View Terr Additional inspection (1 hr min) 66.25/ hr
G5ty/State Investigation (1 hr min) 66,25/ hr
Happy Valley, OR 97086 Induatrial plant (1hrmin) 78.18/hr
Phone: (503) 698 - 3417 I Pax :(503) 698 -2486 Inspections for which no fee is 90.00/ hr
a. • .ifcall lintod 'b hr min
CCBLie,: 51539 I Electrical Lic,:3 - 2 4 30 I Soprv.Lich: 2053S .,`(: >':Iw? `7"( '(il ''a "'v'� "r 3 ''%1:y5 : ^id
subtotal: G+. /g
Suprv. Electrician signature, required: -
�AQ �•e4�'Rd' ! Plan review (25% of permit fee):
Print name: Carl J 1i` a sen Or Date: 4 / 19 / 12 State surcharge (12% of permit fee): (i ,7 Li
TOTAL PERMIT
Authorized signature: (,._.. - , . FEE: i
This penult application expires if a panels .,`��
pera�t b Trot n n widths 180
Print name: Charlynn Leifsen Date; 4/19/12 daya after It has been accepted ascomplete.
• Number of inspeeteae &Hawed par permit.
mousbeerreiunCLwermitAce .doe 07/01 nn 440.46t3
Z /T 'aOVd 98bZ869£0S 98IZ869E0S 'Darla NaSNVHOr Na Tb :TO ZTOZ'61'2dV