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Permit CITY OF TIGARD ELECTRICAL PERMIT • COMMUNITY DEVELOPMENT Permit #: ELC2012 -00298 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/21/2012 . Parcel: 2S 113AA01000 Jurisdiction: Tigard Site address: 16578 SW 72ND AVE B9 Project: Gingerbread Traditions Subdivision: ROSEWOOD ACRE TRACTS Lot: PTS C,C Project Description: (12) branch circuits for TI Contractor: JOHANSEN ELECTRIC INC Owner: PACIFIC REALTY ASSOCIATES 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 12 crt Branch Circuits wo /Purchase 05/21/2012 $137.80 Specifics: Service or Feeder 1 ea 12% State Surcharge - 05/21/2012 $16.54 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $154.34 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 0 001- 090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. ` Issued By: Permittee Signature: ON / CI - 77o - �/ 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 603.639.4176 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. Si RECEIVED . Electrical P emit A lic atio n AY 1 8 2012 i )1: l 1 I:1( 1: (`l i 1 City of Tigard �+'� Rrxcived ‘m Ponnit►LCiAOI ?— oOd -98' ■ 13125 SW Hall Blvd„ Tigard, Olt 9Gmt8 I OF TIGARD ___ , Phone: 503.639.4171 Fox: 503 B�pp�p1(��W�►t� f ? �y ;� C'1/yA l other Permi►KEie. .)O A.-- r 0 - v DdJTLiJ�l� tJ� �.7:V1`i ® SeePage2for : � . � i , � � Ltspsetirul Line: 503.639.4175 lisle Ready/By: Internet; www.tigard - or.gov Notiaed/MoOted: liM SupplanadalInferntatton c ' ❑ New cons I Add /replacement Home cheek all that apply (submit a sets of plans vv/itonta ahookod Wow): ❑ Service or feeder 400 amps or more ❑ Building over thew auriaa. ❑ Demolition ❑ Other: where the available hull currant ❑ Marinas and boatyards. ` '''',:.• ,000 amps at 150 volts or 0 Floating buildings. ..''':':.':.i....'....::. ......: ..... +elt'rEl + of 'i CI 00 • ••,: ; , � .. ' ' ' oxooadss l0 ' less to ground, or axcocde 14.000 0 Cem,mdrelel -uec agrloullural ❑ 1 - and 2-family dwelling ® Commercialfmdusttial ❑ Accessory building amps fur all ether installations. buildings. ❑ Multi - family • Master builder ❑ Other: I7 Fay lip. ❑ Installation of 75 KvA or Q Emtrgcaoy system. ha mar separately derived systole. JOB > tz''•i . 'AND. LOCATION ❑ Additionof newmotor loadof ❑"A" "E "I- 2 ", "1.3", Job n0.: I Job S address: 16578 SW 72nd - 1001.IP nr more. occupancy. ❑ Six or more maidomtial units. Q Recreational vehiete parks. City/State/ZIP: 0 rualth.carc facilities. ❑ Supply valtaggo the more then ty ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt.no.: I Project name: Gingerbr Tradition gServicaor Cross street/directions to job site: Dtvrrlaann 1 Qtr. 1 am. I Taw (.• New residential single- or multi -family dwelling unit. Includes attached garage. Subdivision: I Lot no,: 1,000 sq. R. or less 168.54 4 Ea. WWI 500 eq. ft or portion 33.92 I Tax map/pamel no.: Limited energy, residential 75 2 Limited energy, multi- family 75.00 2 Tenant Improvement rueidential (with ebpVe sq. ft.) Services or feeders Installation, alleratt0tt, and/or relocation _ ( 2 ) earpveb ei/QC u (T Fps �t 200 umps or Iris 100.70 2 r ; : : , • . : . ' ©, ,� 400 amps 133.56 2 ....E�: . ' . . . • .. . i. :. • • :: '.. ,.: ao l amps to � 401 amps to 0 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: ( ) 1 Fax: ( ) 200 amps or Ices I 59.36 2 1 201 amps to 400 amps 125,08 Owner Installation: This installation is being made on property that I own which is not 401 amps to 599 amps I 168.54 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. P P Branch circuits — new, alteration, or extension, zar panel Owner signature: _ Date: A. Pee for branch cirsuits with above .service or feeder foe, 7.42 2 0:a1t9PLXC J4T 1, . C n N ThCI P+ t • each brmoh oirwit Business name: Johansen Electric Pl. Peo for branch circuits without service or feeder fee, first � I D 2 Contact name: Charlynn Lei f sen branch circuit ' -7,42 56.18 5(10. 2 (Sash [KIWI branch circuit , 1 s L 2. Address: 10948 SE Valley View Terr Mlseellaneons (service or feeder not included) I Each manufactured or modular City/State/ZIP: Happy Va 11 ey , OR 97086 dwelling, service and/or feeder 61.x4 2 Phone: (5 0 3) 698-3417 I Fax:: (5 0 3) 698-2486 Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 E - o r outline lighting _ 67.84 2 l�y�3sis Signal circuit(,) or limited - energy pa alteration, Business name: Johansen Electric ditooal insnw extension. P ' Each additional over allowable In any s 2 of the abov Address:. 10948 SE Valley View Terr Additional inspection (1 hr min) 66.25/hr Investigation (1 hr min) 66.25/ hr City/State/ZIP: Happy Valley, OR 97086 , t industrial plant (I Armin) 78.18/ hr Phone: (503) 698 -3 17 I Fax: 698-2486 (�llN Inspectiornsfor which no foe is 90.00/ hr iticall listed n6 hr min /CB Lic.: 5 15 3 9G1 J Flrrctricel Lio.: 3 - 2 4 3 . d rv. Lic.: 2 0 5 3 S .Z� % ` �1 Subtotal: 3y.$G Suprv. Electrician signature, regUired:( J k , P Plan review (2596 of permit fee): , Print name: Carl hansen Dec 5/18/12 Slate sttrobarge (12% of permit fee): /C, 54/ TOTAL PRRMET FEE: ii, /./,'" Authorized signature This peterdt application expires ifs permit h not ahmeted willdn 180 nn Leifsen f sen Dale: 5/18/12 ins a after it has d per accepted as complete Print name: Char 1 y • Number of insper<tinn allowed per ptstait. I:tnuildtt Wermitiou C PermitApp.dee 07/01/10 440.4615T(11/05000 1 Z IT '3DVd 986Z869E05 986Z869COS Z03'I3 M3SNVHOf lad EV:TO ZTOZ•8T •AuW