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Permit a CITY OF TIGARD ELECTRICAL PERMIT lq COMMUNITY DEVELOPMENT Permit #: ELC2012 -00380 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/25/2012 Parcel: 2S113AB01201 Jurisdiction: Tigard Site address: 12909 SW 68TH PKWY 120 Project: Phoenix Subdivision: COUNCIL VIEW ACRES (LOTS 21 -44) Lot: 30 Project Description: (6) branch circuits and (1) 200 amps or less for TI REPRINT 7/2/12 Complete Specifics q e- 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 1 ea Services or Feeders - 200 06/25/2012 $100.70 Specifics: amps or less 6 crt Branch Circuits w /Purchase 06/25/2012 $44.52 Type of Use: COM Service or Feeder Class of Work: ALT 1 ea 12% State Surcharge - 06/25/2012 $17.43 Electrical Type of Const: Occupancy Grp: Total $162.65 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 the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: jaVIA. t.,C Y� t DN Permittee Signature: Q PPU C4T) of 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. CITY OF TIGARD ELECTRICAL PERMIT • - COMMUNITY DEVELOPMENT Permit#: ELC2012 -00380 T [GA.RD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/25/2012 Parcel: 2S113AB01201 Jurisdiction: Tigard Site address: 12909 SW 68TH PKWY 120 Project: Phoenix Subdivision: COUNCIL VIEW ACRES (LOTS 21-44) Lot: 30 Project Description: (6) branch circuits and (1) 200 amps or less for TI 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 1 ea Services or Feeders - 200 06/25/2012 $100.70 Specifics: amps or less 6 cA Branch Circuits w /Purchase 06/25/2012 $44.52 Type of Use: Service or Feeder Class of Work: 1 ea 12% State Surcharge - • 06/25/2012 $17.43 Electrical Type of Const: Occupancy Grp: Total $162.65 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 -001- 090. You may obtaina copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: .2 L / L x.� ./ Permittee Signature: OM / T 1' 1 411 bid t� 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 Application rctl‹ oi:Fic r. l <I,: o'1,, City of Tigard JUN 2 2 2012 EREMIZEMIff" i PemitNo.: std a p / 003 ; !. u 13125 SW Hall Blvd., Tigard, OR 97223 Man Review • b Phone: 503,639,4171 Fax: 503.598. ( n� �p� p i Other Permit: Inspection Liao: 503.639.'1 175 '-' 1 u' n ARD Dare • . ' illy: !w' ti'J Sec Parrs 2 air w Intmnct: ww.tigard- or.gov BUILD NrG D11/ISIOr Nodflod/Mothod: 1 mipptemental Information !�� ..,�a... :a r ti .4 :z . ..�. -,r" 5.y2- rx.n'L� :n'r:y r<la' .,k.,.. ,,. ri..A9 `..,!-' r . ,:r Y lrf.. : p �; ?'..:' F,. •57. r.l y; > '�yy t. . r .. r ,SS: �` i. .Gl:. r ."J9 > °� ".. L �'il . 4 i.,�'.,. r '7h f: `. ii�ai ° ..11 �. � "'r �y i' j � , q i t.:;.�,,;.��T,!:�''y.�g. ,,,.r;x�. §.. .., .y�2:j• ,•.. .::�,. ,.r.., .J. M�', _•.:�: ,.ij: r. �a.v�.S,,.,fLf, y .� '- .. �:kiia o: .::.: .. .,.i"M:'l 0 New construction ® Addi tion/alteration /replacement Please cheek all that apply (submit Isms of plans wlitrma checked below), ❑ Demolition ❑ Other: 0 Service or feeder 400 amps or more CI Ruilding over three stories. where the available fault current 0 Marina. and boatyards. r "t ;. a s,I '"' ti . ;. ' "p<" ,. � .V.,,, ''''''''• ' ..k amps B 6 9. P' i "•t3 > ry `e�wa�w -0. r�: `' .. 'r ', 6, ... •.iv.A exceeds !0,000 aN at 150 volts Of Floating buildings. : :;a:. '' :5,' ' -" hL . � i.' i ::rr' • .. . t = 1 ,.. r;�'I: : 4 . 1 � [. :P.,: ly .tij '' .`..T_s -• L ' '' . i - � lose to ground. or exceeds 14,000 (] C:cxnmwcial •use egriculmref ❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building amps tor all other installations, buildins•+. O Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 75 KVA or `nx r s-17 u. ".. t r, °.3r"' '{ Q l?t"raci y °Alm. larger separately derived system. • :. r r . ' , .+� ` ^:;�a'L�Ir,,a °,', ��'„'�� n - :'µ -' i' . y'6' - - ❑ addition of new motor toed of ❑ "A', "l: ", 9.2 . Lt.S "^ Job no.: (Job site address: 12909 SW 68th Pkwy 100HP w more. occupancy. ❑ Six or more residential orals, ❑ Raerationel vehicle puke City/State/ZIP: 0 Health-care facilities, 0 Supply voltage for mute Qum ❑ Hazardous locations. 600 vobn nominal. Suite/bldg. /apt, no.: 120 I Project name: Phoenix ❑ Servicc or fcaler 600 amps or move. v ,*.4, ,;r..: i:t ,.;' 5 ::e ; Q'_ er t_;. r 1 : .' . 4't n'; 15Z.' Cross street/directions to job site: neserlpuoa Qty. Vac ^' 't otal New residential single -or multi -t mlly dwelling unit. Includes attached garage. Subdivision: —I Lot no.: 1,000 sq. ft. or tact 168.54 4 Ea add'l 500 sq. ft. or portion 33.92 1 Tax map /parcel no.: Limited energy, residential 75.00 2 .0g'i:.r ,fi . U ":A,"! . : x` X Wr,. ::,k :n•f. ;, :" ' ; :'r : s (with above K. ft.) Limited energy, multi- family 75.00 2 Tenant improvement residential (with above . ft.) Services or feeder, installation, alteration, and/or relocation :'i 200 amps or loss I 100,70 /(�Q; yb 2 h Oa , .' irj 1: s ;' L 201 amps to 4 OOe s6i " aPiaF :n: r A: iav;n' es:,F ' ?t °. p p. amps 133.56 ,- 2 NemC 401 amps to 600 amps 200.34 2 601 amps 10 1,000 amps 301.04 2 Address: over 1,000 amps or volts 552.26 2 City/State/ZIP: Temporary services or feeders installation, alteration, and/or relocation Phone: ) I P ax: ( ) 200 amps or less 59.36 1 1 201 amps to 400 amps 125.08 1 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, rant, or exchange, according to OILS 447, 449, 670, and 701. Branch eireulta — new, alteration, or extension, per panel Owner signature: __ _ �_ Date: A. Pee for branch circuits rvf/h - ,,. -. .:, n ` , r y rr�� "< 4 • : ., above service or fader foe, /_ 7.42 4/44 :ri::::; ;4;y: 'x : :dot ' r � 1.8.+:0� •: � r' "?,r 19 .1;: r` ��ah:,' ` ". ., ... IpR �lel'.�L 1-k 4D.Y� . } ' each branch oirouil 2 H . Fa for branch feede fee, with/nit Business name: Johansen Electric service or feeder few, first 56.18 2 Contact name: Charlynn Lei fsen branch circuit , Each edd'I branch circuit 7,42 , 2 Address: 10948 SE Valley View Terr Miscellaneous (service or feeder not included) _ Each manufactured or modular 67.84 2 City/Sum/ZIP: Happy Valley, OR 9 7 0 8 6 dwelling and/or feeder Phone: (503) 698 -3417 I Fax: :(503) 698 -2486 Reconnect only 67.84 , 2 Pump or irrigation circle 67.84 2 13-mail: Sign or outline lighting 67.84 2 ' L , 4 .. M ,a 1y' .. r ,4.r, hy ' t v,.,1, t .,,r.� j °, . h'. 'i :� .,..,.`; "6'r, :,,;7 Tr^ -- qt -p'•.. i I`: , •;. l'..."%., ...... ' :' ; t.c „i Signal oirouit(6) or li -anagy BUSincas Jphanseri EleCtr3C pmlel, alteration, orextension. _ Page 2 2 Each additional Inspection over allowable In any of the above — Address: 10948 SE Valley View Terr Additional inspection (I hr min) 66.25/ hr , City/State/ZIP: Happy Valley , OR 97 086 Investigation (l hr min) 66.25 / hr r in plant (1 hr min) 78.18/ hr Phone; (503) 698 -3417 I Fax: ( 503) 698 -2486 Inspections for which no fee it lu iftoall listed ',5 hr min �/ � CB Lic.: 51539 cetncal Lic.: 3 -243C j,Suprv. Lic.: 2053S ":'Y. , :; ?;, *,:1: ± ?x'51 1 .�:. °, , `;' "; `'° 8 touil: l4/4` Suprv. Electrician signature, required: � r , a f 0 `" ' ■ Plan review (25% of pennit fcc): Print name: Carl Johansen ate: 6/22/12 State surcharge (12% of permit fee): /7, .v Authorised signature: ()/til TOTAL PERMIT FEE: /42,,,4, / nib permit appneallmi expires It a permit b not obtained within 180 Print name: Charlynn Le / / i f sen I D ate: 6 22 12 days after itime been aceepfed se complete } • Number of impatiens snowed per picnic I:Wuildineen uucLC- ParmitApp.dua 07/01110 440-46151(11/05/COMAWR0 9 /9 - 3DVd 98VZ869E09 98VZ869E0S ZOTIE NHSMVHO2 Wd ZE :ZO ZTOZ - ZZ - unr