Permit n CITY OF TIGARD ELECTRICAL PERMIT
;51 COMMUNITY DEVELOPMENT Permit #: ELC2012 00310
T [ GA.RD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/23/2012
Parcel: 2S113AB01201
Jurisdiction: Tigard
Site address: 16260 SW UPPER BOONES FERRY RD
Project: Game Day Subdivision: COUNCIL VIEW ACRES (LOTS 21-44) Lot: 30
Project Description: (2) branch circuits for TI
REPRINT 6/25/12 (4) branch circuits and (2) 200 amps or less added 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
2 crt Branch Circuits wo /Purchase 05/23/2012 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 05/23/2012 $7.63
Type of Use: COM Electrical
Class of Work: ALT 2 ea Services or Feeders - 200 06/25/2012 $201.40
amps or less
Type of Const: 4 crt Branch Circuits w /Purchase 06/25/2012 $29.68
Occupancy Grp: x Service or Feeder
Total $302.31
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 R 952 -00 -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: Permittee Signature: 4PPU ('14 TJ 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 503.639.4175 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.
RECEIVE
Electrical Permit Analication FOE r tl I( I `I': 1.1
City of Tigard JUN 22 2014 u sy Penult N , eL-Ci.1(j( a,.Do3 / 1
• 13125 SW Hall Blvd., Tigard. OR 97223 Plan Review — --
Phone; 503.639.4171 Fax: 503.598,1 9G�i I X OF T;(,AR 10 s wB r: IA �eapa
Other Permi _ i
Inspection wwwiig3
ard. 7s c�i� BUILDING �I.1�1)L . ady
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•
CI New construction T ® Addition/alteration/replacement Please check all that apply (submit 1 eels of plans wtitetma checked below):
Q Service M feeder 400 amps or more ❑ Building over tatree atones.
❑ Demolition ❑ Other: where the available fault mutant Q Marinas and boatyards,
$::•':a- i- '+ . ; { r. :
p r,.: ; • :,*, 4.'i' '. { +:),. i r exceeds 10,000 amps at 150 volts or ❑moating buildings.
<fi r d. -'r 1 ;,: ,O, ;. t 5 i ' :,` ' .r : . 1-' loss to ground, or e+xoeod>:14,mto ❑ Commetcialruo agricultural
} ❑ 1 - and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
0 Multi - family ❑ Master builder ❑ Other: ❑ Piro pump. O Installation of 75 KVA or
. y , : Q Etnmgmwy system. larger separately derived system.
•1' f%r S. ' e: I 8 F t. J .4,--h",- :. :
1 ) . . . . . Y'a
1 n ; .. . 4 . - : d'-'''• . o , , . . K.1.1 y "" �;xs , :he Q Addition ol M A W of Q " .E„ „ 1 -2 ", "1;1 ",
no.: site no: Jo address: adress: worm a more. QCctlpancy.
162 6 0 SW Upper Boone s Q Nix or naxm residential units. Q xecteatiatel vehicle parks.
City /Stale /ZIP: ❑ health -care facilities. D Supply voltage for mum than
Q Hazardous lomations, 600 volts nominal.
Suite/bldg. /apt. no.: I Project name: GameDay ❑ Service yr ka i 600 am or more.
Cross street/directions to job site: Description w -
Vu' I Bee t Teat ' 1` •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'l 500 aq. ft. or portion 33.92 1
Tax map /parcel no.. Limited energy, residential
Ny IY - ': ��S `o;(.'�r;/ y.- .,_ �'k• '� � � °. y ` e, , 'O+ ,...� A` o,•:. “3:;:-...;; .r ,!' , Y .! ai;t+ 1i!'�i. `' (with 4' 'i* a.) 75.00 2
•. :- './•.: !� „' ' �,( .H- . , .i , .:
Limited energy, multi- family 7100 2
add equipment residential (with above sgfl.)
Services or feeders Installation alteration, and/or relocation
200 amps or leas ., 100.70 241 2
L, ti , > r, 47) mac. ,7 3:• rnyl;:ii ) > ✓y' r, "•' . G �''.' : ° .i
M' r:471 { ��f di'�, '-h; , : ,, f h •; e : 201 amps to 400 amps 133,56 2
inn e•:1+,' ,.f'� ..�i, { � \! ; ° �r��' i �
Name: 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301,04 2
Address: Over 1,000 amps or volts 552.26 2
relocation Temporary services or feeders Installation, alteration, and/or
City/State/ZIP:
Phone: ( ) I Fax: ( ) 200 amps or lam _ 59.36 1
Owner installation: This installation is being made on property that I own which is not 201 amps 14 umps 125.08 2
intended for sale, (case, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 imps to 599 amps 166.34 2
Branch circuits — stew, alteration, or extension, r panel
Owner signature: Date: A. Fee for branch circuits with
n7 r , ,. r „ ',,: '. above amino or feeder fee, 7,42 2
" = a v ? ':i F r,� %i .'��) n, s'ys::' : °na. • oat breach circuit 1/$
-
Business name: Johansen Electric f3
service or feeder Coe, rat 56.18 2
Contact name: Charlynn Le i f s en branch Circuit _
Each -del branch circuit 7.42 2
Address: 10948 SE Valley View Terr Miscellaneous (service or feeder not lndaded)
City/State/ZIP: Each manufactured nr modular 67.84 2
t3 Happy Valley, OR 97086 dwelling, service and/or feeder .
Phone: ( 503) 698 -3417 I Fan:: (503) 698 - 2486 Reconnect only 67.84 2
Pump or irrigation circle 67,84 2
E - mail: Sign or outline lighting 67.84 2
�. _ ? :..1 fi :3 rl,WfY ti �:M. . .: �, 1.!'iVliYtr.'• V : t. .J. '1: �ig ZKY ' X Signal circuit(s) or limited-energy
Business name. Johansen Electric
panel, a a ddidon nrt ,oroxtateion. _ PeRo2 2
Each dditial inspection over allowable to any of the abov
Address: 10948 SE Valley View Terr Additional inspection (1hrmin) 66.25/hr
City /State/ZIP: Happy Val OR 9 7 0 8 6 Investigation (I hr min) 79,18 hr
_ PP Y Industrial plant (t hr min) 78.18/ hr
Phone: (503) 698-3417 I Fax: (5 0 3) 698-2486 Inspections for which no fee is 90.00/ hr
iftcall listed 14 hr mitt
it . r. a�,':jr A • :� .�:
/CCB Lic.: 51539 electrical Lic.: 3-243C �uprv. Lie.: 2 0 5 3 $ "'!
�- •`. �' : ' -' ; ; : ��' �i:��>�c ��;E..0 �:�1_' ; < ; ;;
Suprv, Electrician signature, required: d _ Su
lc .0., , Mr,1 „..,u.,, , Plan review (25% of permit it fee): ) " :
Print name: Carl J en Dale, 6/22/12 State surcharge (12% of permit tee): 27173
Authorized signature: ( i w TOTAL, PERMIT 1711: $ g
'itch pe m t a pplication H
8 expires a pant* la not obtained wft MO
Print name: Chart n Lei! sen I Da te: 6 / 22 / 12 days after It has been p e mi td as complete.
Yn +Number of inepootieme allowed nor Pevrn 3/. d $
f .4 ,--
ltltuiainaV 'exaitaLC- PertnitApp.des 07/01/10 440.461sr(lIes4OMAVER
' 9 /£ 'HDVa 9862869£09 9862869£09 ZDaZ3 NaSNVHOr Na O£:ZO ZTOZ'ZZ'unr
CITY OF TIGARD ELECTRICAL PERMIT
>s COMMUNITY DEVELOPMENT ELECTRICAL
ELC2012 -00310
•
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/23/2012
Parcel: 2S113AB01201
•
Jurisdiction: Tigard
Site address: 16260 SW UPPER BOONES FERRY RD
Project: Game Day Subdivision: COUNCIL VIEW ACRES (LOTS 21-44) Lot: 30
Project Description: (2) branch circuits 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
Q uantity Description Date Amount
2 crt Branch Circuits wo /Purchase 05/23/2012 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 05/23/2012 $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 through OA 952- 001 -0090. You u may obtain ' a copy of the rules or direct questions to OUNC by calling 503. o
r
Cy'f
Issued By: i_& t Permittee Signature: ° 4 . ni1"iery7 0&L
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.
• 9( D
RECEIVE.
Electrical Permit Annlication MAY 2 3 20 r _ a(t l rr i (, I s i: ()NIA A C
City of Tigard o io'0) a - t' 3!0
-
13125 SWIlalnBlvd .. Tigard, OR 97223 CfrYOf ' 1 rICA C i II Other P�erttl84 ,ta,p,a.. 6-0
I Phone: 503.639.4171 Fax: 503,598.1913 -- D - , e i .
Inspection lino: 503.639.4175 L ' E Y
Internet www.tigard- or.gov �t1 :� Porm N
'.: �' :: •. ` , .. •:,'; :.per r ..' .. ' .. : be.
❑ New construction ® Addition/alteration/replacement Please cheat al that apply (subrtnit s Ran of plena wlitom r checked bw):
❑ Servioo or feeder 400 amps or more ❑ Building aver three nodes.
❑ Demolition ❑ Other: where the available fault ourrenl ❑ Marine and boatyards.
•.. ,
:.. .. .., '••,....,'."•': .. R amps It volts 01' ❑ Floating buildingo,
C11'Cls>lt lY `O� r(�t} 1:. leas to ground, or exceeds 14,000 D C ommoro[al -we sgrieullural
❑ 1 - and 2- family dwelling ® Commercial industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump, ❑ Installation 0f75 KVA Of
- -- -. tut.
.:.. 40 . for wad o
f
'l�St1'3+f9CAtIQI, ❑Addltionofnowmo ❑ ` ' a ' Ep " l2
• _ • , system.
lob 91te address: IOOHP or mom occupancy.
Job no.:
I 16 2 6 0 SW Upper Boone s ❑ Six or more residential wilts. ❑ Rwurenliomal vehicle parka.
City /State/ZIP: ❑ Health-vote faeilitios. ❑ volts v � more than
❑ Hazardous locations.
Suite/bldg. /apt.no,: I Project name: CameDay ❑ Service or Roder 600 amps ormore.
Cross strcct/direclions to job site: ` Deaedvtlun 100• Fee. F Tan 1 • ''
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 so, ft. or less 168.54 4
Ea. add'I 500 aq. fl or portion 33.92 1
Tax map /parcel no.: Limited energy, residential 75.00 2
r' ••"•' '. ' ` ' _ '1Ll$0141 .. (with above &I N
' Limited energy, multi•femily 75.00 2
furniture connections residential (with above sq. A.) _
Services or feeders Installation,, alteration, and/or relocation
200 amps or less 100.70 2
r ..
. a 2n1 Imps in 400 amps 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 lees I I 59.36 I 1
201 amps to 400 amps I 1 125.08 ` 2
1
Owner Installation: This installation is being made on property that I own which is not 401 amp, to 599 amps 168.54 I 2
intended for sale, lease, rent, or exchange, acoor to ORS 447, 449, 670, and 701. Branch circuits- sew, alteration, or extension, Qer panel
Owner signature: Dale: A. Fcc for branch uirouiu with above service or feeder too,
01 1 �. W _ each branch eiremil 742 2
Businessname: Johansen Electric B. envies branch ern rdrhorn
service or reader fez, first 1 56.111 5 6.18 2
Coutactnamc, Charlynn Leifsen brand circuit
Each add'I !smith circuit 1 7.42 7 . 42 2
Address: 10948 SE Valley View Terr miscellaneous (service or feeder not included)
CI /Slale/Z1P: Each manufactured or modular 67.84 2
ty Happy Valley, OR 9 7 0 8 6 dwelling, service and/or feeder
Phone:(503) 698 -3417 I Fax::(503) 698 -2486 Remained only 67.84 2
Pump or irrigation uncle 67.84 2
E -mail: 67.84 2
Si gn or online lighting
CO1 OR Signal circuits) or limited•rmcrgy
Businessntune: Johansen Electric Each additional s en Ifipen 2
Bach addlttonel Inspection over allowable In any of the shav
Address: 10948 SE Valley View Terr Additional inspeetian0 hr min) 66.2S/hr
City /State/ZIP: Happy Val , OR 9 7086
Investigation iplant l hr min) 66.25/hr
PpY Y Induahiolplont(I hrmin) 7A.IA /hr
Phone: (503) 698 -3417 F : . . 503 ,•8- 2486 Inrgweti "am far which no feeis 90.00/ hr
'noun listed I. hr min
i tCB Lie.: 51539 l,Eicetrical ' .: 3 - 2 4 3 C '' prv. Lic.' 0 5 3 5 ) ... ' :. •;;; � t . < < x'. 44, :. • ':
Subtotal: -3. • s
Suprv. Electrician signature, required: �• . Plan review (25% of permit fee);
State surcharge (12%0 of permit fee): 7.63
Print name: Carl J sneers pA 5/23/12 St e •
y PERMIT FEE: 71 . 2 3 _�
J
Authorised signature: ��. This pcmdt applketlwn expires Ira pernt t is not obtained within ISO
Print name: Charlynn Leifsen I Date: 5 / ka' a has been accepted as complete.
• Number of inspections allowed per permit.
1: 113uitavePotmiuUh .c:- PermitApp.doo 07/01/10 440.44131t1 tro5e. /W1ID
Z /T •aDVa 98VZ869E05 98VZ869E0S 'Darla NaSNVHOr WV TS:80 ZTOZ•EZ•AEW