Permit CITY OF TIGARD ELECTRICAL PERMIT
11 COMMUNITY DEVELOPMENT Permit #: ELC2012 -00400
T WARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/02/2012
Parcel: 2S112AC01500
Jurisdiction: Tigard
Site address: 7319 SW KABLE LN 600
Project: Solestruck Subdivision: FANNO CREEK ACRE TRACTS Lot: 23, PT 2
Project Description: (15) branch circuits and (2) 200 amps or less 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
P
PHONE: 503 - 624 -6300
PHONE: 503 - 698 -3417
FAX: 503 - 698 -2486
FEES
Quantity Description Date Amount
2 ea Services or Feeders - 200 07/02/2012 $201.40
Specifics: amps or less
15 crt Branch Circuits w /Purchase 07/02/2012 $111.30
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 07/02/2012 $37.52
Electrical
Type of Const:
Occupancy Grp:
Total $350.22
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 acoopy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: W K Lt Permittee Signature: Did A PPi-/ t' iOki
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.
RECEIV .
Electrical Permit Application JUL 1011 01.11 , 1: 1'.1: 00,1,1
City of Tigard 2 201 4 _ �l - oa � J
Permit No ,
13125 SW Hall Blvd., Tigard, OR 97273 I oF TIG A D
Phune: 503.639.4171 Pax; 503,598,1 WI 1 1 x/1(71 Other Penult: bit 0�I�,• ? BIQ A
inspection Line: 503.639.4175 LDING DIVIS 1 '• 16 Ready /13y: 10 Sao Pace 2161
Interne: www.liganl•or,gov ` oil f ield/Metho d : SupplementallnfornmtIon
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; , %r . �' .(, ,..,'c a yr+1, '.::',:y.‘ ` dw � � , :�( ,a- l ; , r � _ ,,�,`I °:� �.. ... � • '!,;.1.,,,,,,'.=...'66., a t r s ; c � , , '��,r � .L e:f r a P i G
❑ New construction ® Addition /alter'ation/replaccmcnt Please cheek all that apply (submit a seta of pions w/Itmm chec below):
❑ Service or feeder 400 amps or more ❑ Mild log over dupe stories.
Demolition ❑ Other where the available Ault current CI Marinas and boatyards.
y, ' �.t.,y 'v , t , vYts`fs -•s` j < °'` ' "" .; 41 17 :(� n` exceeds 10,000anmpsat150 volts or CI Floating buildings.
^ , � , ''':''''''''':1''''''I'''''''' i �, °. 1 � ` ,,,1" \i,.. ; o y r „ lose to growtd, or tomcods 14.000 ❑ Cranmarosal•uw narLWlturet
� ❑ 1- and 2- family dwelling ezi Commercial /industrial ❑ Accessory building amps for all other inendlationa, buildings.
❑ Multi - family j] Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
'� „'6 "� ?;">; }.a..: „' >;sL.,'S',r•�� • - " . `�, • < ^r S.fi X'rr•.i -.. ❑ Emergency system, larger separately derived system.
....,\.,
n,.
�, .... - R•... .�' .. �...,...,., ". , �:�1�.. .A4;:' �. '',n :. k: ❑ Addition ef now motor load ot ., A ... 'Y, "..r ", "r
,•�n „
Job no.: Job site address: 7.,3� IOOHP or more. occupy.
SW Kahle Ln, 600 ❑ Six or more residential units. ❑ Recreational vehicle parks.
City /Statc/ZIP: ❑ Heal h -are facilities. o Supply voltage for more than
?3 r q ❑Hazardous locations. 600 volts nominal.
Suite/bldg. /apt,no,: I Pro� ectntmte : Solestruck ❑ Se rvico orfeeder600ampsormoro,
6 0 0 , /,: 3,!" =; , .. 10
Cross street/directions to job site; Description q
4lY• '4 Y •, �
Eft. )
I� TOW I •
New residential single- or multi -family dwelling unit,
Includes attached garage,
Subdivision: 1 Lot no.: 1,000 aq, ft or less 168.54
T 4
Ea. add'l 500 sq. ft, or portion 33.92 1
Tax map/parcel no.: Limited energy, residential
Y > i.�r ,y 'y ;zY. fr, > • (with above sq. £1) 75.00 2
Limited energy, multi- family 75.00 2
Tenant Improvement residential (with above eq. ft.)
Services or feeders inatallatiuu,niterution, and /or relocation
200 snips or loss 2 100.7212 M,i) , dill 2
¢ is sir %t t A .r. ` "': ';tii' r: 'ii < > w e`: I r, dlaT i rp amps ro 400 amps 133.56 2
JM.' '' i:: . F .d , iC "ct��=;,di: ^.:M11'i'r ..,,,':'.:f t,' 44404:8! i tL i " tc d 201 .
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 a services or feeders installation, alteration, and/or
City/State/ZIP:
Phone: ( ) I Fax: ( ) 200 amps or loss 59.36 1
Owner installation: This installation is being made on property that 1 own which is not 201 amps to 409 amps 125.08 2 40 I
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. I amps to 599 antra 168.54 a
Branch circuits - new, alteration, or cxteesion, per panel
Owner signature: Date: A. pee for branch oirouits with
• .„ - ;* 1` ^; My , above ran c or feeder ix
%,,.i' ��;': , l a : .4 ^:' ': vL �n•`:,� :. i S 7.42 r/rY 2
?4 s. -.; <: ,'J J: j(•`' ?. , enchbran I
Business name: B Yee for bmnoh circuits without
Johansen Electric aervi000rfeoder fun, Prat
Contact name: branch 'drool t
56.18 2
Charlynn Leifsen
Each add'1 breach circuit I 7.421 2
Address: 10948 SE Valley View Terr Mbe ctInneuua (service orfeeder not included)
Rash manufactured or modular 67.84 2
City /Slate/Z1P: Happy Valley, OR 9 7 0 8 6 dwelling, service oncvnr feeder
Phone: (503) 698 -3417 _I Fax: : (503) 698 -2486 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E -mail:
:. �.« a,r ,.: ss %..... . "eF ; F.; i;5 s: ; = ,r;'t;(.:e >'i'„ h �.,. = ;oc.r. Sign or outline lighting 67.84 2
t','. , ; ....r, r r R,,/ „ „ i+' , , `:�.�: _;.;., a' *' Signal cirouit(s) or limited•energy
Business name: Johansen Electric paael,a Pege 2
Each additional Inspection over allowable I aux of the above
Address: 10948 SE Valley View Terr Additioani inspiration (l hr min) 66.25/hr
Investigation (1 hr min) 66.25/ hr
City/State/ZIP: Happy Valley, OR 97088 Industrial plant (l hr min) 78.18 / hr
?bone: (5 0 3) 699-3417 Fax: (5 0 3) 698-2486 - Inspections for which no fee is 9000 / hr
ifivoll listed 14 hr min
CCB Lic,: 51539 Electrical Lic.: 3-243C ' u rv, Lie.: 20535 .•'w';'= � ' '`s" ° ' ",ir= s'' ,
Subtotal: 2..70
Suprv, Electrician signature, requited; �. _ / / ,e 44, Plan review (25% of permit fee):
Print name: Carl J 17,ansen 7/2/12 ____ I Date State surcharge (12% of permit foe): . �rf r 5,
TOTAL PERMIT FEE: .
Authorized signature; , , 2Z,
r
�'J Tits perndt d n s been a a wunh, 180
Pratt name: Char lynn Le i f a en I Date: 7/2/12 • Number of inspections allowed par permit.
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