Permit CITY OF TIGARD ELECTRICAL PERMIT
111 • COMMUNITY DEVELOPMENT Permit #: ELC2012 -00424
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/18/2012
Parcel: 2S113AC00101
Jurisdiction: TIGARD
Site address: 16655 SW 72ND AVE 400
Project: Microlnterconnects Subdivision: COUNCIL VIEW ACRES (LOTS 21 -44) Lot: 37
Project Description: (15) 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
Quantity Description Date Amount
15 crt Branch Circuits wo /Purchase 07/18/2012 $160.06
Specifics:, Service or Feeder
1 ea 12% State Surcharge - 07/18/2012 $19.21
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $179.27
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 9 2- 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. ; 7
Issued By: Permittee Signature: Oki 4PP1/ C,4 1 L ad
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 503.639.4176 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.
P RECEIV1 w Electrical Perm it A pllCatl011 f 11l( 11 I( t: I ";l: t l\ I.1
City of Tigard JUL 17 201 1 vis 1 ti`s Penult N '2. co la.- twliAVf,
13125 SW Hall Blvd., Tigard, OR . 97223 plan Review Other Permit:
t+ Phone: 503.639.4171 Fax: 503.598.1960 Dale'lsr
I 1 + Inspection Line: 503.639.4175 CITY OF TIGA • t.. to R- Jaw: I I ` 6O I l ap a I lnio
InterInternet www.ligard- or.gov RR % , Kt otiflad/Mothod /
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❑ N ew construction ® Addition/alteration/replacement Ploaae check ell that apply (submit j sere o> pleat wlitema checked below):
❑ Demolition ❑Other. 0 Bttvico or Corder 400 amps or mole 0 Building we three stories.
where the availabk fault current ['Marinas and boroards,
i , - j;�. 41,.•<> k ,'r,C : .} `" ; : F T0°" ,7 ,' `A0 71.,' ' x :. , ti a• Y t exceed 10,000 amps at v 0 Ploatin ild
".:...:. , . ` ; '� "'''•� lest m grow or cxeexd e 150 L4 olts or , 000 ❑ CO -u' se agriatlhnaa
❑ 1- and 2- family dwelling ® Commercial /industrial 0 Accessory building amps for all other installations. buildings.
❑ Multi-family
0 Ma ter builder CI Other: 0 Fire pump. ❑ Installation of 75 KVA Or aye s ! . r� cR }'? q .i.rq N5' s -. ,•, t.. ❑ Fmerglxtcy syatl m. larger separately derived system.
. /!'' 'YLn�S. " ,' �' t�,aj'�jj y .,w: : ,; !:'.. i'. f
' a�`�..._ ; c1, 1;� _. .. �A� +7;=1 ���, >.���i�; ^.a ..�: �,;;'.i.. r.y., ❑ nddttm of mow load of O,.A. "E". "1-2". ..1_3•
Job no.: I Job situ address: IOOHP or more. occupancy.
16 6 5 5 SW 7 2nd , 4 0 0 0 Six or more residential units. a Recreational vehicle parks.
City /State/ZIP: 0 Heath -care faeilit 0 Supply voltage for more than
0 Hazardous locaticmt. 600 volts nominal.
Suite/bldg. /apt.no.: 400 I Project name: Microlnterconnects 0 Service or feeder 600 amps or more.
Cross strcct/dircctione to job Bite: R ' i ' o '•�; " " ' Teo. Total I
cute r'• I •• �, � •
New residential single- or multt•famlly dwelling unit
_ Includes attached garage.
Subdivision: Lot no.: 1.000 sq. f. or loss 168.54 4
Tax map /parcel no.: Ea. edd'1500 sq. ft. or portion 33.92
i . ... N .,. n 7:r ` Y I•nurod energy, residential 75,00 2
::: f :;..''''; _ , 5 ' O if 'ij �r {y( 1:':'.':: t.:: r . k. =' - ? r': y;,'' (with above sq. IT.)
United ener multi - family 75.00 2
Tenant Improvement residential (with above s4. ft.)
Service, or feeders Installation alteration, and/or relocation
200 amps or leas 100.70 2
:':.k,4i;7;:d ^ ,s , =71,i+�y.`,.r,_:1:r .,SrjG',...., J. " :,; , 201 ampsto40 133,56
Mpg 2
'� ..r r�l 1 sT :�'b< l. r r A��.. ' .��/ 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 55226 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone; ( ) j Fax: ( ) 200 amps or loss i $9.36 I I
Owner installation: This installation is being made on property that I own which is not 201 amps m 409 amps 125.08 I z
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps en 599 amps 16s,54 1 2
Branch circuits — new, alteration, or extension, ter jianel
Owner signature: bate: A. Fee for branoh circuits with
e! r "f ,.c, ry ; : < fi' 'ti<' above service or feeder fie,
, .. x 4' ;'' "r�`F�''• : f, "sa; s f %... .% ' n^ :, • kt K k: ; ;: ::l '. , sash beech circuit 7.42 2
Business name. B. Poo forhmnoh oiruuiln with
Johansen Electric service Or feeder fee, first
Contpetname: Charlynn Leifsen
branch oireuil / 56.18 ,4,.1g 2
Each add'I branch circuit Vi/ I 7.423,
Address: 10948 SE Valley View Terr hibccllaneous (serviceor fender not Included)
q /state /ZIP: Happy Valley, OR 9 7 0 8 6 dwelling, service and/or feeder Each manufactured or modular '
PPY ce 67 2
Ci
Phone: (5 0 3) 698 I Fax:: (5 0 3) 698 Reconnect only 67.84 2
E-hmail:
Pump or irrigation circle 67.84 2
Sign or outline lighting 67.84 2
: nS, .�'l,, ;k',� .�+. rct��sresr�e�;����n��.�j�- ,,7.= >;:�.ri:- r ,1c: .t I:.
•.. !•c'. :.T: ,. � .:i: + - . ... Signal circuit(s)arlimited-energy
panel, alteration, or eatta,:tion. Page 2 2
Business name: Johan a en Electric . Each additional inspection ove allowable In any of the above ,
Address: 10948 SE Valley View Terr Additional inspection (lhrmin) 66.25/ hr
investigation (1 hr min) 66.25/ hr
City/State/ZIP: Happy Valley, OR 97086 Industrial plant (l 11rmin) 78,I8/hr
!'hone: (5 0 3) 698-342.7 I Fax: (5 0 3) 698-2486 ' Inspections for whioh no fee is
90.00i hr
B. ificall listed 14 hr min
t eCB Lic.: 51539 Vectrical Lic.: 3-243C ?rv. Lic.: 2 0 5 3 3 Y', f .+ ' -i- 3 ,; ,`' ^ •^
Suprv. Electrician signetum, required: a , GI. /k Subtotal: fee ,./ / /
Plan review (25% of perils fee):
Print name; Carl Jo / n �' e ' e � ni Date: 7/17/12 State surcharge (12 %elperrmit fcc): 1,
Authorized signature: / TOTAI.P FEE: oblalned within ! � ��
TIM pemdt appUcanem expires Its pemdl is not thin IR
Print name: Charlynn Le ' en ( Date; 7/17/12 days afar a has veal perms w complete.
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