Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00101
,, • DEVELOPMENT SERVICES DATE ISSUED: 3/3/03
.'1 11 13125 SW Hall Blvd., Tistard, OR 9 23 (503) 639 -4171
PARCEL: 2S112AD-01000
SITE ADDRESS: 14945 SW SEQUOIA P 110
SUBDIVISION: PACIFIC CORP. CENTER ZONING. I -P
BLOCK: LOT : JURISDICTION: TIG
Project Description: Install 1 200amp service and 20 branch circuits.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 1 W /SERVICE OR FEEDER: 20 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor: •
PACIFIC REALTY ASSOCIATES JOHANSEN ELECTRIC INC
15350 SW SEQUOIA PKWY #300 -WMI 10948 SE VALLEY VIEW TERRACE
PORTLAND, OR 97224 CLACKAMAS, OR 97015 -000
Phone: Phone: 503 - 698 -3417
Reg #: LIC 51539
SUP 2053S
FEES ELE 3 -243C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 3/3/03 $213.30
[TAX] 8% State Tax 3/3/03 $17.06 Elect'i Service
Rough -in
Total $230.36 Elect'I Final
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws.
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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952- 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) '
246 -6699 or 1 -800-33 -2344.
Issued By: �� /tom Permit Signature: 6'i a7.7� l:t 7 4 4 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'N: DATE:
LICENSE NO: 53 S
Call 639 - 4175 by 7:00pm for an inspection the next business day
•
•
From: Char, In J. I :ity of Tigard Date: 2/18/2003 lime: 1:11:48 PM Page 2 of 3
lectrical PermitApplication
1- . . C E I V L. J Date receive: . —0 3 Permit no.' ' ,, Off •
. , '' . _ i _ City of T i g ar�E Pmjecdappt. no.: Expire date
City of rtgard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: Rub Receipt no.:
Phone: (503) 639 -4171 FEB 1 8 2003
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: CITY OF TIGARD
BUILDING DIVISION
111'1 01 1'1 1011 I
U 1 & 2 family dwelling or accessory ED Commercial/industrial Cl Multi - family ❑ Tenant improvement
O New construction ❑Addition/alteration/replacement ❑ Other. Cl Partial
Job address: 14945 SW Sequoia Bldg. no.: Suite no.. Tax map/tax lot/account no.:
Lot: 1 Block: 'Subdivision: / 10
Project name: Spec Space lIesription and location of work on premises: Basic TI, service and feeders
Estimated date of completion/inspection: 2/24
((1 \lit \( Kilt \1'1'1 l( \IIO\ II .1. x(1111)11
Job no: 8108 Fee Mmt
Business name: Johansen Electric Inc. DenQ4'a°° '' (ea.) Toed no.mip
Newraddeatia -able ormail4hnMyper
Address: 10948 SE Valley View Terr. dwetlliftaM.ledadesatfaeiedwage.
_ City: Clackamas 'State: O R 1 ZIP: 97015 Sec eludlaaed:
Phone: 503 -698 -3417 1 Fax: 503-698 -24861 E -mail: Johansenelect@aol.com 1000 sq. ft. or less 4
CCB no.: 51539 f Elec. bus. lic. no: 3 -243C Each additional 500 sq. ft. ur portion thereof
Limited energy, residential 2
/me kno.: 4896 • Limited energy, non-residential 2
2/18/03 Each manufactured home or module/ dwelling
Signature of *sing electrician (inquired) Date Service and/or feeder 2
Sup. elect. name (print): Carl K. Johansen License no: 2053S Services or ttledera— hartaliatloo,
alteratloa or relocatloa:
200 amps or less 1 80.30 80.30 2
Name (print): 201 amps to 400 amps 2
401 amps to 600 mops 2
Mailing address: 601 amps to 1000 amps 2
City: !State: 1 ZIP: over 1000 amps m volts 2
Phone: 1 Fax: + E -mail: Recr meet only I
Owner installation: The installation is being made on property I own Temporary 'mkt' or feeders -
lastalla
which is not intended for sale, lease, rent, or exchange according to tlO ''` kQit1O° ' °rrelocation:
ORS 447, 455, 479, 670, 701. 200 amps or less 2
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 �, • s 2
I \(,1 \ t I It breath circuits - new, alteration,
Name: or exempla. ■ per panel:
A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 20 6•65 133 2
City: I State: 1 ZIP: B. Fee for branch circuits without purchase
Phone: Fax E-mail: of service or feeder fee tint branch circuit: 2
Each additional branch citcuie ,
1 ' I \ \ ' i l l II'1 Il'I,•a.e rIlccl. All 111.11 aplll,I Mise -(Serdreor feeder Not lodaded):
Cl Service over 225 amps - commercial O Health-cem facility mach pip or irrigation circle 2
O Service over 320 amps rating of l&2 CJ Hazesdons location Hach sign or outline lighting . 2
family dwellings Cl Building over 10,000 squae fed four rr Signal circuit(s) or a limited energy panel,
O System over 600 volts nominal mom residential units in ram structure alleratios. or ettension• 2 •
U Building over three stories U Fenders, 400 mops or more •Description:
U Occupant load over 99 persons U Manufactured structures or RV park Each additional Inspection over the allowable to any oldie above.
U Noma/lighting plan U Other: Per inspection L I I I
Sabtdi _ sets of plane with any of the above. lovestigatien fee
lit: abo►e are net applicable to temporary coastructioa service. Other
Not an jurisdictions accept credit cards, Vase call jurisdiction for mere inhmoition. Notion: This permit application Permit fee $ 213.30
ee
u visa U Plan review (at _ %) $ MasoerCard expires if a permit is not obtained 8%
g a s • 17.06
Credit an edit ct number: - / I within 180 days after it has been State surcharge ( )
Expires accepted as complete. TOTAL $ 230.36
Name of cardholder as shown on nedit cant
S
Cardholder signature Amount 440.4613 (6/OO/COM)
CITY OF TIGA' RO - 24 -Hour
Inspection Line:
BUILDING (503)
I? ( ) 639 -4175 MST
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Reque ted — ( AM PM BUP
Location / Lt q L/ 5 ! Suite `(v MEC
Contact Person / Ph ( ) C f y sa - PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC 3 - Lv /D
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof C_ •
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
fr a SPART FAIL 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date 9 Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL