Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00495
,,� +i� DEVELOPMENT SERVICES DATE ISSUED: 8/7/03
;I II 't 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S112DA -00800
SITE ADDRESS: 15115 SW SEQUOIA PKWY 150
SUBDIVISION: PACIFIC CORP. CENTER ZONING: I -P
BLOCK: LOT : JURISDICTION: TIG
Project Description: JOB NO. 8266 Tenant Improvement
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 TERR
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 8/7/03 $213.30
[TAX] 8% State Tax 8/7/03 $17.06 Ceiling Cover
Wall Cover
Total $230.36 Elect's 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 - 332 -2344.
Issued By: Permit Signature: ,y - 4_
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:
Call 639 -4175 by 7:OOpm for an inspection the next business day
From: Charlynn J. Leifsen To: City of Tigard Date: 8/6/2003 Time: 3:13:34 PM Page 2 of 3
Electrical Permit Application , )1 1 I 1 1 h :\ I.
4, it
rate received: $ t'p D Permit mgt. fin3— tra y9
_ , )1 . _I City of Tigard Projec(/appl. no.: Expire date:
City of Ti grad Address: 13125 SW Flail Blvd, Tigard, OR 97223 Date issued: By: Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case fde no.: Payment type:
Land use approval:
I \I'I O1 I') 1( x111
0 1 & 2 family dwelling or accessory Ell Commercial/industrial O Multi - family 0 Tenant improvement
O New construction 0Addiition /alteration/replacement O Other. 0 Partial
Job address: 15115 SW Sequoia Bldg. no.: Suite no.: 150 Tax map /tax lot/accotmt no.:
Lot: 'Block: I Subdivision:
Project name: Westlake Consultants Description and location of work on premises: Tenant Improvement
Estimated date of completion/inspection:
( () \lit \( I Olt \I'I'IJ( \ 1111\ 1 1.1. ..( 111 1)1 1
Job no: 8266 Fee Max
Business name: Johansen Electric Inc. Ilma 1lo. Qty. (m.) Total nod's')
Newre■fieana1 -Endear -bmilyp per
Address: 10948 SE Valley View Terr. asep•(■dade.atta,
City: Clackamas [State: OR 1 ZIP: 97015 Sevleeladaied:
Phone: 503 - 698 -3417 1 Fax: 503-698 -24861 E -mail: Johansenelect @aol.com 1000 sq. a. or less 4
Cal no.: 51539 [Elea. bus. lic. no: 3 -243C
Each additional 500 sq. R. or p oRton thereof —
Limited mangy, residential 2
nal kno.: 4896 • Limited energy. non - residential 2
8/6/03 Each manufactured home or modular dwelling
Signature of m 'sing electrician (inquired) Date Service and/or feeder 2
sap. den. name (print): Carl K. Johansen Lionise no: 2053S Services or feeders— Iaetalkdoo,
idteratloaorrebutloa.
2110 amps or less 1 80.30 80.3C 2
201 amps to 400 amps 2
Name (print): 401 amps to 60D amps 2
Mailing address: --
601 amps to 1000 amps 2 ,
City: !State: 1 ZIP: Over 1000 amps or volts 2
Phone: Fax: l E -mail: Reemmect only I
Owner installation: The installation is being made on property I own Temporary services or feeders -
which is not intended for sale, lease, rent, or exchange according to lmdmd°a,`te°'tl°°'°'re!°"tlr ° m
ORS 447, 455, 479, 670, 701. 200 amps or less 2
201 amps to 400 amps 2 ,
Owner's signature: Date: 401 to 600 , . • a 2
1 \(,I \ t 1.11 Braneb chcdl■ - new, alteratbn,
or elteamios per pane:
Name: A. Fee for branch circuits wilh purchase of
Address: service or feeder fee, each branch circuit 20 6.65 133 2
City: 1 State: 1 ZIP: B. Fee for branch circuits wAhoot purchase
Phone: Fax E-mail: of service or feeder fee, that branch circuit: 2
Each additional branch circuit
I'I \ \ itl \ II \\ (Plu'isr tied. "II Iliuh ahpltl Misc. (Service or feeder sot indaded):
O Service over 225 amps- commercial O Health - fatality lurch pump or irrigation circle 2
O Service over 320 amps -rating of I&.2 U Hazardous location lveh sign or outline lighting 2
family dwellings O Building over 10,000 square fed four or Signal circuit(s) or a limited energy panel.
O System over 600 volts nominal more residential ruin in rase structure alteration. or extension* 2
O Budding over three stories O leaders. 400 amps or mom *Description:
O Occupant bad over 99 persons U Manufactured *ees or RV park Each additional lion over the anowable la any of the above: _
O Ewen/lighting plan U Other: Per inspectien L 1 I I
Sabmdl _ sets of pins with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Nut all jurisdictions ■ moept credit c+[tls. please call jurisdiction for more information. Notice: This permit application Permit fee $ 213.30
U Visa U MasterCard expires if a permit is not obtained Plan review (at _ %) S haz 8 a (8%) S 17.06
Credit cant number _ / 1 within 180 days after it has been State surc ( )
cPII6 accepted as complete. TOTAL 5 230.36
Name of cardholder as shown on reedit card
_ S
Cerdbolder signature Amount 440 .4615 (6/00/C0114)
CITY OF TIGARD. . 24 -Hour
BUILDING Inspection Line: (503)039 -4175
INSPECTION DIVISION ' Business Line: (503639 -4171 MST
)
BUP
Received Date Requested /(— AM '.. PM BUP
. Location f S ( (S Suite L-C6 MEC
Contact Person ���� Ph ( ) 7D 'I — AS 3 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC $ - 60 c (5 -5 . .
Footing
Foundation ELC
Ftg Drain Access: ELR
Crawl Drain
Slab : Inspection Notes: SIT
Post & Beam -
Shear Anchors
Ext Sheath/Shear . . .
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall _
Fire Sprinkler 6/
Fire Alarm
Susp'd Ceiling
Roof _ 2.
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
Fi re larm
SS PART FAIL 111 Reinspection fee of $ - required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
• SITE ❑ Please call or reinspection RE: Unable to inspect — no access
Fire Supply Line - �
ADA
Approach/Sidewalk Date Inspe /� - / /ffA Ext
Other:
Final DO NOT REMOVE this Inspection record from the j , site.
PASS PART FAIL