Permit C I TY OF T I GA R D ELECTRICAL PERMIT
PERMIT #: ELC2005 -00184
a DEVELOPMENT SERVICES DATE ISSUED: 3/25/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2 S 112AD -01000
SITE ADDRESS: 14945 SW SEQUOIA PKWY 170 ZONING: I -P
SUBDIVISION: PACIFIC CORP. CENTER LOT : JURISDICTION: TIG
Project Description: 15 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: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 14 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
•
FEES Reg #: LIC 51539
Description Date Amount SUP 2053S
ELE 3 -243-243
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[ELPRMT] ELC Permit 3/25/2005 $139.95
[TAX] 8% State Surcharge 3/25/2005 $11.20 REQUIRED ITEMS AND REPORTS
Total $151.15
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 -3 2 -2344.
Issued By: , � , �,� ` , Permittee Signature: t7 — early '��
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 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
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.
From: Charlynn J. Leifsen To: City of Tigard Date: 3/25/2005 Time: 1:43:16 PM Page 2 of 4
Electnccal $ermit Application r 1 1 1 < t l ( i i t r 1, r. ().1 1
City of Tigardp
13125 5W Hall Blvd., Tigard, OR 97224�AR 2005 Dales : O5 i I + - e - i �i
.
Plan Review
Phone: 503.639.4171 Fax 503.598.1960 ' �: : I Dat- :: Other Permit:
Inspection Line: 503.639.4175 -Tw ; �;, ' 1 Date Read .+' ® See Page i for
Internet: www.ci.tigard.or.us �� g ll OF 1 1 �� Notified/Method: 1 G � Supplemental Information
, - 1i i I \1 i1. r iAt i ' �, : ; *, • ! --a ti 1 f ti �u{iyn.. - t ... .. . _ ' ..n c, ., t r Y r ,, � Y 't;
r� T. -� . xiF.� ,.. ! ,�i 'h � ,.:... ._., t ...: '� r a _ -.:- - -.:. � � .....- ,'t. • r {f�. ,.ts`•�1" !: $.ki r, ,... -.-
N ew construction Please check all that
E l New apply:
❑ Demolition ❑Other ['Service over 225 amps, comm'l ❑Hazardous location
{ x ['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
r ;t �' t aj't n';'• , h „ .; - . -. r,::- 1 f ,4 1 ,t , of 1- and 2- family dwellings 4 or more new residential
fiiF" �� .. Win _ . - E._.rh c, ,. .
❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
❑ Multi- family ❑Master builder ❑ Other: ❑Building over three stories ['Feeders, 400 amps or more
❑Occupant load over 99 persons ['Manufactured structures or
44'0W,_:,-.4''-';=''''.,:7 ,t4 ,, .:T - t t r E :c,;',11. l ❑Egress/ plan RV park
Job no.: Job site address: 14945 SW Sequoia, 170 ❑Health -care facility ['Other:
Submit .2, sets of plans with any of the above.
City/State/ZIP: Portland, OR 97224 The above are not applicable to temporary construction service.
. T .
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Suite /bldg. /apt. no.: Project name: J.C. Reeves , ' " x - :
,.��-. - ' ' r a a ` . .,,: - , ,...",--
onvlptloe Q4. Fee. Tad
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
Includes attached garage.
1.000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea add'I 500 sq. ft. or portion 33.40 1
Tax map/parcel no Limited energy, residential 75.00 2
I - r ti' •s� F i t r � ,, , , Limited energy, non-residential 75.00 2
�.. � ... -.ry• ... � .._r. ��.. <.�t, ; t:;:.:Y s ::,. �, ..:. E ac h manu factured or modular
Tenant improvement dwelling, service and/or feeder 90.90 _ 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
, .„ Ks
__ ,
! r 1 t I ,, if,1a r Ti . t 201 snips to 400 amps 106.85 2 •
.'i nk'., -Itl:v_ _,... _. K! ..■..:J. -;t. _,sv 1 ,, , ,,z.,m 1, r: , '_. i 3 -7-- - 2.,31
401 amps to 600 amps 160.60 2
Name: Pacific Realty Associates 601 amps to 1,000 amps 240.60 2
Address: 15350 SW Sequoia Pkwy, 300 Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/ State/ZIP: Portland, OR 97224 Temporary services or feeders installation, alteration, and/or
Phone: ( 503)624 - 6300 Fax: ( 503 ) 624 - 7755 relocation
200 amps or less 66.85 1 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
'Y` err r 11 1 1 'V v! 'r r l 3 1 1 l( li - �, r .., '' P",, 1 i A. Fee for branch circuits wild!
4p. . 4 ,t.,. ; - k,tx4 , ,i;;_.,<.1 ... -._ r,1 i 1
,,.. .. I : :4 „ , 111 , 14,4,:s. r. -'1 _ .' ?),, ?',0
1 .
service or feeder fee, each 6.65 2
Business name: Johansen Electric Inc. branch circuit
Contact name: Charlynn Leifsen B. w ee o ur branch or feeder without service or feeder fee,
Address: 10948 SE Valley View Terr. each branch circuit 1 85 46.85 2
Each add'I branch circuit 14 6.65 _93.10 2
City /State/ZIP: Cl ackamas, OR 97015 Miscellaneous (service or feeder not included)
Phone: ( 503 ) 698 - 3417 Fax: : ( 503 ) 698 - 2486 Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: lohansenelectQmsn.com Signal circuit(s) or limited -
1, ' - ' 17 -:''+''''W'' -- "''''' . rri .1 1 s r , 1 nzt "'{r' r , . ti`I r 1� ' _ energy Panel, alteration, or
, ; _ ? ..c � ,, V ,, I ` 11: .,,. `r",,,,-7---: " extension. Describe: Page 2 2
Business name: Johansen Electric Inc.
Address: 10948 SE Valley View Terr. Each additional Inspection over allowable in any of the above
Per inspection 62.50
City/ State/ZIP: Clackamas, OR 97015 Investigation per hour (1 hr min) 62.50
Phone: (503) 698-3417 Fax: (503) 698 - 2486
Industrial plant per hour 73 75
CCB Lic.: 51539 Electrical Lic.: 3 -243C Suprv. Lic.: 2053S Subtotal 139.95
Suprv. Electrician signature, required: / / _ _ i Plan review (25% of permit fee)
_
. ■ ~ A. a � State surcharge (8% of permit fee) 11.20
Print name: Carl K. Johansen / Date: 3/25/05
TOTAL PERMIT FEE 1 51 .1 5
Authorized signature: i This permit application expires if a permit to not obtained within 180
' i/� days after it has been accepted as complete
Print name: Charlynn J. LelfS , Date: 3/25/05 • Fee methodology set by Tri -County Building Industry Service Board
•• Number of inspections per permit allowed.
isSBuildinglPer miu\ELC-PermitApp.doe 12/03 4404613T(10e2/COM/WF8
' CITY OF TIGARD -
BUILDING DIVISION PERMIT #: ELC2005.00184
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/25/2005
Phone: (503) 639-4171 . . 1 1,
Inspection Inspection Requests (24 Hrs.): (503) 639 -4175 __..
INSPECTION WORKSHEET FOR DATE: 4/ 053/ I OS TIME: 7:11AM PAGE: 101
SITE ADDRESS: 14945 SW SEQUOIA PKWY 170 CLASS OF WORK:
SUBDIVISION: PACIFIC CORP. CENTER LOT #: TYPE OF USE:
PROJECT NAME: JC REEVES
DESCRIPTION: 15 branch circuits.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503698 -:417
Inspection Request Scheduled For: Date: 4/29/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 005620 -01 503-969-5262 N
Corrections /Comments /Instructions:
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WIP Ibt "
D.\ - T O cp L Ci p„)). i ktt 1 \ ? )--0 Ce 114 CTEkAlon
m ._
vc
....
1
1
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vr(--F t 6 ` v°
❑ PASS t] PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
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Inspector: l Datee — ^ 02. -73 Phone #: (503) 718-
CITY OF TIGARD ._ • 0 •
BUILDING DIVISION - PERMIT #: ELC2005 -00184
I 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/25/2005
Phone: (503) 639 -4171 : i1hi
Inspection Requests (24 Hrs.): (503) 639 -4175 . - ` __..
INSPECTION WORKSHEET FOR DATE: 4/21/2005 TIME: 7:06AM PAGE: 79
SITE ADDRESS: 14945 SW SEQUOIA PKWY 170 CLASS OF WORK:
SUBDIVISION: PACIFIC CORP. CENTER LOT #: TYPE OF USE:
PROJECT NAME: JC REEVES
DESCRIPTION: 15 branch circuits.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503-698 -3417
Inspection Request Scheduled For: Date: 4/21/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
130 Ceiling cover 005014 -01 503. 969-5262 N .
Corrections /Comments /Instructions:
WASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
El FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 4 Date: le 2 4 'Or Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION .• • . PERMIT #: ELC200S-00184 _
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/25/2005
Phone: (503) 639-4171 :41_10
Inspection Requests (24 Hrs.): (503) 639-4175 —61- 1L
INSPECTION WORKSHEET FOR DATE: 4/7/2005 TIME: 7:14AM PAGE: 43
SITE ADDRESS: 14945 SW SEQUOIA PKWY 170 CLASS OF WORK:
SUBDIVISION: PACIFIC CORP. CENTER LOT #: TYPE OF USE:
PROJECT NAME: JC REEVES
DESCRIPTION: 15 branch circuits.
OWNER: PACIFIC REALTY ASSOCIATES, CI PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503.6983417
Inspection Request Scheduled For: Date: 4/7/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
125 Wall cover 003986-01 503-704-1534 N
Corrections/Comments/Instructions:
•
A PASS 0 PARTIAL APPROVAL D CANCEL El NO ACCESS
111 FAIL 0 CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: Al....da., , L) Date: D 6 Phone #: (503) 718-