Permit •
ELECTRICAL PERMIT
CITY OF TIGARD
° PERMIT #: ELC2007 -00636
COMMUNITY DEVELOPMENT DATE ISSUED: 9/12/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S112DA-00800
SITE ADDRESS: 15055 SW SEQUOIA PKWY 100 ZONING: I -
SUBDIVISION: PACIFIC CORPORATE CENTER LOT : JURISDICTION: TIG
PROJECT: PAC STAR
Project Description: 2 services and 10 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: 2 W /SERVICE OR FEEDER: 10 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: Contact #: PRI 503 - 698 - 3417
FAX 503 - 698 -2486
FEES
Description Date Amount Reg #: ELE 3 -243C
[ELPRMT] ELC Permit 9/12/2007 $227.10 LIC 51539
[TAX] 8% State Surcharge 9/12/2007 $18.17 SUP 2053S
Total $245.27 REQUIRED ITEMS AND REPORTS
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: Permittee Signature:
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.
•
JIL -Its- ,.
RECEI`'. .It .
Electrical Permit Application 1 < I I . ( I I I I< I. 1 11 <) \ I .
T
City of Tigard S t ? �+t�i ' Pert No.
13125 SW Hall Blvd., Tigard, OR 97223 ..1-71,'S ...DP , '
i llii
• Phone: 503.639.417] Fax: 503.598.1960 CITY OF TI I Other Permit
Inspection Line: 503.639.4175 BUILDING DI =:';
Internet: www.tigard- or.gov
'1 1'1'. n 1 ., :Y 11 i "t:' 1:. Y fill 1 I VI Ir'111 - . 7; . ( t .i r- :-∎,∎� " •- i : ;1 1 I , 1 oil' oG 1
1 tl, I I i( I '.s 4 I I ,.f} .i,l ,I I f{'t.'' ���� 'ml i,l 1 1 G'1
i ,s « ! . i 1' 1 :11i<iw1itA. Jf i , II l st<:141 r Il ll� • �.I1 C i 11 i ,Y I "t: �., II ii Y 1, 1.,6 �iI'l C 11
t Yt j1 D Iii �� i i i E �ifALt 41 e�1]s ���� 118�61I 4��lI� . � <.lil - I�tllI11J11�1Ff� .R��'.t(,'.41...Str�r in . � II 1�.:1.0 .. _: �L..C,e;�111�1.,)
' CY'13uen k tl! E'i Ili(! 9 .
❑ New construction ® Addition/alteration/replacement Memo check all that apply (submit 1 acts of plane wfitems checked below
0 Service or feeder 400 amps or more 0 Btdlding Data three etoriea.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas end boatyards.
i i , 'R`' Y�"II r 4 it i iWl r lIt Irt •a'�"] I�){�I I� Irlu l u..tt� r l
`I ta 1 .'ll l r 11, I 6`sn lk r exceeds 10.000 am
�, l►�;< 1s�1.t ? �a,.t�;:;,L: �1�l�Il;,C�ir = f. x' at 150 volts or D
lass m growl, or exceeds 14,000 Floating bm1dinge.
Commercial-use e
❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi-family ❑ Master builder ❑ Other: D Fire pump. O Installation of 75 KVA or
I � �, • �i -� �1a r t I.. t' �,.Ia:.J1 .: N ts{ } y ., 0 Emergency larger separately derived system.
Tj #1 Ll �i► 1. IiiL��� . J 1 ytLL' + I °' ij 2 ..5'}I�' "�1t�s."PtZ .3915SjN '' 1 I t - V `il ❑Additionof now motor load of D •p.. 8 .... 1. 2.... 1. 3..
r ��Y�. -k La I .CJ.Y4::�. L.._.u., Itr'Sl1t.t , L ' L` ! � J.. . • lOOliPormom. occupancy. Job no.: Job site address:
i1 . . / . , tO / D Six or more residential wits. D Recreational vehicle parka.
City /State/ZIP: 0 Health -Caro facilities. D Supply voltage for more rim
D Hazardous locations. 600 volts noininal.
Suite/bldg./apt. no.: O Project name: h # afar D Service or facia 600 or more
7' i : lull litxn ) 11 . 1 . v a< w• , t t "'r I S f't
jYl:tii:......I �r"rl,IEl1 .,, d I:,,' , , ':;rr� :; ��LIr�;tl. v.
Cross street/directions to job site: DaseAeooa Oh. Pow Total •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: l Ito,: 1,000 sq. it or less 145.15 4
Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.:
ire • 7. Ii '. Mul : 9; a . :� :: i < � ' , Limited energy, residential 75.00 2
I I Ij 1 i 1
ll 1 .. i 17 0-- 53Vil1 I111hi kitld :` ii lfl= ti Y .yrlt .,i 3'oilc FI B. l P: ° .la.,Nii 1 li h r t iii k 1 d 1 d.* i I lI�ij (with above sq. Ii)
:11,111E � .I . k.... � � I ti6i � f� � I I..n 16L.II1lI
Limited energy. multi - family 75.00 2
I ♦ 1 / tl\ I JL _ t1 residential (with above sq. ft) _
Services or feeders installation alteration, and/or relocation
Tr-7 ?:7 l t tit t t jr4_, ;' 0, t 1 1, � Nr r r 77.:7 as . :7 . tI
200 amps or less 'L 80.30 1( 40 2
.i.111,fS :Ai a rt• 1t4)1•�ir ,m4he.4.., : `:1/11 :1 stileYpP,1} } i R IB if, wt< A ibl i lriio?ultaiL ninirift II 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2 -
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City/State/ZIP: Temporary services or feeders Installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 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 599 amps I 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
�
hi r ri'9g ,, 1 1 lI 1 inn, a +.:u I 1 . I tk lm n rue „ 1: ,t p
A. Fee for branch circuits with
MO i 91 1f ., M t i i'.. d r ill 0. 72 . 1- u�illl1,1 :i II .1I ala igiato:2:j � I.ai T. ,I.r�< -: Y, s.�r01ii121L8 above service or feeder fee, e 6.65 �� 2
Fee branch branch -
Business name: Johansen Electric Inc.
B. Foe for branch circuits
Contact name: Charlynn Leifsen wtrkaa °r feeds ' 46.85 2
first branch ch circuit
Address: 10948 SE Valley View Terr. Each add'( branch circuit 6.65 2
Miscellaneous (service or feeder Dot included)
City/State/ZIP: Clackamas, OR 97086 Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: (503) 698-3417 Fax: : (503) 698 -2486 Reconnect only 66.85 2
E -mail: Johansenelect@msn.com Pump or irrigation circle 53.40 2
Iivw i_ III 1 . .. "I 1 s1,: r 3 I rit .: it �.�r�r-y l -I :3 r r l i a'In sat „r dal
���� stir �;� �i I >�..�<�;>�"._.>?..I..�w�.�4."i 'r{'; ti�i III I d���iiiii�;ll��' si or on -line lighting 53.40 2
Business name: Johansen Electric Inc. Signal circuit(s) or limited -
energy panel, alteration, or
Address: 10948 SE Valley View Terr. extension. Describe; Page 2 2
City/State/ZIP: Clackamas, OR 97086 Each additional inspection over allowable in an of the above
Per inspection 62.50
Phone: (503) 698 -3417 Fax: (503) 698 -2486 Investigation per hour (i lrr min) 62.50
CCB Lic.: 51539 Electrical Lic.: 3 -243C Suprv. Lic.: 2053S Industrial • ant • r hour 73.75
n
/ Ir I 1 ° I i .1 1 t i ., lllt .. n > la:.
Suprv. Electrician signature, required: 01311115/ lit._il l! I�I�Liiicl .,.'2�xo.,u.�hr,.rI i. is ".tiL�l � t il.t ...,Ic.1l & . l< .
`tea , L Subtotal: Z2_'1. t
of permit fee):
Print name: Carl Johansen " Plan review (2s
Date: f,, (25%
State surcharge (8% of permit fhe): I e • ii
Authorized signature: ��. TOTAL PERMIT FEE: 24 5 .2'1
Print name: Charlynn Leifsen I ' ate D TWA permit applleadon expires If a permit Is not obtained within ISO
q ►�l' days after H has bee. a epce red as =swim.
• Number of inspections allowed per permit
L - \HailcatePermitslELC-PermitApp .see 05/246 440.4615TO Um/COwaen
I ' d XUA 13CZI3SEi1 dH WEND : B L002 21 daS
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007 -00636
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/12/2007
Phone: (503) 639 -4171 : °
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 9/27/2007 TIME: 7 :00AM PAGE: 41
SITE ADDRESS: 15055 SW SEQUOIA PKWY 900 CLASS OF WORK: •
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: TYPE OF USE:
PROJECT NAME: PAC STAR
DESCRIPTION: 2 services and 10 branch circuits.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503 -3417
Inspection Request Scheduled For: Date: 9/27/2007 Pour Time:
Code # Inspection Description ' Confirm # Contact # Message
199 Electrical final 056465 -02 503209.3917 Y
Corrections /Comments /Instructions: S \NV
:(\
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
ATL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: NM Le Date: q PIT) Phone #: (503) 718- 1't i�
CITY OF TIGARD
BUILDING DIVISION A . PERMIT #: ELC2007 -00636
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/12/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 IL.
INSPECTION WORKSHEET FOR DATE: 9/27/2007 TIME: 7 :00AM PAGE: 42
SITE ADDRESS: 15055 SW SEQUOIA PKWY 100 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: TYPE OF USE:
PROJECT NAME: PAC STAR
DESCRIPTION: 2 services and 10 branch circuits.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503 - 698-3417
Inspection Request Scheduled For: Date: 9/27/2007 Pour Time:
Code # Inspection Description ' 7Confi?rn -# Contact # Message
115 Electrical service 056465-01 503 203.3917 N
Corrections/Comments/Instructions:
1 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: Phone #: (503) 718-