Permit CITY OF TIGARD ELECTRICAL PERMIT
s COMMUNITY DEVELOPMENT Permit #: ELC2012 -00469
T [ G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/07/2012
Parcel: 2S112DD00701
Jurisdiction: Tigard
Site address: 15808 SW UPPER BOONES FERRY RD
Project: Lamar Company Subdivision: 1994 -006 PARTITION PLAT Lot: 2
Project Description: (2) branch circuits for office TI
Contractor: JOHANSEN ELECTRIC INC Owner: PACIFIC REALTY TRUST
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
Specifics: 2 crt Branch Circuits wo /Purchase 08/07/2012 $63.60
Service or Feeder
1 ea 12% State Surcharge - 08/07/2012 $7.63
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $71.23
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 OAR 001 -009 . You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. T D n
Issued By: CaYI Permittee Signature: D� ,4PPu 1 (/
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 503.639.4175 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.
. . Rrarr- iliC RE CE V E : i _
Electrical Permit Annlication AUG I'()It b11'11( 1 tit. () \I 1
City of Tigard HU r� 0 f 2012 tEgmEmzum PermitNo.'6i OLJ Ie1- '0040
13125 SW I lall Blvd., Tigard, OR 97223 n --lt ", f • -
" Phone; 503.639.4171 Fax: 503.598.19640 i Gee l ! Pe ePaoia -• Qb /S
+ Inspection Line: 503.639.4175 DLO f S,. t E r`, F,"K Pnte Roaly/By. See Page 2 err
Internet: www,tigard- or,gov • Y Notified/Method: Supplemental lntnmotiun
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❑ New construction ® Addition /alteration/replacement Pleas. check all that apply (submit V sets of plans wlitcros checked below);
❑ Service or loader 400 Amos or mule 0 Building over three stories.
❑ Demolition ❑ Other: where the available faith currom ['Marinas and boatyards.
k��,- :�.., `;e .f.. :.t:,� V , c� , <�,r i a +,,.. ;. exceeds 10,000 sat volts or L1 Floating
w.: a a.. . �,�, ' e a I��i�°; ::; :li':;:,�.�b' .
:.r ,�� d 10000 °mD 150 l
a g
' " .." ! y ..: f., -r .....�. .,. 3 v. f ' ,.', :, �` �. ; i'i .:: ,?,r' ° :: .,`.
leas to grand, or exceeds 14,000 El Cornmeal-UM ag
❑ 1 - and 2- family dwelling ® Commercial/industrial 0 Accessory building amps Ler all other installations. buildings.
❑ Multi- family [] Master builder ❑ Other: 0 Fire pump. ❑ Installation of 75 KVA or
t .. t �., „ rs y M : ❑ Emergency system. larger towns* derived system,
; ''' s ' C' Y,. i `t. ''7. t+: : e 6 w 'i , a ' rr !I - .4:. a � �:,l .k;',::',L.fi :- 6
: O t: ,',; h'w., , ' t :It vah s '. s .. 0 Addition of now motor load of ❑ "A ", "E".1.2"."1.3",
Job no.: Jab site address: 15808 SW Upper Boones ❑ l x o rormom. occupancy.
Si or more residential units. ❑ Rcaentionalvohiolotmrk>ti
City /Stale /ZIP; ❑ Health-care facilities. ❑ Supply voltage for more then
❑ Hazardaas locations. 600 volts nominal.
Suitc/bldg.lapt no.: I Project name: Vacancy 0 Service or feeder 600 Amos or moo.
`�.,' ?; g ,F .; ..� . � . •k 4 (_;, .r'r' ,le'i∎; r:e F? "rig .e -
Cross street/directions to job site. ;4' "r :: .:1: � :
j l� n' "( t � 'acct �
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: 1 Lot no.: 1,000 sq. ft. or leas 168.54 4
map/parcel no.: Eta. udd'1500 sq. lt. or portion 33.92 1
Tax mA
P/p y Limited energy, residential 75.00 2
1 .,,.. 1 :' ' " • " -., .;•.c . .. r '.a.'lo�," :L I :::o: :. .n:' � do :� soil.)
'p'y'.. ;_; ,., : ,1i= `.%.. . � .F., . :... :. . . ,ems , r 5 � : # t
. .. : �.S "1�, ,
` �.: 'y..: , '- -. �, "'.:1ni •.�',;� i.• v (with above
• Limited energy, multi-family 75.00 2
Add receptacles residential (with above so. It) _
Services or feeders Installation alteration, and/or relocation
200 amps or less 10(1.70 2
, *.; %fi t ., :s, ca ' �:�` ", NPr.'-°A:r, .' 'r:: p; y , . rr-, 0.e, 201 amps to 400 amps 133.56 2
lly.:. ..I(KiM1I 1fl�11* J • . " t,'n?
Name: 401 amps to 600 amps 200.34 2
601 amps to IMO amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
City/State/ZIP: Temporary services or feeders installation, alteration, and /or
ty relocation
Phone: ( ) I Fax: ( ) 200 amps or less 59.36 1
Owner installation: This installation is being made on property that I own which is not 201 mops to 400 mops 125.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. - 401 amps to 599 amps 16854 2
Branch circuits - new, alteration, or extension, r mend
Owner signature: Date: A. Fee for bntnch cirtanits with
�.: +, , }• `
tn..
•.,, :. i ". abovesetviceorfeedtrfee,
a
...:�riw"."�, >,' .: x:;:.,. i:�� �'F;;: eachbtnnchcircttit 7.42 2
Business ntntle: A Nee for brunch cimuil wither/
Johansen Electric service or feeder fee, first
Contact name: Charlynn Le i f sen branch circuit 1 56.16 6.18 2
Each add'1 branch circuit 1 7.42 7.42 2
Address: 10948 SE Valley View Terr Miscellaneous (service or feeder not included) _
Each manufactured or modular 67.84 2
City/State/ZIP: Happy Valley, OR 97086 dwellinR, service and/or feeder
Phone: 698 -3417 I Fax:: (503) 698 -2486 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
8 -mail:
Sign or outline lighting 67.84 2
KC•'. .'+ +.:':-� : . : :.i , :�'..,1 '+` arll' Y" kil$: P. bra ',f.g': q.,<,''* v *''i + 's` er: Signal circuit(s) or • mi ted.cnergy
Business Hanle: Johansen Electric panel, alteration, or octension. Pape 2, 2
Each additional h ape lion over allowable in an' of the above
Address: 10948 SE Valley View Terr Additional inspection (1 hr min) I 66.25/ hr l
City /State /ZIP: Happ Valley, l a OR 97086
investigation ( t 1 mm) 78./ hr
P�X y • induslriril plant (11th min) 78.18/hr
Phone: (503) 698-3417 I Fax: ( 5 0 3) 698-2486 Inspections for which no fec is 90.00/ hr
•ifmnll listed tt4hrmin
CCB Lie.: 51539 I Electrical Lie.: 3-243C I Suprv. Lie.: 2053S ,.• a Poi. a ; .a71Y ' g;1"ME ' -'_.. ' <.'!'• : • -•
Subtotal: • . 60
Suprv. Electrician signature, required:
/ • / Plan review (25% of permit fee):
-i P V • r 0, -; — - -• o
Printnamc: Carl Johansen / 'ae: 8/7/12 Slate surcharge (12 %ofpermit 7.
TOTAL PERMIT FEE: 7]. . 2 3
Authon7ed signature: - • this permit application expires penult / I _ i_ r P PPa p If A It Ia not obtained within 180
Print name: Charlyn Le ■ ' - en Date: 8/7/12 daps Li if has been permit as complete.
• Number of inspection!! allowed per permit.
1: Ulull&ngwormili\P.t.C- PeroclApp.da 07/01 /10 400- 4615111U0S/COM/Wlr
Z /T 'aDVa 986Z869E09 986Z869E09 iOHZa NaSNFIHOr Nd E6 =TO ZTOZ- LO'bnV