Permit r
I CITY OF TIGARD ELECTRICAL PERMIT
° PERMIT #: ELC2007 -00771
• ',, • COMMUNITY DEVELOPMENT DATE ISSUED: 11/15/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 112DA -01400
SITE ADDRESS: 15350 SW SEQUOIA PKWY 250 ZONING: I -
SUBDIVISION: PACIFIC CORPORATE CENTER LOT : 002 JURISDICTION: TIG
PROJECT: COMMON SENSE
Project Description: (2) 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: SIGNAUPANEL:
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: 1 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 11/15/200' $53.50 LIC 51539
[TAX] 8% State Surcharge 11/15/200' $4.28
SUP 2053S
Total $57.78 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: ii‘d: /,,eu,, A Permittee Signature: ern ` _ r / l'�.„A
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.
•
Electrical Permit ADULCe IO I ri,l: Ol l l(l I .I t,.l.,
City of Tigard NM 14 2001 ,
13125 SW Hall Blvd, T' c'._ Pere _ 4 ,,y ... , 040
Phone: 503.639.4171 Fa 03. 97223 y 3, Other Permit:
Inspection Line: 503.639.4175 ( � 1 s. a 3.„4„,..
1 I ,- -; ::: t I 1
or . hua / ff See Page 2 for
Internet www.tigard-or.gov "(� - * , 7
I a s ,� L i ' 16 l � BoPPaeaad i�orm.tim
II. t ,1r� 7i l I�iiI �ivj yr� gc 8.t a�-s_ -•:r. it t:.' ti: y , r- as u; sew ..�x a,�
tl,� n.'I�G+3.7'' 9:1.',. 1�d c : iri?IA ,E.SI.I.ier 7. 't'c� s�! �. i ''I I�iinIA' b, ' . .r• `% s+P < ti : }/.'' -1 � l,: n ;4 . n-.p, P p• r
❑ New construction ® Addition/alteration/replacement Please check all than apply (tube& a sea of plans widens checked below):
❑ Demolition ❑ Other 0 Service or feeder 400 amps or more 0 Building over three stories.
G jL�1� +�i:! 'd ,� ='y al g '' ax u` when m
the available fault currant 0 Marinas and boatyards.
:; " ieT:'. '',�_r'��',cvir��R exceed/ 10,000 =am et 150 volts or ❑ Flowing Mnldiaga
El 1 - and 2 - family dwelling ® CommerciaUindustrial ❑ Accessory building less to groaod, or meals als 14,000 0 b w1di to l:nal - um agricultural
ry � ��ell other;aatdladws. .
❑Multi -famil
Y ❑ Master builder ❑ Other. 0 Fire pwnp. 0 lnstallanon of 76 KVA or
• "9- i ii ` carp ?Si�{r. a; a r<: `s > . `�� ❑
I u,A xtN::laiLt..�,,_ t x41 . n I 1 1 / t is ^, i ll I i ! .1 ^ - ,"�' "1. s, M of ne arum. lag, separately derived s ,iwb ru:.. �s 31:.1 . luihim.:� �tid:ri�. �:. >� 0 Maim, of now mot r load of ❑ "A" 'E • l-, 2 °I -3".
Job no.: Job site address: I Dam �O /) Z 100HP or more occupancy.
❑
s " ❑ Sox or more residential emits Recreational vehicle parka.
City/State2 0 Healthcare facilities. 0 Supply voltage for more than
0 Hazardous locations. 600 vein nominal.
Suite/bldg./apt. no.: J.# Project name: . ii ALA , A A i r ❑ Servit a or feeder 600 amps or more.
Cross street/directions ddir actions io job site: `- . (o 11 v ��. � `"'71 1 "73 !J ' rrr •t '
Description OD. Fee Total ` •
New residential single- or multi- family dwelling emit
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. R. or less 145.15 4
Tax map/parcel no.: Ea add 500 sq. ft or portion 33.40
sl '>i}l f! i I 11tux1y.14 r+:.a!ea, Limitedenergy,lesidemial 75.00 2
i .-i il�rf}iu'ill ;c s ;}a ice x `:: it. o- l a riaLV , E Mi (with atwvo r9.8.)
r Limited energy, multi - family 75.00 2
1.: / . F4 14 ' . l .14.1■ residential (with above sq. it)
Services or feeders installation, alteration, and/or relocation
•'r ( I ° gR Z ka'e'�xa t��`t�.
200 amps or less 8030 2
-'zit.I' t..�.a ` . r T''• : Gl f+s «::1 ?(ethyl /51 a { I if ° S1' F r 7sxc "'t nx, ,:g'1': i i i ..;:j :. ' itifi 201 amps to 400 amps 106.85 2
Name: f f li ' .0 4"-t . 401 amps to 600 amps 160.60 2
` � 4f 601 to 1,000 amps
Address: 15 l '" G )t j bL_ r Over 1,000 amps or volts 454.65 2 SILO
City/StateJZIP: % A EL !I ,tom 1 (,ivr-7:?... Temporay services or feeders installation, alteration, and/or
T 644-1/241D 2 am on
Phone: ( J ) Fax: (�) �(,!' 1' �S✓ 2W 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 133.75 I 2
Owner signature: Date: Branch circuits -sew, alteration, or extension, r panel
I� "g Iw t, - -� .� , " . { ,�', r; At x sli x � y � & Fee for branch circuits with
Iii;;Ch ..' '•`_ie;4: E:P1=' FI i 1 T y ° l`ti nilai. above service or feeder fee,
1: T it. [a� �m'es` t�ix �s� 6.65 2
Business name: Johansen Electric Inc. each branch circuit
B. Fee for brunch circuits
Contact name: Chatrlyna Leifsen without service or feeder fee, I 46.85 2
first branch circuit 4G .gs
Address: 10948 SE Valley View Terr. Each add, branch circuit 1 6.65 (, , (
City/Stste/Z1P: Clackamas, OR 97086 Miscellaneous (service or feeder not included)
Each manufactured or modular 90.90 2
Phone: (503) 698 -3417 dwelling:, service and/or feeder
( ) Fax: (503) 698 -2486 Reconnect only 66.85 2
E-mail: johansenelect@msn.com
,�: ,,.,, 1 �! Pump or irrigation circle 53.40 2
iIIe Li , M . ;hi; 1 ! x? " €!. . . ,:s II I i o• t iraar y, Si gn ' t �':;' gn or outline 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 anv of the above
Phone: (503) 698 -3417 I Fax: (503) 698 -2486 Per inspection 62.50
Investigation per hour (1 la- ®n) 62.50
CCB Lic.: 51539 1 Electrical Lic.: 3 -243C I Suprv. Lic.: 20533 bndustrial •lent . - rhour 73.75
Suprv. Electrician signature, requited:
'1171: Tr; ,1G441., .E t�-eu l , :' ' � : :Ln .� ,3 - I:
• / J / Subtotal: 5,3.
Print nacre: Carl Johansen a ate: 1 , 07 Plan review (25°4e of permit fee):
State surcharge (
Authorized signature: ) -
83 of permit fen): ,
TOTAL PERMIT FEE: 51 .
Print name: Charlynn Leifsen Date: J t Hs permit application expires if a permit b us. obtained vwIthia 180
I 0 7 day. after It bas been accepted as complete.
CvBaldxag�pt7mit >•ELC PensitApp.dx 03123.9X5 • Number ofinspe tions allowedperpermit.
440.461ST( I I/05/COM/WF9
6 ' Cl Xdd 13C213Sd1 dH Wd . I :2 L002 b- i nob
CITY OF TIGARD
BUILDING DIVISION . PERMIT #: ELC2007.00771
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/ 1612007
Phone: (503) 639- 4171
Inspection Requests (24 Hrs.): (503) 639 -4175 1
INSPECTION WORKSHEET FOR DATE: 11/28/2.007 TIME: 7: 00AM PAGE: 20
SITE ADDRESS: 16350 SW SEQUOIA PKWY 250 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: 002 TYPE OF USE:
PROJECT NAME: COMMON SENSE
DESCRIPTION: (2) branch circuits.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503 - 698.3417
Inspection Request Scheduled For: Date: 11/28/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
108 Electrical final 0G0401:: 503-969-5262 h!
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: �7' r 4 j L. Date: U 1, Q1 Phone #: (503) 718- �'ioo