Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00034
Atip
DEVELOPMENT SERVICES DATE ISSUED: 1/24/2005
..� I - ' 13125 SW Hall Blvd., Ticard, OR 97223 (503) 639 -4171
PARCEL: 2S 112 DD -01600
SITE ADDRESS: 15495 SW SEQUOIA PKWY 100
SUBDIVISION: PACIFIC CORP. CENTER ZONING: I -P
BLOCK: LOT : JURISDICTION: TIG
Project Description: (20) 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: 19 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 1/24/2005 $173.20
[TAX] 8% State Surcharge 1/24/2005 $13.86 Rough -in
Elect'I Final
Total $187.06
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: Z) Permit Signature: Sj (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 639 -4175 by 7:00pm for an inspection the next business day
From: Charlynn J. Leifsen To: City of Tigard Date: 1/24/2005 Time: 12:20:34 PM Page 2 of 4
Electrical Pe snit Applicatio» E D ` 11 1 1 t 1 1 1 1 I t F 1 1.1, \ l .
City of Tigard RE ' .-y 0 i—' e- Permit No.: 6C,� f/V�d l.4/ Q
13125 SW Hall Blvd., Tigard, OR 9 Plan Review
Phone: 503.639.4171 Fax 503.598.19 A ' 1- ' t� I I D - : • Received �P :
Inspection Line: 503.639.4175 SAN 't L _ !.. ' _ � _ _. Date Ready/BY 0 See Page 2 for
Internet: www.ci.tigard.or..us Notified/Method: Supplemental Information
❑ New construction ®. ... s ,! V 1 , • • ioNreplacetnent Please check all that apply:
❑ Demolition ❑ Other ['Service over 225 amps, comm'I ['Hazardous location
S
HIES:: ervice over 320 s — rating t t �: ; tr �P g Buildng over 10,000 sq. ft.,
t ❑
1,0 . a . : : , IT., 1.,,, .. .._ ; ' _;,_, + ,, , '1_ of 2- family dwellings 4 or more new residential
❑ I.- 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 [Weeders, 400 amps or more
s
..
, : ❑Occupant load over 99 persons ❑Manufactured structures or
,
1 f ' I1),. _
' nom....... ' : :... r t G . ..,1, ,:
, . r _.... .. ..� .. . . .... r' .z ' : . r ❑Egresslligh � P� R V park
Job no.: Job site address: 15495 SW Sequoia, 100 ❑Health -care facility ❑Other:
Submit j. sets of plans with any of the above.
City /State/ZIP: Portland, OR 97224 The above are not applicable to temporary construction service.
Suite/bldg. /apt no.: Project name: Securityco : :, , . .
" ' ' ' ,: . ••
neelptioe Qty. Fm rolal
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'1500 sq. ft. or portion 33.40 l
Tax map/parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
e 71 c- i t I °j
, ;,_ a, , I, t I j i t , , ; a T' .. { Each manufactured 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
, T' : 1j I = 201 amps to 400 amps 106.85 2
w s ,i '. +' ,. _,, , :it , , .I 1 _., N";:`,1 +;y .: 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 an 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
1 , t , n+ 4I i, 'v� ';', +, A. Fee for branch circuits with
Business name: Johansen Electric Inc. branch circuit fCe ' each 6.65 2
B. Foe for branch circuits
Contact name: Charlynn Leifsen without service or feeder fee, 1 46.85 46.85 2
Address: 10948 SE Valley View Terr.
eadtbranchcircuit
Each add'I branch circuit 19 6.65 126.35 2
City/State/ZIP: Clackamas, 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 1 2
E -mail: johansenelectgimsn.com Signal circuit(s) or limited -
e ' -r a,- , , ( I I i , , ti 111 t f1p energy panel, alteration, or
. ., .,, . ,r, .:.c y ,.. ,tom.,, _.
. I . �u.. .. :.., .... . 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 (I hr min) 62.50
Phone: (503) 698 -3417 Fax: (503) 698 - 2486 industrial plant per hour 73.75
`a•f
CCB Lic.: 51539 Electrical Lic.: 3 -243C Suprv. Lie.: 2053S Subtotal 173.20
Suprv. Electrician signature, required: / / — _ Plan review (25% of permit fee)
State surcharge (8% of permit fee) 13.86
Print name: Carl K. Johansen / Date: 1/24/05
TOTAL PERMIT FEE 187
Authorized signature: • 4 Olt This permit application expires if a permit Is not obtained within 180
days alter it has been accepted as complete
Print name: Charlynn J. Leifs- Date: 1 /24/05 • Fee methodology se by Tri-County Building Industry Service Board
•• Number of inspections per permit allowed.
is lauadieglramiu \Pl.C- Permtupp.doe 12/03 440.4615T(10/ 2/COMIWFB
CITY OF TIGARD
•
•
BUILDING DIVISION Ai.. PERMIT #: ELC2005 -00034
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/24/2005
Phone: (503) 639 -4171 .s�n %�,� ` J
Inspection Requests (24 Hrs.): (503) 639 -4175 -_ __..
INSPECTION WORKSHEET FOR DATE: 3/23/2005 TIME: 7:08AM PAGE: 49
SITE ADDRESS: 15495 SW SEQUOIA PKWY 100 CLASS OF WORK:
SUBDIVISION: PACIFIC CORP. CENTER LOT #: TYPE OF USE:
PROJECT NAME: SECURITYCO,INC.
DESCRIPTION: (20) branch circuits.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503.698
Inspection Request Scheduled For: Date: 3/23/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 002580 -01 503 - 969 -5262 N
Corrections /Comments /Instructions:
7 4pASS ❑ PARTIAL APPROVAL ❑ CANCEL El NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: v ' ``" N t (7 LIE Date: 3 -23- 6S Phone #: (503) 718 -