Permit ELECTRICAL PERMIT
CITY OF TIGARD PERMIT #: ELC2005 -00538
,�# DEVELOPMENT SERVICES DATE ISSUED: 7/28/2005
f I 13125 SW Hall Blvd., Tigard, OR 97223 503- 639 -4171 PARCEL: 2S112DD -01600
SITE ADDRESS: 15575 SW SEQUOIA PKWY 130 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: 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: 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: 503 - 624 -6300 Phone: 503 - 698 -3417
FEES Reg #: LIC 51539
Description Date Amount SUP 2053S
ELE 3 -243C
[ELPRMT] ELC Permit 7/28/2005 $139.95
[TAX] 8% State Surcharge 7/28/2005 $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 - 332 -2344.
Issued By: , Permittee Signature: .... ® Nc
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 Leifsen 503 - 698 -2486 To: City of Tigard Date: 7/26/2005 Time: 5:52:10 PM Page 2 of 3
Ce Na.
Electrical Permit APPlieatio , i,; , ,, , l t I , . I . \ I ,
City of Tigard n G il.! ��
13125 SW Hall Blvd., Tigard, OR 97223 JUL i L berms N o.: ' 6 a _ C' S3
Phone: 503.639.4171 Fax 503.598.1960 L 2U , ,, Other Permit:
Inspection Line: 503.639.4175 L j. . I pee Ready/By EIN 0 See Page 2 for
Internet: www.ci.tigard.or.us V OF TIGARD Notified/Method: Sa
ppk W stes Istormatfoa
❑ New construction ® Addition/alteration/replacement Please check all that apply:
❑ Demolition ❑ Other: ❑Service over 225 amps, comm'l ❑Haterdow location
['Service over 320 amps — rating ❑ Buildng over 10,000 sq. IL,
of I- and 2- family dwellings 4 or more new residential
❑ 1 and 2 family dwelling ® Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
❑ Multi - family ID Master builder ❑ Other; ❑Building over three stories ❑Feeds a, 400 amps or more
❑Occupant load over 99 persons ❑Manufactured structures or
❑Egteas/lighting plan RV pmic
lob no.: Job site address: 15575 SW Seq, 130 ❑Elea a facility ❑Other.
Submit I sets of plans with my of the above.
City /State/ZIP: Portland, OR 97224 The above are not applicable to temporary construction service.
Suite/bldgJapt. no.: 1 Project name: MCPC r6 Ts '
Desuiptlas Qtr. 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: l Lot no.: Ea add'I 500 sq. ft. or portion 33.40 I
fax map/parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential • 75.00 2
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
201 amps to 400 amps 106.85 2
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/StaterhlP: Portland, OR 97224 Temporary services or feeders Installation, alteration, and/or
Phone: ( 503 )624-6300 1 Fax: ( 503 ) 624 -7755 200 a °
200 amps or less 1 66.85 1 I
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 10030 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
A. Fee for branch circuits with
service or feeder fee, each 6.65 2
• Business name: Johansen Electric Inc. branch circuit ,
B. Fee for service circuits
Contact name: Charlynn Leifsen feeder service err feeder fee,
Address: 10948 SE Valley View Terr. each branch circuit 1 46.85 46.85 2
Each WWI branch circuit _ 14 _ 6.65 , 93.10 2
City/State/ZIP: Clackamas, OR 97015 Miscellaneous (service or feeder not Included)
Phone. ( 503 ) 698 - 3417 I Fax: : ( 503 ) 698 - 2486
Pump or u l n ation circle 53.40 ' 2
_ Sign or outline lighting 53.40 2
E -mail: johansenelect @msn.com Signal circuits) or limited -
r energy panel, alteration, or
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 (u ttr min) 62.50
Phone: (503) 698~3417 I Fax: (503) 698 - 2486 Industrial plant per hour 73.75
CCB Lic.: 51539 I Electrical Lic.: 3 - 243C 1 Suprv. Lic.: 20535 Subtotal 139.95
Suprv. Electrician signature, roquired :e, J i Plan review (25% of permit fee) _
Print name: Carl K. Johansen Date: 7/26/05 State surcharge (8% of permit toe) 11.20
TOTAL PERMIT FEE 151.15
Authorized signature: Ck This parole application expires if a permit Is wet obtained within ISO
days alter It lua bees accepted as a.pieta
Print name: Charlynn J. Leifse I Date: 7/26/05 • Fee methodology Set by Tel-Calmly Building Industry Service Board
•• Mamba of inspections per permit allowed.
islauad ineParar't4ffi.C- PaniItAppAcc 12 3 440•4615T(10/177/t'OMMEB
CITY OF TIGARD r •
BUILDING DIVISION • PERMIT #: ELC2005 -00538
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/28/2005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/22/2005 TIME: 7:10AM PAGE: 63
SITE ADDRESS: 15575 SW S UOIA PKWY 130 CLASS OF WORK:
SUBDIVISION: PACIFIC CORP. ENTER LOT #: TYPE OF USE:
PROJECT NAME: MCPC INC
DESCRIPTION: (15) branch circuits.
OWNER: PACIFIC REALTY ASSO TES, PHONE #: 503-624 -6300
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503 - 698 -3417
Inspection Request Scheduled For: D- e: 8/22/2005 Pour Time:
Code # • - - ' - • P escription Confir # Contact # Message
199 Electrical final 014008 -0 503 - 209 -0395 N
Corrections /Comments /Instructions:
5LR O 5- 2- - � s1 , �
23 – von VGA
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K PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: . 6° Date: 11
7, 7 5 Phone #: (503) 718-
•