Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit# ELC2012 -00540
Date Issued 09/18/2012
TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503 718 2439 Parcel 2S113AC00102
Jurisdiction TIGARD
Site address 7272 SW DURHAM RD, BLDG# 750
Project Pattern Ninja Subdivision COUNCIL VIEW ACRES (LOTS 21 - 44) Lot 25 - 27,2;
Project Description (10) branch circuits and (1) 201 amps to 400 amps for TI
Contractor JOHANSEN ELECTRIC INC Owner PACIFIC REALTY ASSOCIATES
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
10 crt Branch Circuits w /Purchase 09/18/2012 $74 20
Specifics Service or Feeder
1 ea 12% State Surcharge - 09/18/2012 $24 93
Type of Use COM Electrical
Class of Work ALT 1 ea Services or Feeders - 201 to 09/18/2012 $133 56
400 amps
Type of Const
Occupancy Grp
Total $232 69
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 OA 952- 001 -0090 Yo u may obtain a copy of the rules or direct questions to OUNC by calling 503232 1987 / or r/ 1 � 8800 332 / 2344
Issued By J� }' /l.{/ti elki te . bt AP
Permittee Signature ��+ AuC4T70k/
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
CaII 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
RECEIVED
Electrical Permit Application SEP 1 8 201 Pt)I2 Oil IL I-. 1 ,q.: tt \I.)
lig City of Tigard C i Y t r�6E:3r"�, r ` ► 8 a.- w Pcnnit No. — ,a04,,),..— „- ,£
• 13125 SW Hall Blvd„ n Ttgatd, OR 97229 t 1- 1,1 q-rte �, t; s'i . . Rovtow
B Phone 503 639 4171 Fax 503 598 196& , L - ” ' ' ' - Date/B
t. t , Inspection Line 503 639 4175 Date Ready /By, IN2. fin See Page 2 for
Internet www bigurd -or gov Notified/Method Supptementat lnfotmation
71 :1;''''''i'^7,''''. , ,. n y , en $ r ,' , /
1, f' ,\ { ,,, . � ,�`�, }��/�P, ,A 't (, 4; ,�i,'1, 'i� „i I� „�' v N .,, r .') {rye � '' �',I ^il ' ;, `1
n .�h(, l 1 .' I ` t ' y � '' tai � .l
❑ New construction ® Addition /alteration /replacement Pleas ahovl all that apply (S144114 2 .rtn of pions w /items checke below)
❑ Servers or lbeder 400 amps fir more ID Building over three merles
❑ DCn101rtten ❑ Other
150 voila or
( �����((((]���� y � a �j,p(ti�,� whoro the available fault ourrart ❑ Marinas and boatyards
;,:t , J` - 1*'0,�/'I!” 1 , ' 1 1 C',`, r X 51 ,
', i rl,� ,' 'l_ ''' , ' '' ' '' ' '' ''' ' 1,''''','''''' ,�� , , ((,+���. -, s' <,; : u�t, a�,• r , , ”, .. 4 crowds 10,000 amps rat El Flouting buildings
loss to ground, or cc:owls 14,000 ❑ Cumrnercial.ase agricultural
❑ I and 2 - family dwollmg ® Comntorciallindustnal ❑ Accessory building amps for all older Installahnns buildings
❑ Multi -family cu r
gp��p Master builder ❑Other ❑ Nvn punm ❑ Installahun of 75 KVA or
. ? '' 'r -; ?'.;' ' -g " ti y il ,4� t '+aVr'1 ' - „ -' ” - ❑genoy system larger separately denvedsystem
S .: „ I s Nr. .- - 7 _ "' � �f` ,, 1 ` . , t. f, , i c ' , 1 'Lner
' ❑ Addition al new motor hind „t 0 "A. " . 1.2 " " "
1
Job no, 7obsiteaddress 7272 SW Durham, 750 or MOM occupancy
, ❑Shcix or more caldontlal rain ❑ ltecrcanoiuil vehicle parks
City /State/ZIP 0 Healthcare facilities ❑ Supply voltage tor moor than
❑ Hazardous Moutons 600 volts nominal.
Suite/bldg /apt no 750 I Projectname Pattern Ninja ❑ Service or healer 600 amps ormer A 7
Cross street/directions to job site. ir.o., on t�7
Now residential single- ur multi - family dwelling unit.
Includes attached garage
Subdivision ` Lot no 1.000 eq ft or Icaa 168 54 1 4
Tax Wisp /parcel no Ea edd'I 500 sq ft oh portion 33 92 I
Limited energy, residential
" "; ',1. , '., " f t 0,R . i '' (
i , '-, ; 1 } ' ° ' (with abovo q9 ft) 75 00 2
Limited energy nmin -family 75 UO 2
Tenant Improvement residential (with abovesq ft )
- - Sendces or feeders inatallatlon and/or relocation
y 200 amps or tern 100 70 2
''' ' �'* � n - h > ' j ' ' •', := : , 'ik" 7';'1 20! antis ei 400 ump>t / 1. 56 �. .. 2
40! amps to 600 amps 200 34 2
Name.
601 amps to 1,000 nmpa 301 04 2
Address Over 1,000 ramps or volts 552 26 2
City/State/ZIP Temporary services fir feeders Installation, alteration, and/or
reification
Phone ( ) 1 Fax ( ) 200 amps or loss 1 59 36 I 1
Owner installation: This installation is being made on property that I own which is not 201 s. 400 am 125 08 [
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701
40! ams to 599 amps 168 54
Branch circuits — new, alteration, or ex tension, per panel
Owner signature, Date A Pee for branch circuits with
1. <Ij,� , � � JR�' V above servtw or feeder fee
o ,' FS""s+ t , i ' ` /,It s17 ' '° ' MM r!± ► ?'IF.�iQp} /p 7 42 1y. 2
`' each branch circuit
8uslneBAname Johansen Electric B Fee for branch circuits without
service or feeder fee, lirs1 S6 18 2
Contact name Charlynn Le i f sen branch circuit
Each add'I branch moult 7 42 2
Address 10948 SE Val ley View Terr Miscellaneous (service ar fader not included)
City/State /ZIP Ha Va 11 a OR 9 7 0 8 6
Each manufactured service fir modular 67 84 2
ppY Y dwelling, service and/or feeder
Phone (503) 698.3417 [Fax (503) 698 - 2486 Recouueuonly 6784 2
Pump or irrigation circle 67 84 2
E-mail.
Sign or outline lighting 67 84 2
, ' 1 ' F
— D n
. r• y ,n i ` •„ � , ' ', _'. , sr <;, Signal circu or low lodcnotpy ,
- -, 3 -
. n (s)
Business name. � Johansen Electric pnnel,nitemuon,orexrrnaion Page 2
Johan
Each additional Inspection over allowable in any of the above
Address 10948 SE Valley View Terr Addtbatalmspocuom 6625/hr
Invcanganon (I hr min) 66 25/ hr
City/State/ZIP Happy Valley, OR 97086
Industrial plant (I hr min) 78 18/ hr
Phone, (5 0 3) 698-3417 1 Fax (5 0 3) 6 9 8 - 2 4 8 6 lnapecnona for which no fee is
I s • ftwll hued 'b hr min 90 00/ hr
CCB Lie 515 3 9 Electrical Lic 3 - 2 4 3C Supry Lic . 2 0 53 5 ,' " , : • ; yt; {;Y') ; �_ i ; r,. t, fib'- .,, •; ,
Supry Electrician signature, required,
Subtotal Zito
Od Plan review (25% of permit fee)
Pnnt name Carl Johansen Date 9/18/12 Slate aurcharge (1 2% of prIrn( fee) '
/, _ ! Al AL PLRMI1 FLL, 2.3 41
Authorized signature � � . j,f/ This permit appltunon expires If a pettish is not obtained within 180
� days after It hoe Besse accepted as complete.
Print name Charlynn Le i f s en Date 9/18/12 • Number of inapocoons allowed per pon n
1 ViwldugarimibViLC- ParailApp due 07101 /10 440 - 461511! 1/05/COM/Wba
Z /T ' 30Vd 986Z869COS 986Z869CO5 1.3H'I3 MaSNVHOI' NV LV:OT ZTOZ'ST'd9S