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Permit - ' CITY OF TGARD ELECTRICAL PERMIT PERMIT #: ELC2004 -00096 • II� DEVELOPMENT Ir S SERVICES DATE ISSUED: 2/27/04 CES (503) 639 -4171 PARCEL: 2 S 112 D D -00700 SITE ADDRESS: 15780 SW UPPER BOONES FERRY RD SUBDIVISION: BLDG D ZONING: IP BLOCK: LOT : JURISDICTION: TIG Project Description: Job #8513 Install (6) 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: SIGNAL/PANEL: 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: 5 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 ASSOC IATES 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 2/27/04 $80.10 [TAX] 8% State Surcharge 2/27/04 $6.41 Rough - Elect'I Final Total $86.51 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- -2344 Issued By: Permit Signature: 07 ��i �`'` - c C� ac dl"-- 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: S Call 639 -4175 by 7:00pm for an inspection the next business day V From. Charlynn J. Leifsen To City of Tigard Date 2/27/2004 Time. 9:57.38 AM Page 2 of 3 •m ' ' " :� "ri "r F.OR OFk10E SVON.IL7r' S'•• .MiEiY Electr a Permit Reeeived Lleetncai 1 v Planning Date/By • pp O Portot No 02.00- DC7��C' R ! Pl ann ing pp al Sign C of Tigar e Iar:/fi• • _ Case ���4 Date/By: Perrot No.: ----- 13125 1 12.5 SW Hall Blv �" d, 2, Plan Review. Other . 1, Ot�gon 9, 223 Tt487 7 1 • • • Date/By: Permit No.: —. 1( __.. cw Land U ^^�� ' Ttr :i Phl.onc: 583 -639 -4171 Fax: 50t- 1-W 6 V • - r, * No • _ [ii e 7L'1" �1rVVV'.C1.tigaiCl 0 1'.U5 l lrai�,p1NG 0 . ; ...; ` ' Y Post- M '4r• Contact Juria.: " j 5eei "age 2 for mm Rrt� 241 -hour Inspection Request. 50 .- 43 9 -1175 1 13amefMethod: _ r IC1 Supplemental Information. I v { �'y N° 11,F1 y iii A�4Aw.4 !'V�A'n + - i y'• �/ r a�r'�mTr�• O _r, : "':X :'A' :' V.'FiVS;x ^-N` I : . :' §-,' T'�1� P D' .P7 i�lEAT4 aira.kta t t i•[t l [r' _ i•"l 'µ -_.. ±A^ . y ' , r,� ;..`.7��'It h_.� f, . � ' t T :� - - - -- :�J.K1.1 1 ^.[1!�. [(- - rr . _ : - � ' - �....� I New construction. " ' I ❑ Service over 225 amps- ate facility UcnlUslilU' s- I ❑ Health -I ❑ ,� . -_ ---- -.. _. _...m. _ --- - _ , . , , Flazureuus 10C360:1 © A dditim alteratiorJr"placL111cn1 Other: 0-s amps-rating :r l ❑ Building u•:cr1,0,00f square feet, li .... -..- ❑ ormter'. 0-service over 3rtb ; ,•ri :, °"" +• + _ r 'r - i' %`- : '', i A•; ':'::: 2 farr,Ily dwellings i four Jr :17, ^.7C re_idL'ilUel p111:S at i n 1 & 2- Family d wellinr X Commercial/Industrial J --� ❑ S • : ` : olts norrinai one stn;rtore 1. — ..._ —._- _ - _..- -- ---- !, - 0 ISu ld n over three stones 0 Feeders, 400 amps or tnom Accessory Building y _ - - - -- ❑ Occupant toad over 99 persons ❑ 'Manufactured structures <x kV park [] Mast -et' Builder .. [] Other: 0 Egress/lighting plan 0 Other: „ �,,,,,,,, _._ „„ rr..� -• :__- r•c�r Submit sets ot plans with anyorihc above. :,,., .� ;;rtT! :Jill?«i1►kAT[ <s I�o<'lc ;; • :'� r .;;a ' +' Aah�a . - -- ..- Thr shove are not s ['cable to [cutpnrary construction service. J }b l 4 e a 15780 SW Upper Boones . ",.., y :; ^�; R +^ t �� } %'F ,.,. ' ,rrg 4 - t7 , r' :; u ....,.._ ,:s t S ui e, I _ '` J -BId� /Ap ?.'7: — — � � Number of In'sp } ` t ddr' s Pp ' '4i _' *i a *t t . - :• . • ectil►ns per permit allowed 1 ___ -----• Bug Byte Description i ply Fee(ea.) Total- t I'ro' t ct N ame: 9 Yt -- - , ...._. -._- New residential-single or tout per • Cross st-rcet'Direetions to iob site: dwelling unit. Includes attached garage. Service included: 1000 aq. ft or less _ 145.1 S 1 4 Eech Orin i :nal500sir. ft. or portion thereof _ E 33.40 I _....._ - - _.._.__- ._....- T -- -- -.- Limitedcnergy_residential _ 5.0ll 2 8lli3di.v14it1n: _ ______ ---- Lot n. .�.-.._ -- ..>I" __ 7500 2 . i Limited nonresidential t �; Each toast = factored home or maiLlar dwelling Tax map/ )e. CCI a- - . +} Y ocn•tce and/or feeder 9090 .ra z a•�: t* ,7. - S _ _ i 41?C �RT{o- - ; _ ;; •• � -f : :>' ` ^" ° "' ' u Services or feeders - installation, I I alteration or relocation: 200 amps or kss Tenant Improvement -- - - i 80.3a � I P - -- - __. _- - 201 amps to 40O anips 40I amps to 490 gimps 160.60 ; 2 1 am P i�`.�Q�"��'��R�k`iH' *il�� "^i �'Ct�� .} '- �_A�A°:'�,�' , ��arl`�s to ICAO a ;u .. �59.G5 �_ F I £ _ - n( _)n amp or voila Name: i" � �`� —_ -- ; Reccprca any —.. -- - - 66 35 � t Adrlr,855: Temporary srrviccs oc feeders - installation, 1 -•- --- - - - - -- alteration, or relocation: City/State/Zip: 1 2UU wino or less 66.85 i _ 201 amps to 4l- O amps 1 0 30 2 Phone: _ , • �_ x: ryQ� r� i ' 401 to 600arrps - 133.75 21 � ' ; c� . YfF 4'' •a t`' 11 . 3/ S.R } '�T'�I?l milS t . S .:, _ alteration , or ,-, ;._ (AN I .•� t,; ' ` Branch circuits - new, 1. , # cxt;crucion per panel: Name: Electric Inc. �._ - - -- .._.-- - -.. -- I A. Fee for blanch circuits with purchase or Address: 10948 SE Valley View Terr. i tn v: ce_orfeederfee,eachbranchcircuit __. CTS 2 i • Clackamas, OR 97015 I3. Fen for branch circuits without purchase of I Li ly. / l "(te 5 69.8 -2486 -__,. 1 Each additional c or hr f circuit n h circuit 1 i 46 gy 46 85 12 I Phone: (5�. - ) 698 3417 1 Fax ) E service or :ceder not t rc1, ....... - 6.65 33 25 i...1 - -- service or feeder Ice, first branch Ffa -bail: Johansenelect @aol.com ) r _ = ;E M . : : :r2 3 :'' sra 'Aaq , + Loch ptttn�t trr vri�tralion circle �9 4p € q'ta-t' . f P, ° a :::.:'., sa_. , i 53,4 2 rfftt.. :l f: �:', AG7IC►E . _.._� , E sign or outline I fihtin�- - -..._ 8513 OlJ�. tiigr al cast u;tfs) or a limited anew panel, 1 - -- - - 1 _ • .--- - ---•- alteration, or c�y>'nsicet Pad e 2 2 - 1 Business Na me: Johansen Electric Inc. — I Address: 10948 SE Valley View Terr. -••°•-- _ .._. - -_ -.- -•- -- - - - - -- Each additional Ins!ectlon over the altnwahle in ans•of the ebos'e: 6 2.30 .1 City/State/Zip: Clackamas, OR 97015 _ Per inspection net `your (min I bola) .. Phone. (503) 698 -3417 Fax (503) 6 -2486 fnvccti rattor. fce_ r - Other - C;C B Lie. ti: 51 Lie - 4 . 3 -243 ,. .,, --- �'° : "�E. `. ? _ `." , s_ p. z� ft" , :vA, 1' •�;: Am Ic tits S't'le_ A i, o . r _ ,'. Supervising electrician - Subtotal S 80. • -J s 5 °1° ignature required: Plan Review (2 of Permit Peel -- _ E ; (8% of Permit Fee' S 6.41 Print Name: K. Johansen I Lie. 4: 2053S State Surcharge —._ _ ... + —_. - -- __ �- TOTAL PERMIT FEE. $ : •.51 - Authorized . - notice: 'rhis permit application expires if a permit is not obtained within Signature. : 'Ay - ' i \d to t ftC 2/27/0 *Pee methodology set by 'Fri- County Building Industry Service Board. Charlynia Y. Leifs n L' J - - - - (Please print nau :e) - -- - — i. \Dsts'Perrrul Forms\FIoPertnitApp.dac 0 110: