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Permit . CITY OF T I G A R D ELECTRICAL PERMIT PERMIT #: ELC2003 -00699 ...4 DEVELOPMENT M SERVICES CES (503) 639 -4171 DATE ISSUED: 12/3/03 PARCEL: 2S112DD-00701 SITE ADDRESS: 15822 SW UPPER BOONES FERRYRD SUBDIVISION: 1544tGON BUS. PARK II ZONING: I -P BLOCK: LOT : JURISDICTION: TIG Project Description: Install 10 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: 9 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 12/3/03 $106.70 [TAX] 8% State Surcharge 12/3/03 $8.54 Rough - Elect'l Final Total $115.24 This Permit is issued subject to the regulations contained in the Tigard Muniapal 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- .' 2 -2344. Issued By: � O_i_ i�i •40 / Permit Signature: ij7) 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 l Leifsen To City of Tigard Date 12/3/2003 Time 10 32 AM Page 2 of 3 •. T•R1n7NNnr - wrr .. .. -. n : i w roe w ?. Electrical Perm ' tion r , F.oR aF:YrG. USEi' oi`�.r`: ..,. �,;;- / . /► ter �L � /) Received ` wlecttical � J(l I � Y . , R t �_ Uatcr a- 0 3 {]r E'ermit'Vv. W Planning Approval Sign City of Tigard a Uztelli }_ Permit No.: }:5;7.5 :l Yir Hall Blvd. DEL 3 003 Plan Review tither _ -._- 'I;tgard, O:•egon 97223 ww Phone.: 5 D �t�R o t - Land us _....- _-.._- Permit No. -- - ______ '3 -639 -4171 f�aY• 5 ( k• 1 ¢5.) - Ft_. icw' ___ .._. -_.__ e T^•W- ft, ' ealx: Case No : Late rnet• w'.c1- Ligattl-€1 ? ry ,�.:• g �� ��G _<�IVISION ,�+t�L.ar�. t.oraat.t _kris.: cee Page 2 fnr 24 -hot:r Inspection Req . -4 175 i Name ? \4ethoti: Supplemental Information. � •;. 1 � i )Ti ;'y, 9 :: ::A.1 ;Fµ,;_ :1 . ~ 1; t77 75 r ;;,=LP,Z . 1!I Xil.'�rf` '0 !_it:as elcta tttillstppl }'l.' , A. , tu. ..Y• h,LGlf+ : .,2_':i':i,i'.. ,. :A, r _.. , ..__ • Demolition_ J ' •❑ N_', CORStrllCtlUr1 __ - - _- _- ••- - - -- j ; � Service over 225 aurp,- I flcalth�aM facility -� ,• 1 :untrner•.;ial 1 ❑ Hazardous Location © Add ' itlolsalteratlorJr '::place:iZt:nl [] Other ❑ Sctvtce o +tr31.0 untps- rating ^f ❑ Building over 10,000 sriuw� feet, .4� •PITY^ „ , { i' -ice '' •; •+ -1g, . :. .. ra v r fOUT OT MOTC ITSldetrllBI 7r:1'.S 51 r.: _ ,�•,:• "' r I � 'G O � ' �'i(� �: Q�1 _$ ;- 1•]t�C.I?I,O�, ' " '' ' �. "�' - & 2 t'a mil, dwellings k h & 2 , Family dwelling 1- © Commercial/Industrial 1 0 `'ystvr,7 over 600 volts normal i One ctru: taro ! _ -. -- - -- ❑ Master BLII ui [1] r. dint? lula 1 amlly - tsuildinoJ':c: L ree SEOnrs ❑Feeders, 40Q:tstps or caste I 0 Occupant toad over 99 persons 1 0 Manufactured sanctums or kV park 1 U Other: r Other: a . . - ,, r* , :zc° -• ' ----- - , .m;ai ' i n - b ; - tictsofplanswithnyofthcabove a L s H( ° It;�f T f)ti,und Q'I"i�T' 5 are , ',- A ;, + °_,_�•. __ . ...._. at otar construction service. b • , ° •• ° • The shove are not sir Ilcabl to [c �� 5• 1" .. Ite address: 1 SW Upper B oones ..... .___._.- _T...._...j - v�� .�,:«a}.�•���ti 13faAritro.13c,; . u,,:,:4 = .::-:,', Suite ?i`: I Bldg,. /Ants/: Number of Inspect Rios Par permit allowed I Pro Name: Spec Space Description I Qty Fee (ea.) Total I ,. _- - - ...._._- .... -- New residential - single or multi- family per i (,rosy street/Directions to lob 61,1,C: dwelling unit. includes attached garage. I 1 Service include: 1 1000 . it. nr less 1 145.15 __ t 4 ...._.__._.- Each .. - adr,ninnal 500 sq. ft. or prrtien thereof _ - .;1.40 - - - - -- .-- ._.m..._- - --- -- 'Limited eas residential I 75.00 _ 5110(11, 7Slcin: _ , .- . - .._ -_. I Lot imitecl nonresidential z5 �� I_ 1 . Each tu hone or modular dwelling - i - --- L't ch cna fact:ned Tax ma r arcel �. , }� '.n... *x��- [ r��} / F ■�� - _ r;. Ate, /4 fir.., gcr+•lce orld /or teede. ; 96.;0 2. 4 :ti : A_ ' h M�Si,r. n} F1•' ale$ C;MNI T ✓�i T Ir.TIe.Ii _...•i'.•�J %-1 ly. $YK _ _ - . 1 �� Services or feeders - installation, Spec Space Improvement alteration or relocation; _. - _ - - -- -- - -- -._ - - �0 200 amlx r,_ less 80.30 201 amps to 400 amps 105.35 w .. J ..:. .._,_ �' .. - '" -r-. -` ^, �;�„- � ,# � 44 azn s to 61.;o amp _.. ,0.� -- -- .. . ti � Nr - ,t -sd 1ar� r o1G+10amps 2: GO l 24U. M� ti �I'RQE'ER?I�YaA'tiR ::' Ik�A. a € ,;': y 454. - GS a }._ . � . , ..'- =- ' � Over Qt 1: +mom or volts .._.._.. I ----•- N ame: __T i Reconnect only I Addre 1 Temporary services or feeders - Installation, _ -_ - - -- - i ( alteration, or relocation: i 1 I State:/Zip - - .... .._.. -� Z UG amps t I P _ ._ _... -- - - - I Llt�,'I � 1 , r 66.85 � r.._ 201 m o Am , 4 I(}l 10 2 1 Phone: Fhx: -aril to 6011 amps - 1-t39c { 2 f'. A� ( ^['mr �, p . Ff�F;•'S 1i ik1''• Yiat,' t D .t�',i .`�� I Name: " g6 - 1.-i ;t.i EV ; i1 C lljtj U ,T _ et raki$0' c�: , i3rnne circuits - ne w , alteration, or ; ra e Johansen Electric 1 P �. Inc. . Ij e t1 1 per '' " "a ` I.. - --"' -' -- + A. Fee for Branch circuits with purchase or I ' Address: 10948 SE Valley View Terr. - -- _ -. _service or feeder fey each branch circuit 1 - 6.65 _ 2 com aol Clackamas OR 97015 i 13_ Fee Mr branch circuits withoat purchased I I i .. P _ -... - iervite or ?ceder fe„ tirsl t�ranCla elret 1 SG 35 9 85 -1-.;27 Z ,. 6 5 Frame: (50) 698 -3417 I'ax: (503) 698 2486 i Hach nedilhrai branch e,Teuit 9 6,65 5 Johansenelect@aol.com 14Tisr:- (Service or feeder not included)' ly- iT,all: @ F:teh or Qri ti�u Circle 53 40 0. l._'. Rw• ` , 'A'r J b': v: A Ai:: , +it }' .'s., '� • �__ ' ` ; t � '-__ ':_ � 2 _ w. r + '- - - , ' Rr� Tt( a,: _.','' . _..-v. . "W:U 1 53.4 t. _: r• ..:; �� ;cM_acl:srlfturoutlivairfihtin� a..__. �' 8388 signal ci:cutt(s; v : a limited energy panel, • .r Sob No: !ILL .••- ^•. - -- .. ---- -- °- -- ��'T -- alteration, or emensioa 1 Business Name.: Johansen Electric Inc. `leecri ion: Address: 10948 SE Valley View Terr. 417 M- -- (503) 698 -2486 " t additional insjtevlion over thealiewabla in any the above: --- . - -1 Litt,' /State!Zip: Clackamas, OR 97015 - t 625 0 . � _.. - tnspCehan per hear (mm. hour) (503) 698 -3 Pax: _- -. _ non ___ __ _ _ _ ._- __ _-.... - - - - -.- Other Lie. 51539 L . c 4: 3 - ,� ..•.n . - �r ru I ' I C,C,13 L1C. it, -- _ --- - - - ", ' r+k -4 1' • ,i . ;f•p AElec,D� S1,'1 441A ic e t' '4'1 Mpr,- 4;. ;ky`.:` Supervising electrician . Subtotal S 106.70 signa rcy uired: Plan Review (2G% of Perini: Pee) u S �_..___... I a Print Name: Carl K. Johansen Li.c 2053S Stale Surcharge (% of Perini: Fee) $ 8.54 _ - -•- - _ - I TOTAL PERMIT EGA 5 X15 24 Authorized j 5 b t rl ` 1 < M 12/3/03 Notict: 'this permitapplicatioo expires if a permit is riot obtained within Signature p t4 .- � �� .1 ' r� " ti c: - __ - - -- 180 days after ithus been accepted as complete. "Fee methodology set by Trl- County Building Industry Service Board. Charlynkl i Leifs n ,v - . - - - (Please print name) - i:\DststPemut Forms\l loPermitApp -doe: 01(03 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (563) 639 - 4171 MST P / BUP Received o? Date Requested 13 � 7 AM PM BUP Location ! 2- Z ,� A . • e MEC Contact Person �rZ,' � "�c � Ph ( ) ' 6 9--5 a PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ( JD Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspec e - • ) SIT Post & Beam `' . •`' C- Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service / Rough -In L UG /Slab Low Voltage ./ ` PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SITE Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line ADA J� ( l _ T _Q (� � ( Q Approach/Sidewalk Date + ( 1 Inspector [ 1�. V OD L Ext Other: LI Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL