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Permit '-:, CITY OF TIGARD ELECTRICAL PERMIT RMIT #: ELC2004 -00151 PE A, /. DEVELOPMENT SERVICES DATE ISSUED: 3/26/04 '� ` 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S113AB-00600 SITE ADDRESS: 16150 SW UPPER BOONES FERRYRD SUBDIVISION: PAP9CCCREEK ACRE TRACTS ZONING. I -L BLOCK: LOT : JURISDICTION: TIG Project Description: Job No. 8513 , Tenant Improvement 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: SIGNALJPANEL: MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10): SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: 2 W /SERVICE OR FEEDER: 20 PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 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 3/26/04 $293.60 [TAX] 8% State Surcharge 3/26/04 $23.49 Ceiling Cover Wall Cover Total $317.09 Elect'I Final 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: Permit Signature: ".„,„":-/) 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: 3/25/2004 lime: 1:59:08 PM Page 2 of 3 lee as Permit ` ea Rece d o qw .1:;VIt 0.1'Flcl. ? 17o Mi l An i , m ]Permi ication Electrical UateiBi Pe;rmi - 0 /5 � ` O Q� Planning App vat Sign t 0 � igar Q UatlJ Petmvt No.: - -- _._.__... "-- 13125 SW Hall Blvd. P P \ O Plan Review other — '-- `l'i Oregon ?7223' ~ 'S\� Day: Pernik No • ,r0 J / C. Phone. 03 -639 -4171 Fax: 59hty9 6D l'os't ,view — Land Use J 1 ,Oi Internet: et: wrww •cY_ti and onus .. \ � : 4, mmt!s 1 , i . ., Contact `' carJ�••: - case No : _ - - -� Jutis.: + See Page 2 for - - -, 3, 24 - 11out inspection Request: 503 75 NameiMothod: Su fementa IInformation. -.- ;) , t��f�•'"'��_�)'- / .- T.r_'� —.. '..A n y ' a' dtia c: �nT- 1� !•4 ^{'�j{'t��`Y��yp�,�yy��{�'k ��'M.S �y,. �J awv { "'i'i; .t . :,A r �.✓ s/., if t.f :}f � �'. i :. '. .g'—:L _ h' C.l 3.' „ _ i ;:k.K1�R :AMR',K` :NW' +'..[atai4i 41�lrllF it�ti 1''i- _ ,h ,°°;' :��. •' ,�v',',, '_ ,, ;; -, :. °21� , IT �` � : ' : :; :,, >'�,.,,, , : � . , . ... — __._ pp �). �� El New construction � Demolition_ Service over 225 amps - 0 Haalth -care facility I ( — commen•,iat i ❑ ria2ardons location I © . Add ltlo /alteration /re la cement, ID Ot1'e ❑ 3e tvicl ovcl 320 amps - rating of E ❑Buildingovcr 1,O,I.Ni1 s<ruur, fee;, [ ' n - , -. `; ""e5 °'132 d � ' °; '' . 'err —1 e & 2 family dwellings four or more residential units irt j & • 2- Family dwellin © Commercial/Industrial ©'`s'ystaru over 600 volts norninat one $Iructurc j .T -= .--- ❑ Building over three stories Feeders, 400 amps or runic- 4 Multi-Family r�t;Cs'83t7t'V Building ❑ tJ ❑ Occupant toad over 49 persons ❑ Manufactured structures or KY park ❑ Master Builder Other: 0 Egresslligrtrng plan 0 Other; ,, . - = '��€_ �Ia vt a . ,*, , -' do i ?C t r' ' . �.- Sub mit sets of plans with any of the above. The above are construction service. site addre -ss: 6150 SW Upper Boones F * -r }-:,,., �;f_,. � not applicable ,, to temporary e. , ;� r,., ,;,• ,,,�..... , ` Suite It: I Bldg,. /Ant . m: Number of Ins pectio ns pe,r permit allowed i Pro Name: Tanning Concepts Desert tion TQty Fee (ea.) Toni New residential- single or multi- family per T 4 Cross street/Directions to lob site: dwelling unit. Includes attached garage. t Service included: i I00Q; ft or less - j � 145x25 4 Each additional 500 s.: ft orjortion thereof 4 3340 a Limited energy, residenliai E 75.00 Subdivision: _ . _. -.. -__ I Lot #: - I.imitedene , non residential t 75,00 - El - i Tax Ilan, Jarcel it: re Each manufactured home or modular dwelling v ";y;;' ., :. (j' T �y[f�t 1 ;ayy ;' q ,,r ;per ,,., sons ttndlorfeeder 40.90 . Services or feeders - Installation, alteration or rolocattorr ' Improvement - -- - - -• - . ...__�_... _.- - - - -' - .._..._ - -- -- --__ -- 60.60 20:0 am or Tess 2 80.30 l - a _. -.____ ._......--- ---- '----- _- ----- . --•-' 201. amps rn .00 amps l0 .85 409 am s' 600 amp -- 140.60 l 2 1 I 'ti{ i i ' k TM-`' "F'• ra r4' :, X01 amps 10 1000 am 240.60 2 t t : f0 4 �>)7 .,n . +s; l g . +t °' -„ - ,t, ,, iw 454.65 N 5 Name: -' :.'� ' RecoanUvt7I .N}ampsor�roEts eet only 60.g 2 r. Add ess : Temporary services or fcedcrs - installation, ` — - ---- -- _ -- --- alteration, or relocation: City/State/Zip: _ - - - _ 200 amps or less 8 _ L "" — - _ 201 amps to 400 amps L0 771 Phone: _ it'.1 t'” � y � y � , � y � 0 , tra,wf 4111 10 C ants •° 133.75 ® I ����� :41*1 F . i$ �3 ; 'kn = ' 'C3 T 3 �i4:, ';'41 !' V:#$_'1'' °, c n r �� +' � .ti.sz�:::: +: ,'�. :�. ,- �" - -�� illatt0h circuits - new, altcratl r , 4 Name: Johansen Electric Inc. extension per panel. . A. Fee iel' blanch circuits with purchase of Address: 10948 SE Valley View Terr. - -- . —. __. service or feeder fee, each branch circuit _._ 6,65 _' Cil ' /State /Zi : Clackamas, OR 9 7 0 1 5 ' T I Fee fnr branch circuits without purchase of _ - - M --- -- - ---- --- sorvice. or feeder fee. first branch circuit fib 35 i 2 - ' _ n om e (50 698 -3417 Fax (503) 698 -2486 Each ndditirrtal branch first - -- 20 -�- x,65 ia3 00 lallcl .... —.... 1 1�laii: Johansenelect @aol.com - -- lvfisc.(Service or feeder not inaucied) S3 a s : ar Each .. ,i orirri tivaeircle 40 2 r- ^, ;u ,_ � s u'e:i or, t _ oAk'..:: s. '�� I{ 5 .,,,- ,� 0 ti ..... _. -. —. -�..._ , ,pp�' �p � µ{1T {yj� � µ 1, �,, ',. tic 1 ,,,o,"'' v' 41 "'1'. -.'' S ''- ' ' ' '''1,P=''''I ",1�L" "'ar {t"'- 'ur li'�1 "'1, _ 2 _ " r J. © , 'i " ^r w., +r Each sipp ar outline lighting_ 53.d0 No: 8513 Signal cir�cutl( &) or a limited energy panel, ..--- ""- --.... _. _._- ..- ........ _.- alteration, or 62.50 coensrou I are 2 __ . -- 1 . Name: Johansen Electric Inc. e — _.._.._ Address: 10948 SE Valley View Terr. � ' Each additional !fivectivn over the eilowable in anv of the above: _ C lackamas OR 97015 ' lt1Business ' /ccitdiE /Z1?: -- i fee' Phone: (0) #: 61539 _ Lbc. : 3 -243 a,.._ . ,,o T, .,, •, , � � jj+ - , :i7 ' �Q f 1 4, 4 ;t . •,,' , \..1.13 )_.lt, rr h , "'d ° 00 , y �'y�F �'�,66.TS,a3: h .fat .r. `' y�. h'+F- 4i ri'1 4d1 .,N a' t Subtotal ., Supervising electrician - S 293,60 i signature respired: d: Plan Review (25% of Permit Pee) $ , Print Name: Carl K. Johansen I..i.e. #: 2053S State Surcharge (8%of Permit Fee $ 23.49 . ____ -_..^... —.___ , h _._..,...^ — TOTAL ' PERMIT PeS S 7.09 _ a ,A uthorized ( Notice: This permit application expires if, a permit is not obtained within Signature. � ;. �. °� 3/24/04 '. • ��- +tc: 180 days after it_Rrlts been accepted as complete.. ' *Pee methodology set by Trl- County Building Industry Service Board. Charlyn . Leifshn (Please print mime) I; \Dsts\PcrrruI. Forms 1PloPermitApp.doc 0l /QJ CITY OF TIGARD 24 -Hour • • BUILDING,_ -_-40.- Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST r� � // BUP 1J 4 Received ' Date Requested `/ - Z3 -0V AM PM BUP Location /6 / 56 Suite MEC Contact Person . �cP Ph ( ) Z0 9 0 3 9 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner y ® -0 6 1 <5 Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation "1"i0/41**----(F1514F— Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING C - 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 UG /Slab Low Voltage___ Fi - la 4 44;11_ - El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SIT Please call for reinspection RE: El Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date ,7/ Inspector ® -! ./ AtalS.r — + Ext Other: Final DO NOT REMOVE this Inspection record f °om the ' ' site. • PASS PART FAIL