Permit w CITY, OF TIGARD ELECTRICAL PERMIT
II PERMIT #: ELC2006 -00057
"1111' DEVELOPMENT SERVICES DATE ISSUED: 1/26/2006
13125 SW Hall Blvd., Tigard, OR 97223 503- 639 -4171
PARCEL: 2S113AB
SITE ADDRESS: 16250 SW UPPER BOONES FERRY RD BLD.E ZONING: I -
SUBDIVISION: PACTRUST BUSINESS CENTER LOT : JURISDICTION: TIG
Project Description: (20) 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: 19 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: Contact #: PRI 503- 698 -3417
FAX 503 - 698 -2486
FEES
Description Date Amount Reg #: LIC 51539
[ELPRMT] ELC Permit 1/26/2006 $173.20 SUP 2053S
[TAX] 8% State Surcharge 1/26/2006 $13.86 ELE 3 -243C
Total $187.06 REQUIRED ITEMS AND REPORTS
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:
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 r Date: 1/27/2006 Time 11:25:04 AM Page 2 of 3
_ :� ELG�� te
6— a J
Electrical Permit Application IU1i 01.1.r( 1 I .I: ll\I.\
City of Tigard Received g
Date/B Permit No.:
13125 SW Hall Blvd., Tigard, OR 97223 '. Plan Review
Phone 503.639.4171 Fax: 503.598.1960 � s ix I f i Date/8 : Other Permit
Inspection Line: 503.639.4175 .,..a 411 I Date Ready/By. !aria El See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method Supplemental Information
! 'Qli r T n i -� e r _... , ... , r .� .i :- s ?' � a v imr . 1 - - 7
c 'I L... ^i.i:ii ,.. .s 4%. ll — c; ,' F
�lk .�tJ i -1 yp ��t li s� r i1i 4 .� � -1,yi 10 ∎,. - ,I. , : rs I`` 4 -,
❑ New construction ® Addition/alteration /replacement Please check all that apply:
El Demolition El Other: ❑Service over 225 amps, comm'I ['Hazardous location
° , tF r - it x , � r .+ t ,.'��- : ny s C r � Q ira rr,.r k j ttu ,_.,..., ❑Service over 320 amps — rating ❑ Buildng over 10,000 sq ft.,
,.., _ �._r.x t- ..,.t!" ._ ,. _ .:.. G_.;. ,, n e_.. - /-;r , ..,. b r r t >n u , r u _ . .,- ; :i:.� of I. , and 2- family dwellings 4 or more new residential
❑ I - and 2- family dwelling ® Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
❑ Multi family ❑ Master builder El Other: ['Building over three stories ['Feeders, 400 amps or more
x s i' ll i�+ 7+u rs _ r �, 1
? ❑Occupant load over 99 persons ID Manufactured structures or
z �b r + f a of 4 = ,. e r
;?? `i.i{., a _ .. : f ; 1 :? ._1:.. _ � .. e I i i F •, q �, • ❑Egress lighting plan RV park
Job no.: lob site address: 16250 SW Upper Boones DHealth-care facility ['Other
Submit' sets of plans with any of the above.
City/State/ZIP: The above are not applicable to temporary construction service.
r Y , i 4 y+ lit,
Suite/bldg. /apt. no.: Project name: Synergy DocTiptlsn Qty. , rm Total *-
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: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
•^. ii f t 9 ; W ' so en stti y r t s, ' �. g ' ItSi^s- Limited energy, non- residential 75.00 2
kik- si .'• ..� _, '
`_i�n? .t6.. . . . ! t, ° . : : , :. ''i; :i',lar' / % I'd,r - �.1;4 .. _... -._ Each manufactured or modular
TI dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
F 200 amps or less 80.30 2
a � l+..1 i 7 ._;. ttrv i ... _ �'I S `
,` I:r+t'' r �,.. ? �..•. < Sh �� rl.S;z::• 201 amps to 400 amps 10685 2
a. 1 401 amps to 600 amps 160.60 2
Name: 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66 85 2
City/State /ZIP, Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that 1 own which is not 201 amps to 400 amps 100.30 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
144171'3 sc t F ,t ii r c , `
f ` 1 f" t , n � j' )� A. Fee for branch circuits with
_ ..._ -._ _... _ . S._ ' I rtll: .vsti ...S 1..-" .+ ii 4 ∎, b s. v..,7- eia e_s _ q ,L.i1;1 ?:..:R. service or feeder fee, each
Business name: Johansen Electric Inc. branch circuit 6.65 2
B. Fee for branch circuits
Contact name: Charlynn Leifsen without service or feeder fee,
Address: 10948 SE Valley View Terr. each branch circuit 1 46.85 46.85 2
Each add'I branch circuit 19 6.65 133 2
City /State/ZIP: Clackamas, OR 97015 Miscellaneous (service or feeder not induded)
Phone: (503) 698 -3417 Fax: : (503) 698 -2486 Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: johansenelect@msn.com Signal circuit(s) or limited -
z t'� ? ' i s F i Z4i r °' fa ` -c c � t'n., � s xi p
s :..11it .r :: . ilr.f fr,.i,a �*` ',.. �! ,_i ��a iii iV. c� V;P:`,`._. �. { ; a Nlit i 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 (I hrmin) 62.50
Phone (503) 698 -3417 Fax: (503) 698 -2486 Industrial plant per hour 73.75
i- .L F ie J "S"le"� x '� i" tr
k % .... . ter. r[..,.., �r._. a.. s... � .....�_...._.._�.s, {sw.� i ,Nb �l t': :r�'I .i.a2"sr.:ti:
CCB Lie.: 51539 S . Lie.: 2053S Subtotal 179.85
Suprv. Electrician signature, required: ire, / f^ sP7- Plan review (25% of permit fee)
State surcharge (8% of permit fee)- 14.39
/!�./ ,'
N / Date: 1/27/06 194.24
T TOTAL PERMIT FEE
Authorized signature: .,�_ This permit application expires if • permit is not obtained within ISO cc
days after it has been accepted as complete
/ g ,. Date: 1/27/06 • Fee methodology set by Tri - Cotmty Building Industry Service Board
" Number of inspections per pemut allowed
s 1Butlding\Per,m ,W.C- PermlLApp doc 12/03 4444615T(IlWD2,COM/WeB
CITY OF TIGARD E
BUILDING DIVISION PERMIT #: .:2\00‘, —0 DOS 7 j
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 40 i11� •
Inspection Requests (24 Hrs.): (503) 639 -4175 K__:.
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: ( (P D--ST L � C l ` / �2 SS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
•
Inspection Request Scheduled For: Date: 3- f ( — Pour Time:
'ode # Inspectio : - cription Confirm # Contact # Message
/7 q
eaA_e) /2e
rections /Comments / Instructions:
•
X PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: • " / \ (V Date: 1 1 1 6/6 'Phone #: (503) 718- Sti4
• •
CITY OF TIGARD
. BUILDING DIVISION 4 PERMIT #: ELC2006-000
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/26/2006
Phone: (503) 639-4171 ./.01111
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 2/10/2006 TIME: 7:04AM PAGE: 44
SITE ADDRESS: i6760 SW UPPER BOONES FERRY RD BLD.E CLASS OF WORK:
SUBDIVISION: PACIPUST BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: SYNERGY
DESCRIPTION: (20) branch circ:uits.
OWNER: PACIFIC REALTY ASSOCIATES. PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503
Inspection Request Scheduled For: Date: 2/10/2006 Pour Time:
Code # Ins•ection Description Confirm # Contact # Message
130 Ceiling cover 026669-01 603-969-5262
Correct'. • _ -; - - ns ructions:
• RP 61.1
‘kt.Mq1/4, Cfib
tfTI PASS PARTIAL APPROVAL CANCEL - L NO ACCESS
FAIL CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: G' IV613 • Date: 2/1 6 Phone #: (503) 718- Z
•
r l i
CITY OF TIGARD
BUILDING DIVISION Lr PERMIT #: ELC2006.00O 7
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1 / 26'2(]06
Phone: (503) 639 -4171 ,■■� � �►
Inspection Requests (24 Hrs.): (503) 639 -4175 ±i '''I_�.,
INSPECTION WORKSHEET FOR DATE: 1/30/3006 TIME: 7:01/0/1 PAGE: 69
SITE ADDRESS: 16250 SW UPPER BOONES FERRY RD BLD.E CLASS OF WORK:
SUBDIVISION: PACTRUST BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: SYNERGY
DESCRIPTION: (20) brarich circuits.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503 -690' 3117
Inspection Request Scheduled For: Date: 1/30/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
125 Wall cover 025322-01 503.7t114.1534 N
Corrections Comments /Instructions: •
•
,%PASS • ❑ PARTIAL APPROVAL ❑ CANCEL LI NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑•ADDITIONAL FEES ASSESSED
Inspector: G - N 66 L5 Date: 36 61 Phone #: (503) 718- ZA