Permit CITY OF TIGARD ELECTRICAL PERMIT
Ili II - COMMUNITY DEVELOPMENT Permit #: ELC2012 -00619
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/29/2012
Parcel: 2S112DA01400
Jurisdiction: Tigard
Site address: 6650 SW REDWOOD LN 160
Project: New Penn Subdivision: 1996 -048 PARTITION PLAT Lot: 2
Project Description: (6) branch circuits for TI
Contractor: JOHANSEN ELECTRIC INC Owner: PACIFIC REALTY ASSOCIATES
10948 SE VALLEY VIEW TERR ATTN: N PIVEN
HAPPY VALLEY, OR 97086 15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 698 -3417 PHONE: 503 624 -6300
FAX: 503 - 698 -2486
FEES
Quantity Description Date Amount
6 crt Branch Circuits wo /Purchase 10/29/2012 $93.28
Specifics: Service or Feeder
1 ea 12% State Surcharge - 10/29/2012 $11.19
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $104.47
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 • e 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. AT NTION: Or- •on law requires you to follow the rules adopted by the Oregon _o'i'•- • Center. Those rules are set forth in OAR
952 -001 010 thro ,,
through OAR • • 1 1' - 1 190. You may obtain a copy of the rules or direct questions to ,inlP< 1 32.1987 or 1.800.332.2344.
Issue B y: , • Permittee Sign • ;� - ; l � <�� / 1 .-�—
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' ( ` _ _ 40 i1i_ / ),.∎ ■. Date: ld fo. /'..._
i •
LICENSE NO. AS-35
Call 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.
Electrical Permit Application RECEIV I rUit ill:rli I. t st': 0 N1.1
1111 City of Tigard OCT' 2 9 2014 � io AIR .. , , _ , • , ;
13125 SW Hall Blvd„ Tigard, OR 97223 Ptan Review
Phone: 503.639.4171 Fax: 503.598.1960cm rr T . • i�a Dato/B . Other Permit:
i , , . h t , Inspection Line: 503.639.4175 .II " ® ;ice Pap For
.�r.� Internet. www.ligmdor.gov B ( NG , ll .,. - Supplemental Intormatlon
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❑ New construction In Addition/altc ationheplaccmont Please chock all that apply (submitl sots of plans w/itoms chocked below):
0 Service or feeder 400 amps or mom ❑ Building over three stories.
❑ Demolition
❑ Other: whom the available fault current ❑ Marinas and boatyards.
el r �. ','z`...el 4,? , "; ;, . y Y iit 'P '" { =; �W4i ,,, ;: q �:;; ? . ro UMW, :. ;;`i'1 exceeds 10,000 amps at 150 volts or 0 Floating buildings.
less or cICCeada 14,000 ❑ t::o.unorcinl -use agricultural
El 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family 0 Master builder ❑ Other: ['Fire pump. CI Installation of 75 KVA or
un,�t : , +. ',,my�; ;; . n w,: Fn �,1' e :r: ; :ti ,, ;. <. ,, ,r,• Fattetgatcy system. larger separately derived system.
':��.., e .a: :: '.4 'Ck i. ',r.' -s " ) "q'a�;,'?Y' is iic""i : � "" ' X _MiM,r "f;. ❑
g4i r's, `t:.t4 c ,'. 4�. ' •• i � ,. ` r ', ;5t ;, ".;' ;r s �;t,+ 1,.../ Addition of new motor load of
❑' A" •G" „ 1 , 2 ,. , 't_3
100HP ormore. occupancy.
Job n0.: Job site address: 66 5 0 SW Redwood , 16 0 , p Six or more rosidontial units, 0 RwreatIona! vehicle parka,
City /State /ZIP: ❑ Health-care facilities. ❑ Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: 1 0 I Project name: New Penn ❑ novice ortbeder 600 amps or more. _ : r
Cross street/directions to job site; i . `:; ;':. Total " : .
Description I Qty. � Yee. , f Toul � I "
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq, It or leas 168.54 4
Tax map /parcel no.: Limited energy. residential 75.00 2
0.: Ea, add'l 500 sq. R. or portion 33.92 I
a T ^ Js.` p/ }, n * i Y . 1„ ts^ y+ ::;`�,;: x,*!'„i;;�x� .:F. ...,:,A i 1r' �:'`5 .' ` Y,; `�i;:s ;?.' ; i:..' : (with above sq. R)
+ s. ,.:: s .ra .
" ... r.. d:...,, , . ,�.. ..:. y .. .x '. ! :L.a� r
.r =l.. a.; A - < .nµ
" . " Limited energy. multi- family 75.0U 2
Tenant Improvement residential (with above sq. (l,)
. Services or feeders Installatlon,alteratlon, and /or relocation
200 amps or less 100.70 2
:t4 ) c.' - iik iF,' � ,i yi w, , tiW: s ,, A .3,. , /, r : :� e� . • . 4 r ' . , r13 ^.� r -
.- i;:, `
'?.:::a;' ,,. 75 6: "v!:.:4•; '' e,. stl...,,;ir.. �r ? �RA, :.g. ;! , '•r, ;.e-v. ,.;'t,. 201 amps to AOOampa 133.5G 2
Name: 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: Over 1.000 amps or volts 552.26 2
Gity /State/ZIP: Temporary services or feeders Installation, alteration, and/or
relocation
Phone: ( ) I Fax: ( ) 200 amps or less 59.36 I 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 16R.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits - new, alteration, or extension, per panel
Owner signature: . Date: _ _ „ A Fcc for branch circuits with
' ^ i y a+cn�q?» ' ;.''.',';;:.:,1".i'. , ® AV/ ' .hove service or feeder foe 7.42 2
S. - 1 , • i ,, �•. "A; , r. r � r - a 1 cash brunch c
Business name: 13. Fee for branch circuits without
Johansen Electric .ervice feeder fee, first 1 56.18 .ICt 2
Contact name: Chas• lyr3n Le i f s en brnnoh cironit
Each add 'I branch circuit --- 7.42 31, 10 2
Address: 10948 SE Valley View Terr Miscellaneous (service orf:oder nor included)
City /State/ZIP: Happy Val OR 9 7 0 8 6 Each manufactured or r (ceder 67.84 2
PpY Y dwoilinR. service and/or feeder
Phone: (5 0 3) 6 98 - 3 417 `Fax : (5 0 3) 698-2486 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E -mail: - -
nai;i.i ' ,,. r' , Si pi or outline lighting 67.84 2
,• d„ ' `i.• r , „c;� �" :. !0 h. fir• + h•• - Signal circuit(s) or limited energy
Business name: Johansen Electric panel, alteration, or extension. Page 2 2.
Each additional Inspection over allowable In any of the above
AMcros: 10948 SE Valley View Terr Additional inspection (1 hr min) J 66.25/br
Ci /State /ZIPt Investigation (1 hr min) 66.25/ hr
ry Haply Valley, ey , OR 9 7 O B 6 Industrial plant (1 hr min) 78.181 hr
Phone: ( 50 3) 698-3417 1 Fax: (5 0 3) 698-2486 Inspections ibr which no fee is 90.00/ hr
ispeoi listed 54 hr mm
CCB Lic, , 51539 I Electrical Lic.: 3 - 243C I Suprv. Lic.: 2 0 5 3 S :::,,,.'.6:;' ; ; "'i +. r � 4 ;' $.' �; ":�,', ,,; ";
Subtotal: lS
Suprv. Electrician signature, required: Plan review (25% of permit fee):
Print name: Carl t7 hans en " / e: 10 29/12 - w✓ _ State surcharge (12% of permit fee): //, L �
TOTAL PI RMff 1•'EE: ID 9 • Vi
Authorized si 67 ------- Th This permit application expires ifs permit 1a not obtained within tw
days after It has been accepted as complete.
Print name: Char 1 yen e f s en Date: 10 / 2 9 / 12 • Number of inspections allowed per permit, Y �
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