Permit N . CITY OF TIGARD ELECTRICAL PERMIT
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COMMUNITY DEVELOPMENT Permit #: ELC2012 -00621
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718,2439 Date Issued: 10/30/2012
Parcel: 2S113AC00102
Jurisdiction: TIGARD
Site address: 7272 SW DURHAM RD, BLDG# 400
, Project: Lucas Foods Subdivision: COUNCIL VIEW ACRES (LOTS 21 -44) Lot: 25 -27,2;
Project Description: (2) 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 SE SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 698 -3417
PHONE: 503 -624; 6300
FAX: 503 - 698 -2486
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 10/30/2012 $63.60
Specifics: Service or Feeder
1 ea 12 •State Surcharge - 10/30/2012 $7.63
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $71.23
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 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 the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through 0 R 952- 001 -0090. You ay obtain a aa copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: t (.f Permittee Signature: Oki 4 PPLI C4- r 1 1 CIL\
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' Date:
LICENSE NO.
Cali 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 Applicatio EcIUE •
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City of Tigard OCT 29 2012 Date/ _ , Pumi;NO.: - �ew) �t.Ba ,- I
DatUB , •
• 13125 SW hall Blvd„ Tigard, OR 97223 Plan Review n
Phone: 503,639.4171 Fax: 503.598. Date/B , OlhorPerm;t: �fJl�
�
i . ,, ,) Inspection Line: 503,639.4175 pp��� BUILDING /� Da te Ready/BY '� See Page 2 for
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Internet: ww.tigard- or.gov BUILDING Ut v tS • S Notified/Mathod: E i Suppleflttmtal Infornmtion
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Please chock all that apply (.sulmilt sets ot'plaas w/lrenne checked below);
El Ncw t onstntetion ® Addition /alteration/replacement
C I Service or feeder 400 amps or more CI Building over three stories.
❑ Demolition ❑ Other: wAara the available faults camel' D Marinas and boalYerda.
I R l : ,.� .r { f p �s ov , "rr�., :. �'5 -`nk ■,;i; . '.' exceeds 10,000 amps at 150 volts or Floating buildings.
`'/ � , L �'' ' x . • • y � 9 � ' ' ' 1 = ' • ` T � G � � ` � : • °< . '•'_ . ` , J • •'' S ' lass to ground, or exceeds 1 4 , 0 0 0 D CammatoinlK4.a agrleulturel
❑ 1• and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps for ell other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: O Fire pump. CI lnstnllatlon of 75 KVA or
� ',s .,r Q 4;margcyaoy system. larger separately derived system.
.2:4. F(,' a.. y' ' r n „fi t • ;.i o..rtW'!tu ; t ,,i,. .. a dditionofnewmotorloadof
,': U .:: „•:rr r.,;,. .. • .e � w;r! ,.t-,,rt A
100HP or morn, oouupancY.
Job no.: Job site address: 7272 SW Durham, 100 O Six or more residential Units. ❑ Rooreatlonal Vehicle parks.
Ci /State/Z1P: , / CI Health-care facilities. ❑ supply voltage for more than
U �i [] Haardoue locations. 600 volts nominal.
Project name: Luc Foods ❑ Service ortixdor600 amps ormore.
Suite/bldg /apt. no.: 1 0 .. `: T i , i '' .-:; ;:i; - ..
Cross street/directions to job site: nervlpmon I Qty. 1 Foe. .1 Total : ' 1 '
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: {Lot no.: 1.000 sq. ft or less 168.54 4
Ea. add'I 500 8q.11. or portion 33.92 I
Tax slap /parcel no.: Limited energy, residential 75,00 2
ti ;ti) ,s ` ... ,`'. . (with above sq. A.)
Limited energy, mualti•fnm 75.00 2
Tenant. Improvement itsidenhtaL (with above sq.
Services or feeders Installation, alteration, and/or relocation
200 amps or less 100.70 2
n , : -. .:.,:n,.ct^ 2`p ; r " , : h ur ",,1.. �: , g' ."•`:::' 201 amps to 400 amps 133.56 2
,'-' . �G.:\ 'r�]{,},yJf� ( [��;•.jy���f}' '�'j �'':. 1 5�r., y ', . A : ;�,,, x:.
401 amps to 600 °nun 200.34 2
Name: 601 amps to 1.000 amps 301.04 2
-
Address; Over 1,000 amps or volts 552.26 2
Temporary services or feeders Installation, alteration, and/or
City/State/ZIP; relocation
Phone: ( ) I Fax: ( ) 200 amps or less , 59.36 I 1
• 201 amps to 400 amps 125.08
Owner installation: This installation is being made on property that [ own which is not 401 amps to 599 amps
168.54 2 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. Pee for branch circuits with
-
,, }7� .... . , . , , t' , 0 4 } ■ [�.L ��yj, .y .,, r Y above service or feeder fee, 7.42 2
4 :g ;Vg } ftsa ktea.. ; f ' i..' �4: r= 11. TWW4 ...7wH
SYa`RC..'.^,i,,: ouch branch circuit
Business name: Johansen Electric B• s evforbreneheircuitawrurnu1
service or feeder fiw, rind
I 56.18 54, , l $ 2
Contact name: Char Lynn Le i f sen branch circuit
Each add'' branch circuit I 7.42 '7 , e(Z, 2
Address: 10948 SE Valley View Terr MlscellaneouyservIceor feeder not included)
Each manufactured or modular 67.84 2
City/State/ZIP: Happy Valley, OR 97086 dwelling, ;urviee and/or feeder
'
Phone: (5 0 3) 698-3417 I Fax; : (5 0 3) 698-2486 Reconnect only - 67,84 2
Pump or irrigation circle 67.84 2
E - mail: Sign or outline lighting 67.84 2
;.,. yy • "
7, * .'fli t tt' ,Y u r, :5.: .,-....1)< '%' ,, W., ; '.`. :'tom. ..
; �l�� 1' -� +.ry{K4'S S� = %,. r� �'�__•_;'_ signal {NW
r �'` � � ..; <, 'K,� ,rcc: Q� : .'4•'r.,', -. - r:: %'� „z,::':r�' .... ::- lSn oir it(n) energy
panel, alteration, or extension. Pogo 2 2
Business n8n10:
Johansen Electric Each addlttonal Inspection over allowable In any of the abov
Address: 10948 SE Valley View Terr Additional inspection hr min) 66.25/hr
Investigation (1 hr min) 66.25/ hr
City/State/ZIP: Happy Valley, OR 97086 Industrial plant (1 hr min) 78.18 / hr
Phone: (503) 698-3417 I Fax: (5 0 3) 698-2486 inspections for which no fee is 90.00/ hr
s•. ifcall listed t4 hr min
Electrical -243C Suprv. Lie.: 2053S :'` r " :,14:; C"�i; .;r • 7, -M '-: "`"„ ;`'
CCB Lie.: 51539 I .Elxu : 3 p :��'•���:< �r�,. . � •,.,;�.. e�'- : � : �: r -0
_
Subtotal: :': tp3 ,(v f?
Suprv. Electrician signature, requir ,d k Plan review (25% of permit foe):
Print name: Carl 17 an s en ; .-. Date: 10/29/12 State surcharge (12% of permit fee): 1 ,10 '
TOTAL PrRMIT 1 ( Z
Authorized sigUalure: C / ., G /! /� ......-e--- ......-e--- / +' This permit application aspires If a perrtdt Is not not obteHftd within 1x0
drys after It has been accepted w complete.
Print name: Char l ynn f sen Date; 10/29/12 • Number of inspections allowed per parfait.
1: 113uildinnWormiu \tLt':•PamiLAppdoc 07/01 /10 440.4615T(11 /0/Cnt.11weO
Z / T ' 3DVd 98VZ869C0S 98bZ869EOS ZCH'3 MHSMIHOf wd Ob:ZO ZTOZ'6Z'4°O