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Permit • CITY OF TIGARD ELECTRICAL PERMIT C COMMUNITY DEVELOPMENT Permit #: ELC2012 -00685 TIGARLD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/06/2012 ...................... Parcel: 2S112DA01400 Jurisdiction: Tigard Site address: 15350 SW SEQUOIA PKWY 150 Project: Harrison CPA 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 12/06/2012 $93.28 Specifics: Service or Feeder 1 ea 12% State Surcharge - 12/06/2012 $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 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 OAR 9 2- 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: ' r " `,"'` e'tCct± Permittee Signature: /li /'t 1 -(-Li !r't k- • 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. 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. _. RECEIVE' Electrical Permit Application DEC 0 6 2012 I:01t (11.P1( I Si: x1\1.1 Received Sr Pamir No: City of Tigard Date/: • t y_ s 'LGo tab48 rt 13125 SW Hall Blvd, Tigard, OR 97223 ITY (F TIG • , �� N Phone: 503.639.4171 Fax: SU3.598. s • = l�her .. Go� tea` I I I ..t :, I' inapeetio Line: 503.639.4175 ILDtNG DIVIS10 " ® See Page for Internet: www,tigard- or.sav Supplcmtnlnllntbrteallon n ., ,...,, �. . - s . : ...w .,+ u:r,�• ....o a r ,.,'.:x ".gi }.p,. -e ^; y. .:e, ,:. '' >" ,.N' , 'o'(-';'' ;∎,:i +,r, y (I , ),. y .. r t ,. r(a � � . I 's. 1 , �1, `.f ' ;r. -u. ,. ,`,t 'iii "/ L'', ',' e Pl ❑ New construction ® A ddition /alteration/replaccment umes cheek all that apply (admit 2 seta of plans w/items checked below): 0 Service or trader 400 amps or more Q Building over three atones. Q Demolition 0 Other: where the available fault current I l Marinas and boatyards. x : ' "- i;;. i;1'- a v � G, r r: '' I. ' e l ;,,, •: }; ; i,. ;'W'c,,' J. ;'-4iIN. ip..,.;< :.t axcccds 10,000 amps at 150 volts or 0 Floating buildings. :',; ;; r ="` r ",.,•. ...`,'y,r.t - °. '.i ',,:' ,',> s,r `, r, t... ground, or exceeds 14,000 ❑Commercial- uaoagriuulhmd ❑ 1- and 2- family dwelling ggi Commercial/industrial 0 Accessory building amps fur all other installations. buildings. ❑ Multi- family ❑ Master builder ❑ Other: ❑ [lea pump. Q Installation of 75 KVA or w !x � .. u , . " ,,�,; .,: _ r , . ❑ Ymtagemq systm. halm separately derived system. Cti'S a hp :.k :-': ✓.' k I }] 011 } ` ..,. . ..... i'.,k4 Addltiun motor load of ❑ "A ", "�, "1.2 ". "1 -3 ", Job no.: ( Job sit° address: Six or or more. Recr 15 3 5 0 SW Sequoia, l el , 15 0 Q Six ar more residential units. � Recreational vehicle parka. City /State/ZIP: Q Health-care facilities. © Supply voltage for more than Q Hvardnus locations. 600 volts nominal. Suite/bldg. /apt. no.' 15 0 I Project name: Diana Harrison l7 Service or theder 600 amps m more, Cross street/directions to job site: esserapttoa Qa Iree, Total New residential single or muitlAamlly dwelling unit. Includes attached garage. Subdivision: 1 Lot no.: 1.000 sq. it, or ter. 168,54 4 F.a. add'l 500 sq. f. or portion 33.92 1 Tax map /parcel no.: Limited energy, residential 75.00 2 ' :! ". '.;k'; ::i' ;' , ;;7K .77 4., .:4 i>; ;V'! ; ah:: . `r'!;'..' (with above s9. ft.) r Limitod energy, multi- family 75.00 2 T I residential (with above a9. (t.) Services or feeders installation alteration, and/or relocation 200 amps or less 100.70 2 v 4f • �. .Y f,:4,jr:'T1' ,. ;y 1, r ,•)snit 'v •:? ,a,, ,i amps to amps 133.56 2 1' .r ;: ,.� �,.' y Ra ,���yy'��� �.p r.::.;. . 201 tops Pa .` : 14 Yl� i�':'nI i ^� ' '':��.: �h.•� !w'.�� 401 amps to 600 amps 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: ( ) Fax: ( ) 200 amps or loss 59,:6 1 201 limps to 400 amps 125.08 2 Owner installation: This installation is being made on pro that I own which i s not 401 amps hl 599 amps 168.54 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits - nov1altcrattan, or extension, r panel Owner signature; Date: A. Poe for branch circui with `{' a _: .. .,; :: , 1': r ,:,:, above service or feeder fee, 7 42 2 ,;, r ,�v� ,y.' r !: :< r'`,�r`�i'�)�(`,. ., ' "a., .; { r;y: ? r, ' i.. �1�'�.X±�: �' "�-` cachbrmvhuirunil Business name: Johansen Electric A.P rviceo r feede f without .. service or loader fee, fire[ 1 56.18 6.18 2 Contactname: Charlynn Leifsen branch circuit Each adc1 1 brunch circuit 15 I 7.42 37 • 10 2 Address: 10948 SE Valley View Terr Mbcelleneons (service or feeder not Included) Each manufactured or modular 67.84 2 City/State/ZIP: Happy Valley, OR 97086 dwelling, service 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 A ':a1, 0:,'.,;,,'(q - 1 : el•' -.: .y - . . ;0 nI :,f, c i 1 or limited V '' ,' , . ' w' ... , ,. ,. , � " . „ , _ ..... e . .. .. ' { � Signal rca 9 K E+y panel, alteration, or extension. Page2 2_ Business name: Johansen ; Electric - Each additional inspection over allowable in any of the abov Address: 109 SE Valley View Terr - Additional inspection (I hr min) 66.25/hr Investigation (1 he min) 66.25/ hr City / State/ZIP: Happy Valley , OR 9 7 086 Industrial plant (I hr min) 78.18/ hr Phone: (503) 698-3417 I Fax: ( 503) 698-2486 Inspections for which no f e is - 90.00/ hr apeoi fically listed c'/, hr min) CCB Lie.; 51539 I Electrical Lie.: 3 - 243C l Suprv. Lic.: 205 3 S '.':. 1: iev : Lv !1_, ' di. y , ` N ..: 111 :y.;,' :. ?i7::. 4 s Subtotal: '3.2: Suprv. Electrician signature, required( ,, /(101.1,44140.44..„, Plan review (25% of permit fee): Print name: Carl J ban s+en D a l e' 12/6/12 State surcharge (12% of permit fat): 11.19 / TOTAL PERMIT FEE: 104.47 Authorized signature: /'( 'fhb permit application aspires Ifa permit b not obtained within I89 Print name: Charlynn Lei f s en I Date: 12 6 / 12 days altar h haw been permit. e aLS complete, P yn / • Number of insyamtlona allowed per l;' sildingtPeunuls\a.LC- PerrohAtt4se 07101/10 410- 4615T(11M5/COMhVfD Z /T 'aevd 98tZ869i;0S 986Z869E05 ZOH'I3 NHSNVHOC NV L1i:60 ZTOZ- 90'Dec