Permit CITY OF TIGARD ELECTRICAL PERMIT
C COMMUNITY DEVELOPMENT Permit #: ELC2013 -00001
T I G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/02/2013
Parcel: 2S112AC01500
Jurisdiction: Tigard
Site address: 7319 SW KABLE LN 500
Project: Quality Commercial Dist. Subdivision: FANNO CREEK ACRE TRACTS Lot: 23, PT 2
Project Description: (10) 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:
FAX: 503 - 698 -2486
FEES
Quantity Description Date Amount
10 crt Branch Circuits wo /Purchase 01/02/2013 $122.96
Specifics: Service or Feeder
1 ea 12% State Surcharge - 01/02/2013 $14.76
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $137.72
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 O � 52 - x
52-001 090. You ay obtain copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: 6.2 "' L w' Permittee Signature: O N r f I ( /'�-�C 4 1 l Dki
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.
RECEIVED
Electrical Permit Application JAN 02 201 , 1.01z 01+i( E
City of Tigard
gi
1311.5 SW lion Blvd., Tigard, OR 97223 CITY OF17GAR li Date/B .
Phone: 501539.4172 Fix: 5°339811tILDINGDIVISI Other Pound
II '' "
Impaction Lino: 503,639,4175
Internet www. tigard-orgov Received .4 (3 -t-- Permit No46 a-0 f - "e 1 12,70 I
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i •'•''';, , ,V1Z,... ' ' .4s4 Vitilf . Vtl.' 4 C-P•4+ , "•:eri s , 7 •W:tik*Olf.tiiir0007.-tr:\i'Sk4 - 1W1 - •FS - 43%. * :147'y',.q,'F• 7 i.i . T ;,
1 . --. 1‘...v. , ..r - Y.2•••• 7 11%." . 1g?..t.`:',Ii ,, , , `,..:.•••. , . • . :', • ':, - • • . Y '',1: ':'''• •i•: . .'... r ".:.••■•!. • 4 24 4 't', i •:: :. . , •'•'' '''4i•••j;41.1■4,,, ,E*W • • ...,...,.....6. - . - . -
0 New con struction IFI Addition/alteration/replacement mem caw( all that apply (submit 1 sets of:plena widems checked below)!
0 Service or feeder 409 amps or more 0 Building (wee three stories.
12 Demolition 0 Other: where the available fkult curtail 0 Marina, and boatyards.
' • ...ilLii:**Apitiffk1i$0.......VrTir,,.., eXCOOdS 10,000 amps at 150 volts or Ej Floating buildings.
less to ground, or exoscds 14,000 0 Commercial-us; agricultural
0 1- and 2-funily dwelling pg Commercial/industrial El Accessory building amps for all other installations. buildings.
El Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation 0175 KVA iw
0: ..z .0 ,„. - ... :. ‘ ' 0 iSnergency system. larger teparately derived syseem.
:F , ',..57;•''1".M ' 0 Addition ofnow motor load of 1=1"A", "E", "1 "I
100HP or more. vccummy.
Job no.: 3° " 4 ° add 7.3115 SW Kable Ln, 500 insix or more residential units. 0 Recreational vehicle parks.
City/State/ZIP: qlier 731 et 0 Reatth-care faoilities. a Supply voltage tbr more than
, 0 Hazardous locations. 600 volts nominal.
Suite/bIdgJapt. no,; 500 1 Project Mane; Quality Custom Dist 0 Service or Osader 600 amps or more.
77•7'::•. !',!..!:•!:;•..... • g litiFutt ,..y....:...:.,:,4..,.;:,. , .F "
Cross street/directions to job Idle: nfleve.n ca. n.. Tam
New reniclendal single- or multi dwelling unit.
Includes attached garage.
Subdivision I Lot no 1,000 N. ft. or leas 168.54 4
• Ea. udd'I 500 sq. ft or portion 33.92 1
Tax map/parcel no.:
, 1,.mited energy, rcridoitial 2
t
N../:: • • of •,' %,
"
:i• '1 ' .. , • S.'..:; ,07 f,..
;`■.!. . (with "bo n') 75.00 -,-- ,
*-* Limited energy, multi-family
75 00 2
Miscellaneous electrical work for tenant residential (with above sq. ft.) _
Services or feeders installation, alteration, and/Or relocation
200 amps or loss 10(1,70 2
.' : ' ' • itY 190:44ireY 41164 :•:': . ., 201 amps re um imp. 135.56 2
,.., . .
401 amps to 600 amps 200 34 2
Name: . . --
601 amps to 1900 nmpa 301.04 2
Address. Over 1,000 amps or volts 552,26 2
.
Temporary services or faders Installation, alteration, and/or
City/Statc/ZIP. relocation
Phone: ( ) j Fax: ( ) 200 amps or less 59.36 1
t
Owner installation: This Installation is being made on property that I own which is not 201 amps to 400 amps 125,00 2
401 snips to 599 amps 16634 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch drcuits — new, alteration, or extension, er panel
Owner Signature: Date: A. Foe for breach circuits with
' ', ', :c..e 'Ft above service or feeder fee.
": . ir gs .. ,,'';'..•;;-.:...•.,., '. ' ' . .1:1 CONTACt.P;, !.I=. - "....:V:'.". 742 2
each heriach Lirouil
B l'ee for branch circuits widrour ,
Business name . Johansen Electric service or feeder fee, first 1 56.t0 6 . 18 2
Contact name: Charlynn Leifsen branch circuit .
_ Each Mtn branch circuit 9 7.42 66.78 2
Address: 10948 SE Valley View Terr Miscellaneous (service or feeder not Included)
Loch manufactured or fIMIlliflf
GlyStateZIP• Happy Valley, OR 97086 dwelling, vice and/or feeder 67.84 2
Phone: ( 5 0 3) 698-3417 I Fax; .(503) 698-2486 Revninuct only 67,84 2
Pump or irriaeribe circle 67.84 2
E-mail:
Sign or outline lighting 67 84 2
- , .. .
� . ' %ma circuit(5)or limited-energy
panel, altenticn, or extension. PNO2 2
Business name. Johansen Electric Bath additional inspection over allowable In any of the above ..,
Address: 10948 SE Valley View Terr Additional inspectioo (I hr min) 66.25/ hr
investigation (I hr min) u0.25/ hr
City/State/ZIP. Happy Valley, OR 97086
Industrial plant (1 hernia) 78 18/ hr
.
Phone: (503) 698-3417 I Fax: ( 503) 698-2486 inspections for which no fee is 90.00i hr
specify:al ly listed ,, i H .. ,
CCB Lic.: 51539 I Electrical Lie.; 3 - 243C 1 Suprv. Lie.: 2053
Subtotal: 12.
Suprv, Electrician signature, required; ard k Z Vtt ..., Plan review (25% of permit fee):
Print namc Carl Johansen 1 Date: 1/2/13 stair surcharge (12% of permit foe): 14.76
TOTAL PFAM1T FEE: 137.72
Authorized signature: -
This permit application empires If a permit is not obtained n81110,180
days after it has been accepted as eemplete.
Print name: Charlynn Leifsen Date: 1 / 2 / 1 3 • Numb& of inspections allowcd per permit
ltuildieeemitd1LC-PerniitAredee 07/0140 440-1615T(1 I /05/COMN.rin
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