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Permit p CITY OF TIGARD ELECTRICAL PERMIT 111 11 • COMMUNITY DEVELOPMENT Permit #: ELC2013 -00386 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/11/2013 Parcel: 2S113AA00100 Jurisdiction: Tigard Site address: 16350 SW 72ND AVE Project: Docu Source Subdivision: ROSEWOOD ACRE TRACTS Lot: PTS A,B Project Description: (1) service and (15) branch circuits 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 1 ea Services or Feeders - 200 07/11/2013 $100.70 Specifics: amps or less 15 crt Branch Circuits w /Purchase 07/11/2013 $111.30 Type of Use: COM Service or Feeder Class of Work: ALT 1 ea 12% State Surcharge - 07/11/2013 $25.44 Electrical Type of Const: Occupancy Grp: Total $237.44 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 ough OA' '52-1 • 10'1. You may obtain a copy of the rules or direct questions to OUNC by calling . 32.1987 or 1.800.332.23'4. Issued By. / Permittee Signature: _ di' 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' /if _ • Date: C7/ / 2 LICENSE NO. &o 5 3 ,5 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 AnnlicatkREC,/ ‚' It d If'I. .'.. t ,": d..1., �I�IE� iii c12y o �ga�a JUL 8 7 1, �. Permit No,: CCG - /3— 0038 .. I7at �- 13125 SW Hall Blv d,, TlganS, OR 97223 20 13 Plan Review Phone: 503 Pa x: 5(11 Date/B t „. , r., It I1 Inspection Lino: 503.639.4175 .111110F TIGARD Date Ready/By: lurid: ® see Page 2 for Internet: www,tigard- or.gov NaifieWMeltnxt: Supplemental Information ' - . ' :.T . a> ,, bi R BUILDING [ 1 /,l lG Y ;,; :. ->pt:41+1 ri :. ❑ New construction ® Addition /alteration/replacement Please cheok all that apply (submit j sets of plans w /item checked below): ❑ Service or feeder 400 amps or more ❑ Building over three stories, Q Demolition El Other: where the available fault current ❑ Marinas and boatyards. '.( ; R 0 t STRUC!•IQit t 'weds 10,000 amps at 150 volts or ❑ Flouting buildings. less to ground or exceeds 14,000 ❑ Commercial-use agricultural ❑ I - and 2- family dwelling Commercial/industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi- family 0 Master builder ❑ Other: ❑ Fire pump. ❑ lustallatlon of 75 KVA or Emer s larger separately derived system. ._ ... ❑Addition of new motor land of ❑ •`A" •'F" "1- 2 ","I -3 ", Job no.: Job site address: 16350 SW 72nd 100HP or more. occupancy, ❑ S' re residential units. ❑ sand mai vehicle parks. City /State /ZIP: I lealthwnre Facilities, ❑ Supply voltage for mart than ❑ Hazluduus locations, on volts nominal. Suite /bldg. /apt.no.: Project name: Docusource U Service or feeder 600 amps or more. . ; ;.,..::A:' /*rEE' D,. Cross street /directions to job site: �adsa , I ON. Fee. I Total I • New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 168,54 4 FA add' 1 500 4 IL or portion 33.92 1 Tax map /parcel no.: Limited energy. residential 75.00 2 :1.i ti1 "Rk41r1d14 , .to VvOI (with above sq. 11.) Limited energy, multi - family 75,00 2 warehouse lighting; Add recpts residential (with abovesy.ft) -- - Services or feeders Instailation /or relocation _ ,v a;, " ; 201 amps or 400 amps 13? .56 7C/ 2 Name: 401 amps to 600 am 200.34 2 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 City/State/ZIP: Temporary services or feeders installation, alteration, and /or relocation Phone: ( ) Fax: ( ) 200 amps or less 59.36 I 201 amps to 400 amps 125.08 2 Owner Installation: This installation is being made on property that I own which is not 01 amps to 599 amps 4 168.54 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 41)1 a Branch circuits — new, alteration, or extension, r panel Owner signature: Date: A. Fee for branch circuits with '7 ' © A r endbr erviceorfeederfee, ,..,.. .. �t - each b mneh circuit b 7.42 2 Business name: Johansen Electric B. Fee for branch circuits without service or feeder fbc, first 56.18 2 Contact name: Charlynn Lei faen branch circuit Each add'I branch circuit 7.42 2 Address: 10 948 SE Valley View Terr Miscellaneous (service or feeder not included) Val E OR 9 7 0 8 6 dwelling, service and/or fbeder Each manufactured or modular 67.64 2 City /State /ZIP: Happy Y r Phone: (5 0 3) 698-3417 Fax ::(503) 6 9 8 - 2 4 8 6 Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 E-mail: Sign or outline lighting 67.84 2 ;: (" .' ' Cl'JYdt}IACTOR Signal circuit(s) or limited-energy Business Johansen Electric panel, ao extemion. Pa nay 2 ell Each additional l inspection over allowable in any of the above Address: 10948 SE Valley View Terr Additional inspection (1hrmin) 66.25/ hr Investigation (1 hr min) 66.25/ hr City /State /ZIP: Happy Valley, OR 9 7086 Industrial plant (I hr min) 78.18/ hr Phone: (5 0 3) 698-3417 Fax: (5 0 3) 698-2486 inspections for which no fee is 90,001 Iv specifically listed ('h hr tom) CCBLic.: Si 5 'Electrical Lic.•3 -24 i Suprv.Lic.: 2053S _ E�;ECTR1CetL: E hotV '', y ;';.. „', :..,,. Suprv. Electrician signature, required: C . !'d fr4 4/ Subtotal: 12„ Plan review (25% of permit fee): 1, / r Print name: Carl J ans en Date: 7 / 8 / 13 State surcharge (12% of permit fee): `7 6 , aJ q TOTAL PERMIT FEE: ffjj „ Authorized signature: �� r� y This permit application expires Ifs permit is not obtained In IRO days after It has been accepted as complete. Print nt name: Char 1 ynn Le i f s en Dec 7/8/13 • Number of inspections allowed per permit. I. tBonding \Permits1ELC•PennitApp,don D7/01/I0 440 /COM/WEB IT 'aDVd 98i7Z869E0S 98n869£OS ZOHria NESNVHO2 WV SC:60 £TOZ'80'Tnr