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Permit CITY OF TIGARD ELECTRICAL PERMIT g COMMUNITY DEVELOPMENT Permit #: ELC2013 00436 Date Issued: 07/25/2013 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 7/25/2 D03200 Jurisdiction: Tigard Site address: 12909 SW 68TH PKWY 320 Project: Williston Finacial Group Subdivision: WEST PORTLAND HEIGHTS Lot: 9 - 25, PT Project Description: (10) branch circuits for interior TI - framing, sheetrock, doors and finishes 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 07/25/2013 $122.96 Specifics: Service or Feeder 1 ea 12% State Surcharge - 07/25/2013 $14.76 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $137.72 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through 0 9 -0090 You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: Permittee Signature: ( fl (T7 ' /) L/ (" l/ OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease or rent. OWNER'S SIGNATURE Date: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC' Date: LICENSE NO. Call 503.639.4176 by 7:00 a.m. for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project Approved plans are required on the Job site at the time of each Inspection. RCEIVED Electrical Permit AppIlea loll you OFFICE nisi•. ONLY JUL 2 5 2013 Received City of Tigard lI•V Parfait No.: —4193 /3 3 4 ' 131 � SW [IallHlvd.,'1'i a 7 ZS �3 L1nta/BV: t , C� C a0 %3 a it an Review Phone: 503.639.4171 Ft 9$I pl Date/By• Other Permi c2045 ed / . ), • A ,: I Inspection Lino: 503,6: 1fDING DIVISION Data Mundy /Hy: luris: /iI El ,See Pop Air intcrnet: www,tigaal -o Notified/Method: / U 1 1 Supplemanwllnrnrnmllnn • `LX1iE' OF WORK ; PLAN ,REVIEW • please check ell abet apply (submit 2 sets of Finns w /Mona chocked below): ❑ New construction . ® Addition /alteration /replacement ❑ Demolition El Other: ❑ Service or tbeder 400 amps or more ❑ Huilding over three sto where the available !Ault curcom ❑ Marinas and boatyards. :. :' ' ;..:'_ ':'' , -...: `',.' :',y. :' ST.UUCflON :'' • :'r.,';::: cxcccds 10,000 amps at 150 volts or ❑ Floating buildings. • El I • and Z•ftunll dWCliln 1058 to ground, or axaendss 14,000 ❑ Comm ercinl -uan agriculhvnl y g ® C ommercial /industrial ❑ Accessory building amps for all other installations. buildings. El Multi- family ❑ Master builder ❑ Other: In Fire pump. ❑ Installation of 75 KVA or :: �.., :. '. ':•'‘ ;:- %.... - Wl n e w m Aga. sup e1y der 1 syslum. '::: 0: :0 180$ " :II 00 /,AO I flCl�'P0 , B „ nt 3 ', ,:., . .. _ . Addition 1 motor load of .. 1.2 ", "1. ', /,,? / 0 ❑° Job no.: Job site address: 90 9 se. / 100111 or more. uccp uw cy. l l�� .. ❑ Six ur more residential units. ❑ Recreational vehicle. parks. lty /State/L1P: ❑ Health -ouru t'aailitius. ❑ Supply voltage fur morn than ❑ 1lazardous locations. 600 volts nominal. /Suite/bldg./apt. no. :, Project name: 74 , El Service or feeder 600 amps or more. ' . @n ,M . E'_ -. °'. '. ; '.:: , . • .:FEE .L9.:. MI. ," : , Cross street/directions to job site: lkserlptlea_ _ I QV. woe. ( .,.ate, 1 New residential single- or multi - family dwelling unit. includes attached garage. Subdivision: I Lot no.; 1,000 so. R. or loss 168.54 4 Tax map /parcel no.: En. add'! 500 sq. ft. or portion 33.92 1 Limited energy, maiden ti al 75.00 2 ' :•,:bESckiPT1ON' OF 'WOK.: '. (will, above sq, t1) fillaIRSIMARIllk • Limited anew, mullAmily 75.(111 2 7Z ' 4 / J ' residential (with above &q.11.) v� S ervices or feeders installation, alteration, and /or relocation 200 amps or less 100.70 2 . - PROBRRT (OWNE4 (':•:: a TEN1Ah1'I • 201 amps to400 amps 133,56 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 City /State/ZIP: Temporary services or feeders installation, ullerotiun, unti/or relocation Phone: ( ) I Fax: ( ) 200 amps Or less 59.36 j 1 Owner installation: This installation is bong made on property that I own which is not 201 amps to 400 amps 125 2 401 amps to 599 amps 108.54 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 6711, and 701. Branch circuits— new, alteration, or extension, per panel Owner signature: Date: A. Fee for brunch circuits with ' ' a serv or feeder fee, ' :.'.. ' �:`1415!eIiICAIYT,. © P fd f 7A2 2 ... , . .. CgNTACT E>�f�oi�. ' . each brunch eirwil • Business name: Johansen Electri tl. Poo f o r breach circuits w i t h o u t scrvien or loader fee, first / 56.18 ,.. 6 . 44 2 on Ctactname; Charlynn Leifsen branch circuit / Each add'! branch circuit • Cy 7.42 to Gr7f! 2 Address: 10948 SE Valley View Terr ^ Miscellaneous (service orfeedernotincluded) l;neh manufactured or modular City /State/ZIP; Happy Valley, OR 97086 dwelling, service and /or feeder 67.84 2 Phone:(503) 698 -3417 I Fax: : (503) 698 -2486 Reconnect only 67.84 2 E -mail: Pump or irrigation circle 67.84 2 ,. • '''''-•••••:•'.:: '. CQN' C'POR :: • • Sign or outline lighting 67.84 2 out In • '': ' ' Signor 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 Address: 10948 SE Valley View Terr Additional inspection (I hr min) 66.25/ hr City/State/ZIP: Happy Valley, OR 97086 rnvostigalion (I hr min) 66.25/ hr Industrial plant (Ihrmin) 78.18/ hr A 698 -3417 I Fax; (503) 698 -2486 Inspeclinnx for Which nil roc is 90.00/ hr specifiun ('it lly listed hr min) CCB Lie,: 51539 I Electrical Lic.: 3-243C 1 Suprv, Lie.: 20535 .:' ' !''' '..'...;' BLECTRICA -L. p$R1 nr' 'F Suprv. Electrician signature, required: t Subtotal, /:22,,4 Plan review (25% of permit fee): Print name: Carl Johansen ate: 7/25/13 State surcharge (12% of pennit fee): / y, 74, / TOTAL • PF,RMiT FRP, /57. 7'Z / 1 Authorized Signature; (''9A A / _ 'rids permit application sxpires if a penult is not obtained within ISO (hip miter It hits hewn a,rcptrd as vumpletr. Print name: Charlynn Le i f s en Ate: 7/25/13 • (hip of inspections allowed per permit. 1 l /smsitni;Le- lkreutApp doe 07/01/10 44 0.9013'I'(11Io.MCOMAveM P / T 'EOFZd 98PZ869£05 98VZ869C09 I3aIE NaSMVHO2 NI 80 :60 £TOZ•5Z•Tar