Permit CITY OF TIGARD ELECTRICAL PERMIT
t;:y- COMMUNITY DEVELOPMENT Permit#: ELC2013 00544
T1OARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/12/2013
Parcel: 2S 112 DA01400
Jurisdiction: TIGARD
Site address: 15350 SW SEQUOIA PKWY 220
Project: Tetratech Subdivision: 1996-048 PARTITION PLAT Lot: 2
Project Description: (4)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
4 crt Branch Circuits wo/Purchase 09/12/2013 $78.44
Specifics: Service or Feeder
1 ea 12%State Surcharge- 09/12/2013 $9.41
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $87.85
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 throug •I.- 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling WS/S.2-.1987 or 1.800.332.2344.
_
Issued By: 1 !:6,_ �/` J _0 Permittee Signature.
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.
i '
Electrical Permit App '1,.:iii, r r(11:(Irr1( r l':-;1•:11:\1.1
City of Tigard
Received 9® I Ete /p-0,51/
Tigard Oaten: 7 / Permit No.: !
• 13125 SW!loll Blvd„Tigard,Si.4}1228 2013 Plan Review
Phone: 503.639.4171' fax: 503.598.1960 pale/B : Other Permit: /la
1 I c,,t:I, Inspection Line: 503.639.,OF TIGARD •atc Reedy/By; !uric. Id See Page 2 for
Internet: www,tigard-or. Notifie/Methti: Supplemental Information
• ,..... , .. YPi v
[SION ...
. ... .. PLiAN,..IiEVIE'Utr�•:::::.: :.
El
construction ®Addition/alteration/roplaccment Please check ell that apply(submit 3 sets of plans w/items checked below);
❑Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition ❑Other: where the available fault current
❑Merinos and boatyards.
. .. :' CATEGORY•OF CONSTRUCTION'..' •• ' ` •• .: . exceeds 10.000 amps at 150 volts or 0 Floating buildings.
loss to ground,or exceeds 14,000 ❑Commercial-sue agricultureI
❑ I-and 2-family dwelling ®Commercial/industrial ❑Accessory building amps fbr all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: ❑Fire pump. 0lnamllmiun o175 xvA or
mergenc system
larger separately derived system.
3N SITE•INFORMATION 'AND`LOG4TION y
['Addition of sew effeter load of ❑"A""L`""1-2"."1.3",
Job no.: lob site address: 15 3 5 0 SW Sequoia, 2 2 0 lix or or more. i e creation
Qll01 a, ❑Six or more residential units. Q Recreational vehicle polies,
City/State/ZIP: ❑Health-care theilitics Q Supply voltage for more than
❑Hazardous locutions, 600 volts nominal.
titi Suite/bldg./apt.no.: 220 Project name: Tet rat ech 0 Scivicc or feeder 600 snips or more.
' . FEE S IIEDULE ' ..
Cross street/directions to job site: Dmertpdoa I Oh. I Fee. I Total I •
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq.ft.or loss 168.54 4
Ea.add'I 500 sq.ft.or portion 33.92 1
"Fax map/parcel no.: Limited energy,residential
75 00 2
' DESCRIPTION.OF WORK •.: '.:`.., .swhh above sa fee _
Limited energy,multi-family 75.00 2
Tenant Improvement residential(with above sq.ft.)
Services or feeders inatalIation,alteratlon,and/or relocation
200 amps or loss 100.70 2
' d.PROPERTY oWNER J' 0.TEP ANT' . 201 amps to 400 amps 133.55 , 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 5,51,26 2
'Temporary services or feeders installation,alteration,and/or
City/Slate/ZIP: relocation
Phone:( ) Fax:( ) 200 amps or less I l 59.36 1
Owner installation:This installation is being made on property that I own which is not 201 amps 10 400 amps 125.08 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. Out amps to 599 amps 168.54 2
Branch circuits—new,alteration,or extension, r unreel
Owner signature: Date: A.Fee for branch circuits with•® APPLICANt:` • •', . '"", ... . above service or feeder fee,
. I Q CONTACT PBR$ON each branch circuit 7.42 2
Business name: B.Fee for branch circuits without
Johansen Electric aerviccur feeder fee,first i I 56.18 54
-i$ 2
Contact name: Leifsen branchcitwit
�q��i�
Each add'I branch circuit I.� 1 7.42 2.2,;Mel 2
Address: 10948 SE Valley View Terr Miscellaneous(service or feeder not Included)
City/State/ZIP: Happy Valley,a OR 97086 Each manufactured or modular 6,7,84 2
Ppy Y r dwelling,service and/or feeder
Phone:(503) 698-3417 Fax::(503) 698-2486 Reconnect only 67.84 2
Pump or Irrigation circle 67.84 2
FE-mail: _Sign or outline lighting 67.84 2
.. ' .. 'CONTRACTOR ••. ,.. ;
. . - 5iYttul ur0uil(s)or limited-energy
easiness 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(1 hr min) 66,25/hr�
City/State/ZIP: Happy Valley, OR 97086
Investigation(I hr hr 66.25/hr
Industrial plant(1 hr min) 78,I S/hr
Phone:(5 0 3) 698-3417 I_Fax:(5 0 3) 698-2486 inspections for which no feels 90.00/hr
specifically listed(1/2 hr min)
CCl3 Lic.: 51539 Electrical Lie.:3—243C Suprv.Lic.: 20535 ' . . • ELECTRICAL:JPERMIT.FEES'• ' ,
Subtotal: lig i YU/
Suprv.Electrician signature,required:��,ar e Plan review(25%of permit fee):
Print name: Carl Johansen•�+�� Date: 9/11/13 State surcharge(12%of permit fee): (3,4/
TOTAL PERMIT FEE: 1,..'1,g ;—
Authorized signature: This permit application expires if a permit is not obtained wtthln 180
days after it bas been accepted es complete, Q/ /
Print name: Char lynx Leif s en Date: 9/11/13 • Number of inspections allowed per permit,days {I/
1:11 1uildingiPorn+as\F.I.C•PenniiADA. 07/Ot/I D 440-461 St(11/05ti0M/Wili
•
/T '3DVd 98bZ869£0S 98bZ869£0S 10TI3 NaS1''HOr Nd Ob:60 £TOZ•TT-daS
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
15350 SW SEQUOIA PKWY 220, TIGARD, OR,
97224
Commercial - Electrical
199 Electrical final
2013-10-29 00:00:00
ELC2013-00544
PASS - No C of O
Violation Summary:
Inspector Contractor