Permit CITY OF TIGARD ELECTRICAL PERMIT
s • COMMUNITY DEVELOPMENT Permit#: ELC2013-00674
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/07/2013
Parcel: 2S112DA00800
Jurisdiction: TIGARD
Site address: 15055 SW SEQUOIA PKWY 170
Project: Day Law Subdivision: PACIFIC CORPORATE CENTER Lot: 2
Project Description: Electrical for TI:(2)feeders and(10)branch circuits.
Contractor: JOHANSEN ELECTRIC INC Owner: PACIFIC REALTY ASSOCIATES LP
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:
FAX: 503-698-2486
FEES
Quantity Description Date Amount
2 ea Services or Feeders-200 11/07/2013 $201.40
Specifics: amps or less
10 crt Branch Circuits w/Purchase 11/07/2013 $74.20
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 11/07/2013 $33.07
Electrical
Type of Const:
Occupancy Grp:
Total $308.67
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 952-001-0090. You ma •• a cop s or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Low _ _ 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 Ume of each inspection.
N4C,IFANS
Electrical Permit Application ��� t' 103 FOR 01'1'1( I. l' I`("I.`'
City of Tigard �l - ��Ar Perini No,: ! — t3� if
■ Phone:s 03 619B1171 Tigard.
fax: 07223(p 1l ®�������'� Other Parmit.or i I ._ -_ - ;-
I I t..,,p.t+ inspection Line: 503.639,4175 � i St See age for
Intcntet' www.tigard-or,gov 0311°513 _ Supplemental Information Eiili
TYh bF
:, PL,AN'RE1rt
❑New construction ®Addition/alteration/replacement •Please check all that upply(snh+uit 1 sets of plans w/items chocked below):
❑Service or feeder 40U amps or more ❑Building over dime stories.
❑Demolition ❑Other: where the available faun current ❑Marinas ttnd M,atyerrts•
' CATEGORY,OF CONSTRUCPION, exceeds 10,000 imps at 150 volts m• 0 Floating buildings.
less to ground,or exceeds 14,000 ❑Commercial-use agriwitural
❑1-and 2-family dwelling ®Commercial/industrial ❑Accessory building amps for all other installations, buildings,
❑Multi-family ❑Matter builder ❑Other: 0 fire pump, ❑Installation of 75 KVA or
, T ❑t•.mergency system. larger separately derived system.
JdB'srrE INFORMAlrioN'AN4:Lock Oro ' ' ❑Addition'Anew motor loadof ❑''A""C" 'I.2" "I-]',
100HP or mute. occupancy.
Job no.: Job site address: 15 055 S W semi 01 a, 17 0 ❑Six or more residential units. ❑Recreational vehicle park,.
❑Health-ct,rc Gtulities. El supply voltage for more than
City/State/ZIP: ❑Hazardous locations. 6(10 volts nominal,
Suite/bldg./apt.no.: 17 0 Project name: Day Law Group D Service or kcder 600 amps or more.
FEE.9CI Eft JLE'
Cross street/directions to job site: Description I Ow.1 F'es 1 TMg I
New residential single-or multi-t'amily dwelling unit.
_ Includes attached garage. _
Subdivision: Lot no.: 1,000 sq.ft.or less 168.54 4
En.add'I 500 sq.R.or portion 33.92 'I
Tax map/parcel no.: Limited energy.residential 75,00 2
'' :-.'...• DESGrR11?'t"CQ1!(by•WORK.• .., • ; • •• -• (with above sq. J
' Limited energy,multi-fhrnily 75,00 2
Tenant Improvement residentinl(with above sq,ft.) ,
Services or feeders Installation,alteration,and/or��relloMocatti�ion f�/
,., ,.. • ? 201 atria in 400 amps 13356 /'�D 2 �L�/•D'PROPERT1f OWNEI4 '• C:TENANT
2
2
401 amps to 600 amps 200.34 2
Name: 601 amps to 1,000 snips _ 301.04 2T
Address: Ovor 1.000 amps ur volts 552,26 2
Temporary services or feeders Installation,alteration,and/or
City/State/ZIP: relocation _ -
Phone:( ) Fax:( ) 200 amps or len 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 001«raps to 599 amps 168.54 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. Branch circuits-new,alteration,or extension,per panel -
Owner signature; Date: -,,_ A.Fee for branch circuits with
CONTAC'C PERSON' ..• above service or feeder tee,•®.. IPPLkCANT I • Q.•. . . each branch circuit /0 7.42 7,6 2_•
Rosiness name: 11.F•ce for branch circuits without i
Johansen Electric service Of feeder fee,first 56,18 2
Contact name: Charlynn Leifsen branch circuit
bitch add']branch circuit I 7.42 2
Address: 10948 SE Valley View Te rr miscellaneous(service or feeder not included)
Each manufactured or modular 67.84 2
City/State/ZIP: Happy Valley, OR 9 7 0 8 6 dwelling,service and/or feeder
Phone:(5 0 3) 6 9 8-3 417 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
roNTRr -
C Cf 5igmd cirouh(s)or limited energy
iness name: panel,alteration,or extension. Pone 2 2
l3us
Johansen en E 1 ect r i C J Each additional inspection over allowable in any of the above
Address: 10948 SE Valley View Terr Additional inspeelion(lhrmin) 66,25/lir
Investigation(I hr min) 66.25/hr
City/State/ZIP: Happy Valley, OR 97086
industrial pima(Ihrmin) 7R.18/hr
Phone:(5 0 3) 6 9 8-3 417 Fax:(5 0 3) 6 9 8-24 8 6 Inspections t''or which no fee is 90.00/!v
specifically listed('h hr min)
CCB Lic.: 51539 Electrical Lic.:3-2 4 3 C J Suprv.t.ic.: 2 0 53 S ELBE-roCAa••PERtir14' MS.. . •
subtotal: 216-t/�
Suprv.Electrician signature,required: /�a,, �t4.,. ,�Q,r±,,. Plan review(250(of permit tee
Print name: Carl Johansen t Date: 11/6/13 State surcharge(I 2%of permit fee)' :44.,OT
TOTAL PERMIT FEE: og,(p� ✓11
Authorized signature f1/� ,-r-'' This permit application expires If a permit h not ebta oed within 1811
dayo after It has been accepted as complete.
Print name: Charlynn Leifsen Date: 11/6/13 • Numbrof inspections allowed perpermit.
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Z IT 'Nova 986Z869COS 986Z869COS 'Darla NaSNVHOr Wd V5: 60 ETOZ'L0 •AoM
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
15055 SW SEQUOIA PKWY 170, TIGARD, OR,
97224
Commercial - Electrical
199 Electrical final
2013-11-14 00:00:00
ELC2013-00674
PASS - No C of O
Violation Summary:
Inspector Contractor