Permit I` ; 1' CITY OF TIGARD ELECTRICAL PERMIT
t ' •'- COMMUNITY DEVELOPMENT It Permit#: ELC201500933
,u L1r�- ., Date Issued: 11/23/2015
TICr RI7I 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S101AD03200
Jurisdiction: Tigard
Site address: 12909 SW 68TH PKWY 170
Project: Alegis Subdivision: WEST PORTLAND HEIGHTS Lot: 9-25,PT
Project Description: small office remodel. 12/1/15:Reprinted permit to change address from suite 160 to suite 170
Contractor: JOHANSEN ELECTRIC INC Owner: PACIFIC REALTY ASSOCIATES
16869 SW 65TH AVE, SUITE 311 ATTN: N PIVEN
LAKE OSWEGO, OR 97035 15350 SE SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-747-2503 PHONE:
FAX: 503-972-1861
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 11/23/2015 $100.70
Specifics: amps or less
5 crt Branch Circuits w/Purchase 11/23/2015 $37.10
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 11/23/2015 $16.54
Electrical
Type of Const: 45 Misc Administration Fee 12/01/2015 $45.00
Occupancy Grp:
Total $199.34
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 0 952-001-0090. Youa c•• of the •es or direct questions to OUNC by calling 503.232.1987 or 1 800.332.2344.
Issued By: �/-ti�j✓��c- — / Permittee Signature: 4;ff
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.
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12909 SW 68TH PKWY 170, TIGARD, OR, 97223
Commercial - Electrical
199 Electrical final
PASS - No C of O
ELC2015-00933
Chip Barnett
Violation Summary:
Inspector Contractor