Permit (25) CITY OF TIGARD ELECTRICAL PERMIT
t . ', COMMUNITY DEVELOPMENT Permit#: ELC2017 00058
T[GA.RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/24/2017
Parcel: 2S112DA01400
Jurisdiction: Tigard
Site address: 15350 SW SEQUOIA PKWY
Project: PacTrust Subdivision: 1996-048 PARTITION PLAT Lot: 2
Project Description: (4)branch circuits for second floor common area.
Contractor: JOHANSEN ELECTRIC INC Owner: PACIFIC REALTY ASSOCIATES
16869 SW 65TH AVE, SUITE 311 ATTN: N PIVEN
LAKE OSWEGO, OR 97035 15350 SW SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-747-2503 PHONE:
FAX: 503-972-1861
FEES
Quantity Description Date Amount
4 crt Branch Circuits wo/Purchase 01/24/2017 $78.44
Specifics: Service or Feeder
1 ea 12%State Surcharge- 01/24/2017 $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 through OAR 952-001-0090. You may obtain a copy o .-. .r direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
a
Issued By: �^' Fermittee Signature: ___2&—C— ...es-
- , _....-1—i
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.
To: Page 3 of 7 2017-01-19 20:33:35(GMT) 15039721861 From: Charlynn Leifsen
Electrical.permit Appticat 41C/11Vil
°"-'4 FOR OFFICE USE 0NLj`
i Received
A, 1,125 SW Hryall Blvd Tigard,OR 972. 1 `� u? I Dan Review/iZ�/�7 $ �/'���` f� _
City oft ar( 1-crrmt*.
Phone: 503 718.2439 Fax: 503 598,1960 a ; Dat By I Related Permit r1,
Inspection Line: 503 639.4175 y ' / T+TIC C 1 §p , i7 adv )ate t3y -- 1 Juni, to Sec Page 2 for
9a It h
Pt�AitD, I ����•-
- w Internee: www.tigard-or.gov Notified/Methods d/iictitod � ��•-•-,-_,�,-Sapplementai information
..
i ;:11.V'£ a Il 1. a
❑New construction El Addition.altei't3tion/replaeement 1 Pease cheek all that apply(submit2 sets of plans w items checked):
0Seiv�ceor feeder 400 amps or more 0kut dntg over three stories.
Demolition ❑Other:
where the available fault current 0 Marinas and boatyards.
'r CA ,t0f. t V OF CO STR[ICl'IOI t cvcseds 10,00 coups at 150 volts cr Q Floating buildings
1-and 2-fantil'dwellingless to ground.or eticeeds 14,000 0 Commercial-use agricultural
0 } ®Carnntctcial%ifTdu treat 0 Accessory building 1
amps fear all other installations. buildings.
f]Multi fanttlr ❑ Master builder El Other: ❑Fire pump. 0 lnstaltaiton of 150 KVA or
❑1 m'a nc system. lar¢r separately.derived
-car .e-"- lel($ 41 11()t aav k(?f A31Fa J > > s
u�- _._.-._._.. .mm.+ 0 Adlerian omtreea auntie lead of system.
Job Job site address:15350 SW Sequoia Pkwy IUOtfl'ormorc 0"A 1. 1-' t
j CitY/Sl. .,'c1P: j 0 Six or mere residential units. - - rH:enpante.
— _ {health-eare facilities. 0 Recreational vehicle parks.
i Fitt ilelbldg lapt 4:2nd fir i Project name:iBldg 241 common area rem
❑Hazardous locations.
❑Supply voltage Its more than
---- 1 _..._.. 600 e irks nominal_
--- — 0 tyle rn{redo 600 maps�,more.
Cross strcct;'directions to Job site: t Sc-:1ilm11•,k
n uytu o I 9tv. I.. B>K.s 1 Total 1_
__.....----' New residential single-or multi-family dwelling unit.
Subdivision: 1 Lot 4: I includes attached garage.
-—"""'"'5 1,000 rel.ft.or less j 168.54 I 1
{ lax map,parcel#: - -
f
J t add 1500 sq Jt or portion i I, 3392 i Iw
f ►F ClRtd'TtOS1 01 O8ti -. j Limited cher a tesue mit) 1 I ----75- 2
Common area remodel on 2nd floor
(with above s 1.ft,/ __-�
_ .___--.. Limited etterav,multi-tamely I — 75.(it) I 2
' l— residenti al(with above sq ft.)
Renewable f rter�r_— 1 0 See Pag 2
P20Pk3i `l ,,,.,-,lt kF '' Services or feeders installation, •alteration,and,or relocation
I Name: 230 amps or less f 10070
I.Address. 201amps to40))amps— 1 133.56 --
1±4D
-1 D
1 arrips to 600 amps 200.34
1
City/State'/IP: r 26il amps to J i cH)amps__ I1. a01.04
Phone:( ) Fax:( ) Over
1,01X)soups or volts ( 1 552,26 - _2
Temporary services or feeders installation,alteration,and/or
l.,mail: _d 1 relocation ..-r..._..i
Owner installation:This installation is being made,on property that I own which.is not r 200<.mps or less 1 53.36 i z
intended for sale,lease tent,or exchange,according to ORS 447,419,670,and 701. 201 amps to 4O&)amps 1 125.08 1 2
Owner signature: Date: 401 amps to 599 amps 168.54 i �2
l f(''t`''y �y , iC't)1tx��(1 iiItii(>`r 77 Branch eircurts-Herr,alteration,or extetnronper panel
Business name.30131 ..__.. _...�.,_..._
j A }ccforhinchciecunswith j 1 �
Johansen Electric above service or feeder fie. 7_42 E__ -_-__ each branch circuit __ _. ..
Contact name:Charlynn Leifsen B.Fee for branch circuits without
-
J 1
a,.- . r sw-vice o feeder fie,fent � J 56.18 56.18 2
Address: 16869 SW'65 Ave#311 i
I - ( blanch c reit ?
Cite/State./11'Lake Oswego,OR 97035 Each dad 115171 ch circuit 3 7 42 J 747/6 ; 2 1
I_ - — - Miscellaneous(service or feeder not included) i
Phone:(503)747-2503 Fax::(503)972-1861 Each manufactured orniodular 67-84 , 2 1
— - — ----— di ,iinLiervue and/or leerier _...
Email:office(ujohansenelectric.com 1 _ 67.84 2 '1
Reconnect only
t,(),Nf . cFo12t_...
- .... --- I Pump or irrigation circle 1 67.84 2
1.3ustncss name:Johansen Electric i
SSign orignal c outline
lightingI 67114 2
-.._ .._
I Address:16869SW65`t'Ave#311 panhtddatiem. rineonovera0HeePage2 ?t
` 1
�tacl ahcrttt<nt orextension,
-- able in any of the above
City/state/"LIP:Lake Oswego,OR 97035 , - ,_r 1
_---- ._____. Additional inspection(1 br mint ' 1 66.25 hr
Phone:(503)747-2503 Pax:(503)972-1861 1 Imcstigt stio (1 hr min) . 9000;hr I_ i
1 Industrial plant(1 hr min) 178 18/hr 1
Email:office(4)johansenelectric tom ,
_ E
inspections for which no fee is y(})t I
CC13lie 59539 Lbkctrica.l o-243{:' Suprv.Lie.: 53785 sp ctttc ilv list d( hr mut, I t'
. I d .(.".•!'R1, A1: P AINItI.T F1'I S,:..
Suprv.I loctuetan signature,required: Sub?oral. 78-44.
Print name: Jonathan Johansen Date: 1/19/17 i 0 flan Review Required(25%of permit fee):
______ _ _-._.._.._. __ State surcharge(12%of permit fee): 9.41
Authorized signature: ------ - TOTALP PERMIT FEE: 87.85
— ---— -- — This permit application expires if a permit is not obtained within 180Printname. Charlynn Leifsen Date: 1/19117 1 mdays after it has been accepted as complete.
-__ --. ........_ -. ._ -..- fff -.._ _.__.. .. .--___. ' Number of inspections allowed tet permit.
I-'4dailding.Penull'''r.LC 6'e:uitapi k i R_E:kt[.due ace-Veil-7/2.0 i:!, 440-40,1'41 l,05,Ct7rLi WC.:a
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
15350 SW SEQUOIA PKWY, TIGARD, OR, 97224
Record Type: Record ID:
Commercial - Electrical ELC2017-00058
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
14368 SW 88TH AVE, TIGARD, OR, 97224
Record Type: Record ID:
Residential - Electrical ELC2017-00580
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor