Permit (24) CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2017-00057
T E GAR J 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/24/2017
Parcel: 2S 112 DA01400
Jurisdiction: Tigard
Site address: 15350 SW SEQUOIA PKWY
Project: PacTrust Subdivision: 1996-048 PARTITION PLAT Lot: 2
Project Description: (4)branch circuits for first 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 $87.85
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale,lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR.ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
To: Page 2 of 7 2017-01-19 20:33:35(GMT) 15039721861 From:Charlynn Leifsen
1 `; V •
Electi'ICc`I 1CIi31 1��(3liCall i y :FOR OFFICE USC ONLY
City U Tigard t� 1 7 ! 00" / C`2'lrnt p��
t -a 13'125 SW Miall Blvd Tigard,OR 97223 lNan ltev;ew
Phone: 503.718.2439 Fax: 503.598 1960, RelatedPcrmitt:.
y i F t)at I3t
I'It�IcR£J�. lnspecut)n Line: SU3.639.4ll? , yr��i �'PGA� i� 181 See Page for
��$r�� I Ready D t t3v
torn;
Internet wwyy tigard or soy 1�,., v ,i h Nnti0echM had I Supplemental Information
❑New construction El Addiiioil;alte�atiOtlrl'eplitcCt71ent Please s..wet all thrd apply(submit 2 sets of plans w n_ms checked):
❑Service or le--der 400 amps or more 0 Building over three snirics.
❑Demolition ❑Other: I when;the available fault current 0 Marinas and boatyards
';S fk GiOR1 OF f"ONS.fRLif;1 I43imt l 2stcaeds 10,000 amps at 150 volts or 0 Floatin,,bs»ldintts
❑ I-'<tnd 2-family dwelling la Cutxtnxereial.iindiistrial ❑Accessory ory builc$.tt less to ground,or exceeds 14,000 0 Commercial-use agrieahit it
amps for all other installations. buildings.
❑Multi family 0 Master builder ❑Other i ❑Fide pump 0 installation of 150KVAor
1011 SITE I1W-6kYt4l,7 iO)1s A'�D 4LOCslTICSN ❑ mutgenGv>v:4tent larger separatelydenvecl
/ .�"` -'�'""" 1 '"" "-"-'- '--"•' ' - I 0 Addition ii next motor load of system,
✓ Job `' __ I Job site address_ 15350 SWSequoia Pkwy ; IOOFrn or mote, ❑' 1 , l_t"
ern or more toJe a usaucy.City State/ZIP
0 Health-care I iciltiies 0 Recreational vehicle parks.
Suite/bldg./apt. 4:1"fir Project name:Bldg 241 common area rem Dhazardous tocanocs 0 S00Simply voltage for more that
..__. 0 Sun ice or feeder 600 ampsor iron 't
is nominal
F
Cross street directions to job site: 1 -5(L{EDL E `
I"asp;;ipti0- I-Qty. h r d;zi Tot.d 1
--.---..--.-.- ,..._j New residential single-or multi-farnily dwelling unit.
Subdivision: 1l.,ot4: i Includes attached garage.
Tax map/parcel t,c.1,G --- 1,000 1 sq.tt or lass ._. ! 168 54 1 4
Ea.add'!500 sq ft or portion 33.92 I 1
1)FSCltl.k'll1O'01', W`O1 A ,rnrt.dener v.residential i I I
Common area remodel on 1't floor
- (with above sq ft.)
75.00 I
t misted energy,may-family
- !
residential(with tthose sq.ii.) 5 00 ! 2
I'ROPFR7 -•-. R ::' ',,: 1 Renewable Energy 0 See Page 2 Il,
...... _._O. ,:_.-_ I. ; ') ti ;N 1'.': 1 1 Services or feeders installation,alteration and/or rtlocatiott
I
Name: - 200 amps or less 1 100.70 I 2
_ - i
201 amps to 400 amps 1 t 133.50 ' 2
Address: �_
_---• 401 amps to 600 amps L 200:34 2
City State/L.IP: 601 amps to 1,000 amps _..1 301.('4 2
Phone::( i ht�e:( ) �� Over 7.000 azrps or volts 552.26
- Tentporar-t services or feeders installation,alteration,and/or
]-snail:
relocation
Owner installation:This Installation is being made on property thus I own which is not 200 amps or less I )9.36 i 1
intended for sale_,lease,rent,or exchange,according to 0125 447,449.670,and 701. 701 amps to 400 amps 125.08 _ I
401 amps to 599 amps '168.54 1
Owner signature: Date: .1._`
i - 1 Branch circuits-new.alteration,or extension,per panel, _
' ( ,A "k; !CAN. ❑ 001N1.AC's'.PC[LSCI'�t I. ___.
—:-1 1 ee for lar la cies circuits H ith
Business name:Johansen Electric I above service or feeder fee,
7.42 j n
-1 ( each branch circuit
I
Contact name:Charlynn Leifsen It Fee for branch circuits without f.. T
service or feeder fee_.first i I 56.18 `
Address.,16869 SW 65111 Ave#311 i ' __ _56.18 , 2
branch circuit
Foch tide!'!blanch circuit 3 7.42 72-51i.67-1---,i-
City/State/ZIP:
Lake Oswego,OR 97035 I 1 .__ -_-_1
--- _ ._.__.—.. ______ _____ ---j i Miscellaneous(service or feeder not included) -I
I 67.84 I 2
Phone:(503)747-2503 i-ax::(503)972-1861 I i Each t manuf cured or modular
1 dwelling,service and'or leder I
]'maul.ofEce@johansenelectric.com " E 2
Reconnect only (i7 b4 1
C'.ON1if4T"1'O1t' '^ ` ' Pump orfrrtemtionemei, f 6784; I .2.{
Business name:Johansen Electric I Sign or outline lighting 6x.8.4 7_2_
r ___ y ,
aJ nalcitestt(s)orlimited-energ
Address:16869 SW 65th Ave#311 I asset.alteration,. or extension ❑ See Page 2
City/Stale/ZIP:Lake Oswego,01?97035 L_E,ach additional Ins.talon over allowable in any of the above
��-_.____------___- j Additional inspection(]in min) i 66.25/hr
r
Phone:(503)747-2503 i Fax:(503)972-1861 I Investigation(1 hr min) 40.00/hr
[mail:office johansenelectru_com
Industrial plarrt(1 1n min) III75.18/hr
..,_, __. _._.__. Inspections for which no les is
CCB Lie.: 51539 1 Eleetriea 43C 1 S;iprv, Lie.: 53788 1 spectfh.illy listed 1/hr mu)
90.00/hr
__•_-_-_-
I a .i.t C 1 1C�xTr F R 3IT Ft I S
Suprv-.Electrician signature,required: ,� , Subtotal:1 - 1 74.44
L Print name: Jonathan Johansen I Date: 1/19/17 L. Plan Review Required(25%of permit fee): (
State surcharge(12%of permit.fee): 1 9.41
Atdhorired sigltture TOTAL PI 12 f1I I-Li- 87.85
This permit application expires if permit isnot obtained within 1SFi
I Print name: Charlynn Leifsen _ Date: 1/19/17 days atter items been accepted as complete.
L- - -_'_ ' Number.I n,iwctions allowed per pomit.
I'nuitl ennite1,IA.feratit-51 ELR_ERr--doe Rev eke I 7f20i3 441)-4ir:5r(11/os en etecit
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 ELC2017-00057
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor