Permit A - �� 1':. C I TY OF T I ELECTRICAL PERMIT
' PERMIT #: ELC2006 -00413
4 I•t DEVELOPMENT SERVICES DATE ISSUED: 7/28/2006
' ' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171
PARCEL: 2S112DC-00701
SITE ADDRESS: 15985 SW 72ND AVE BLDG -A ZONING: I -P
SUBDIVISION: OREGON BUSINESS PARK III LOT : 038 JURISDICTION: TIG
Project Description: Emergency repair.
•
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 1 W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
PACIFIC REALTY ASSOCIATES JOHANSEN ELECTRIC INC
15350 SW SEQUOIA PKWY #300 -WMI 10948 SE VALLEY VIEW TERR
PORTLAND, OR 97224 CLACKAMAS, OR 97015 -000
Phone: 503 - 624 -6300 Contact #: PRI 503- 698 -3417
FAX 503 - 698 -2486
FEES
Description Date Amount Reg #: ELE 3 - 243C
[TAX] 8% State Surcharge 7/28/2006 $6.42 LIC 51539
[ELPRMT] ELC Permit 7/28/2006 $80.30 SUP 20535 •
Total $86.72 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Speaalty Codes and all other applicable laws.
All work willbe-done in. accordance with approved plans. This permit_will expire if work is not started within 180 days of issuance, or if work is
suspen d for more than 180 da s. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules re set forth in OAR 9 -001 0 ,throug OAR 952 - 001 -0100. You may obtain copies of the s or direct questions to OUNC at
503 46 -6699 or 1 -800 -3 2 -2344. ( , _._
i / Permitte Si ature: i / � .
Iss ed By: K X.R . l2' / g� r1 y� / �c l
(f
-- 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. ELE r ,� • tt /B ` DATE:
7�t1�
LICENSE NO:
Call 503 -639 -4175 by 7:00 a.m. for an inspection that business day.
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.
Jul 26 2006 3:57PM Johar 'i'1ectric Inc. 503 - 698 -2486 p.2
l ectrical Permit Anpilcatid ' i t ( () L L l I l (I \
City of Tigard 2006 ��
lD DareBy: '! alG ' ' G Permit No,: iii [ ° 100�' L�Q � // 3
13125 SW Hall Blvd., Tigard, OR 97223 J U L Plan ReNiew
Phone: 503.639.4171 Fax 503.598.1960 `''',' t,11 : i , Date/By: Other Permit:
Inspection Line: 503.639.4175 V it L . a L4- Date Ready/By: Juri • ® See Page 2 for
Internet www cJ tigard or us U Notified/Method: /C. Supplemental information
-/. ` + 1 -r ±' :.� . ..' . r L t r - ` •S ;0. ,n. .;. } -. 4( *7y D. T ��1 .1.
❑ New construction ® Addition/alteration /replacement Please check all that apply:
❑ Demolition ❑ Other: ❑Service over 225 amps, comm'I ['Hazardous location
ti 4 , ❑Service over 320 amps — rating QBulldng over 10,000 sq. ft.
+ ; i „„,2.c ¢N t4. , . • of 1- and 2- family dwellings 4 or more new residential
❑ l- and 2- family dwelling ❑ Commercial/industrial 0 Accessory building ❑System aver 600 volts nominal units in one structure
❑ Multi-family ❑Master builder ❑Other: ❑Building over three stories ❑Feeders, 400 amps or more
pant load over persons
❑Occu 1 ei 99 ❑Manufactu red structures or
. ,....•:msg*. . 1t* -. f , „ ) , OK t:. . , .,„ ❑EgressllrghmigAlan RV park •
Job no.: 1 Job site address: 15985 SW 72 ❑Health -care facility ❑Outer:
Submit 2 sets of plans with any of the above.
City/State/ZIP:'igard ) 0 R The above are not applicable to temporary construction service.
Suite/bldg./apt. no.: Project name: 72 °d Avenue Salon • ; z - 'i ..- A J; ,,. r _, •i:Y .t. ". ?.
Description. 1 rte. 1 Feu I Tow I :.
Cross street/directions to job site: New residential single- or maid-family dwelling unit
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea add'l 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map/parcel no
Limited energy, non- residential 75.00 2
s' _,. , �t E ?; ,', Y ` 11)1 4D1,t1F {7 ; , k 4 s - Each manufactured or modular
Emergency repair dwelling, service and/or feeder 90.90 _ 2
Services or feeders installation, alteration, and/or relocation
200 amps or leas [ 80.30 gel 50 2
< Y0 P$1 .,r :_. 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City /State/ZIP: Temporary services or feeders installation, alteration, and/or
Phone: ( ) Fax: ( ) relocation
200 amps or less 66.85 1
Owner installation: This installation is being made on property that 1 own which is not 201 amp to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 imps 133.75 _ 2
Owner signature: Date: _ Branch circuits— new, alteration, or extension, per panel
: ? .,` +. l ;q l: ?. ;'0, „' i i T;C'f/l!)�FAt "!' SOIL ` • A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: Johansen Electric branch circuit
B. Fee for branch circuits
Contact name: Carl Johansen Electric without service or feeder fee,
first branch circuit 46.85 2
Address: 10948 SE Valley View Terrace -
Each add'1 branch circuit 6.65 2
City/State /ZIP: Happy Valley, Oregon 97086 Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: (503) 698.3417 I Fax :: (503 - 698 - 2486)
Sign or outline lighting 53.40 2
E -mail: Signal circuits) or limited-
a <l 4 energy panel, alteration, or
extension. Describe: Page 2 2
Business name: Johansen Electric
Address: Same Each additional inspection over allowable in any of the above
Per inspection 62.50
City /State/ZIP: 5 lnvestigatian per hour (1 hr min) 62.50
Phone: (S°3) (d $ LI f 1 I Fax: ( 03) 1o4$ � ,1.1 S c Industrial plant per hour 73.75
CCB Lic.: 51539 Electrical Lic.: 3 -243C Suprv. Lic.: 2053S Subtotal gO ,3t)
Suprv. Electrician signature, required: Plan review (25% of permit fee)
Print name: (.i n R L K Id (-{ f'( 1`15 G (v I Date: 1..2 - Q(p State surcharge (8% of permit fee) Lo , LrL
TOTAL. PERMIT FEE g(,) , - a
Authorized signature: This permit application, expires ifs permit is not obtained within 180
days after it lies been accepted as complete
Print name: I Date: • Fee methodology set by Tri- County Building Industry Service Board
•• Number et per permit al lowed.
• CITY OF TIGARD .
BUILDING DIVISION • PERMIT #: ELC200G -00413
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/2P,/7006
Phone: (503) 639 -4171 A:' h . ' � I &
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET. FOR DATE: 7/31/2006 TIME: 7:06AM PAGE: 63
SITE ADDRESS: 1h985 SW 72ND AVE BLDG - CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK III LOT #: 030 TYPE OF USE:
PROJECT NAME: 72ND AVENUE SALON
DESCRIPTION: Emergency repair.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: 50;::624 -0300
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503 693.31417
Inspection Request Scheduled For: Date: 7/31/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
IL Electrical final 034036 -01 503.698 -3417 N
Corrections /Comments /Instructions:
•
N
A PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: + N ba L&., Date: 1(1l Op Phone #: (503) 7181-0°