Permit CITY OF TIGARD
COMMUNITY DEVELOPMENT ELECTRICAL PERMIT
511111 ° PERMIT #: ELC2009 -00084
°
D ATE ISSUED: 2/26/2009
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S112AD
SITE ADDRESS: 14945 SW SEQUOIA PKWY 180 ZONING: I -P
SUBDIVISION: PACIFIC CORPORATE CENTER LOT : JURISDICTION: TIG
PROJECT: SCS ENGINEERS
Project Description: Install (10) branch circuits.
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: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 9 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 HAPPY VALLEY, OR 97086
Phone: Contact #: PRI 503 - 698 -3417
FAX 503 - 698 -2486
FEES
Description Date Amount Reg #: ELE 3 -243C
[ELPRMT] ELC Permit 2/26/2009 $106.70 LIC 51539
[TAX] 12% State Surchar 2/26/2009 $12.80 SUP 20535
Total $119.50 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
• OAR 952 - 001 -0010 through OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: 40\0) Q �� Permittee Signature: QS 140 1 � Y 01 11
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'N: DATE:
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.
•
Electrical Permit Application ' `J J
I m(l)1 1 I(T I \(. .l ) \I 1
City of Tigard FEB 2 6 20 I ° °d
I I I 13125 SW Hail Blvd., Tigard, OR 97223 Dar°Bv • . s ,. Q. I, ` �i y � („4=1, a. Phone: 503.639.4171 Fax: 503.598.1960 CIYY ®F TIGA ' other permit, 1 lc reu • • • • • MI
i �,
Inspection terne: wv 503.639.417 BUILDING DIVI Vii, • S« Page 2
Internet: wow.. tigard- or.gov �! at 1 [atormadoa
f:t:..` ! :a 11 I�;.10 RVIS li �` i ` ? '1. i �� `�i y s a. y sysMv., M : I���,;•q qj�*�7¢i�@ijt --lt�,d�,r 1r �
� •�" .d I � I '' S� •,; BFI ...,.... ����li' 'G:i.�:.�t..:, eft .:�i111N�1i3�'ud6l�hSsF��sl�i:
❑ New construction 0 Addition/alteration/replacement Elmo check all that apply (submit j sets of plans wfitems chocked below):
❑ Demolition ❑ Service or feeder 400 amps or more 0 Building over three stories.
❑ Other:
w a ;, s r -I. ;xn r c.;c �Itw+exa , ' I where the available fault current ❑ Marinas and boatyards.
7 I N tgrf" ��E iy 7 , l IMAI � il,t f 1] ` I exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
El 1 - and 2 family dwelling ®Cotnmerciallindustrial 0 Accessory building less to ground, or exceeds 14,000 0 Com
❑ Multi .a,e agricultural
y ❑ Master builder Fires for m all other installations Installation of 75 KVA or
;{� ❑ Other: ❑ Fire pump. 0 foataDalioG 5'� 's { M a ob t E:2 � '' ❑ Mai= new system. larger separately derived system. r
t i L�ita pie &,;ICI t .l �; dl, j,az k, Jz + p^ds, 2' : , ❑ Addition of new motor load of ❑ "A°, 'E 1.2 ^, "1.3
Job no.: Job site address: 14 94 5 SW S e q , 18 0 10o Bp or Most. occupancy'
❑ Six or =WM residmni al units. ❑ Recreational vehicle parks.
City/State/ZIP: ❑ Health -care facilities. ❑ Supply voltage for more than
O Hazardous locations. 600 volts nominal.
Suite/bldglapt. no.: 18 0 ' Project name: SCS Engineers ❑ servico or seeder 600 amps or more.
Cross street/direcdons to job site:
Den :deli= •`'.. "ri , `Hlh rgrE ,. e T Total .,..:
Weli= Otv. Pe e. oed •
New residential single- or mold- family dwelling unlL
•
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. it or less 145.15 4
Tax map/parcel no.: Ea. add'I 500 sq. R or portion 33.40 1
:.11 {. "' - " 1fl, ICI' I r�'�Sagneluagar llP,i fl � , 1 Limited energy, residential 2
•
�til:l,c gl c�.[u •�, q s!Cr. t�, M1 7y' , I t 75.00
�lal!!INAM: c�L. .vt.ru.Tn. if i .>r' 'i !x!![61' .1+ REV t_., • , ;'', (with above eq. ft.)
Tenant Improvement Limited energy, multi- family 7500 2
residential (with above sq. 9.)
Services or feeders installatio alteration, end/or relocation
I qs, + 'i,sc 200 amps or less 80.30 2
r•+ ' litiF itrinmE „w , I I M , 3e 'I,. l`�{ I L , Iag' •:u ti.,�s'_;: 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
Address:
601 amps to 1,000 amps 240.60 2
Over 1,000 amps or volts 454.65 2
City/State/ZIP: Temporary services or feeders irstafation, alteration, and /or
I relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 1 100.30 1 I 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extensity, pe panel
• :��ti����� i 1 A. Fee for branch circuits with
:.lk; • . e"i) "``' -:' ua1 �I !pnlw
.a I.ar!r)u14: t above service f
ce or feeder fee,
+2t: (`I' :Gi1fi,^� +vF;'�!. m..a - i !i ab 6.65 2
Business name: Johansen Electric Inc. each branch circuit
B. Fee for branch circuits
Contact name: ChaNyon Leann without service or feeder fee,
' first branch circuit I 46 85 -PS 2
Address: 10948 SE Valley View Terrace Each add'I branch circuit Q 6.65 1 E35 - 2
Miscellaneous (service or feeder not Included)
City /State/ZIP: Happy Valley, OR 97086 Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: (503) 698 -3417 l Fax :: (503) 698 -2486 Reconnect only 66.85 2
E- mail: johansenelect@msn.com Pump or irrigation circle 53.40 2
.. "IV
I „
I a. I . ti.R 141 u s ,iT _ a °.: r t op . r;.•, f .. Sign orouthne lighting 53.40 2
Business name: Johansen Electric Inc.
energy Signal circuits) or limited-
Address: 10948 SE Valley View Terrace extension. el, alteration, or
Page 2 2
City/State/ZIP: Happy Valley, OR 97086 Each additional Inspection over allowable in an • of the above
Phone: (503 698 I Per inspection 62.50
Fax: (503) 698 -2486 Investigation per hour (t hr mm) 62.50
CCB Lie.: 51539 I Electrical Lie.: 3-243C 73.75
o 33 - 2 2433C /J � Subtotal: / Suprv. Lic.: 2053S Industrial plant . -•
Suprv. Electrician signature, required: �. /� of e h '.1•. �'..` . W..=1:1t / l }'I .t) y,
tal; %D 6. '70
Print name: Carl K. Johansen Date: 2/26/09 Plan review (25% of permit fee):
State surcharge (12% of permit fie): /Z, 70
Authorized signature: C TOTAL PERMIT FEE: (/ 950
Print name: Charlynn J. Leifsen 'Date: 2/26/09 lhb permit application expire' if a permit b not obtabsed within 180
days after it has been accepted as complete.
El « mitADRda 05/23/06 • Number of inspections allowed per permit
e404615T(11 /06 /C OMItFB
T • 4 XI,dd 13C213Ski1 dH WdOS t E 6002 92 clad
CITY OF.TIGARD
BUILDING DIVISION PERMIT #:i42WA 94
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175 '. _..
INSPECTION WORKSHEET FOR DATE: 3- - ct TIME: PAGE:
SITE ADDRESS: 149 M5 S W 5 .uo1a1tI' -O CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 343 cool Pour Time:
Code # Inspection Description Confirm # Contact # Message
Corrections /Comments /Instructions:
LA PASS ❑ PARTIAL APPROVAL ❑ CANCEL NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: e • '8 LE Date: 3113101 Phone #: (503) 718- 2,* 16.
CITY 0191
BUILDING DIVISION PERMIT #:E C1® 000€9
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 3 —01 • O9 TIME: PAGE:
SITE ADDRESS: LA of Li 6 - s act ts 0 I CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3 f 4001 Pour Time:
Code # Inspection Description Confirm # Contact # Message
30 c.X11-1 1 C(V
Corrections /Comments / Instructions:
J PASS (l PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL n CALL FOR INSPECTION ] ADDITIONAL FEES ASSESSED
Inspector: • t\it8 Date: 3 - , ").' 1 Phone #: (503) 718- 2,3gL