Permit t -,, CITY OF T IGARD ELECTRICAL PERMIT
'' ° ' p COMMUNITY DEVELOPMENT
• PERMIT #: E /27/20 00605
DATE ISSUED: 10/27/2008
TIGAKD; 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S112DD-01600
SITE ADDRESS: 15495 SW SEQUOIA PKWY 150 ZONING: I -P
SUBDIVISION: PACIFIC CORPORATE CENTER LOT : JURISDICTION: TIG
PROJECT: SPEC SPACE
Project Description: TI.
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: 14 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 10/27/200! $139.95 LIC 51539
'TAXI 12% State Surchar 10/27/2001 $16.79 SUP 2053S
Total $156.74 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 throu.h 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.
N
Issued By: c i Permittee Signature: , � �
—/ � . (327/017C
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:
Cali 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 Applic EI`IED 1 01. 1.1( I. l q
City of Tigard Received t ff ',
DatelB
3125 SW Hall Blvd., Tigard , oR 1 2 4 2008 .�� _ ` 5
.1„....„.• �� D ian Review
Y -4 n ��� )3
Phone: 503.639.4171 Fax: 5O3.58.1960 Other Permit: ���JJJ //
Date/By Oi
1 1 , r, ill. Inspection Line: 503.639.4175 Dat Ready/By: tun See Page 2 for
Internet www ttgard or gov CITY OF Notified/Method:
77 � QN Supplemental Information
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❑ New construction ® Addition/alteration/replacement Please check all that apply (submit 2 sets of plans white=s checked below):
0 12 Demolition ❑der; Service or feeder 400 am or more Building es.
1 } t ii } !F t where the available fault current ❑ Marinas ov
and boatyards.
t
rk 1 i'HI11 1` 1 r f j�a . ii l t , r t t • ti exceeds 10,000 a
, A..:.,,, 1111 1., „' .P � : YR-17 ^ 1." ! ?"" J 'M 14 `.. 1, f ' G it: i{` ter.. , l i ..,f amps at 150 volts or ❑Floating btril�iings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building amps for all other installations buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
ti
1 i 11
at' 1 + Qi , i P.. t f+ I;T'1' x°11.'1' 0 ` L i. r -'t? t i ' r':'1. ❑
Emergency of new are. for load of larger separately derived system.
., ,.. � � �'ti N 19 Addition frno ❑•'A" "E" "1 -2" "I -3"
Job no.: 1 Job site address: 15495 SW Sequoia 1001fP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
C ity /StateiZl P: $l Health-care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal
Suite/bldg,apt- no.: 15 0 1 Project name: spec office TI ❑ Service or feeder 6001' amps � more. 7
1 ff
tit 41. hill.- {il.,i , 10* ' APi�h.'r iitr� f . 1 1 E ":gSl ,;I,,+l,v,;j i'k.1 r1r,
Cross street/directions to job site:
Description pn. 1 Pee. 1 row 1
New residential single- or multi family dwelling wait.
Includes attached garage.
Subdivision: ! Lot no.: 1,000 sq. fl. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
i t 1 + �= ¢ ' i ". ?,k'Lli � i �� . t ai i .- t
it ire , Lilt ,, :,' ,, .. ; 111 . :,r X u - II + - ° d 1 ) (1 lk , ",f (with above sq. A.) 75.00 2
r9
Limited energy, multi - family 75.00 2 •
Tenant Improvement residential (with above sq. ft.)
Services or feeders installation, alteration, and /or relocation
r k 1 ;. i l k 3 411+ i 1 1 1) 0 i - . r s t o 200 amps or less 80.30 2
"f a i . r,: ,' .. . 75 t 1 ! + „'it t . 1 �{ ' 1 II - .'. +y, .i „t-: hi a - 1 .. 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 , 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City /State /ZIP: Temporary services or feeders installation, alteration, and/or
I relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 I 1
Owner installation: This installation is being made on property that 1 own which is not _201 amps to 400 am ps 100.30 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 extension, r panel
� A. Fee for branch circuits with
' f 1 ' , )r' .. i•� �..y{��r�.�v ti R 1 ' ' t 1 r1 . ! ti" Of 0Olti'7t' G '' jl` i r r t" t . ,
r t .1.. C .F Y a 1 r�'i l.rlt n, ,r llli:r r(' .. 1, +,, l; w above service or feeder fee,
6.65 2
each branch circuit
Business name: Johansen Electric Inc. H. Fee for breech circuits
Contact name: Charlynn Leifaen
without service or feeder fee, 1 46.85 46.85
2
first branch circuit
Address: 10948 SE Valley View Terrace Each add'I branch circuit 14 665 93.1Q2
Miscellaneous (service or feeder not included)
City /State/ZIP: Happy Valley, OR 97086 Each manufactured or modular 90.90 2
dwelling, service and/or feeder
Phone: (503) 698 -3417 Fax: : (503) 698 -2486 Reconnect only 66.85 2
E -mail: jobansenelect@msn.com Pump or irrigation circle 53.40 2
.', I' I,':. fr+I ;',.i`f l n ' i '; tE I1*a: °j".'6.::: , �.'i 'i''.,'v' hi }.;,` i , ! 't Si or outline lighting 53.40 2
Business name: Johansen Electric Inc. Signal circuit(s) or limited -
energy panel, alteration, or
Address: 10948 SE Valley View Terrace extension. Describe: Page 2 2
CitylState /Z1P: Happy Valley, OR 97086 Each additional Inspection over allowable in an of the above
Per inspection 62.50
Phone: (503) 698 -3417 Fax: (503) 698 -2486 _ Investigation per hour (l hr min) 62.50
CCB Lic.: 51539 Electrical Lic.: 3 -243C Suprv. Lic.: 2053S Industrial plant per hour 73.75
P g q � � ` ` ... +fa %Z i� Y,a Sub tis _
Suprv. Electrician signature, required: ..„ � Subtotal
-
Print name: Carl K. Johansen I te: 20/24/08 Plan review (25% of permit fee):
State surcharge (12% of permit fee): 16 9
Authorized signature: TOTAL PERMIT FEE: 156.74
Print name: Char This pertapplicadon expires if a permitis not obtained within 180
Charlynn J. Leifsen Date: 1 / 2 4 / 0 8 im
days after it has bees accepted as complete,
Number of inspections allowed per permit.
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1 - d Xd3 13C213S1J dH WdBi»: i BOOZ bZ '400
CITY IGARD
BUILDI DIVISION PERMIT #: EI t 7008.00C =()r
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/27/2008
Phone: (503) 639 - 4171 '
Inspection Requests (24 Hrs.): (503) 639 -4175 jr 47 ' I ..
INSPECTION WORKSHEET FOR DATE: 1/16/2089 TIME: 7:01AM PAGE: 7
SITE ADDRESS: 'I W.35 SW SEOl1OIA PKwl 150 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: TYPE OF USE:
PROJECT NAME: ei;p - C SPACE
DESCRIPTION: -I•!
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503.698..17
Inspection Request Scheduled For: Date: 1/16/2009 Pour Time:
Code # Inspection Description Corifirm - #_ Contact # Message
199 l:lectlical finer! 079791 -03 03•x)88 -0211 N
Corrections /Comments /Instructions:
CNAC. - 1,00$ -0 06 86
\\
/\,
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
- PArL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: (Ye) Date: 1. 1 ! Phone #: (503) 718- .-'F"W
CITY IGARD
BUILD G DIVISION PERMIT #: FL C200t3.00606
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/27/20
Phone: (503) 639- 4171' �� i
Inspection Requests (24 Hrs.): (503) 639- 4175 ..
INSPECTION WORKSHEET FOR DATE: 11/14/2008 TIME: 7 :00AM PAGE: 10
SITE ADDRESS: 1,95 SW SEQUOIA PKWY 150 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: TYPE OF USE:
PROJECT NAME: :APL(: SPACE
DESCRIPTION: TI.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 50.59(;.417
Inspection Request Scheduled For: Date: 11/14/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
130 Ceiling cover 078096 -01 503-969-5262 N
Corrections /Comments/ Instructions:
PA PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: \7 1 te) L Date: al 114 i Phone #: (503) 718- jig)____ f