Permit •
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CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT
Permit #: ELC2010 -00391
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/29/2010
Parcel: 2S113AB00101
Jurisdiction: TIGARD
Site address: 16101 SW 72ND AVE 200
Subdivision: PACTRUST BUSINESS CENTER Lot: 0
Project: Sunset Mortgage
Project Description: 20 Branch Circuits for T/I
Owner: FEES
PACTRUST Quantity Description Date Amount
15350 SW SEQUOIA PKWY SUITE 300
PORTLAND, OR 97224 20 crt Branch Circuits 07/29/2010 $197.16
wo /Purchase Service or
PHONE: 503 -624 -6300 Feeder
1 ea 12% State Surcharge - 07/29/2010 $23.66
Electrical
Contractor:
JOHANSEN ELECTRIC INC
10948 SE VALLEY VIEW TERR
HAPPY VALLEY, OR 97086
PHONE: 503 - 698 -3417
FAX: 503 -698 -2486
Type of Use: COM
Class of Work: ALT Type of Const:
•
Occupancy Grp: B
Total $220.82
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 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: t ./k Permittee Signature: O iV lq ', /_ _, ,' -�!� t Tr
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 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.
VE
Electrical Permit Application �E�
City of Tigard Ili 2 7 2 10 Permit No.: E L (. lO - 00 341
13125 SW Hall Blvd., Tigard, OR 97223 p
Phone: 503.639.4171 Fax: 503.598.1960 OF -r 1 Date:
/um- Pt i e i d r a U ge a ibr
Supplemental Information
der y 7
Inspection Line: 503.639.4175
Internet www.tigatd- or.gov BUILDING DIVIS , l' °ufiod/Method:
S 1 •^C , "lie y"�tr i t �I•�'''Ss# RiFu. °..ice, �.F- t Y3L:� r ` "ha �• n g r rm.,ktca�7a
.i .� "I 1 0 14k '" ' ']7L' 7
��. i_1� {(1 t d J s a S 4 F I x tl E t. l' 11l'�+� MORM m i!S. a.. t•'i ai k 114(1 .
..�klE�t L:a'^ �it1L'CtL1 !if�:l�x�a+arlarhSuail uilkl� I .'lli L:. 1 , ]a! du. "1 c. r_:, ...tl,tl'���ir!�C�11��:1��:�`• ..
❑ New construction ® Addition/ alteration /replacement Please check all that apply (submit a sets of plans witems checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition 0
_ where the available fault current ❑ Marinas and boatyards.
I t I,lih -�f i ! ,t a -' 1 ° ern, �f.1 .. .., ..>stms !`'�' ••31SIF7 .NL7{nn} }i'7 c f -'t Ott v° + u .n, ss �•r;r•
tit* ; _s ] r i J : e, ,t 1 v1 ' y u r t o u 1} exceed. 10,070 amps at 150 volts or ❑ Floating buildings.
s ,J t 1�"! � { �F' . .f. � •' ". , r . 1
� exc less to ground, or exceeds 14.000 ❑ Commercial-use agricultural
❑ t- and 2- family dwelling ® Commercial/industrial ❑ Accessory building amps for other installations. buildings.
❑ Multi family ❑ Master builder ❑ Other: ❑ Fire pump ❑ Installation of75 KVA or
! 4l r{ . rrstatttek?�rnraats y ur In rip !ynr n:C r w R _ y, in Emergency aysmm. larger sensately derived system
1 1¢t(u r l r+eEt:•iiiu i . a rb7tl:lta3elmiildl ` t I ' ° 1 ,1 1 �drA ° ' S ' i.Ev , E - ❑ Addition of new motor load of
Job no.: Job site address: I i, or mare. occupancy.
16101 SW 7 2nd , 2 0 0 0 Six or more residential units. ❑ Recreational vehicle parka.
City/State/ZIP: ❑ He alth-eare facilities. 0 Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg /apt.no.: 200 Projectnarne: Sunset Mortgage ❑ Serviceor feeder600 s ormore
M L RE:111 i r.'... 47 6 ' tL'Lit?.iz ItP3 .'?�F,i�'Ll�i
Cross street/directions to job site: oeee ietloa o . Ike. Taal •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft or less 168.54 4
Ea. add'l 500 sq. lt or portion 33.92 1
Tax map /parcel no.:
Limited energy, residential
T I' ail ,i 'tit�y{t�F�f�, � (' � trl .� f �oA ��� i }. �! �r� S ^ I {7� to 75.00 2
I!t!1 t:SiIIF.Il11l. . l>G+ ,: c mr..dtilti { M�;',L+! v!ir. 1 1411EIti l ila i ts i (with above"Ift) .
Limited energy, multi - family 75.00 2
Tenant Improvement residential (with above sq. S.)
Services or feeders installation, alteration, and /or relocation
200 amps or less 100.70 2
ar'?t,+JFyt:c.5a-:�- -,Ft z•,h Y' ..a2 r, u GVi i 201
ii„1 _�h ter+ iia y3s,iitW :urn t � e2179/2 -� a iq� It! � s i ) '{ ti'I "a sir sw ;, t : y "Ps to 400 amps 133.56 2
,� '� �1��9 • •� tl !#fall
Name:
4.01 amps to 600 amps • 200.34 2
601 amps to 1,000 aarpa 301.04 2
Address: Over 1,000
amps or votes 552.26 2
City /State/ZIP: Temporary urvices or feeders installation, alteration, and/or
relocation
Phone: ( ) J Fax: ( ) 200 amps or less 59.36 I 1
• Owner installation: This installation is being made on property that I own which is not 20l amps to 400 amps 125.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Owner signature: Branch circuits - new, alteration, or extension, per panel
gnature: Date: A. Fee for branch circuits with
� (�L�,�,,•�l y jta I�--�,�, i ,rl, I u I r , , �1 i' a"'! 1.11 �. �5 /?)5' 'gym' �(t F , s(r above service or feeder fee.
1 d1},N� �,..jt i ,l &1 F� ill:; l ti�a: �i. 4 �m. 31 ,+o.�,.i{d:e�!'L�lasaa`,. €t. 7.42 2
each branch circuit
Business name: Johansen Electric B. Fee for branch circuits without
Contact name: service esut or r fee. first 1 56.18 56.18 2
Char Lynn Leifsen f sell Each add't branch circuit 1 19 7.42 _14 0 . 9 0 2
Address: 10948 SE Valley View Terr Miscellaneous (service or feeder not included)
City/State/ZIP: Ha Valley, OR 9 7 0 86
Each manufactured or modular 6784 2
Happy Y r dwelling, service .allot feeder
Phone: (503) 698 -3417 Fax::(503) 698 -2486 Recomrectonly , 67.84 2
Pump or irrigation circle 67.84 2
E-mail:
It.���l' ° p'e"t !II)III'tl�° °' '.?tt°"r'+:v snit 91 v =r<r 1uttM Sign or outline lighting 67.84 2
's.hdrillit�:...l.,.it.t .. M ..3 Ille e: �,e,i~°.!,a+! ilr-LIi1 :1.11 : I llIE ! Ir, Id1iP Y4! • Signal circuit(s) or limited - energy
Business name. Johansen Electric
panel, alteration, or extension. Page 2 IT
Each additional inspection over allowable in any of the abov
Address: 10948 SE Valley View Terr Additional inspection (I hr min) 66.25/ hr
Investigation (1 hr min) 66.25/ hr
cityfState2lP: Happy Valley, OR 97086 Industrial plant (lhrmin) 78.18/ hr
Phone: (5 0 3) 698-3417 Fax: (5 0 3) 698-2486 Inspections for which no fee is 90.00/ hr
s • ifrca1I • listed % hr min
CCB Lie.: 51539 Electrical Lie.: 3-243 C [ Suprv. Lic.: 2053 S iti Pell jJ a,,;, J nl,_l s , _; �,1 r , !-;_,_- , li t' 4 F
Suprv. Electrician signature, required: Subtotal: 197
Plan review (25% of permit fee):
Print name: Carl Johansen D 7/26/10 ✓ State surcharge (12%ofpenntfee): 23.66
TOTAL PERMIT FEE: 220.82
Authorized signature: 0 kiki\-----
/ This permit application expires if a permit is not obtained within 180
days after It has been accepted as complete.
Print name: Charlynn Le i f s en I Date: 7/26/10 • Number of inspections allowed per permit.
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