Permit CITY OF TIGARD ELECTRICAL PERMIT
o COMMUNITY DEVELOPMENT Permit #: ELC2010 -00498
T [ G A R n 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/14/2010
Parcel: 2S112DA01400
Jurisdiction: Tigard
Site address: 6650 SW REDWOOD LN 290
Subdivision: PACIFIC CORPORATE CENTER Lot: 0
Project: Fairway America
Project Description: Electrical TI, (11) branch circuits.
Owner: FEES
PACIFIC REALTY ASSOCIATES Quantity Description Date Amount
15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224 12 crt Branch Circuits 09/14/2010 $137.80
wo /Purchase Service or
PHONE: 503 -624 -6300 Feeder
1 ea 12% State Surcharge - 09/14/2010 $16.54
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:
Total $154.34
Required Items and Reports (Conditions)
This per • s issued subject to : regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be d in accordance with approved •tans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
da . ATTENTION: Oregon law : = 're- you to follow the rules adopted by the Oregon Utility Noti Center. Those rules are set forth in OAR
9 - 001 -0010 through OAR 952 -1 -0100. 4 4 ay obtain a copy of the rules or direct questions to OUNC by lina 503 246.6699 or 1.800.332. 44.
ssued By: ■
Permitt
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' %W Date: 9 /.,/ ,,
i
LICENSE NO. oS� 5
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.
RECEIVED Pae /o -ao_ e9
Electrical Permit Aaalication 1 1 1 ] t 1 / 11. 1, 1.1 .I ()\1 1
City of Tigard SE P 1 4 2010 ed 9 / 7 M Permit No.. f� aO ••' ef 9e
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review «!
Phone: 503.639.4L71 Fax: 50Vr F T1GARD Dates Other Permit
1 . 1 , hispection Line: 503.639.417 5
Internet: www.agar or.gor DU ILDING DIVISION Notified/Medved: R Supplemental I Inhumation
! lrla 2.1 144:4 to ltl1 x : ✓ fh4"}4fO �Y:. ' 'I'•'�p� :� 11f51.. , :r niffi11 4(" 4 71'..1 i iTi 1 1 1 1L� ^ir.N• f ,! t' v •J 1 °v1Fli l,- 1 friEth'1'�.. -1T-.
11x. :.. i..•r. biliii n, i.it.0 :;:.... >.9a.i2•8k,..n[1114.Ski:.u_diia :1W. laM�a MPw�lt�i+'�3Ek(•�'e1 :1 n a l lilltiKallad 3. .•0;L:11!' -1 §11f . e-31.1.�1f'r` i g
❑ New construction ® Addition/alteration/replacement Please check all that ripply (subaut 1 seta of plans whereat checked below):
❑ Service or feeder 401 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other.
where the available fad& current ❑ Marines and boatyards.
ri ii..;T t & +C rr a Ittrrrv_ra.t l q °c ./.x.1t 77alne U 1,12 1IFII ,fi r r exceeds 10.000 at ISO volts or buildings
illt`7lc, . m tJlIL3 U1 C.?tltil('?;f o.�w. l.l:tr 1, .,; ,,,. t � 2 '_= .,....2i r r I b :,11,3 l J�.'ixl L SIal S Ms;i li ❑ Be-
t "`� ; r less to !round, or exceeds 14,000 ❑ co nmerdal - use
1,0 1- and 2- family dwelling ® Co>nmerciaF'ind El ustrial Accessory building amps for all otter installations. buildings. �
❑ Multi -family ❑ Master builder ❑ Other ❑ Fire pump. ❑ Installation of KVA or
rzrxn „. ❑ Emergency stem largersepar y system
L ``,,ji. it;;I ts��: -..'I « i t (i +rr } rsr�lr ,I:'u.^.•r.e2. S t it .. r i aI 7ii `• tl f 4 i11 ❑� Of new motor load of ❑ "A - .'E "1 iii ."-- :', x. ..,. ';^" 3r,„T - . - ._ §n1 ..., 7 pT! ,_ r x.' ,.".. TI ,lv �.i•, ..nail ut i I
Job no.: Job site address: 6650 SW Redwood 290 100HP or more occupancy.
❑ Six or more residential umta. 0 Recreational vehicle pmica.
City /State/ZIP: ❑ Healthcare 9cilities. ❑ Supply voltage for more than
0 Hemdoas locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: Fairway America ❑ Service or feeder 600 amps or more
kiyi! y ^ �' I-a>(ltr:rtffi.�,�p,lt�cy S r lry •. + �+gnlu ,,�yi � {r� vs-+7
Cross street/directions to job Site' ! at li:Ut. h 1 lA•:1:.3,Ci3O1fb.�....a ..... 1Y LLl.�t :, fes. idilg :" L '
DrxAr On. Wee Thal •
New residential single- or mldti -family dwelling unit
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. R or less 168.54 4
Tax map/parcel no Ea add'I 500 sq. ft. or portion 33.92 1
Limited energy, residential 75.00 2
} 414 t -al�� �'alii),h , :�"I� ^ ?A i ..,,�f - 17m. 1mIt. i i." u7f' ,aalIf�'I'� !!`` 1' r t 1 ° :.1' MIX (With tAF,(
_t.l l�:.f 1 4 /11441�IN . .44A1111 . i ra t,..�-.4 4 1L rldei i
-1.1 • rkialk1111A1 d.,;;1Fb tt above e-4 it)
Limited energy. multi- family 75.00 2
Tenant i m • rovement residential (with above sq. ft.)
Services or feeders inatallation and/or relocation
k f - SRIe! 1 li- YNf !. Y I 200 amps or lass 100.70 2 •
t u - 1512- F.`" r �rseet• /r ,c� ]r : II���� q
iru I s `l l ii.i :. ,fi ;i7_ • i I r i fr %av!., � (i�R c n 9 r If°f - 'gC ! i i t ' i 1. 201 amps to 44 amps 133.36 2
.r 1. YT 'xArdb 1),ft a 11 L..c,.....111 }u,iltiv o, 1L I .
Name: 401 amps to 600 amps f 200.34 2
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 stops or volts 552.26 2
City/State2IP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 I 1
Owner installation: This installation is being that I own which is not 201 amps m 400 amps
m8 made on PsoPe�Y I 125 168.54 .08 2 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 soaps to 599 amps
Branch circuits - new. alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
t# ` ff : f �j' uLUt w:! , .74 ,r7� r + ti ; f - r , y malt: 2.enr..• <- • " bOVe service or feeder fee.
{ ( . dJ it. 1'•.. 1, �. u �. � + � t }' :, ∎ � _. ' ,:,. Ii. : - 91. t:_.b ° .abut < c .: 2 Itli ' a cad, branch circuit 7.42 2
Business name: Johansen Electric B.Fa for branch ciretdl without
service or feeder fee, first ( 36• 18 .1% 2
Contact name: Charl Leifsen branch circuit
Each add•t branch circuit _1, 7.42 142.- 2
Address: 10948 SE Valley View Terr Miscellaneous (service or feeder not included)
City/State/ZIP: Happy Valley, OR 9 7 0 8 6 Each tom" or modular 67.84 2
p pY y r dwelling. service and/or feeder 6
Phone: 698 -3417 Fax::(503) 698 -2486 Renamed only 67.84 2
Pump or irrigation circle 67.84 2
I s E-mail: E-m .�1
:. > - -•,•! 1, . _ Sign or outline lighting 67.84 2
I' <firt'.i $ d 'faJl�l ,al4il1 )¢: ,., = ::21: I E utt` 111 J : a sn. ti AMMO. `�`f g
• � ,,_u :l �,� 11i1f�?�a. :ta.lt;Lgll�..... i,�.y( ?!'.�i.Lt.'i.;•�f I .'oral;. ,_t�!� ^�� :!u Signalcircmt(s ) otlimited- energy
panel, alteration, ar erne t f Page 2
Business dame: Johansen Electric
Each additional inspection over allowable in any of the abov
Address: 10948 SE Valle View Terr Additional inspection (1 hr min) 66.25/ hr
City /State2JP: Happy Valle , OR 97086 Investigation (l hr min) 66.25/ ht
Industrial pleat (1 hr min) 78.18/ In
Phone: (5 0 3) 698-3417 Fax: (5 0 3) 698-2486 Inspections for which no fee is
a • p - . ifical t � , listed i4 hr min 90 -00/ hr
CC13 L ic.: 51539 Electrical Lic.: 3-243C Suprv. Lie.: 2053 S }^ iK:.� aViiift VS; it ik ''" - �; +r' . ; ? "`• i I � >�"Tt u '1'? '.;. i
, ._�: ...11 ''.1
Suprv. Electrician signature, required: - / / /
s, '; ubtotal: ' S 1 ' ':
.. _ ��,..-_..... A. :',_, :. Plan review (25% of pens* fee): ,
Print name: Carl J • � an �
This
ansen / Date: 9/14/10 State surcharge (12% of permit ilse): /69 6 . g41
Authorized signature: Fi/ I , /, TOTAL PERMIT FEE: , 3Lf
%�� ,r1 � permit application expires [fa permit is awt obtdoed within 180
Print name: Cha r l ynn Lei. Date: 9/14/10 days after it complete. has been accepted as
Number of inspections allowed per permit.
1:1BeiltEn Pe pemurArte doe 07/02/10 440.4615T(1 1005/COMdWEB
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