Permit CITY OF TIGARD ELECTRICAL PERMIT
° PERMIT #: ELC2008 -00351
• C COMMUNITY DEVELOPMENT DATE ISSUED: 6/19/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 101 AD -03200
SITE ADDRESS: 12909 SW 68TH PKWY 170 ZONING: MUE
SUBDIVISION: TIGARD TRIANGLE CENTER LOT : JURISDICTION: TIG
PROJECT: COMMON CONFERENCE
Project Description: Installing (4) branch circuits in first floor common conference room.
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 HMI 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: 3 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 6/19/2008 $66.80 LIC 51539
[TAX] 12% State Surchar 6/19/2008 $8.02 SUP 2053S
Total $74.82 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: i - Permittee Signature: �i . # G�7
- psi / _
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 1 01; f 11 1 f(,: 1 ,sl: (1 \1)
City of Tigard 'e1V� v (p /' / L'L�
�� DetoB, Ay, .
13125 SW Hall Blvd., Tigard, OR 9 • �� . �� Plan Review
--
' Phone: 503.639.4171 Fax: 503.598E r DatdBv. Other Permit: r P -., . a i 4
I . , c: A , Inspection Line: 503.639.4175 Q Date Ready/By: See page2 ror
Internet: wwtv.ti and or.gov l Noc Sed/Med,od : (s Supplemental Informaton
,'' - 1 ' 1 I k N.: rv„ Yrtll, t C-417 f , '. j , ♦ �. wl kt Iy k I , 1 . n R e �g las+owkn;c.ak r , , ... ,o;.}
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❑ New construction ® Addition/altera • . o :. 4'�S ® Please check all that apply (submit a sets of plans writer/es checked below)
❑ Demolition ❑Oar: , 1 1 t ` I' N 11 N ❑ Service or feeder 000 amps or more ❑ Building over three stories.
'v ' 2.■
t u� where the available faun current ❑ Marina and boatyards.
` }l'D �1;"``� i s t• i r rwralMg, Ailii�t•1ir1 r il 1 l,y.-Lf� t• ., exceeds 10,000 at 150 volts or g buildings.
i !l. e l „ r ,.1 -��8 K � amps ❑Floaun bml e.
❑ 1 - and 2 - family dwelling ®Cottunercial/industrial less to ground, or exceeds 14,000 ❑ Corttrneteial -use agricultural
❑Accessorybuilding amps for all other installations. buildings.
❑ Fire pump. ❑Installation of 75 KVA or
❑ ,,� Multi-family ❑ Master builder 1:1 Other.
; 6t il:�f:5 " •, .,n- .ai.le'I Y.i�r' r Y:' �' 1't_ ';`461 --;.ii ,....p', .9;•y.`.t ❑Addni no f now mowrloadof lg8Ei60pareMyderived
}L. mach .,. _, :1 . � 2� ., fi, i . ❑ • A" "E", "I -2" '1.3"
Job no.: Job site address: 12909 SW 68 t h Pkwy I OOHP or more. occupancy.
❑ Six or more residential knits. ❑ Recreational vehicle parka.
City/State/Zl P: 1 ® Health -care facilities. ❑ Supply voltage fat more than
70 ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: 1 f *Project name: Common Conf rm O Service or feeder 600 amps or more.
AVEN Y Cross street/directions to job site: m� Total -
New residential single- or multi- family dwelling unit.
Includes attacked garage.
Subdivision: I Lot no.- 1,000 sq. Rot less 145.15 4
Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.; Lime ener residential
"1:.. 1,.; k,l.t ;h a# xs]rs asnl ,��n,w�,y,�}wlv Limited 6y,
: ::,0 f 'll k,Y ?:. . , , . , t l rer lilL.:it9 u'J1E1 4 k ll. (with above sq. 9 - ) 75.00 2
Limited energy, multi - family 75.00 2
Work at 1st floor common conference room residential (with above sq. ft.)
Services or feeders installatiolt and /or relocation
it a;lg k,>an�aarp a raa,oa ry l , n 200 amps or less 80.30 2
', lI .fl1' . '� �ls ur� �lrikattlJ °t •� 1 ;.�1. ,,.'F:1'I r'
sr� � u Oi�d 1'1' +i ; tlf�lfq �'r�ll� � ri`!..: • yl':: fw ?'I`� 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 installation, alteration, and/or
_ relocation
Phone: ( ) I Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that 1 own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps I 133.75 - _ 2
Owner signature: Date: Branch eke nib — new, alteration, or extension, Qtr panel
1; I, k " " Ic A. Fee for branch circuits with
`�i ` 1 �, y t k M,r
vlxr •
r: , . 1 i _ -F,�{ above service or feeder fee, 6.65 2
1 , . "''. i «x:Y, iii, iJ,,,+, o ka�ri��ifdl�ih10 .a1L'l!.�191�>i2 c��i�ie,:
each branch circuit
Business name: Johansen Electric Inc. B. Fee for branch circuits
Contact name: Charlynn Leifsen
without service or feeder fee, 1 4641 8 5 2
first branch circuit
Address: 10948 SE Valley View Terrace Each add9 branch circuit 3 6.65119 . 95. 2
Miscellaneous (service or feeder not Included)
City /State /ZIP: Happy Valley, OR 97086 Each manufactured or modular - 2
dwelling, service and/or feeder
Phone: (503) 698 -3417 I Fax: : (503) 698 -2486 Reconnect only 66.85 2
E -mail: johanstnelect@msn.com Ptunp or irrigation circle 53.40 2
; Y. '- i i 1 t` r truer.., ��.. y ,..,,.
rl f 4 : 1 w'Iiu�w:Y :OI; , . „4!,i' {oil`..;..tif oiif . -. , 'd1 Sign 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
City/State/ZIP: Happy Valley, OR 97086 Each additional inspection over allowable In any the above
Per inspection . 62.50
Phone: (503) 6983417 Fax: (503) 698 -2486 Investigation per hour (1 br min) 62.50
CCB Lic.: 51539 I Electrical Lic.: 3 -243C I Suprv. Lic.: 2053S Industrial plant • - hour 8 73.75
�..r,
Suprv. Electrician signature, required Subtotal: • - -
• i
Print name: Carl K. Johansen Plan review (25% of pentut fee):
State surcharge (12% of permit fee): 8.02
Authorized signature: TOTAL PERMIT FEE: 74.82
Print Herne: Charlynn J. Leifsen Date: 6/19/08 Th° permit neptieadoa aspires ifs permit b not obtained within 180
days after it has been accepted as complete -
-
•
kl BsildmyPenmts■ELC- PerrniIApp.dx 05/23106 440461ST( I 1 r'o5/COMAWEB Number of inspections allowed per permit.
T - XH3 13C2I3S131 dH WULE =L 800E 6T unr
CITY OF TIGARD.
BUILDING DIVISION PERMIT #: ELC200800351
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 6i19/20011
Phone: (503) 639 -4171 X
Inspection Requests (24 Hrs.): (503) 639 -4175 61 I I..
INSPECTION WORKSHEET FOR DATE: 7131/2008 TIME: 7:00AM PAGE: 16
SITE ADDRESS: 12909 SW 68TH PKWY 170 CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE CENTER LOT #: TYPE OF USE:
PROJECT NAME: COMMON CONFERENCE
DESCRIPTION: Installing (4) branch circuits in first floor common conference room.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503. 698.3417
Inspection Request Scheduled For: Date 7/31/7008 Pour Time:
Code # Inspection Description ,/ Coffin Contact # Message
199 Electrical final 073540.02 503 - 969 -5262 N
Corrections /Comments /Instructions:
E 1 NAl, raktsiti - 1 (.10 1
i a KW. A Li._ £, w i°'$ cittlo A oll, o L.. cf.) 046 .
.Pe -II _ P. O CAI. . ;.
ink2 A :11hilLASh.r i .41111 di •
,'\
.K ., --\'
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* PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G---1, 9v (:sg Let Date:111 6 till Phone #: (503) 718- 14110
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2008•00351
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/19/20O13
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7/10/2008 TIME: 7:OOAM PAGE: 16
SITE ADDRESS: 12909 SW 68TH PKWY 170 CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE CENTER LOT #: TYPE OF USE:
PROJECT NAME: COMMON CONFERENCE
DESCRIPTION: Installing (4) branch circuits in first floor common conference room.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503 -698 -3417
Inspection Request Scheduled For: Date: 7/10/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
130 Ceiling cover 072445 -01 503- 698 -3417 N
Corrections /Comments/ Instructions:
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: �m 6 V Date: 1 •1 a • 0 Phone #: (503) 718 - Z-
CITY OF TIGARD • •
BUILDING DIVISION PERMIT #: ELC2008.00351
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6!19/2000
Phone: (503) 639 -4171 p j ( j
Inspection Requests (24 Hrs.): (503) 639 -4175 ' . �!�+L
INSPECTION WORKSHEET FOR DATE: 6/27 /2008 TIME: 7:01AM PAGE: 14
SITE ADDRESS: 12909 SW 68TH PKWY 170 CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE CENTER LOT #: TYPE OF USE:
PROJECT NAME: COMMON CONFERENCE
DESCRIPTION: Installing (4) branch circuits in first floor common conference room.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 603-698-3417
Inspection Request Scheduled For: Date: 6/27/2008 Pour Time:
Code # Inspection Description ( Confirm # Contact # Message
125 Wall cover k� p 071946 -(1 603-969-5262 N
185 U tJ Itr�R+b LA 6
Corrections /Comments /Instructions:
X PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: �7 Phone #: (503) 718 - 2-4114)'