Permit II
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CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2008 00038
COMMUNITY DEVELOPMENT
DATE ISSUED: 1/22/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 101 AD -03200
SITE ADDRESS: 12909 SW 68TH PKWY 350 ZONING: MUE
SUBDIVISION: TIGARD TRIANGLE CENTER LOT : JURISDICTION: TIG
PROJECT: DELTEK
Project Description: tenant improvement
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: WISERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 7 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 CLACKAMAS, OR 97015 -000
Phone: Contact #: PRI 503 - 698 -3417
FAX 503 - 698 -2486
FEES
Description Date Amount Reg #: ELE 3 -243C
IELPRMTI ELC Permit 1/22/2008 $93.40 LIC 51539
ITAXJ 12% State Surchar 1/22/2008 $11.21 SUP 2053S
Total $104.61 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: v „ may` � _ Permittee Signature: , �p/ /C 75;1”
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.
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Electrical Permit Application JAN ZOt•
I11I;01 rte I tit
City of Tigard C TYOF TpGiWV .ed ( Y
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13125 SW Hell Blvd, Tigard, OR 972261 '� R9�' 1�1 1 � /
l r t .-�� Phone 503.639.4171 Fax: 503.598.1 N vs''v: Other Permit: oat, ' %i
1I ,, Inspection Line: 503.639.4175 Data Rcedy/By: rune
Internet: www.ligard-or.gov Notified/Method: +,
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iill��t`���L.l[IL?I��i�l ?I1r �6.. , ' Iwt.ui:,i�T.ws �"i+�' �Nii� fl 1 �� } �.t G�� I Y1 j1 YYI� k) �ltw 1� ��'Y �) mnat b �l Yt lIC �� "-: 5 .. ,.
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❑ New eonstruetion ® Addition/alteration/replacement Please check all Mat apply (submit j was of plan, w/itemr checked below):
D Service or feeder 400 maps or morn 0 Building over three atoriea
❑Demolition 0 Other:
where the available fault amen O Mathias and boatyards.
U,I F n :wet ,�}, iu ifn 1}ry o"
1. : .33 7 's. r • •Y° Y �•
, NN II , Y i l i rli = i, R' y t f• t ; 1 1 ll `, i } • z: s TI Y I S'' r � .it =cede IO,000 carps at ISO votes or 0 bin
u r Ytlrm a , iau t,nn n:s _� � ; ,r,u.xul�tl Ali d:�k! 11L l . 1 lass to ground, or meads 14.000 13 Commercial - use agricultural
❑ 1- and 2- family dwelling ® Cominercial/industlial ❑ Accessory building
❑ Multi- fan* ❑ Master builder awes for all other installations. I
❑ Other' ❑ Fire pump ❑ Installation of 73 K V A or
dl' ft(f I Ftl' i.:!il(:?!i I T If T Sepurate
u ijn•I� r, h�� 1 I ^� II 1r::1 %: �i.� f f- >: -a:r�� l j•i. si�Y¢llsrunavl•tss4. I¢�.•,��slj� Fmmgeoey tyuam.
larger °,. derived system.
`Id1Gwb i ii utr_ ia: ae!S'rliilliiilixiw,iss••a ..:,.4h,e '1miinit�: 1 1:M ,�t;.1.(e`3 E6',� 00Additiaamfnewmoter load of 0 "A•, "E", - - "1 -
Job no.: Job site address: 12 9 0 9 SW W 6 8th Pkwy looHP or prom. occupancy.
City /State,2FP: 0 D Six or - rove iasilit i s. unite. ❑S voltage more than
Heddrsmrc facilities.
❑ Hazardous location. 600 volts nominal.
Suite/bldg./apt. no.: 3 5 0 l Project name: Del t e k D Service or fader 600 ,., . or more.
Cross street'directlons t0 job site: '1% + 72 -I ' g. %� a� 4itln,11 kI
Dnit,s. . •. . Q ty. Pa, reee •
New residential single- or maid - family dwelling unit
Includes attached garage.
Subdivision: I lot no.: 1,000 sq. R. or less 145.15 4 _
Tax map/pareel no.: id
Li
1
Ea. add'I 500 sq• ft or portion 33.40 1
Limited energy, 75.00 2
N, 51 r•;,y. i no ,. - r.��54.-.•k5'�tt.�inYW r.11 Fly , residential
1i 'h' '_i.4.'_1 t" I �t 7 :' ; u a Y7t 1 l w � I )
Ye a �t► ce I �''F� ! :: r t e ..t '.: .4a'x'.I II. P1 (wideehmvow.R.
xt` .t uu�eiorsc - -:_,: .r'.r, n' ;si,.u�.R. ? e 1 s �>� ,� �1YY'
Limited energy, multi - family
Tenant Improvement residential (with above sq. ft.) 75.00 2
Services or feeders installs alteration, and/or Notation
200 amps or less 80.30 2
r ,t f, ,^..11 '!1 ellilJitA +.:]N, re i Fu
i CI ii ~Sir. 1 t ��¢ . I .. i,�7 ��r13. ilr4st rn.,. 11M?' L Nm e'c 5 'tr. ;!>.
1F1 1 �r ::lln•+.xe �!:�r�llxsllf�i� IC�fitlll�tll(ttA_•. � �Y� 3��` ;y " a �,;,, }; � y 9 201 amps to 400 tYmp9 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
relocation
Phone: ( ) I Fax: ( ) 200 at 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 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, oratemion, per panel
11 ' ' 1 til " i l P17!". �� 7 -1 pJ+Ifi1Y • ts,•y " rl�. ;; : p ;m u p i f cncui: ^ +� �, A. Fee for branch circuits with ne b1 ' , :. t.0 ., ; IA,i,a $411 dl�lf!� ai:0.`k._, � ;" )S t;" ;;r , : yl�, EATV'..t above service or feeder fee, 6.65 2
each branch circuit
Business name: Johansen Electric Inc. B. Fee for branch circuits
Contact name: Charlyna Leifsen
without service or fade fee, 1 46.85 46 • 8 2
first branch circuit
Address: 10948 SE Valley View Terrace Each add'I branch circuit •1 6.65 46 . 5 2
Miscelisneoas (service or feeder not included)
City/State/ZIP: Happy Valley, OR 97086 Each manufactured or modular 2
Phone: (503) 6984417 I Fax: : (303) 698 - 2486 dwelling, service and/or feeder Reconnect only . 66.85 2
E - mail: jobansenelect@msn,eom Pump or irrigation circle 53.40 2
.? rl1 Y.!' ld gigi`t c` na vat : ei i , . lira ,' 1R ' ')•• 4! a 1 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 iaspet ion over allowable in an of the above
Per inspection 62.50
Phone: (503) 698 -3417 1 Fax: (503) 698 - 2486
Investigation per hour (1 hr min) 62.50
CCB Lic.: 51539 I Electrical Lic.: 3 -243 S rv. Lic.: 2053S Industrial plant . hour 5
73.75
Suprv. Electrician signature, required: Ot ! 'i °i l'':.i _ :
' }::5 Ii �i `1' i54 11
Subtotal: • ' 1
Print name: Carl K. Johansen Date: 1 /18/08 Plan review (25% of permit fee):
State surcharge (12% of permit fee): 11.21
Authorized signature: TOTAL PERMIT FEE: 104 61
Print name: Charlynn J. Leifsen 1 Date: 1 /18/08 This w ash application expires :1s permit is not obtained within 180
days elIer it has been tempted as complete.
• Number of inspections allowed per permit.
L•1BafWmgl hanitMELCiremutApp.doc 05 /23/06 440.4615T(IIPoS/COM/W B
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: EL.C1000 00038
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 1/22/2000
Phone: (503) 639-4171 4 V.V
Inspection Requests (24 Hrs.): (503) 639 -4175 .. ' �:..
INSPECTION WORKSHEET FOR DATE: 2/11/2008 TIME: 7:01AM PAGE: 15
SITE ADDRESS: 12909 SW 68TH PKWY 360 CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE CENTER LOT #: TYPE OF USE:
PROJECT NAME: DELTEK
DESCRIPTION: tenant improvement
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503 -698-3417
Inspection Request Scheduled For: Date: 2/11/2008 Pour Time:
Code # Inspection Description ■ �.- Gonfirm # Contact # Message
199 Electrical final O61811 -1 503 - 069 -5262 N
Corrections /Comments/ Instructions:
\\.\\, •
! ►7i PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
`_
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G X Date: 7-4(• 01 Phone #: (503) 718 - 2-4/110
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC20080003$ A •- •
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 102/2008
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 ' `:_,.
INSPECTION WORKSHEET FOR DATE: 2/1/2008 TIME: 7:02AM PAGE: 17
SITE ADDRESS: 12909 SW 68TH PKWY 350 CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE CENTER LOT #: TYPE OF USE:
PROJECT NAME: DELTEK
DESCRIPTION: tenant improvement
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 203.698 -3417
Inspection Request Scheduled For: Date: 2/1/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
— 1EPI -- Eleetticel ►el. 0&4363 -U1\ 503. 698.3417 N
130 C \x-100 GA
Corrections /Comments /Instr ctions:
;7, - ..snirmes AN al a0=j!Jt�'n 9C<Lt
!44 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAI ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Cam` b e Le Date: t. — ba Phone #: (503) 718- L4
CITY OF TIGARD
BUILDING DIVISION r PERMIT #: ELC2008 00038
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/22 /2006
Phone: (503) 639 -4171 1 �'+�
Inspection Requests (24 Hrs.): (503) 639 -4175 I L
INSPECTION WORKSHEET FOR DATE: 1/23/2Q08 TIME: 7 PAGE: 16
SITE ADDRESS: 12909 SW 68TH PKWY 360 CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE CENTER LOT #: TYPE OF USE:
PROJECT NAME: DELTEK
DESCRIPTION: tenant improvement
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503-698
Inspection Request Scheduled For: Date: 1/23/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
126 Wall cover 063737 -01 503 - 969 -5262 N
Corrections /Comments /Instructions:
$ PASS [7] PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G-- Date: I'Z3' Phone #: (503) 718 - 3416