Permit Y CITY OF TIGARD ELECTRICAL PERMIT
° PERMIT #: ELC2008 -00672
COMMUNITY DEVELOPMENT DATE ISSUED: 12/11/2008
. T I G A R D 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 112 D D - 00200
SITE ADDRESS: 15688 SW 72ND AVE ZONING: I - P
SUBDIVISION: PACIFIC CORPORATE CENTER LOT : JURISDICTION: TIG
PROJECT: DIAMOND POINT
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: SIGNAUPANEL:
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: 1 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 12/11/2001 $53.50 LIC 51539
[TAX] 12% State Surchar 12/11/2001 $6.42 SUP 20535
Total $59.92 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 ma • • . • • • • ies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
•
Issued By: ` / _ Permittee Signature: e s .k. .
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 Applicat• �� CI ? 1-(1k 1/1 1 It I.: 1 \ I.() \ I ,,
City f Tigard � riV
tY g C
W Hall Blvd., Tigard, OR 97223 `� 1 • ` < i %�
'� 13125 S Phone: 503.639.4171 Fax 503.598.1960
0 �`L �, .
Other Permit:
:. inspection Line: 503.639.4175 � �` ' p Reedy/By:
Internet w Line: 03.63 .gov : `�O Nobfed/Mehod: ��
�' + ) , t •( ;r. ., , r s v t.. •,
« ( i : I Et E c l r .�l4J 'f. .i �is�r4r Noelk�i , 4 rdlp:4i.n.' k 1 1 .. 4 r a. i�,. - IG„ %'.!4. ;r2 ' ec - . I�e P . s YI •. : s
d ��i�4ilrec. u.. lu i t-
❑ New construction CO Addition/alteratio , • placement Please check all that apply (subm 2. sets of
plans w /iWm checked below):
❑ Demolition ❑ Other 0 Service or feeder 400 amps or rnm-e ❑ Building ova three stories.
where the available huh current 0 Marinas and b
+a , .• r , At , asp ^.+xwwlun tsisesar5ru :..,. r, (rtl ' F oatye[da.
' �� a r�tr ;r 1' s `, e, •' , 'i ; ' c , F . 141i ,,, , Y - a + f t :, r it(f exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
i3iez..W�,. r: Ra
❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building user m grand, or exceeds J1ai 1 n 000 ❑ Com
❑ Multi - family ❑ Master builder Commercial-use agricultural
Fire for all other installations. Installation ❑ Other ❑Fire Pump- ❑ lastdlationef 75 KVA or
4 • N 6piSi { i ' , ; . fi r ( , = 1 1'-'A' 7...0. + r k t y. tw , s , ❑ Fmesgency system. larger separately derived symm. , . iNtllaai l + 4:11. 1s�:}� i t d r l ' I r I ,. +i'; s ` s, t „ r . " 0 Addition of new motor load of ❑ A ", E" 1_2 "! 3°
Job no.: Job site address: 15 6 8 8 SW 72nd 100HP or more. occupancy.
❑ Six or more residential units. 0 Recreational vehicle parks.
City/State/ZIP: ® Health -care facilities. 0 Supply voltage for more than
0 Ha:undoes Locations. 600 volts nominal.
Suite/bldgJapt.no.: Projectname: Diamond Properties ❑ Savior orfeeder
600 am , or more.
Cross street/directions to job site: k;r,,: ;:i'' i :” )I'' '.li_'!.. 1h 1
Description (Pr. Feet. Toad •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 145.15 4
Tax to / Ea. add'1500 sq. ft. or portion 33.40 1
tip parcel no.:
Win CM �p� Limited energy, residential
} 1 al t411.ks asp ° 116 r ' s et t s a!� i} (with abov 9. 75.00 2
Tenant Improvement Limited energy, multi - family
75.00 2
residential (with above N. eJ _
Services or teeden installation, alteration, and /or relocation
{ 200 amps or Tess 80.30 2
u i::b1ul t a.1 ` 1 .Ik . i Z;1t3 d ^ 71� . � `. s �. 5 " ' b � jll t 201 amps 10 400 amps 106.83 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 amps or less l 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps I I 10030 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps f 133.75 2
Owner signature Date: circuits — new, alteration, or extension, per panel
,`�( Kd i� i1 + tan �iu. rs MS �Ii pl, ' Ir. u a. �t.. t�; w A. Fee for branch circuits with
-;r -i • igle ' 1'• r e l l . '. . above service or feeder fee, 6.65 2
a , r., a each branch circuit
Business name: Johansen Electric Inc. B. Fee for branch circuits
Contact name: Charlynn Leifsen withour service err feeder fee, ( 8S lf 4 � 2
first branch circuit (
Address: 10948 SE Valley View Terrace Each add'I branch circuit 1 6.65 ( 2
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 I Fax: : (503) 698 -2486 Reconnect only 66.85 2
E -mail: johansenelect@msn.com Pump or irrigation circle 53.40 2
9N iii ww"� �,
-_. Eye?/ :ai�'k.e�s`,.'.rlY? �itiiirt•v.c. rl`.• :• >;.lkP.u.., Sign or outline Iightrng 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 /StatetZIP: Happy Valley, OR 97086 Each additionalinapection over allowable In any of the above
Per inspection 62.50
Phone: (503) 6983417 I Fax: (503) 698 -2486 Investigation per hour (t hr min) 62.50
CCB Lic.: 51539 1 Electrical Lic.: 3 -243C I Suprv. Lic.: 20S3S Industrial plant . - hour 73.75
Cry k Q 1 , ..=: l t . ,.M ur i i5 :t
Suprv. Electrician signature, required Subtotal: 53 ?j (7
Print name: Carl K. Johansen Date: 12 / 11 / 0 8 Plan review (25% of permit fee ):
State surcharge (12% of permit fee): Cf. . If .
Authorized signature: rj - TOTAL PERMIT FEE: 5/',1.2_,
Print name: Charlynn J, Leifsen I Date: 12/11/08 This permit appllcatim expires its permit is not obtained within 180
days arses it has been accepted as complete.
• Number of inspections allowed per permit.
rlavilding \Pamib\EL.C- PemritApp.doc 05/2106 440.461 ST(1 I /0S /COM/WED
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CITY OF TIGARD
BUILDING DIVISION . PERMIT #: FL C2008-00672
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/11/2008
Phone: (503) 639 -4171 . �� : „qd uyry
Inspection Requests (24 Hrs.): (503) 639 -4175 — `__..
INSPECTION WORKSHEET FOR DATE: 12/12/2008 TIME: 7:00AM PAGE: B
SITE ADDRESS: 15680 SIN! 72ND AVE CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: TYPE OF USE:
PROJECT NAME: DIAMOND POINT
DESCRIPTION: TI
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503G98.3417
Inspection Request Scheduled For: Date: 12/12/2008 Pour Time:
Ins • scription Confirm # Contact # Message
079018 -01 503-989- N
11O t L t1 1 COJ`iL-
Corrections /Comments /In tructions:
I
ill I
p3) PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ F. L ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ' v ((Q L- Date: 12.j 1 7. O Phone #: (503) 718- 2 'D
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