Permit '�• � CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00148
ri DEVELOPMENT SERVICES DATE ISSUED: 2/22/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171
PARCEL: 2S112DC-00500
SITE ADDRESS: 15889 SW 72ND AVE BLDG B ZONING: I -P
SUBDIVISION: OREGON BUSINESS PARK III LOT : 040 JURISDICTION: TIG
Project Description: Repair of 1000+ amp service.
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: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: 1 >=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: 503 - 624 -6300 Contact #: PRI 503 - 698 -3417
FAX 503 - 698 -2486
FEES
Description Date Amount Reg #: LIC 51539
[ELPRMT] ELC Permit 2/22/2006 $454.65 SUP 20535
[TAX] 8% State Surcharge 2/22/2006 $36.37 ELE 3 -243C
Total $491.02 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 a forth in OAR 9 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at
503 - 6-6699 or 1 -800-
Iss ed By: Vie , j. � J_ • Permittee Signat
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:/4
LICENSE NO: ,6 3 5
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.
1 Frnr»' Ch2fwnn Leifsen 503-698 -2486 To: City of Tigard Date: 2/22/2006 Time: 11:59:16 AM Page 2 of 3
j4ctr cal Permit Ap lies i l i i< t i r in 1 1.1 .1: ,)-.1) Received
City f Tigard A E dVED D 0 �9 Qr!0 l
131 SW HaII Blvd„ Tigard, OR 97223 Plan
Other Review -w �`�� � �
DEB 2 2 2006 :, `. ,herPhxmit:
Phone: 503.639.4171 Fax: 503.598.19 , �u? Date/B
Inspection Line: 503.639.4175 ! ' III, Date Ready/By: 1 . • 61 See Page 2 for
Internet: www.ci.tigardor.us -- Notified/Method: (fce. Supplemenallnformatioo
" " ' Please check all that apply:
construction ® � � on/� tetation/replacement aPP Y=
❑ Demolition ❑ether ['Service over 225 amps, comm'I ['Hazardous location
['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
; ' € { « t ti h of 1- and 2- family dwellings 4 or more new residential
❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one strucduc
❑ Multi family ❑Master builder ❑ Other ❑ stories over three stoes ❑ Feeders. 400 amps or more
x a Occupant load over 99 persons ❑Manufactured structures or
} , _.. _ ' z ' : �i : r :'. r ' :a . , ....... , . '. ❑Egress/lighting plan RV park
lob no.: lob site address: 15889 SW 72nd [Wealth-care facility ❑tee
Submit i sets of plans with any of the above.
City/State/ZIP: The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: Project name: f ` 'f
.... --�:� _ -: [rump*. Qty. Fee. Total P i ,
..
Cross street/directions to job site: 0(.... A�e... , y l . • New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea add'I 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.: Limited energy, non - residential 75.00 2
1.: : :::= •r-;. .:.:z . .:
,i..,' - . .:. 1-!, :'4 . :-,!-."-
- ur ��::. `- Ti.: it
.r ..-_: i Each manufactured or modular
Repair of service, service blowing dwelling, service and/or feeder 90.90 _ 2
Services or feeders installation, alteratl on, and/or relocation
200 amps or less 80.30 2
iz . . rk s . i 4 ` 201 amps to 400 amps 106.85 2
..:...:.:4... i . . :... ? : 401 amps to 600 amps 160.60 2
Name: 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 1 454.65 454.65 2
Reconnect only 66.85 2
City /State/ZIP; Temporary services or feeders installation, alteraton, and/or
Phone: ( ) Fax: ( ) relocation
Owner installation: This installation is be' made on property 20 amps to or less 66.85 1
trig p perry that 1 own which is not 201 amps b 400 amp 100.30 I 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
401 amps w 600 amps 133.75 2
Owner signature: Date: Branch circuits- new, alteration, or extension, per panel
y ,i3 ` { 11 '' 1 ` ` ri t' .' i K ! Fee' for branch circuits with
_ . . ... r :? .,.. . , ,.. ,.. . / . - , .. service or feeder fce, each
Business name: Johansen Electric Inc. branch circuit 6.65 2
B. Fee for branch circuits -
Contact name: Cbarlynn Leifsen without service or feeder fee, 46.85 2
each branch circuit
Address: 10948 SE Valley View Terr. Each add'I branch circuit 6.65 2
City / State/ZIP: Clackamas, OR 97015 Miscellaneous (service or feeder not included)
Phone: (503) 698 -3417 Fax: : (503) 698 -2486 Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: johansenelect®msn.com Signal circuits) or limited-
. i €.. 3r - F.1z . 1: : -, , 1 :. l,,.: _ ,, � F - _,-Z . ., ;- . ,;: ,',;-.-',=,‘`. , _ z - ,„ ;: ' i ' .. -.. . t•,, b ' . `nergY Pane On, or
extension. Page 2 2
Business name: Johansen Electric Inc.
Address: 10948 SE Valley View Terr. Each additlonal Inspedion over allowable in any of the above
Per inspection 62.50
City/ State/ZIP: Clackamas, OR 97015 Investigation per hour (1 hr min) 62.50
Phone: (503) 698-3417 Fax: (503) 698 -2486 , Industrial plant per hour 73.75
P 1L
CCB Lic.: 51539 Electrical Lie.' 3 -243 S . . Lic.: 2053S Subtotal 454.65
Suprv. Electrician signature, required: », / i./7 � � Plan review (25% of permit fee)
State surcharge (8% of permit fee). 36.37
i:M/ ./ / , , /' Date: 2/22/06
TOTAL PERMIT FEE 491.02
Authorized signature: T his r a
/ `r pew PP tlndoo expires ifs permit is not obtained within ISO
111= I ������ days after it has been accepted as complete
_ / / �// f MIIIIIIIII Date: 2/22/06 •s Fee methodology set by Tri-County Building Industry Service Board
Number of inspections per permit allowed.
i .waiisiagtPamiu\ELC- PCmIMpp.doc 12/03 44046 IST(1002/COMIWEB
CITY OF TIGARD gl&
BUILDING DIVISION • " PERMIT #:7 — QQ s
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 /onamepo� .
Inspection Requests (24 Hrs.): (503) 639 -4175 j
_..
INSPECTION WORKSHEET FOR DATE: /"Jik.. /D TIME: PAGE:
SITE ADDRESS: six.) p„,, El Lt C3 " CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: CL PHONE #: d �� 7 S-3
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
. rrections /Com - • ��••,� ns:
-- •}Z:i PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: v \ ( \ 6 L . Date: /IS Ile Phone #: (503) 718- 2444
CITY OF TIGARD
BUILDING DIVISION _ F
PERMIT #: FL
C2006-001€18
(1i`ltT
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/22/2 {l0 ,
Phone: (503) 639 -4171 A I i2,
Inspection Requests (24 Hrs.): (503) 639 -4175 "'IL
INSPECTION WORKSHEET FOR DATE: 2/23/2006 TIME: • /:01AM PAGE: 63
SITE ADDRESS: - i 10139 SW 72ND AVE BLDG B CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK III LOT #: 040 TYPE OF USE:
PROJECT NAME: TOLT SERVICE GROUP LLC
DESCRIPTION: Repair of 1000+ amp service.
OWNER: PACIFIC REALTY ASX)CIATES, PHONE #: 603 624-6300
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503 - 698 -3417
Inspection Request Scheduled For: Date: 2/23/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
116 EIeci.rical service 027413 - 01 603 - 704 - 16:34 Y
Corrections /Comments /Instructions:
3
P te: tvA 1N Gria 16>J r
S
111 PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: GISZ\i‘ 1\) Cie '-'° Date: 91 2.$ 0 t Phone #: (503) 718 -2.4 qt.
(.1