Permit 71 - CITY OF TIGARD ELECTRICAL PERMIT
IA
PERMIT #: ELC2007 -00784
COMMUNITY DEVELOPMENT DATE ISSUED: 11/20/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 113A B -00600
SITE ADDRESS: 16125 SW 72ND AVE BLD.B ZONING: I -L
SUBDIVISION: PACTRUST BUSINESS CENTER LOT : JURISDICTION: TIG
PROJECT: ANS
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: 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: 39 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 1/20/200' $306.20 LIC 51539
(TAX] 8% State Surcharge 11/20/200' $24.50 SUP 20535
Total $330.70 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: Permittee Signature: jn / 40 - I /
C `�r�,M .e ' , '
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 App r
ill
City of Tigard 2 0 2007 �. Permit No.: �G a 7- n o 7��
13125 SW Hall Blvd., Tigard, OR PI= Review r
Phone: 503.639.4171 F 5 1 Date/By; Other Pertnu 8 /�� S at 7- -005 9
J
Inspection Lino: 503.639 1 �Ji 1 ��� �� Date Ready/Ely: Ready/Elylens , 7 See Paa. 2 roe
Iattmtet www.::: �9g I. • ' '. , -, 1 suppiemenadinnformation
:, lEi ' rE ` stsf i`l i,i iZ:. � r•: w. r l u ' ' ! ' .'° , ,s ='J ' ZIOL I � , li f t _ "+" � � _ ;" :J
❑ New construction ® Addition/alteration/replacement Please dteek an that MAY (submit laws of plans w/itema checked bdow):
❑ Service or Seeder 400 empe or more ❑ Bidding over duce rerisn•
❑ Demolition ❑ Oth
?�Lt' 1 u c ,I b t u a q w ryes . -w f �r,a : stir -m where the available huh current 0 Maine and boagrards.
r "`i 3 lilted ' '�% ". :; , 7 7.1. ' .i, ,1,. t. =.,.a t ,,,•:,' , p„ I ! i 1 exceeds 10.000 amps at 150 volts or O Floating buildings.
t ... t a. G`5 less to growl, or exceeds 14,000 0 Comrrroreial -use agricultural
❑ 1- and 2- family dwelling ® Commercial/industrial 0 Accessory building
amps for all other i
❑ Multi -family brn7dinga
(y ❑ Master builder 0 Other ❑ Fire pump. 0 b,amllaicm of 75 KVA or
4 i r _I. CSr'f 'y: aH.#W !p'SQ 1 }Y fart• Y t if S
, 13 . - r n l I I p .t it lie`' , ° . r., ft ' o f tjl7 ' u gwre OEmaggeneysystem lager separately derived symem-
+s,4sea. »yci.Li c r. 5'cosiskir...e - L :tiinxx $t "' ,^. :._: ❑ Addition of new mow load of 0 "A " "E ". 1- 2 ", "1 -3 "
Job no.: Job site address: 1 G I25 S� "p ) 10011P or morn. occupancy. -
❑ Sur or more residential units. 0 Recreational vehicle parka.
CRY/State/2 IP: p 02 0 Heath-arc facilities 0 Supply voltage for more than
(3 Hazardous locations. 600 vol norsoael.
Suite/bldg. /apt.00.: I Project name: A s O serviceor feeder 600 ampeormore.
r u
Cross street/directions to job site: m ..., r�i:1?I)'� "� ` rl,, Ir n
j one,ipaoa fiNl 41 ieg':.
. Flee, Total •
New residential single- or meld-family dwelling unit.
Includes attached garage.
Subdivision: I lot no.: 1,000 act. R. or less 145.15 4
Tax map/parcel no.: Ea add'l 500 sq. R or portion 33.4 1
� - 1,: e'.fi'(' a �7( t u!>:u,ri, t:er�r:.t,y 4"O.u'}Ir;: r, v� , „ Limited energy, residential
f'il� - 7{InIIRIR ! :r;.m.er..�,: aaa I �;..,�:° ': °.. 3 3 r 1 t• .:' 1! (with above it') 75.00 2
I t // ?T D #'t ?en y Limited energy, molt }fsmity 75.00 2
1C7 residential (with shove so. R)
Servkes or faders Installation and/or relocation
i rrlr.' ^:w :''r� sawas�M1 r ,s, E , 200 amps or less 80.30
X 51 �A ±�• r I F .t Ill I { : Ar C t t 2
i u•IJlIRlr.'l .2 ),t2u,F.t:.....11 . 7167 I rvy '•n i " .1t, U P.
n 4G r `� m ,.0 um 1 201 8 t0 400 amps 106.85 2
Name: RaC-7) - 1 - " Cr17 4/4-$SOCrGt 44 401 amps to 600 amps 160.60 2
601 Address: I ?,C� ..514L-99, iQl ampso amps amps 240.60 2
, / 9 3 O Ov ver 1,000 0 atrrps or votes 454.65 2
City /State/ZIP: PoP tJ
, Temporary services or feeders installation, alteration, and/or
/
Phone: ( ) I Fax: ( ) 200 amps or less 66.85 i 1
Owner installation: This installation is being made on property that I own which is not 201 amps in 400 amps 1 i 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133 2
Owner signature Date Braecb circuits - new, altsretloo� err e xtension, ner panel
A. Fee for branch cimutita with r
I1 Wide! III raci;ir r: . tfir , iii i (if 1 ax ;Argo 1
'i - - r � . ,. aut L! .F tal . . :! dlM fh 6 1 N 1� h_. ;i�.-1%.n :utL�'! above Service 07 feeder free,
each branch circuit 6.65 2
Business name: Johansen Electric Inc, B. Fee for branch circuits
Contact name: Cbarlynn LeiEsen without service or feeder fee, ( 46.85 it L •Q 2
first branch circuit
Address: 10948 SE Valley View Terr. Each addi branch circuit 51 6.65 Z59 2
City/State/ZIP: Clackamas, OR 97086 Miscellareom (service or feeder not Included)
Each manufactured or modular
dwelling, service and/or feeder 90.90 90.90 2
er
Phone: (503) 698 -3417 I Fax: : (503) 698-2486 Reconnect onl
E-mail: johaosenelectQa msn.com t 66.85 2
p %: + t � � � n 1'um or irrigation circle
ySf ;ra!S"" F31 s: ! iii ai ist 7 7' 1,3?'. .t: - � s` P 53.40 2
t ' i +.. : t� i? � �. �,;� :'P�,✓ :,t,`a Sign or outline lighting 53.40 2
Business name: Johansen Electric Inc. Signal circuit(s) or limited-
energy - Address: 10948 SE Valley View Terr. extension. Describe:ton or Page 2 2
City/StateJZIP: Clackamas, OR 97086 _ Each additional inspection over allowable in any of the above
Phone: (503) 698-3417 Fax: (503) 698 -2486 Per inspection 62.50
Investigation per hour (1 hr min) 62.50
CCB Lic.: 51539 I Electrical Lic.: 3 -243C Suprv. Lic.: 2053S Industrial . per hour 73.75
Suprv. Electrician signature required: ) k s: ti ri '': _ .( _: »i... Is r i s t _ y
u f 3 i etzei
°�� Subtotal: _ 06. AO
Print name: Carl Johansen D i � 2.49k7 Plan review (25% of permit fee
1 j - _� Stale surcharge (8% of permit fee): 2. 1. r J )
Authorized signature: ` 1,(� _ TOTAL PERMIT FEE: 3=4, , 70
Print name: Cherlyttn Leifsen Date: This permit apptkadon expires if ■ permit is not obtained within 150
1 - 2t • - D 7 days after Jibes been accepted as complete.
sa�PranirslELC 141rait • Number o f inspectioe allowed per pemrit.
LlBuilm App.doc 05/23/06 4404615 TO ttosecOMIWBB
1 ' d XUJ 13Cd3SU1 dH W1366:01 L002 02 AOW
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007•00784
13125 SW Hall Blvd., Tigard, OR 97223 0 DATE ISSUED: 11/20/2007
Phone: (503) 639- 4171 ('
Inspection Requests (24 Hrs.): (503) 639 -4175 AI-
INSPECTION WORKSHEET FOR DATE: 3/31/20013 TIME: 7:01AM PAGE: 19
SITE ADDRESS: 16125 SW 72ND AVE BLD.B CLASS OF WORK:
SUBDIVISION: F'ACTRUST BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: ANS
DESCRIPTION: Tenant Improvement
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503-69(1.3417
Inspection Request Scheduled For: Date: 3/31/20013 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 0E67580 -01 5037041534 N
Corrections /Comme s /Instructions:
:4 PAS PAS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
IL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: C► M (6e Lg Date: '31'01 Phone #: (503) 718 - 1 F4
CITY OF.TIGARD , . r ,
BUILDING DIVISION PERMIT #:tLC20 1 6 00184-
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 -..' IL
INSPECTION WORKSHEET FOR DATE: 2, 2,2; 01 TIME: PAGE:
s tl
SITE ADDRESS: It 1 215 S W '1 2.. B LOG-, B CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION: 1
OWNER: PHONE #:
CONTRACTOR: ' UOhANSES) E - PHONE #:
Inspection Request Scheduled For: Date: Z' 2 2 Wk) Pour Time:
Code # Inspection Description Confirm # Contact # Message
s >r nlsrft Ot (":111 5- 262.
t 3 G� t►.►�/' WALL'
Corrections/Comments/Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: % be Date: � 22 � Phone #: (503) 718- 1-144ti
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007..00784
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/2012007
Phone: (503) 639 -4171 . 10
Inspection Requests (24 Hrs.): (503) 639 -4175 '+ i l l ..
INSPECTION WORKSHEET FOR DATE: 1/29/2008 TIME: 7:02AM PAGE: 22
SITE ADDRESS: 16125 SW 72N0 AVE F3LD.B CLASS OF WORK:
SUBDIVISION: PACTRUST BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: ANS
DESCRIPTION: Tenant Improvement
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: JOIIANSEN ELECTRIC INC PHONE #: 503-698-3417
Inspection Request Scheduled For: Date: 1/2912008 Pour Time:
Code # Inspection Description Confirm--# Contact # Message
125 Wall cover 064123-01 503 6913 -3417 N
Corrections /Comments/ Instructions:
? KO' AA. . to./ Sit i - 4 ■) 66" Pl 4.)
"*"6 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G`' NO 3 Date: 1 ' A . OA Phone #: (503) 718 - 14kr
CITY OF TIGARD _ _
BUILDING DIVISION OA . PERMIT #: ELC2007 00184
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/20/2.0(17
Phone: (503) 639- 4171ui (r \
Inspection Requests (24 Hrs.): (503) 639 -4175 IL.
INSPECTION WORKSHEET FOR DATE: 12/11/2007 TIME: 7:00AM PAGE: 22
SITE ADDRESS: 16125 SW 72ND AVE BLD.B CLASS OF WORK:
SUBDIVISION: PACTRUST BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: ANS
DESCRIPTION: Tenant. Improvement
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503- 696 -3417
Inspection Request Scheduled For: Date: 12/11/2.007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
125 Wall cover 061283-02 503 - 969 -5262 N
Corrections /Comments /Instructions:
- '1A6j - (51) P Iktq 6(A)
al, . S.. 9..0 ow.r : 40 LANK
❑ PASS �JPARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
ii FAIL � CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: v , 0 Date: 12-f on Phone #: (503) 718-1-44,6