Permit • A CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00035
DEVELOPMENT SERVICES DATE ISSUED: 1/18/2006
° --�' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S113AB - 00600
SITE ADDRESS: 16195 SW 72ND AVE BLD.D ZONING: I -L
SUBDIVISION: PACTRUST BUSINESS CENTER LOT : JURISDICTION: TIG
Project Description: (3) 200 amp services, (70) branch circuits.
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: 3 WISERVICE OR FEEDER: 70 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: >=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 1/18/2006 $706.40 SUP 20535
[TAX] 8% State Surcharge 1/18/2006 $56.51 ELE 3 -243C
Total $762.91 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: p VAT
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.
From: Charlynn Leifsen 503 - 698 -2486 To: City of Tigard Date: 1/17/2006 Time: 4:49:24 PM Page 2 of 3
' Electrical Permit Ap i Q 1 1,,1 1 I I T r1 l. i a: t 1.1,
City of
W H a l l B l a v r d � , Tigard, OR 97223 JAN 1 Received " 7 200 l . , 6 Pcrmil No. `_ -- /1. d /631
Phone: 503.639.4171 Fax: 503.598.1960 '
All■ :,: >. i ;` D . Other Permit:
Inspection Line: 503.639.4175 r !. " '1 �� Date ReedyBy: ® See Pyle Z for
Internet: www.ci.tigard.or.us � � ` v • ' ' a -- Notified/Me Supplemental Information
i ' a ' t!1: '.a. ' 1. :a. 1 *r,r-rr i ,
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❑ New construction ® Addition/aheration/replacement Please check ail that apply:
❑ Demolition El Other: ❑Service over 225 amps, comm'I ['Hazardous location
I Y5' 1 S h ,VP '' 1 ['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
. _ 2c _ ..._ . , ; ... _.... . .., ..,:, ... ,i , ,, r, : ... .:: . of l-
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 structure
❑ Multi- family ❑Master builder ❑Other: ❑Building over three stories ['Feeders, 400 amps or more
r r :: + !, is s 1 ' i 1 ['Occupant load over 99 persons ❑Man structures or
�-* ° t. . - :t {t :._ l u +r 1 , q . -.. , ...., 5 .,• 1 ten Plan park
i 7 . , � ? 4 *-' ! 1 : ,t . i
.t .� ❑Egressll ' g p RV
lob no.: lob site address: 16195 SW 72nd ❑Health - care facility ['Other:
Submit 2, 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: OptionCare
Deeripdee Qtr. Fee. Total
Cross street/directions to job site: New residential single- or multi- family dwelling unit.
Includes attached garage.
1,000 sq. R or less 145.15 4
Subdivision: Lot no.: Ea. add'I 500 sq. R or portion 33.40 1
Tax map/parcel no Limited energy. residential 75.00 2
,� I ti i. U1n M i ' ." Ir r I� Limited energy, non - residential 75.00 2
`, , ' } e 4 r a , , Each manufactured or modular
TI dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 3 80.30 240.9 2
1 ( 5 r , 1 - r c... .r k r . . _. i T 4 ,' F t 1 'i-,--'-'-''',=‘,'-'..:-,-":-;":';' _ , 201 amps to 400 amps 106.85 2
.._ . I,. .{... ,:�, < ..:. ., _z.. . ., ...f . .... f � .. 40 amps to 600 amps 160.60 2
Name: 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
Phone: ( ) Fax: ( ) relocation
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 to 400 amps I 1 100.30 1 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
i " , , . ,t ,y„ } ';'i. t)ti ! 7f, " A . Fee for branch circuits with
, - , . . ! . , service or feeder fee, each
Business name: Johansen Electric Inc. branch circuit 6.65 2
B. Fee for branch circuits
Contact name: Charlynn Leifsen without semce or feeder fee,
each branch circuit 46.85 2
Address: 10948 SE Valley View Terr. Each add't branch circuit 70 6.65 465.5 2
City /State/ZIP: Clackamas, OR 97015 Miscellaneous (service or feeder not iaduded)
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 circuit(s) or limited-
• ,. i t1' ; t. s 1 - ' r Q -- -..a , panel on, or
ezten Page 2 2
Business name: Johansen Electric Inc.
Address: 10948 SE Valley View Terr. Each additional inspection 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
CCB Lic.: 51539 Electrical Li . 3 -243 S ' . Lic.: 2053S Subtotal 706.40
Suprv. Electrician signature, required: r ,-,1 r / /^ t�>• Plan review (25% of permit fee)
�!!/ ,' State surcharge (8% of permit fee) . 56.51
/ D at e: 1 /17/06
TOTAL PERIKIT FEE 762.91
Authorized signature: , T permit apptkatton expires is ire- permit not obtained within 180
I � /� � tds days after it has been accepted as complete
Date: 1/17/06 • Fee methodology set by Tri.Cmmty Building Industry Service Board
. _ / / w- •• Number of inspections per permit allowed.
i .BuildinsWemi1AELC- PermltApp.da 11103 444461ST(I0N2/COM/WBB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC200&00035
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/18/200
Phone: (503) 639 -4171 imma
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/8/2006 TIME: 7:07AM PAGE: 46
SITE ADDRESS: 16195 SW 72ND AVE BLD.D CLASS OF WORK:
SUBDIVISION: PAC BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: OPTION CARE
DESCRIPTION: (3) 200 amp ..ervices., (70) branch circuits.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: 503.674- 6300
CONTRACTOR: JOIHANSEN ELECTRIC INC PHONE #: 603-6913 -1417
Inspection Request Schedule. or: Date: 5/812006 Pour Time:
Code # Inspection Descripti• Confirm # Contact # Message
199 Electrical final 029466.01 603 - 969 - 5262 Y
Corrections /Comments /Instructions: o 71
w \A y .
QP`f X03 01 36 - 1 4) 3 t7 - t'�A ' � .
1
1 , _
1KPASS El
APPROVAL 111 CANCEL ❑ NO ACCESS
i ❑ FAIL El CALL FOR INSPECTION ❑ADDITIONAL FEES ASSESSED
ector: NCO `� Date: v �� 06 Phone #: (503) 718- 21 4 U
CITY OFTIGARD
BUILDING DIVISION PERMIT #: ELC200&00035
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/18/200(3
Phone: (503) 639- 4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4/24/2006 TIME: 7:02AM PAGE: 44
SITE ADDRESS: 16195 SW 72ND AVE BLD.D CLASS OF WORK:
SUBDIVISION: PACTRUST BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: OPTION CARE
DESCRIPTION: (3) 200 amp services, (70) branch circuits:.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: 503 - 624 -6300
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503-698 3417
Inspection Request Scheduled For: Date: 4/24 /2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 028550 -01 503-969-5262 N
Corrections /Comments / Instructions:
ssv eagit bA'git cloud gym, \at\ C j r l e ua'4K
d N bit. r 6.6-s .
? ?
pkttab Roottis.
P
❑ PASS *PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 6 Date: 4( SO) Phone #: (503) 718- 2A 4k)
CITY OFTIGARD =' = , Z <.
BUILDING DIVISION PERMIT CO 006 — G 00 3S_,
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 "I NA ' i',
Inspection Requests (24 Hrs.): (503) 639 -4175 i '.
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: / 4 / ' 5 7 d. CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Dater 3 — l 7 CO Co Pour Time:
Code # Inspection Description Confirm # Contact # Message
G .3 - 0 � (e q —S AC° '
Corrections /Comments /Instructions:
b0f1
bo 0 Z;77 i ‘ CE's L.. s N o v.) 11 li +4■3T
rEtLyA CV
kk. ilkamsc.1 bgth -r. sl'as 1
S E \ Mt? ) .414b, erc,J
X PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G N684 Date: ) 3 D 4 Phone #: (503) 718- 2
CITY OFTIGARD : _-
BUILDING DIVISION PERMIT #: El C200&•00035
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: vie/ x006
Phone: (503) 639 -4171 AMO,
Inspection Requests (24 Hrs.): (503) 639 -4175 - °'I L
INSPECTION WORKSHEET FOR DATE: 2!23/7006 TIME: 7:01A i PAGE: 73
SITE ADDRESS: 16195 SW 72ND AVE BLD.D CLASS OF WORK:
SUBDIVISION: PACTRUST BUSINFSS CENTER LOT #: TYPE OF USE:
PROJECT NAME: OPTION CARE
DESCRIPTION: (3) 200 amp services, (70) branch circuits.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: 603•Ei2�� 6300
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503,698.3417
Inspection Request Scheduled For: Date: 2123/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
125 Wall cover 027397 -01 503. 6913.3417 N
10 'j - /6 - 3y
Corrections /Comments /Instructions:
IA PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
0 6s is 1 Ins pector: � ' �� Date: 9_,I 2 3 b Phone #: (503) 718- MIA'
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: ELC2006 -0003G
13125 SW Hall Blvd., Tigard, OR 97223 • DATE ISSUED: 1/18/21106
Phone: (503) 639 -4171 ,u' 4i � j �i
Inspection Requests (24 Hrs.): (503) 639 -4175 ._'J
INSPECTION WORKSHEET FOR DATE: 2/10/2006 TIME: 7:O4AM PAGE:. 43
SITE ADDRESS: 16195 SW 72ND AVE BLD.D CLASS OF WORK:
SUBDIVISION: PACTRUST BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: OPTION CARE
DESCRIPTION: (3) 200 amp services, (70) branch circuits.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: 503-624-6300
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 1 ,;O3 -6398-3417
Inspection Request Scheduled For: Date: 71 1 01200E Pour Time:
Code # Inspection Description Confirm # Contact # Message
'195 Missc inI ::per.:r.i 026669.02 503 - 969.5262 N
Corrections /Comments /Instructions:
CA Ez L -'17 uf1• IJ iNF3ov�
J b-k'b ' . E . ct50■. • r 0
-4 \A R.v G . `i , (AO .
❑ PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ ALL FOR INSPECTIO ❑ ADDITIONAL FEES ASSESSED
Inspector: r Date: / -0.
6 Phone #: (503) 718- 24