Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2007 -00307
° COMMUNITY DEVELOPMENT DATE I SSUE D : 5/4/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S113AA -01000
SITE ADDRESS: 16570 SW 72ND AVE B9 ZONING: I -L
SUBDIVISION: OREGON BUSINESS PARK I LOT : OOC JURISDICTION: TIG
PROJECT: SERVICE MASTER OF TIGARD
Project Description: TI with (10) 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: 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: 9 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREAISPEC 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
[ELPRMT] ELC Permit 5/4/2007 $106.70 LIC 51539
[TAX] 8% State Surcharge 5/4/2007 $8.54 SUP 20535
Total $115.24 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//cii
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 Application 11)1: I )I I I, I I 1 f 1 1
itt o I 18 rd Tlgerd,OR ECE"VE® 1 "`Ev .1., -_ 0� Ri1
Phone: 503.639.4171 Fast: S03.S98.1 OthPe
- Pernik:
S AY 3 2007 .L.L • �' Date Read
inspection Line: 503.6394175 ! hurls: El Sea Pap 2 ter
Internet www.d.tiiard.or.us 11 ,t T a ■ �: Supplemental h�sraaetoa
. .....
❑ New construction ® Additiodalterstionfreplacement Please check all that apply:
in Demolition ❑niter. ['Service over 225 amps, comm'1 OHtardo s location
— ova 10,000 sq. oe over amps rating
1- or mote new
❑ 1- and 2-family dwelling ® Commercial/industrial ❑ Accessory building 0Systan over 600 oohs nominal tapirs in one structure
❑ Mt1ld- firmly ❑ Masser builder 0 DButIding over three stories ['Feeders, 400 amps or mote
Doccupans load aver 99 persona Didanullictured
stnrcarra or
::....:....
plea RV park
Job no.: Job site address:
Olicelth-care facility OM=
tA/ 0 • � 2 40 Submit./ ads of plain with any of the above.
City/State/ZIP: The above ate nit applicable to temporary construction soviet.
Suite/bldg./apt. not: Project name: Service Master of Tigard
naeebass Qa Prot Tad ..
Cross street/directions to Job site: New residential Wage- or niniti-family dwdliag salt.
Includes attached garage.
1,000 sq. 8. or less 145.15 4
Subdivision: L o t n o. : Ea add'1500 sq. 8 or portion 33.40 1
'Ilex map/parcel rho.: Limited energy, residential . 75.00 2
Limited energy, lean- residential 75.00 2
Each mam>1aAhned or motbrlar
TenantimerOVemt3nt d" ��' s` � �
OOrfeeder 90.90 2
Services err feeder hrstalladon, elaersdoa, and/or relocation
200 amps or leas 8030 2
,, . 201 amps m 400 Ita�s 10685 2
401 amps to 600 imps 160.60 2
ame: • 12 601 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 Insmfadoa, attention, and/or
relocation
Pitons: ( ) Fax ( ) 200 amps or less 1 66.85 1 1
Owner in tellat ion: This installation Is being made on property That 1 own which is not 2,01 t 400 am 100.30 2
intended for sale, lease, rant, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: Date: Brink dreads — sew, alteration, or extension. per paled
,,. ..... A Foe for branch circuits wide
service or Redo the, each
Business name: Johansen Electric Inc. brmuah circuit 665 2
B. Fee for branch circuits
Contact names C6arlynn "Afton without savior of feeder boa
each branch elm* 1 4683 46.85 2
Address: 10948 SE Maley View Terr. - Each add'I branch circuit b 6.65 59.85 2
City/State/ZIP: Clackamas, OR 97015 Misee ['noes (service or fader not iaduded)
Phone: (503) 698.3417 Fax:: (503) 698-2486 Pump or irrigation circle - $3.40 2
Sip or outline lighting 53.40 1
E -mail: Johannenelaetemem.eom Signal circuit(s) or limited-
p
_ e:mensien. Describe: Page 2 2
Business name: Johansen Electric Inc.
Address 10948 3B Valley View Tarr. Each additional inspecdoa over allowable in any of the above
Per inspection 6230
City/State(ZZIP: Clackamas, OR 97015 Investigation per hour (1 br min) 62.50
Phone: (503) 698-3417 Fax (503) 698.2486 Industrial t hour 73.75
CCB L.ic.: 51539 Electrical Lie; 3 -243 .. . Lia.: 2053S Sulaotsl 1 06.70
S uP rv_ Electrician sr; � /if % �� ' Plan review (25% of permit fee)
roquirod: State surcharge (8%ofpermit Poe). 8.
Print name: , r % / / Data: TOTAL PERPdIT FEE 115.24
Authorized signature: `, . .- , This 1� app ettp
['dos ins If a plumb b see obtained within 185
. . .. � �i. days after It hos bees sotaot ell as eosplete
/ Date: 5/3/ • Fee methodology set by Tti40mtty Building Wanly Ser.iea Baud
Print porno: / .- , , ;MIS; . t •• Number of inspeatims per pent allowed.
r.d 12/03 11T IOnS/COWW
S ' d XHd 13C2I3Sb1 dH Wd2Z : E LOO CO FeW
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007 -00307
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/4/2007
Phone: (503) 639- 4171�I'I
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7/23/2007 TIME: 7:06AM PAGE: 19
SITE ADDRESS: 16570 SW 72ND AVE B9 CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK I LOT #: 00C TYPE OF USE:
PROJECT NAME: SERVICE MASTER OF TIGARD
DESCRIPTION: TI with (10) branch circuits.
OWNER: PACIFIC REALTY ASSOCIATES. PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503 - 698-3417
Inspection Request Scheduled For: Date: 7/23/2007 Pour Time:
Code # Inspection Description on ' # Contact # Message
99 Electrical final =052527 -01 503- 969 -5262 N
Corrections /Comments /Instructions:
/1\
n PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 0(W) L-Z Date: 1 4.31h9 Phone #: (503) 718- 1446
CITY OF TIGARD , , "~
BUILDING DIVISION .. PERMIT #: ELC2007 -00307
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/4/2007
Phone: (503) 639 -4171 Vlif
Inspection Requests (24 Hrs.): (503) 639 -4175 .. ' °:_—
INSPECTION WORKSHEET FOR DATE: 7/17/2007 TIME: 7:03AM PAGE: 56
SITE ADDRESS: 16570 SW 72ND AVE B9 CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK I LOT #: 00C TYPE OF USE:
PROJECT NAME: SERVICE MASTER OF TIGARD
DESCRIPTION: 11 with (10) branch circuits.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503 -698 -3417
Inspection Request Scheduled For: Date: 7/17/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
130 Ceiling cover 052128 -01 503. 698 -3471 Y
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
F AIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: .7 `/ 7 "09- Phone #: (503) 718-
/,
•
CITY OF TIGARD •
BUILDING DIVISION ` - PERMIT #: ELC2007 -00307
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/4/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7/11/2007 TIME: 7:01AM PAGE: 46
SITE ADDRESS: 16570 SW 72ND AVE B9 CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK 1 LOT #: OOC TYPE OF USE:
PROJECT NAME: SERVICE MASTER OF TIGARD
DESCRIPTION: TI with (10) branch circuits.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503
Inspection Request Scheduled For: Date: 7/11/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
125 Wall cover 051796 -01 503 -209 -3917 N
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ' N u^ Date: ijdr Phone #: (503) 718 - ti