Permit CITY O T' ^ D ELECTRICAL PERMIT
d ° V � PE: C-
° COMMUNITY DEVELOPMENT DATE ISSUED # : 8/14/200 00569 7
T I G A K D 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S113AD-01900
SITE ADDRESS: 16640 SW 72ND AVE B10 ZONING: I -
SUBDIVISION: OREGON BUSINESS PARK I LOT : 009 JURISDICTION: TIG
PROJECT: VERIS
Project Description: TI - add (50) 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/ SVCI 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: 49 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
[ELPRMT] ELC Permit 8/14/2007 $372.70 LIC 51539
[TAX] 8% State Surcharge 8/14/2007 $29.82 SUP 2053S
Total $402.52 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 -00 • hrough OAR 952-001-0110 You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued B /} /1 Li ,/ ' Permittee Signature: /
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 A ! . li , .r . ,!iLl,.
City of Tigard E WE fir. $ 1/ b S P 1Va.:a.c.2Q0- - tp
13125 SW Hall Blvd., Tigard, OR 97223
Phone: 503.639.4171 Fat: 503.598.1960 AUG 1 4 / 0 t...,. i nary. Other Permit:
Inspection Lies: 503.639.4175 . U 'I I Date Rmdy/er
Internet: www.cittgardor.m CITY OF TI =y- • J. NalfedlMAbod A I ® far macs
❑ New construction ® Addihon/altantiott/replaoement Please check all that apply:
❑ Demolition 0 Other: ❑Service over225 amps, o n na'l ['Hazardous location
❑service over 320 amps — rating ❑Boiling over 10.000
of 1 -and 2- t�antily dwel linBt 4 m more new residential
❑ 1 - and 2- family dwelling ■■ Commercial/industrial ❑ Accessory building 10Systair over 600 wits nominal %mils in one Mud=
❑ Mu1H farm'ly ❑ Master builder Other:
persaas structures or
ding over three asotie Feeders. 400 =Per mote
- .... , ,. ❑Occupant load over 99 ❑MmuQaAussd
RV pig
lob no.: Job site address: 16640 SW 72nd 0 e finality Dona:
Submit X sets of pima with any ofthe above.
City /Stan/ZIP: The above are not applicable to temporary comstrucdon service.
Suite/bldg./apt. no.: Project name: Veris
Destriposa Qtr. w. Tan ••
Cross street/directions to j ob site: New resdentlal single- or nnt1B- tinselly dwelling unit:
Includes attached garage.
1,000 sq. 8. or less 145.15 4
Subdivision: Lot no.: Ba, add" 500 sq. tt or portion 3140 1
Tax tnsp/paacel no.: Limited 8R residential 75.00 2
Limited en ergy, non-residential 75.00 2
Eats► mannliecaned or modular
Tenant Improvement -Add 2500 sq ft of office d X90 2
Services or Seeders ismbsllatton, :alteration, and/or relocation
200 amps or has 80.30 2
aaatps to stripe 10685 2
160.60 2
Name
401 amps to 600 amps
601 amps to 1.000 amps 240.60 2
Address: Over 1.000 amps or volts 454.65 - 2
Recanted only 66.85 • 2
City/State/ZIP: Temporary services or feeders Installation, alteitloa,, sad/or
Phone: ( ) Fax: ( ) ti0° _
Owner installation: This installation i3 200 amps Or lees 10030 - 1
being made on property that 1 own which is no 201 amps m 400 amps 10030 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, panel
• A. Fee for branch circuits with
service or feeder foe, each
Business nurse: l
se: Johansen Meade Inc. branch circuit 665 2
Contact name: Charlyna ILelfaen B . Fee for branch circuit
without swine or feeder fee. 1 4635 46.85 2
Address: 10948 SE Valley View Terr. each branch circuit
Eadt addl branch circuit 4B 6.65 325.8: 2
City/State/ZIP: Clackamas, OR 97015 Miscellaneous (service or feeder not included) - -
Phone: (503) 698 -3417 Fax:: (503) 698 -2486 Pomp or irrigation civic • 53.40 2
E -mail: johanseneta�msn.eom Sipe or outlive 53.40 2
Signal checks) or limited-
Business name: Johansen Electric Inc etmertsion Desaibe: Page 2 2
Address: 10948 SE Valley View Tern. Each additional inspection over allowable In ssQof the above
Per °n 6250
City /StateP Clackamas, OR 97019 .
Investigation pa hour (1 br min) 62.50
Phonic: (503) 698 - 3417 Fax: (503) 698-2486 Industrial : lent hour 73.75
CCB Lic,: 51539 Electrical Lie.' 3-243 S' • . Lim: 20535
Suprv. Electrician si I• /0' `ir' Tn�T► Su6fotB! 372.70
��: Plan review (25%of permit fee)
Print restate: D 8/14/07 Stine s ` age (896 of Pert tie)' 29.82
`' / / TOTAL PERMIT FEE 402.52
Authorized signature: •
gnatu e: `i .. . , ,!�.. m. permit apyUw mall all its parmets eat obtained wletto 180
days Ater it luta lees Print name: / , . Date: 8 . F saw hidustry service Bid
"Number A inspections per paamit alowed.
loam laamlalE.C-PamkAwdee ITas 44e41e1sTYIOOMOMAV99
i ' Xidd 13C213S1:11 dH WdS2 c i G002 bi 2nd
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007 -00569
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/14/2007
Phone: (503) 639 -4171 "411111‘'
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/2/2007 TIME: 7:01AM PAGE: - A8
SITE ADDRESS: 16640 SW 721D AVE B10 CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK I LOT #: 009 TYPE OF USE:
PROJECT NAME: VERIS
DESCRIPTION: TI - add (50) branch circuits.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503-698 -3417
Inspection Request Scheduled For: Date: 11/2/2007 Pour Time:
Code # Inspection Description - - • • # Contact # Message
199 Electrical final 058902 -0 503-969 -6717 N
Corrections /Comments/ Instructions:
IA PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: & ' 52) Date: % 1 .2, al Phone #: (503) 718 -1-14%
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2O07.
13125 SW Hall Blvd., Tigard, OR 97223 — DATE ISSUED: 8/14/2007
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/1/2007 TIME: 7 :02AM PAGE: 32
SITE ADDRESS: 16640 SW 72ND AVE B10 CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK I LOT #: Q09 TYPE OF USE:
PROJECT NAME: VERI S
DESCRIPTION: TI - add (50) branch circuits.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503-69E3-3417
Inspection Request Scheduled For: Date: 11/1/2007 Pour Time:
Code # Inspection Description on irm # -- Contact # Message
199 Electrical final 0513603 -02 503.969-5717 N
Corrections /Comments/ Instructions:
' C-di 2CAA s e c MQ � F — L 46aANA chtcAA73
N
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
X FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: CTS, 1 ` Date: I, I I' on Phone #: (503) 718 - Mgt°
CITY OF TIGARD
'
BUILDING DIVISION f PERMI #:
• FLG20O7-00569
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8114/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 - "'� �!
INSPECTION WORKSHEET FOR DATE: 10/1/2007 TIME: 7 :00AM PAGE: 20
SITE ADDRESS: 16640 SW 72ND AVE. B10 CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK I LOT #: 009 TYPE OF USE:
PROJECT NAME: VERIS
DESCRIPTION: TI - add (50) branch circuits.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503,698 -3417
Inspection Request Scheduled For: Date: 10/1/2007 Pour Time:
Code # Inspection Description _____C9nfirm # Contact # Message
130 Ceiling cover 056656.01 503 - 969 -5717 N
Corrections /Comments /Instructions:
VasONI Z p - 17 Tlii ON Orr&
$6:) G LAeff0 (ZT S t'Eottuig A 14-41 1 oE
R t.inN, rtko s V 1&
IX PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G— • IN V e. Date: 1° 1 110/ Phone #: (503) 718- 1iilf-L
CITY OF TIGARD
BUILDING DIVISION
PERMIT #: ELC2007 -00569
13125 SW Hall Blvd., Tigard, OR 97223 + DATE ISSUED: 8/14/2007
Phone: (503) 639 -4171 4W i A
Inspection Requests (24 Hrs.): (503) 639 -4175 „744. ` A
INSPECTION WORKSHEET FOR DATE: 8/31/2007 TIME: 7:OOAM PAGE: 10
'SITE ADDRESS: 16640 SW 72ND AVE B10 CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK I LOT #: 009 TYPE OF USE:
PROJECT NAME: VERIS
DESCRIPTION: TI - add (50) branch circuits.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503-63 8-3417
Inspection Request Scheduled For: Date: 8/31/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
125 Wall cover 054988 -01 503-969-5717 N
Corrections /Comments /Instructions:
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: (• N +4 L Date: 31 Phone #: (503) 718- .2-440