Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2007 -00345
P . ' ..-4 COM MUNITY DEVELOPMENT
DAT ISSUED: 5/18/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S113AD-01800
SITE ADDRESS: 16650 SW 72ND AVE B12 ZONING: I -L
SUBDIVISION: OREGON BUSINESS PARK I LOT : 011 JURISDICTION: TIG
PROJECT: JOHNSTONE SUPPLY
Project Description: TI add (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: WISERVICE 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 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 5/18/2007 $106.70 LIC 51539
[TAX] 8% State Surcharge 5/18/2007 $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 B / Permittee Signature: i 4r,--lien
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.
.:,Iectrical Permit Application , , i l t , t. It 1 (, (. \ 1 1
City of Tigard ' ‘"--l',021, . r v Q - _ I ; • ., Received
13125 S W Hail Blvd., Tigard, OR 9722 , 1 1,, d ;? ,. 1 )" H E r 1 15 � Permit Ni) ELt� 201 } — 60
Phony 503.639.4171 Fax: 503398.1960 . •' v: °lbw : PR I" , zo l -•-(0) IS
nt r nc inspection
C w Line: 3 www.citiprd.or.us us f v l A v 1 8 1 , r f. B Bee Page 7 for
L nmrusrw.cl. H i L - - l
1 simpleauMd 1ate+msgw
❑ New construction ® , . , : ,tr∎rw '' *. • !r,11 Please cheek all than apply:
❑ Demolition ❑ , ' F 1 1 n3X TTe T"1 ['service over 225 amps, coronet ❑Hamrdous location
, ❑ 20 a rating ❑Buildng over 10,000 sq. ft,
of 1• and 2-family 4 or morn new residential
❑ 1- and 2 -family dwelling ® Commercial industrial 0 Accessory building ['System ova 600 volts nominal units in one structure
❑ Multi - family Cl Master builder ❑ Other: ❑ Building over three stories ❑Pccdcra, 400 amps or more
or OMeentlictwed
Amara Amara ,.. ., o over 99 persons
❑EgrensAi�ting per+ RV park
Job no.: Job site address: 16650 SW 72nd O a ih' Daher:
Submit a sets of plans with any of the above.
City/State/ZIP: The above are oat applicable to temporary construction service.
Suite/bldg. /apt. no.: b 12_ Project name: Johnstone
Dortriptim Qty. Fa. Tam
Cross street/direction to job site: New residential single- or mahtl -tamay dwelling oalt
Includes attaebcd garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot n Ea. add? 500 sq. ft. or portion 33.40 - 1
Tax map/parcel rear Limited energy, residential 75.00 2
Limited energy, non- resldeaiial 75.00 2
Each manufactured or modular
Tenant Its • rovement
dwelling. service and/orSeedes 90.90 2
Services or feeders irutallation, alteration, and/or relocation
200 amps or lest 8030 2
` - 201 amps to 400 amps 106.15 2
401 aatps o0 600 amps 160.60 2
E . • e. 601 amps 001,000 amps 240.60 2
Address: OW 1,000 amps or volts 454.65 2
City/State/ZIP: Rearmed ooh' 6685 2
temporary se vvices or faders installation, alteraton, and/or
tion
Phone: ( ) Fax: ( ) relOa
Owner Installation: This installation is made on that 1 own which is not 200 amps a teas 003 1
intended for sales lease, rent, or exchange, according to O , 449, 670, and 701. 401 amps to 600 amps 133.75 2
4Di amps fo 600 gasps 133.75 2
Owner signature: Date: Branch circuits— new, alteration, or extension, per panel
A broach circuits wfdr
service or feeder lee, each
6
Business name: Johansen Electric Inc. brand, circuit .6 2
B. Fee for
Contact nature: Chartynn LLefton s eav ic e a fee
Address: 10948 9E Valley View 'Tern. each brands circuit 1 46 85 46.85 2
Each add, branch circuit y 6.65 59.85 2
City/State/ZIP: Clackamas, OR 97015 Mbedhneous (service or feeder not included)
Pump
Phone: (503) 698.3417 Fax:: (503) 698 -2486 or irrigattoa cicrhe S3.4o 2
signor outline Ngiding S3.4o 2
E -mail: jobanseaelectemsn.com Signal cirarit(s) or limited-
m•x8Y a
Business name Johansen Electric Inn: exnion Describe: PsBe 2 2
Bleb additional inspection over allowable e 1n aay of rte above
Address: 10948 3E Vslley View Terr.
Leer inspection 62.50
City /Stat /ZIP: Clackamas, OR 97015 lnvesdgstionyer hour (I br min) 62.50
Phone: (503) 698-3417 Fate: (503) 6982486 Industrial hint pa!tour 73.75
CCB Lic.: 51539 ofp
• -- - ` ' . . Lin: 10535 Subeotal 106.70
Suprv. Electrician signature, required: r /J it ' � Plea review (2574 ennk tee)
Print name: `� Date:
5/1 8/07 State surcharge OM of permit kite) • 8.54
. / TOTAL PEA UT t 115.24
Authorized signature: - I � • r b p it apl _ expires W s permit b mot obtained witbin 180 h ha been accepted as complete
Print name: ! , / = Date: 5/ 18/07 ; lea br aoBoard , � Fer permit allowed.
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•
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CITY OF TIGARD -
BUILDING DIVISION PERMIT #: ELC2007- 00345
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/18/2007
Phone: (503) 639- 4171
Inspection Requests (24 Hrs.): (503) 639 -4175 ° I..
INSPECTION WORKSHEET FOR DATE: 6/18/2007 TIME: 7:04AM PAGE: 24
SITE ADDRESS: 16650 SW 72ND AVE B12 CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK I LOT #: 011 TYPE OF USE:
PROJECT NAME: JOHNSTONE SUPPLY
DESCRIPTION: TI add (10) branch circuits.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503 - 698.3417
Inspection Request Scheduled For: Date: 6/18 /2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 050394 -01 503-969.5262 N
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: $144 Date: C -7 8 0 Phone #: (503) 718-