Permit q CITY OF TIGARD ELECTRICAL PERMIT
2 COMMUNITY DEVELOPMENT EZUZNII Permit #: ELC2011 -00091
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/15/2011
Parcel: 2S113AB00600
Jurisdiction: TIGARD
Site address: 16160 SW UPPER BOONES FERRY RD
Project: Dow Agrosciences Subdivision: PACTRUST BUSINESS CENTER Lot: 0
Project Description: TI 3/11/11 renrinted to correct street name from 72nd Ave.
Contractor: JOHANSEN ELECTRIC INC Owner: PACIFIC REALTY ASSOCIATES
10948 SE VALLEY VIEW TERR 15350 SW SEQUOIA PKWY #300
HAPPY VALLEY, OR 97086 PORTLAND, OR 97224
P
PHONE: 503 - 624 -6300
PHONE: 503 - 698 -3417
FAX: 503 - 698 -2486
FEES
Quantity Description Date Amount
2 ea Services or Feeders - 200 02/15/2011 $201.40
Specifics: amps or less
24 crt Branch Circuits w /Purchase 02/15/2011 $178.08
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 02/15/2011 $45.54
Electrical
Type of Const:
Occupancy Grp:
Total $425.02
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accor• - - with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTEN •N: Oreg• I• re•uires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -001 -001 r through OAR A . . -001 -• • • v.. You may obtain a copy of the rules or direct questions to OUNC by calling 50 2.1987 or 1.800.332.2344.
Issued B Permittee Signature: 6-f!
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' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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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CITY OF TIGARD ELECTRICAL PERMIT
' • COMMUNITY DEVELOPMENT Permit #: ELC2011 00091
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/15/2011
Parcel: 2S113AB00600
Jurisdiction: TIGARD
Site address: 16160 SW UPPER BOONES FERRY RD
Project: Dow Agrosciences Subdivision: PACTRUST BUSINESS CENTER Lot: 0
Project Description: TI. 3/11/11, Reprinted to correct street name from 72nd Ave. 4/12/11, Reprinted to include (4) feeders and (80)
branch circuits. BT.
Contractor: JOHANSEN ELECTRIC INC Owner: PACIFIC REALTY ASSOCIATES
10948 SE VALLEY VIEW TERR 15350 SW SEQUOIA PKWY #300
HAPPY VALLEY, OR 97086 PORTLAND, OR 97224
P
PHONE: 503 - 624 -6300
HONE: 503 - 698 -3417
FAX: 503 - 698 -2486
FEES
Quantity Description Date Amount
2 ea Services or Feeders - 200 02/15/2011 $201.40
Specifics: amps or less
24 crt Branch Circuits w /Purchase 02/15/2011 $178.08
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 02/15/2011 $45.54
Electrical
Type of Const: 4 ea Services or Feeders - 200 04/12/2011 $402.80
Occupancy Grp: amps or less
80 crt Branch Circuits w /Purchase 04/12/2011 $593.60
Service or Feeder
120 12% State Surcharge - 04/12/2011 $119.57
Electrical
Total $1,540.99
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or •- • estions to OUNC by calling 503.232 1987 or 1.800.332.2344.
/ 1
Issued B, 3 � ' i�i!i� - ermittee Signature: I '
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' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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.
CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2011 -00091
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/15/2011
• Parcel: 2S113AB00600
Jurisdiction: TIGARD
Site address: 16160 SW 72ND AVE
Project: Dow Agrosciences Subdivision: PACTRUST BUSINESS CENTER Lot: 0
Project Description: TI
Contractor: JOHANSEN ELECTRIC INC Owner: PACIFIC REALTY ASSOCIATES
10948 SE VALLEY VIEW TERR 15350 SW SEQUOIA PKWY #300
HAPPY VALLEY, OR 97086 PORTLAND, OR 97224
PHONE: 503 - 624 -6300
HONE: 503 - 698 -3417
FAX: 503 - 698 -2486
FEES
Quantity Description Date Amount
2 ea Services or Feeders - 200 02/15/2011 $201.40
Specifics: amps or less
24 crt Branch Circuits w /Purchase 02/15/2011 $178.08
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 02/15/2011 $45.54
Electrical
Type of Const:
Occupancy Grp:
Total $425.02
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 the 180
days. ATTENTION: Oregon law requires you to follow the r adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through • !..2- 001 -0090, / You ma ob. -. • • o qt. or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. -
/ 1 n
Issued By: ! ..e..fast--e• Permittee Signature: j S�
- 41110 411V- 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' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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.
pr
Electrical Permit Applicatiiiiliw-fL . Lk)/ 1.0R1111.1( I si.. ()NI \
City of Tigard FEB 1 1 2011 Received
Date/B : , , (11/,, Permit N° "' re i_ C " 0
..---- 13125 SW Hall Blvd., Tigard, OR 9722 3 Plan Review
• Phone: 503.639,4171 Fax: 503 -598- 1
II
Other Permit
• I • .
i ■ r bF TIGARD Date/B :
:1. ; t ; ..., . ,,. i . ) Inspection Line: 503.639.41 75 ... . Date Ready/By: la See Page 2 tor
Internet: www.tigard BUILDING DIVISION Notified/Method: la= Supplemental Information
11 DM
II. „,,, ,,: v ,■ 'I 110.1 !?E; ,I, ,' , , ; " ' ,' i I', .,„: c' •'Ini '1 tin 1 , , 11 •s4=1:Frrilitai o•• ' r-r ••,-.7.' -.•
101 1 11:41;' , :;,fiial: i: :IIKI.!,i;lit:'' , 4?),0 - ikK. t
;...444410 • MP' . - - ' It'.74'4 i442:2" ,•' . '''.'
New construction Addition/alteration/replacement
Please check all that apply (submit 2 sets of plans w/items checked below):
0 [E]
ID Service or feeder 400 snips or more 0 Building over three stories.
C3 Demolition 0 Other: where the available fault current CI Marinas and boatyards.
I ' ' '''' ' 1 14". -Y• k . exceeds 10,000 amps at 150 volts or ID Floating buildings.
CIE '•,'," !,.'il.7 • •
tins to ground, or eorceeds 14,000 1:1Commercial-use agruculnual
Ej 1- and 2-family dwelling Z Commercial/industrial 0 Accessory building amps for all other installations. buildings.
0
Multi-family D Master builder 0 Other: 0 Fire pump. 0 Installation of 75 KVA or
u l , Eme s
larger separately derived system.
P
•<:(,, '1, 177%.";:' i". .,, '1' iiii Isl ',•.-, 0.1 7, ,, ., '1 jklg.02 4 , , Af i - i i iiikiaiji E
21.10 l, RIMIWn..iiiiiiiic,i:.!,: , i' Addition Df n'W =tor laad of
Job no.: Job site address: 1 L I 4 2 04). 100HP or more.
6.4 .- ii - firi Six or more residential units_
0 Recreational vehicle parks.
City/State/ZIP: • 1._. 0 Health facilities. 0 Supply voltage for more than
0 Hazanlous locutions. 600 volts nominal.
PrOjeet name: C) A. , 7.,.. • C..-- l ab -.. .
Suite/bldg./apt. no.: C)Service or feeder 600 arnps ortrif
,
'..' ,
ita i l '* 11L -'11 "/La=0:`! 1 ,iIa l atL •I', ,.., '.."' -f-
Cross street/directions to job site: Description Otv. Fee. Total •
New'residential single- or multi-family dwelling unit.
,...,-- Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'I 500 sc. ft. or portion 33.92 1
Tax map/parcel no.: Limited energy, residential
75.
7 '' , i-,ii ttiA'''' -7-: .afgAl.':.. , .I''''"'•iPliltitm (with above sq. ft) 00 2
Limited energy, multi-family
75.00 2
residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 2_ 100.70 0 2/11 9?) 2
e41 201 amps to 400 amps 133.56 2
N 401 amps to 600 amps 200.34 2
ame:
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and/or
City/State/ZIP: relocation
Phone: ( ) I Fax: ( ) 200 amps or less 59.36 1
78 2
2
Owner installation: This installation is being made on property that I own which is not
.201 amps to 400 amps 12
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
- P ir`P . • — -. .11, ->",i'Mt. =, , • - n ,-; - i ,.., - - I . ... . , ,;., 4. , ...,,,„,
4!.V.I1,, .: 7 , : i dlif i' 740 ::: ...: I8,!.'.'r:.....7.kit;::4ii.•: above service or fender fee, 2 LI
each branch circuit 7.42 /It 2
B Fee for branch circuits without
Business name: Johansen Electric B service or feeder fee, first
56.18 2
Contact name: Charlynn Leifsen branch circuit
Each add '1 branch circuit 7.42 2
- Address: 10948 SE Valley View Terr Miscellaneous (service or feeder not included)
Each manufactured or modular 67.84 2
City/State/ZIP: Happy Valley, OR 97086 dwelling, service and/or feeder
Phone: ( 5 03) 698-3417 Fax::(503) 698-2486 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E-mail:
Sign or outline lighting 67.84 2
1154.,Mratelff,111,„7.1.1FAMI Signal circuit(s) or limited
panel, alteration, or extension. Page 2 F
Dusinessmme: Johansen Electric Each additional inspection over allowable in any of the above
Address: 10948 SE Valley View Terr Additional inspemion (1 hr min) 66.25/ hr
Investigation (1 hr min) 66.25/ hr
City/State/ZIP: Happy Valley, OR 97086 Industrial plant (l hr min) 78.18/ hr
Phone: (503) 698-3417 I Fax: ( 503) 698-2486 Inspections for which no fee is
90.00/ hr
s.ecificall listed V: hr min
CCB Lic.: 51539 Electrical Lic.: 3-243C Suprv. Lic.: 2053S :.wril fr.t! 1 ,,....-.0!1=,;cMPT"Minultilt r,:tiv;
Suprv. Electrician signature, required: 4oilg Subtotal: ' ' g
Plan review (25% of permit fec):
? 4""1411244../
Print name: Carl Johansen ate: 2/11/11 State surcharge (12% of permit fee): 1.7&,,„
TOTAL PERMIT FEE:
Authorized signature: 0 1
A el---.____--' This permit application expires ifs permit is not obtained within 180
days after it has been accepted ss complete.
Print name: charlynn. Leif s en Date: 2 /11 /11 * Number of inspections allowed per permit.
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** *ADDS TO PERMIT ELC2011- 00091 * **
Electrical Permit ADplicatic EiCEIVED I ( ilt i11I It 1 I �t t)vI
City of Tigard Received En Men
w 13125 SW Hall Blvd., Tigard, OR 1 2 972 pp Plan Review Other Permit:
Phone: 503.6394171 Fax: 503 d0 201 D ,
- 1 r ; ;\ ; „ ., Inspection Line: 503.639 4175 Date Ready/By: kris:
Internet: www.tigard- or.gov CITY OF TIGARD Notified/Method r .
y ,t s4" . s ,.,r 1 I �^ Nt01�E s u ' i t I 3 a%'.ax a t y d + I4 it`bt'% r
» )ria�- +��- Wlt:�,�. .. ... !.�.,..e� r�+ r_...,z . .. ... .. ._.,.� _1171Y�"4iH��rr •„ic< ,,:Mat, I ....r. I 3s� -�..k. ",. ° t - " '�fiF�lllr<'�'��'' .rr.,'. -,:
❑ New construction ® Addition/alteration/replacement Please check all that apply (submit 1 sets of plans w/items checked below):
❑ Demolition ❑ Otlter. where the available Service or feeder 400 amps or more ❑ Building over three stories
fault current ❑ Marinas and boatyards.
'" att:l t i1 tll� ' a� + ,,A a rusta}, r-* mi l �, t exceeds 10,000 s at 150 volts or buildings..
.t . x�.�t3 # ( w,., , k Se .,...., »...,., r� .. . 1 d snap Floating cia in
1 - 2-family dwelling less m ground, or exceeds 14,000 ❑ Commercial-use cultural
❑ y ng ® Commercial/industrial E Accessory building amps for all ether installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
;,.�� I °•,- .+r�cr� �.s: ,e,_iey 7.rp rr F t ❑ Emergency system. larger separately derived system.
. -:� t ,wry I i '[ ll :: r, 1 s _ ` E 7 . _ o`.t;n , e 1 1 ll , 4 t P) r#
i �, �• (� . „ ,rns sltn °ia. � i '* . -��"' �'� ❑Addition of new motor load of ❑ "A" "E" "I.2" "1-3
1616 0 SW U
Job no.: Job site address:, f or ormre. Recreational Upper Booties ❑ $ixorinoronsidentielemits ❑Reaeutioaalvehicleparks.
City /State/ZIP: ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazeadous locations 600 volts nominal.
Suite/bldg. /apt. no.: I Project name: Dow B1 ('' " e. /u ❑ Service or feeder 600 amps ormore yryy
■ VV� it I RP I ' - (+ "°'� 1H Itl 11tS1FfsY�l ref d�'±^
e. #`U9i1l. Yail"' +Ale" ,. iii 1 x ... 1 ..v.,. �::.
Cross street/directions to job site: Description I Orr Fee. I Taal I •
New residential single- or multi- family dwelling unit.
Includes attached garage. _
Subdivision: I Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'1500 sq. ft or portion 33.92 1
Tax map/parcel no.: Limited ener gy, residential
��pp��JJ,,.,, 1 ��t
#rl ]Illuuwrv7+E kilki alit,' �? tl , ts.� ,ill la ti ii (with above sq. ft.) 75.00 2
.x, ..N:llu, �,..v.. _51 ... ..u.. w. Limited energy, multi- family 75.00 2
Add to permit ELC2011 00091 residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 4 100.70 402.80 2
nth .ttn 11I 201 amps to am
r4<,la��!� n,, . ' ° 1NtE lll I I 3 snap 400 amps 133.56 2 p
401 amps to 600 amps 200.34 2
' -Name:
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) I Fax: ( ) 200 amps or less 1 59.36 1 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168,54 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
"'" alts `' n .. a Ftltttlllpl 1 1r1 ? ;, . t above service or feeder fee, 7.42
f ..ic is l' ,,.,, . dome , , , _ ..., .t''1 E i• t'•i At S . ,l in t (1 each branch circuit 8 0 593 ) 2
Business name: Johansen Electric B Fee forbranchcircuits
sery ice or feeder foe, first 56.18 2
Contact name: Cha r l ynn L e i f s e n branch circuit
Each add'l branch circuit 7.42 2
Address: 10948 SE Valley View Terr Miscellaneous (service or feeder not included) _
City/State/ZIP: Ha Valley, OR 9 7 0 8 6 Each manufactured or modular 67.84 2
ri Happy Y r dwellitrR, service and/or feeder
Phone: (5 0 3) 698-3417 I Fax:: (5 0 3) 698-2486 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E - m a i l :
� Sign or outline lighting 67.84 2
_•..�' .; `` °. °'a .:41i . i i1" I itl ) m 1 :k�8ll6� tt 6 *-gy +, Signal circuit(s) or Limited-energy
" l usiness name: Johansen Electric panel, alteration, or extension. Page 2 2
Each additioaal inspection over allowable in any of the above
Address: 10948 SE Valley View Terr Additional inspection (I hr min) 66.25/ lir
Investigation (1 hr min) 66 25/ hr
City/State /ZIP: Happy Valley, OR 97086 Industrial plant (1 hr min) 78.18/ hr
Phone: (503) 698-3417 I Fax: ( 5 0 3) 698-2486 Inspections for which no fee is 90.00/ hr
specifically listed hr mm
CCB Lie.: 51539 I Electrical Lic.: 3-243C I Suprv, Lie.: 2053S �i� '/s il f„ � ltiVi, `'.MA1 I'
Subtotal: 996.40
Suprv. Electrician signature, required: p
(d A
o�. / Plan
Print name: Carl Johh sen Date: 4 /11/11 State surcharge (1 2%of permit fee): 119
Authorized signature: TOTAL PERMIT FEE: 1115.97 I
This permit application empires if a permit is not obtained within 180
Print name: Char 1 n L e i f s e n Date: 4 11 / 11 days after it has emcee accepted as complete.
Yn / • Number of inspections allowed per pdatit
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