Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2011 -00192
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/13/2011
Parcel: 2S113AC00103
Jurisdiction: Tigard
Site address: 7204 SW DURHAM RD 300
Project: Consumer Cellular Subdivision: PACTRUST BUSINESS CENTER Lot: 0
Project Description: Electrical for 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 - 698 -3417
PHONE: 503 - 624 -6300
FAX: 503 - 698 -2486
FEES
Quantity Description Date Amount
36 crt Branch Circuits wo /Purchase 04/13/2011 $315.88
Specifics: Service or Feeder
1 ea 12% State Surcharge - 04/13/2011 $37.91
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $353.79
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 throu• . • . 952- 001 -0090. You may obtain - . • of les or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. .
Issued B.. _ Permittee Signature: .�; %.� .�- �
_ �
O ff ° OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
RECEIVED
APR 1 2 2011
Electrical Permit Application I I Ill (►t I N l I' I: 11 \ l 1
City of Tigard CITY OF TIGARD Received in 13125 SW Hall Blvd., Tigard, olli DIVISION oeRevimw 11
a Phone: 503 639.4171 Fax: 503.598.1960 Date/B Other Permit. / . c7
„,,,\ t , r , Inspection Line: 503.639.4175 Date Ready/By , B See Paget for
Internet: wuw.tigtrd- or.gov Notified/Method: Supplemental Information
�-IrC 1•$�N'
i :tp'ria E r as E er 1; 1� ft'` l 1. lid X lsrt l €`i,
aYi ,a �'��� r,,,,.,, -ti t �re {y11�« .$tl d.+" -- .., full ii� _ t, ll .. ,hgFr t ._,. !! • ..: .. f {ice ; -_ :^ Y�t Y� . .._
❑Newconstruction ®Addition/ alteration /replacement Please check all that apply (submit icnt of p1 sna w/ltetns eheelced below):
❑ Service or feeder 400 amps or more ❑ Building over three atones.
❑ Demolition ❑ Other where the available fault current ❑ Marinas and boatyards.
,,.f;;a t 7 `" ,:-,L' f f' s P ,' d ? exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
:, ..• 'n t :c a w : ' 1 u r, ? s a, • ., • -
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi family ❑ Master builder ❑ Other: ['Fire pump. ❑ Installation of 75 KVA or
:I Emergency system. larger separately denved system.
0 � ' sift ', r d tt
s r�,,' �, '� �' - ❑AddiUOn of new umdor load of � • • .. t-2 •• ,. • l -3
IooHPormore occupancy.
Job no.: J Job site address:
72 0 4 SW Durham, 300 ❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State/ZIP: ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: 300 I Project name: Consumer Cellular D Serviceorfeeder000ampsormore
' I 0 r ;tt;tlf 7,lll*st ' c^r '' : iii rna? k.(R!•) ,„.,s lot 5 <
Cross street/directions to job site: Deseriptien 1 Qty. I Fee. I Total
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'/ 500 sq. ft or portion 33.92 1
Tax map /parcel no.: Limited energy, residential ntsg 75.00 2
, .na tzttg i e in a,, .. _ s i 8 , r . r !, ; (with b
aove s4. ft )
a1) d, to . . : :,. l I I l r ,i ' �'�� ,. , ` _ . , ,. . ,
Limited energy, multi- family 75.00 2
Tenant Improvement residential (with above sq. ft) ,
Services or feeders installation, alteration, and /or relocation
t 200 amps or less 133 100.70 2
1 D " ,. li l of ,lust ' 3s 9t " ,4iiillat[:rr.! :... ' . :tF i :,;`. ± il. 201 amps to 400 amps .56 2
t S,` .., 200.34 2
401 amps to 640 amps
Name: 601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
relocation
se rvices or feeders installation, alteration, and/or
City /State /ZIP:
Phone: ( ) I Fax: ( ) 200 amps or less 59.36 I 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not 401 am to 599 amps 16g 54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. ,
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
i)gl' ` ,
r % 1fi¢[). * a: r , . i 1 above service or feeder fee, 7.42 2
' l . 1W-Sa : % 1, , r , ,t Y ��t ,1 , t '''A e,; each branch circuit
Business name: Johansen Electric B. Fee for branch circuits without
service or feeder fee, first
Contact name: Charlynn Leifsen branch circuit 1 56.18 56. 2
Each add' I branch circuit 35 7.42 259. 02
Address: 1094 SE Valley View Terr Miscellaneous (service or feeder not included)
City/State/ZIP: 67 84 2
Each manufactured or modular
Ci
ty Happy Valley, OR 9 7 0 8 6 dwelling, service and/or f eeder
Phone: ( 5 0 3) 698-3417 I ( 5 0 3 ) Fax: : 0 3) 698-24E36 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E -mail: Sign oroutlinelighting 67.84 2
r r ., . „ , " lti .i r ,, r ...,. eh.a-, r t.tn'. t
.,,,,K; .: , .� ,� , , _ _ ':_ Signal circuits) or limited - energy
Business name: J ohansen Electric panel,a Paget 2
+ . Each additional inspection over allowable in any of the above
Address: 10948 SE Valley View Terr Additional inspection (l hr min) _ 66 25/ hr
City /StaterZIP• Happy Valley, OR 9 7 0 8 6 Industr p 1 h im) 78.1/ hr
- PPY y r Industrial plant (1 hr min) 78.168 1 hr
Phone: (533) 698-3417 I Fax: ( 503)698-2486 Inspections for which no fee is 90.001 hr
sirecifically listed <; hr min)
CCB Lic.: 51539 I Electrical Lie_: 3 — 2 4 3 C l Su rv Lic.: 2053S 05 3 S i :,. . -.� ? 2i,ltr 3 ; _
p ' � i brit r ° ��
Subtotal: 315.8 8
Suprv. Electrician signature, required: �J Plan review (25% of permit fee):
o
Print name: Carl J n s ri (,� �: 4/11/11 State surcharge (12% of permit fee): 37.91 .
� TOTAL PERMIT FEE: 3 53, 7 9
Authorized signature: er lll j Y /J l Tbis permit application empires if a permit is not obtained within 130
Print name: Ch rl n Leif f s en Date: 4 / 11 / 11 drys after it has beat accepted as templet.
Yn ' Number of inspections allowed per permit.
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