Permit 4F f CITY o TIGARD ELECTRICAL PERMIT
I f V IZ P #: ELC2007 -00770
COMMUNITY DEVELOPMENT DATE I SSUED : 11/15/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 1 13AC -00103
SITE ADDRESS: 07216 SW DURHAM RD 200 P ZONING: I -P
SUBDIVISION: PACTRUST BUSINESS CENTER LOT : JURISDICTION: TIG
PROJECT: WELLPARTNER
Project Description: 2 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: 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 11/15/200' $53.50 LIC 51539
[TAX] 8% State Surcharge 11/15/200' $4.28
SUP 2053S
Total $57.78 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: o Permittee Signature: cfrii fi ca 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'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.
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Electrical Permit Ap 1 4.
City of Tigard � Received l /
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• 13125 SW Hall Blvd.. Tigard, OR Date/By: t 5 07 35 Permit No � 7f /R
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; _ 42007 E l � � —o� o
Phone: 503.639.4171 Fax: 503.5': s't0 1 Date/
1 „ inspection Line: 503.639.4175 j Date Ready/By: Other Fermat.
1 • 1 - 1 N Date
Internet: www tigard or g � r` �� g I' oefie d loos ® Soe Page 2 for
t
_ _ 1 Supplemental Information
1...' 9 £ t ` •r .: 11 r q rc,a.: a � isy "�` a�! ,,
! � . ll " 1 t R. ..'� —,„... w t ., i ' $4 t .,. , , u,a. 1,.. . ' ., .....„. t a i .F . 5.9�,,,„, sj a t -.
❑ New construction E :+
El 'NF �i 3 9 , 1)/1 J r or1/r'eplacement Please check all that apply (su 2 sets of plans pi/items checked below).
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other:
0_ ;, z v where the available fault current ❑ Marinas and boatyards.
t)� u"llit a a k t . o , tr :1 #1� . S 'S1u: 1 .s. : t` N4., 1,91 meads 10,000 amps at 150 volts or ❑ Floating buildings.
❑ l- and 2- family dwelling ® Commercial/industrial lees to estads 1:3 mmerciultural
❑ Accessory building amp for all ground. o ther or ins tallat i on x 14.000 s. buCoildings. al - use agricultural
❑ Multi - family ❑ Master builder
, a �, ❑Other D Fire pump. ❑Instaltationof75KVAOr
separately derived system.
, � y � e � v �� E wer en stem. • � � � ����I�tsl, i''1".71';::, . ti �` y d t ' y , , � r f` a. � +� • °,� � ` ❑ g oY sY larger
.. ! 1%'. n 1 a . ti,tt ;�. t �[ • x I � . lil a . _" 1..- ,
,•` tl ttes I '•: ID Addition of new motor load of ❑ "AA 'E , "1-3
Job no.: ` Job site address: I 2,4140 D 100HP or more. occupancy,
m 1 /'tw ! ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/Z IP: ❑ Health - care facilities. ❑ Supply voltage for more than
i 1 t Ca n ❑ S rvic Hazardous 600 volts nominal.
Suite /bldgJapt no.: 1 Project name: } t ❑ Service or r feeder b00 snips or more,
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m g
Cross street directions to job site: � ,+)° " q' .li�+•t i,,, I d, I jt i ii r ig
Description Qty. Fee. Total .
New residential single- or multi- family dwelling unit.
Includes attached garage.
-
Subdivision: 1 Lot no.: 1,000 sq. ft or less 145.15 4
Tax map /parcel no.: Ea. add'1 500 sq. ft or portion 33.40 1
i , h Y , r t Limited energy, residential
�'tr. s :- h.4.., }'....i*€ -t.� "al a. `c y r d 75.00
nr1 r .` CEO L:. ? . ( (with a ft 2
1 _ - I. av 1 ,,v A Limited energy, (with multi-family
family
� f l.I residential (with above sq. ft.) 75.00 2
Services or feeders installation, alteration, and/or relocation
rti tss{ -cur c i 11a r
200 amps or less 80.30 2
t �+�
- w rsbt r= ,..
l '. ! Ax t : r, 's ';' 14 `: _ 201 amps to 400 amps 106.85 2
Name: 7 0_6 . C 1 r 0 ._ 401 amps to 600 amps _ 160.60 2 -
Address: l 601 amps to 1,000 amps 240.60 2
V - Over 1,000 amps or volts 454.65 _ 2
City / State/ZIP: � t.. � . :A I. I R Temporary services or feeders installation, alteration, and/or
Z relocation
Phone: y ) (® [/"I – t „ D Fax: ( 6(72f ,_' -- L _200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 1 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, er panel
A. Fee for branch circuits with
fi, 1ItKi ` : r r ' i t7 .a p t above service or feeder fee, .
Business name: Johansen Electric Inc.
each branch circuit 6.65 2
B. Fee for branch circuits
Contact name: Charlynn Leifsen without service or feeder fee, f
46.85 Lib. 2
first branch circuit `
Address: 10948 SE Valley View Terr. Each add'l branch circuit I 6.65 (p , ( 4 0S' 2
City/ State/ZIP: Clackamas, OR 97086 Miscellaneous (service or feeder not included)
Each manufactured or modular 2
Phone: (503) 698 -3417 1 Fax: ; (503) 698 -2486 dwelling, service and/or feeder
Reconnect only 66.85 2
E -mail: johansenelect@msn.corn Pump or irrigation circle
53.40 2
t r,» EENEELW = ' 9 1, 4 ,1 t) <: l ' ne3.. 'I. n;,, Si or outline lighting 53.40
2
Business name: Johansen Electric Inc. Signal circuit(s) or limited -
energy panel, alteration, or
Address: 10948 SE Valley View Terr. extension. Describe: Page 2 2
City/State/ZIP: Clackamas, OR 97086 Eacb additional inspection over allowable in an of the above
Phone: (503) 698-3417 Fax: (503) 698 -2486
Per inspection 62.50
Investigation per how (1 hr min) 62.50
CCD Lie.: 51539 Electrical Lie.: 3 -243C Suprv. Lie.: 2053S Industrial plant hour g 73.75
Suprv. Electrician signature, required: eez/c !ti a � . p °;` e
• Subtotal: 53 , 50
Print name: Carl Johansen / Date: h , 1 j 0 Plan review (25% of permit fee):
State surcharge (8V0 of permit fee): y , 2.5
Authorized signature:
nn Leifsen j I permit application TOTAL PERMIT FEE: ,
Print name: Charl within y Date: I 1 f k LI `O � This PP ,hair if a permit is not obtained withim 180
days after it has been accepted as complete
' Number of inspections allowed per Permit
I: 1 BuilelingkPernrttIELC •Pem,itApp,doc 0527/06 440- 4615T(I 3104 /COMAVEB
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CITY OF TIGARD
BUILDING DIVISION #: ELC2007.00710
13125 SW Hall Blvd., Tigard, OR 97223 . :•
DATE ISSUED: 11/15/2007
Phone: (503) 639-4171 bory114011111'
Inspection Requests (24 Hrs.): (503) 639-4175 AO' -IL
INSPECTION WORKSHEET FOR DATE: 12/11/2007 TIME: 7:00AM PAGE: 23
SITE ADDRESS: 07216 SW DURHAM RD 200 P CLASS OF WORK:
SUBDIVISION: PACTRUST BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: WELLPARTNER
DESCRIPTION: 2 branch circuits.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503690-3417
Inspection Request Scheduled For: Date: 12/11/2007 Pour Time:
Code # Inspection Description 1 Confint Contact # Message
199 Elettlical final 061283-01 \\\ 503-.)69 N
Corrections/Comments/Instructions: ft
) '■i \ 1\ i
---di lj v APASS) 0 PARTIAL APPROVAL El CANCEL 7 NO ACCESS
FAIL H CALL FOR INSPECTION 7 ADDITIONAL FEES ASSESSED
Inspector: G- 1\)0 Date: 12. '01 Phone #: (503) 7181-4
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