Permit r}
CITY OF TIGARD ELECTRICAL PERMIT
s v Permit #: ELC2009 -00268
fl COMMUNITY DEVELOPMENT
- -
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/04/2009
TIGARD Parcel: 2S113AB01400
Jurisdiction:
Site address: 7352 SW DURHAM RD
Subdivision: Lot: 0
Project: Spec Space
Project Description: Install (2) 200 amp panels, install /alter (10) branch circuits.
Owner: FEES
PACIFIC REALTY ASSOCIATES Quantity Description Date Amount
ATTN: N PIVEN, 15350 SW SEQUOIA PKWY
#300 2 ea Services or Feeders - 200 06/04/2009 $160.60
amps or less
PHONE: 10 crt Branch Circuits w /Purchase 06/04/2009 $66.50
Service or Feeder
10 ea 12% State Surcharge - 06/04/2009 $27.25
Contractor: Electrical
JOHANSEN ELECTRIC INC
10984 SE VALLEY VIEW TERR
HAPPY VALLEY, OR 97086
PHONE: 503 - 698 -3417
FAX: 503- 698 -2486
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
•
Total $254.35
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- 0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: Q,l,(1 -Q �_ � b� � . hU Permittee Signature: , • • Ak.5 , ` t .r'r..
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 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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. City of Tigard JUN 0 2 200'1 Date ReeeBiyev. a ., Permit N Z ( C lC CCO III 0 13125 SW Hall Blvd_, Tigard, OR 97223 lan R
: Phone: 503.639.4171 Fax: 503.598 1960 FT IGAt e' atdev Other Permit:: • 0_4; 0_4; • 0 l , d
TV
; 1 ;.; , ,,r,'":.2.1 - Inspection Line: 503.639.4175 CI 1 ► I ` ; R ead y /B y kris: % See Page 2 for
..� ' Internet: www.tigard- or.gov 1LD INGDivt .. ed/Methed� 11 SupplementalInfforniadon
' pfiht i' o� I'fr 15l es r a ,
I 111 , t #' i 1x01 cra {{ l = t y wi t t "�9^ r ill to t t , ;ra a r '.''...j....4
ti; E ,I °lint ,' 7. ° pr: � I4,.Fi : f ' � S e ,.r;•,� 31t t 1i,t!.x. 5 r.'1 Il • i 11' „ l ag e ri s ..F?i '° , a Px w i : .
❑ New construction 1.1 Addltion/alteratlon / replacement Pl ease check all appl 3 sets o lans w belw): 1
❑ ❑ Service or fender 400 amps or more 0 p Buildin over ms c thre e stories o
DI Demolition Other: where the available fault current ❑ Marinas and boatyards.
I ' , >i . r „a., 'r7�, „ a x 517 t o 14,P yy , 1171 yy�,�{ °a. ill' exceeds 10,000 amps at 130 volts or ❑ Floating t ... -. iuif'�.t6r aa�Eatzrit.�,adst � # .5 !. , i�tt'ctF a'A .. .;� �' �$ �;! s buiL s
lees to ground, or exceeds 14,000 ❑ Commercial -use agricultural
El 1 and 2 family dwelling 1Zi Commercial/industrial ❑ Accessory building
apps for all alter installations. buildings.
❑ Multi . Master builder ❑ Other: El Fire pump. ❑ Installation of75 KVA or
µ
' � Ili iP� `t�' , . €. {>` ,1� a >i4: _ y ;.v , Eatergoncya}atem. larger separately derived em.
31 .,,. ° C �3.:iu1.1 '1121 @. ... 21�
�J ;i :;: � 5_ -;8,a - 'wra f `i n ” utea3a�.,: , '�' '; t !� I . alaa ,er. ❑ Addition o f new motor Load of ❑ "A" "E" "1 -2" "I -3 ".
Job no.: Job site address: / 352 51A) bU 100HP or more, occupancy.
❑Six or more residential units. ❑ Recreauomal vehicle parks.
City /State /ZIP: ❑ Health - care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt.no.: I Project name: Vae an( a.-, 0 Semite or feedr 600 amps or more
J� n' 15'i:1; *kid] It td] lj ka ; �u° '� tit° {i,':.m, )� t.
Cross street/directions to job site: oe.r.aanoa Qty. F . Total •
New residential single- or multi- family dwelllug unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 145.15 I 4
Tax map/parcel no.: Ea. add'1 500 sq. ft. or portion 33.40 1
^t a .-0 411 P' l it M r i r mx v w rtxtrt Limited energy, residential
' F:b.. i li .: q . t m`511,�, , (' . ijl It rA ' ,ilhiIjiatird) itiii`ct'r,1 c . -L :; : ith bove sq. ft') 75.00 2
A • Sexy V o Limi (w ted a ener mtilt fam 75.00 2
J e V 02._ Y O-C&f cuy residential (with above sq. 8.)
Services or feeders insfaUation, alteration, and /or relocation
141.4,1',•1 . m1 1 kl ,W ' m�, a w 1lllt ,;71.' . ' l €s€ c M: ii amps or less - 80 i (00.60 0 2
i aa€ ` i t '. 11' u ,,, � r i ' t lCri,�°: '1` -a1ii% .ti it ii, 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 16Q60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City/State /ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) I Fax: ( ) 200 amps or less I 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 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Branch circuits- new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
,,t ?: �� rt rca t lit` - :' ;r as d 1 , :� t tl t , Il. ab fee,
t ��,r, „ u r ( i: t§r � testa a,. 1 - .t, each ove branch service circuit or feeder t O 6.65 /_l f o 2
Business name: Johansen Electric Inc. B. Fee for branch circuits �
Contact name: Charlynn Leifsen withou service or feeder fee, 46.85 2
first branch circuit
Address: 10948 SE Valley View Terrace Each add'! branch circuit 6.65 2
Miscellaneous (service or feeder not included)
- City /State/ZIP: Happy Valley, OR 97086 Each manufactured or modular 2
dwelling, service and/or feeder
Phone: (503) 698 -3417 Fax: : (503) 698 -2486 Reconnect only 66.85 2
E-mail: johansenelect@msn.com Pump or irrigation circle 53.40 2
,iY,q �, - try�1l�9g�
' 6�t t1�€ i a l�ErI o" l' -'l , 1 t 21., :t ;i?, Si or outline lighting 53.40 2
Business name: Johansen Electric Inc. Signal circuits) or limited -
energy panel, alteration, or
Address: 10948 SE Valley View Terrace extension. Describe: Page 2 2
City /State /ZIP: Happy Valley, OR 97086 Each additional inspection over allowable in any of the above
Per inspection 1 62.50
Phone: (503) 698-3417 [Fax: (503) 698 -2486 Investigation per hour (1 hr rain) 62.50
CCB Lie.: 51539 I Electrical Lie.: 3-243C � f � Suprv. Lie.: 2053S Industrial plant per hour 73.75
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Suprv. Electrician signature, required: m r��/ Subtotal: 2,22,2?-7 Z , i d
Print name: Carl K. Johansen Date: (a 1 z,1 a n Plan review (25% of permit fee):
V State surcharge (12% of permit fee): 2 • Z,C
Authorized signature: LK ______.„--------'--_______ TOTAL PERMIT FEE: 25 /0,35
Print name: Charlynn J. Leifsen Date: r _ i 17,109 This permit a pplicadoa expires if a permit is not obtained within 180
Lo V days after it has been accepted as complete.
• Number of inspections allowed per permit.
t: 03u0dtagl ?ermitslELC- PermitApp.dne 05/23/06 440 WEB
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