Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2008 - 00626
COMMUNITY DEVELOPMENT DATE ISSUED: 11/6/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S113AC-00103
SITE ADDRESS: 07244 SW DURHAM RD M500 ZONING: I -P
SUBDIVISION: PACTRUST BUSINESS CENTER LOT : JURISDICTION: TIG
PROJECT: SPEC SPACE
Project Description: Upgrade service.
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: 2 W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 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 HAPPY VALLEY, OR 97086
Phone: Contact #: PRI 503 - 698 -3417
FAX 503 - 698 -2486
FEES
Description Date Amount Reg #: ELE 3 -243C
[ELPRMT] ELC Permit 11/6/2008 $160.60 LIC 51539
[TAX] 12% State 11/6/2008 $32.12 SUP 2053S
Total $192.72 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 more hen 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center.
Those ru s are set forth i • • • 2- 001 -0010 through OAR 952 -001 -0100. You may obtain c• •'-s of these rules or direct questions to OUNC at
503.246 6699 or 1 .800. 234.
Issued 4 . 4 41# i Permittee S ' nature:
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: C ' DATE:
LICENSE NO: l/
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.
.
Electrical Permit Applica>ECEIVED
rul: r1i I I �t cl\I l
City of Tigard Received
Date/ if O r Permit No.: eke
a 13125 SW Hall Blvd., Tigard, OR 97224\1 n V 0 5 / r't - ' i, Plan Review '
a Phone: 503.639.4171 Fax: 503.598.1q%0 Date /B : Other Permit:
T 1, , I 1 Inspection Line: 503.639.4175 CITY OF TIGARI Date Ready/By: H See Page 2 for
Internet: www.tigard No60edVMethod: Supplemental Infonna
Y I
�• 0 _ 9t l i'i - ,bra $•,' i� 'P h T a ir :; 1 1 L u, eve m- . s' 11 `
_ u; : I , .Nili�t x._ ' it I d ; T# X111, "' r , w x �. f ;
❑ New construction ® Addition/alteration/replacement Please check all that apply (submit j sets of plans w /items checked below):
❑Service or feeds 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other:
a a where the available fault current ❑ Marinas and boatyards.
t; it s f s s it 9 t ry a t a , ''5 da : ` exceeds 10,000 am at 150 volts or
r
• ,, i. - La w °>{sr,�utr " -� ,' - - , 1 . i , i , , Ps 10 C o mi ng buildings.
Ell 1- and 2- family dwelling ® Commercial/industrial El Accessory building le ss to mind, or exceeds 14,000 ❑ Co mme r c ial•uae a gri c uirural
amps for a other installations bttildirtgs.
❑ Multi family ❑ Master builder ❑ Other Fire pump. ❑ Installation of 75 KVA or
1 ti a , i . a°w s7 3 ! r , ❑ emergency system. larger separately derived system.
1-141 .. - , �i ,' 't aLm, i; r0eM t. ,,b th' z :: t�Rlh.,,�. %I i. ' u�l �� 2 I
-� � - .- �y ...x�a r f�. ,i ❑ Addition of new motor load of ❑ "A' °g" "1- -3"
Job no.: Job site address: 724 2 SW Durham looHP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: 7 2itlf El Health -care facilities. ❑ Supply voltage for more than
� ��� — ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: 11 0 Project name: " fir — ❑service or feeder 600 amps or more.
:'t I , 4 1' '"r.v� i I - 4 ".1:. " '1,.. y ,.�'� � ,'tt: v!.'
. . 1 a"' , I r t ,
Cross street/directions to job site: o�epa
,;e° 4 h. See. Total •
New residential single- or multi - family dwelling unit
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft o r portion 33.40 1
Tax map /parcel no.: _ Limited energy, residential
pf "�, . 43r. aaleulp Y+ @
O l . x : k " , • f _ . '" l u� i K . , t .EI ""a Al 1 ": T k 7} 75 .00 2
#vQ.ir�ucdc.3r� 4 �.... ,s ��' � ,. i �° . (with above sq, fl. )
Limited energy, multi - family 75.00 2
Upgrade service to vacant space residential (with above fi(,. ft)
Services or feeders installatlo alteration, and /or relocation
a t t ma r w �, . i s i v n� 200 amps or less 2 80,30 16 0 . 02
' it �'8t'' t '' u ' , as ; .; oh :`' ' Hl % r l i 1w#r , ;; Iva. 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 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 66.85 i 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 1 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
�- *� 1nt , L at 1t� , s �.' t A. Fee for branch circuits with
1:,1.t, 7 " u 1.. ; �., Imo " l : # . to 4. above service or feeder fee, 6.65 2
t each branch circuit
Business name: Johansen Electric Inc. B. Fee for branch circuits
Contact name: Charlynn Leifsen without service or feeder fee, 46 85 2
first branch circuit
Address: 10948 SE Valley View Terrace Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State/ZIP: Happy Valley, OR 97086 Each manufactured or modular 90.90 2
dwelling, service and/or feeder
Phone: (503) 698 - 3417 l Fax: : (503) 6984486 Reconnect only 66, 2
E-mail: johansenelect@msn.com Pump or irrigation circle 53.40 2
9
II ni. t c,,�„„( � , 13 is , L" t :+ ;u„ I j +. Sign 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 Terrace extension. Describe Page 2 2
City/State /ZIP: Happy Valley, OR 97086 Each a dditional inspection over allowable in anv of the above
Per inspection 62.50
Phone: (503) 698-3417 Fax: (503) 698 - 2486 - Investigation per hour ( l hr min) 62.50
CCB Lie.: 51539 Electrical Lie.: 3 -243C Suprv. Lie,: 2053S Industrial plant per hour 73.75
i�jk1 � �/ i.: I '11ES � a 11117, 4: 2 iFt hi 1
Suprv. Electrician signature, requii J t /ti Subtotal. s f
Print name: Carl K. Jo sen Date: 11/5 / 0 8 Plan review (25% of permit fee):
State surcharge (12% of permit fee): 32.12
Authorized signature: TOTAL PERMIT FEE: 192 . 72
Print name: Charlynn J. Leifsen Date: 11 / 5 / 0 8 This permit application expires if a permit is not obtained within ISO
days after It has been accepted as complete.
Number of inspections avowed per permit.
1 1 Buildnglperautst5LC- PwmnApp.doc 05/23/06 440.46157(11 /05/COMIWEa
T - d Xd3 13r213S1=11 dH WdBE r T BOO SO AolJ
f
. ,-
,sr Request to Energize an Electrical Installatio RECEIVED
' """ :Ail
NOV 1 0 2008
6 4- CITY OF TIGARD
° x f i,' `f- : _ 3 °(° ice 4 a ::' V.
a€b � .) a 3 B� � #� (—Mai �1P. _. � �.i° � . �� .u: a �� .Y��wua � � � , �t,� .� , _ j °1R�ikr`;{
Name of supervising electrician: (a.r l J t Date of request: 11 1 (p / (5Q,
Supervising electrician's license number: 2...r.) j Date installation was completed: 1 /
Electrical permit no.: 6abO 0Q if a temporary permit is posted at the job site, please include a copy of it with this form.
1 o k �- { 3 -( L` 5 A:k yp,. .g�gr .n�.�u�� '�5�y;,.s,...a`.�'� 1 '
' f , ;i4. , a ¢ 7 1, _ ; �, - a ' LI '�rrKL.�.• L 9 1 G Y .; R 1 g (� _ !n g b g
Name of electrical contractor: J0h.W1. , E1 e_ 'c 1,'L License no.: 3 -2_ 3c
Business address: 1VI 1 4 gcE UnnJI i tit ffA. ,
Cit - app 1 l,pA,1 State: Q�' . ZIP: h,
O
Phone: - (G19 ) - JLJ II Fax: W5 - Vii - 1,Li gc, E -mail: -` Qhck...r Cytc - rititrr n • ccryi
•� #S3a
� r.9
.,. nixs k�a�€ ., r, 1 � a s q u ;-�. .�, , s � s ,F+ , r.'17iR71rA I ��L ' � , +" " :1 kr '�ii� i =1i *;3'N4.tt.;•ifi y ::',,:Wiq4
Customer's name: CTrost
Customer's address: I O Sties) Se994Uni pk4,0t� j QQ
City: +tar cI _ ' State: 012 ZIP: 91 Z2-9
Address of installation if different than customer's address: 1V414 St Divi Ra l 460
City: i State: Oe_ ZIP: 872244
wyili ich =i t.!'diw. t_imotAii: .:.i» ,. idL sp 9 . ' . a , rP1.nv' I 1,! #1 0E4 ,�as.;. 1 d � , `vs
Authority having jurisdiction to inspect: e, I � " M � ar Phone:
) - Io -401
Address: J ?if/5 5u 4- V U"
City: J ($t and State: O fz.. ZIP: 96742:3
A F k� ' la . 7:;i '" }T :. torfi ,,, - . 'L y t .S t 3� '� L,4 ° ._ y 3f 1:! #t, " 1 ;1. �.� �friir . ,�:
� -bra. t �° :"ss., ..__ °SM�.., s ,b- � I. d !
Name of electric utility receiving request: pe E Phone: Do-3 a P - 5 9 S 0
Address: &100 3E- l A
City: PC.1r+ W1C1 c State: QR. ZIP: a'1'2 2-
' @� t I I , ... ky P a1^JS ro � t ^-, q 7 �., S ... f)1 U' >� �n Ik,.?-. k ;i.� � }�i 4 ' 4 F 1 .� 7 4 ( YAA;.
z.� .. ,. , t �.k i�.. n » , & .,. 43�l�k n ,P ' ,�..n a .. ' '-i, _ a ae tJL+..�y,,. , T �� . .<t. a �!�tdJ .., _.
A. Re toring electrical service that was interrupted or disconnected because of either a:
Pr Service change or ❑ Uncontrollable event, such as fire, flood, or severe weather,
or
B. Electrical service at a remote location needs to be:
❑ Initialized ❑ Restored
Supervising electrician Electrical contractor
Note: After sending this form to the electric utility Note: By close of business on the first business day following
named above, you must send a copy of this form to: energizing of a completed installation in response to the above
(1) the electrical contractor, (2) the customer, and request, you must: (1) notify the authority having jurisdiction
(3) the inspecting authority. that the installation has been energized, and (2) request that the
authority inspect the completed installation.
Supervising electrician's signature Date Electric utility
Note: Please consider notifying the inspecting authority
CAa identified in this request when an installation is energized
�� "( /Q{ before inspection. g
F E �Pr1�R TME
IXSE C
440- 0945 -COM (10/08 /COM
T - d XHd 13C21ESd1 dH WdSE : t. BOOZ LO (\oW
CITY OF TIGARD • P
- BUILDING DIVISION PERMIT #: LCZOO$. - 4 2 i
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 ��'� "'F'��4W�yp�glf��''h
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: IL 01 TIME: PAGE:
SITE ADDRESS:12 6 L b ookt" Y 5 OO CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: I 10 .0i Pour Time:
Co. - -- '•n Description Confirm # Contact # Message
tigvq �rAL
Corrections/ o - - ructions:
a PASS I PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
FAIL I j CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ant Me Date: n• 1 • Phone #: (503) 718- 1....41
CITY OF TIGARD - ,..
BUILDING DIVISION PERMIT #: EL C2008-00626
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: i ii&2008
Phone: (503) 639 -4171 -, �r ulpiil�l�� ill ?A
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/7/2008 TIME: 7.02AM PAGE: 12
SITE ADDRESS: 07244 SW DURHAM RD M500 CLASS OF WORK:
SUBDIVISION: PACTRUST BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: SPEC SPACE
DESCRIPTION: Upgrade service.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 03- 69B.3417
Inspection Request Scheduled For: Date: 11/712008 Pour Time:
Code # Inspection Description %.- - Con irm a Contact # Message
i, Electrical service 07782601 503 - 7041534 r
Corrections/Comments/Instructions:
.C k -ETl'a `Tc3 P
FcQ.. wO(LY.. lo f it p60&
orl £E ' ft •
I I PASS X PARTIAL APPROVAL CANCEL NO ACCESS
I FAIL CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: G 1v Q Date: \ l 1 Phone #: (503) 718- L"+it)