Permit C ITY O F T I GA1 D ELECTRICAL PERMIT
PERMIT #: ELC2005 -00109
DEVELOPMENT SERVICES DATE ISSUED: 2/24/2005
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S113AC
SITE ADDRESS: 07250 SW DURHAM RD BLDG J -100
SUBDIVISION: COUNCIL VIEW ACRES NO. 2 ZONING. I -P
BLOCK: LOT : 025 JURISDICTION: TIG
Project Description: 12 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: 11 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: 503 - 624 -6300 Phone: 503 -698 -3417
FEES Reg #: LTC 51539
SUP 2053S
Description Date Amount ELE 3 - 243C
[ELPRMT] ELC Permit 2/24/2005 $120.00
[TAX] 8% State Surcharge 2/24/2005 $9.60 REQUIRED ITEMS AND REPORTS
Total $129.60
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 -33 2344.
Issued By:.���� � Permit Signature: l'_ =.
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 639 -4175 by 7:00pm for an inspection the next business day
From Charlynn J. Leifsen To City of Tigard Date' 2/23/2005 Time: 2'20'38 PM Page 2 of 4
Electrica Perml<t APP _ , mit Ol 1.11 I i :`� i,\I.
I Received /
City of Tigard Date/B : _ i P erm it No : - / -Do / r/,
13125 SW Hall Blvd., Tigard, OR 97223 Plan Rcvi
4 ti .ro
Phone: 503.639.4171 Fax: 503.598.1960 � " �, � ' ` I DatdB : Other Permit'
Inspection Line: 503.639.4175 ,.5 ' _ . ∎ Date Ready/By: rude , la See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: 7 Suppkmental Information
T L t
z . ^s 'Y ' � F � ,�'l �i� }� ;. § r � s 2 2 � riy= 'L�.c �.::,,.. _r.;:r S - xE .�,�Y,s, :� � P 1 1l '��sk i, � . r , �l � �''��i,.., :
r r ° :r•: §.. ..1. ' E 3 F'Pt � x e.fs _> tit- t t t
� 's.,.. -,�... a. 2- ,_ ...: ,e. : ;.. :___w.t ta...� i- ��.... _._. .,.. .<... TM�.:�..:. . ;.,�f..S. ;, s...,,s�e;,l,.�. ����' . er� . , , �i
❑ New construction 1.1 • s 1 ■ ' .0 t • rtlti in%rJplae'enient( 0 Please check all that apply:
❑Service over 225 amps, comm'l ['Hazardous location
❑ Demolition ❑ Other
_ ,, 7'-° iilflP ` i #r i ,,� � am. } l,� OService over 32Q amps - rating [] Buildng over 10,000 sq. ft.,
`;, : >' ' . 'I'i ;;ra ; ,, ;.,. ° .. :. <:_ - ? .l .,. k ;k,a. .11 , . . of 1 - and 2- family dwellings 4 or more new residential
❑ I- and 2- family dwelling ® Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
['Building over three stories OFeeders, 400 amps or more
❑ Multi - family ❑Master builder ❑ Other:
ail � � ❑Occupant load over 99 persons ['Manufactured structures or
t't rtif ,may. `: - I r .j , 6.., .•a.;,,. rx�- ,� . r< ��.i i! ❑ Egress/Iighting plan RV park
. T :~
Job no.: Job site address: 7250 SW Durham Rd, 100 ❑Health-care facility ❑Other:
Submit 2 sets of plans with any of the above.
City/State /ZIP. Portland, OR 97224 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: I Project name: Stash Tea , �. ��� s � 1 �� f y p 5
".ii.Xs � n...t:9 ,.,..X:.., 4} .M..� f ,rt'� :. ��ifa��GuSl2
Deaeriptloo Qty. F. Total
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: I Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 l
Limited energy, residential 75.00 2
Tax map /parcel no.:
r ro r,s 1v
Limited energy, non - residential 75.00 2
li"� ' :r1 '��i LiEr tE.4.i,,u,, .. : � 1 � i �, :E, ..., . ..,..Y Each manufactured or modular •
Tenant Improvement dwelling, service and/or feeder _ 90.90 - 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 ' 2
}
AX .� I �fiL.. , th i t i , , ate$ lr?i IT f ,iii¢ ; - s�m� ;43 i 201 amps to 400 amps 106.85 2
`" _ • ;� ��or a i is
i ,i
- 1l. :,_ .r ..;...;E,to : . , ,,,� ... _ ;s.. '�Ar ,<t ur. �4 >.. ..,l'A _ :....... i`>132 401 amps to 600 amps 160.60 2
Name: Pacific Realty Associates 601 amps to 1,000 amps 240.60 2
Address: 15350 SW Sequoia Pkwy, 300 Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City /State /ZIP: Portland, OR 97224 Temporary services or feeders installation, alteration, and/or
Phone: ( 503)624 - 6300 I Fax: ( 503 ) 624 - 7755 relocation
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 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: q Date: {[ Branch circuits - new, alteration, or extension, per panel
H t I - --tfo t ,'- 4 }5} + }Y�3 xi l ' i tit.u3 .• i ,, tiF ' 1¢ i,
`fr =": A Fee for branch circuits with
� ; ., >. ... .1 : -.,,, 2t t.a :I i, rtivz - .. ,..... >_ io _ serv or feeder fee, each
Business name: Johansen Electric Inc. branch circuit 6.65 2
B. Fee for branch circuits
Contact name: Charlynn Leifsen without service or feeder fee,
each branch circuit 1 46.85 46.85 2
Address: 10948 SE Valley View Terr. Each add•t branch circuit 11 6.65 73.15 2
City /State /ZIP: Clackamas, OR 97015 Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( 503 ) 698 - 3417 I Fax: : ( 503 ) 698 - 2486
Sign or outline lighting 53.40 2
E -mail: johansenelectQmsn.com Signal circuit(s) or limited-
; €� E eF f �� "' {-:�2i1`; ; ever Panel, alterauo or
a .. .
__., :w..,. . fR r t,1 r»c.e, ... °... E" !I ?„ : t'✓ x _ ? 42 m ° ns P 4
*'" extension. Describe: Page 2 2
Business name: Johansen Electric Inc.
Address: 10948 SE Valley View Terr. Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State/ZIP: Clackamas, OR 97015 Investigation per hour (1 hr min) 62.50
Phone: (503) 698 -3417 Fax: (503) 698 -2486 Industrial plant per hour 73.75
CCB Lie.: 51539 Electrical Liie.:3 243 Suprv. Lie.: 2053S Subtotal 120.00
Suprv. Electrician signature, required:a/Jr, -2 I� Plan review (25% of permit fee)
Print name: Can K. Johansen Date: 2/23/05 State surcharge (8% of permit fee) 9.60
�
I` TOTAL PERMIT FEE 1 29.6 0
•
Authorized signature: �Y a, 1 M i This permit application expires if a permit is not obtained within 180
J days after it has been accepted as complete
Print name: Charlynn J. Leifse r�� • Date: 2/23/05 Fee methodology set by Tri- County Building _industry Service Board
'• Number of inspections per permit allowed.
1 IBuildmg \Perniu\ELC- PermitAppdoc 12/03 4404615T(10/02ICOMJWFB
CITY-OF TIGARD �..
BUILDING, DIVISION PERMIT #: ELC2005 -00109
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/24/2005
Phone: (503) 639 -4171 Nn�ii u� i I l
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 9/7/2005 TIME: 7•Q8AM PAGE: 123
1
SITE ADDRESS: 07250 SW DURHAM RD BLDG J-100 CLASS OF WORK: ,
SUBDIVISION: PACIFIC BUSINESS CENTER LOT #: 025 TYPE OF USE:
PROJECT NAME: STASH TEA
DESCRIPTION: 12 branch circuits.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: 503..6246300
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503 -690 -3417
Inspection Request Scheduled For: Date: 9/7/2005 Pour Time:
Code # escription Confirm # Contact # Message
199 Electrical fina 01501401 503 - 704 -1534 N '
Corre ' ns /Comme ions:
A O . -- E - L- . 2 a - 21
/ 1„..,'
OA-
91
� PASS ❑ PARTIAL APPROVAL _ CANCEL ❑ NO ACCESS
n FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G • ► " ' 68 L Date: 3/40,S_____ Phone #: (503) 718- 2
i