Permit q CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2011 -00650
T ARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/17/2011
Parcel: 2S112AD01000
Jurisdiction: Tigard
Site address: 7007 SW CARDINAL LN 185
Project: Cricket Communications Subdivision: PACIFIC CORPORATE CENTER Lot: 1
Project Description: TI
Contractor: JOHANSEN ELECTRIC INC Owner: PACIFIC REALTY ASSOCIATES LP
10948 SE VALLEY VIEW TERR ATTN: N PIVEN
HAPPY VALLEY, OR 97086 15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 698 -3417 PHONE:
FAX: 503 - 698 -2486
FEES
Quantity Description Date Amount
6 crt Branch Circuits wo /Purchase 11/17/2011 $93.28
Specifics: Service or Feeder
1 ea 12% State Surcharge - 11/17/2011 $11.19
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $104.47
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 -0090. You may ob - • • • the rules - ct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: i_ _ _ r Permittee Signature:
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 •
,
Electrical Permit Application NOV 1 7 2011 . FoR ofFici: I
L ci Tigard rr:)Eiv61
ty o ' Milir;W ' "'.
"j . / , Of I.—
, _.-- v i 1 3125 SW Heft BlVd., Tigard, OR 9 01 OF TIGARD ow l Penni!. NO. _
,. .
11 ' 0 1 v . Phone: 503.63 9.41 71 Fax: 503BUI ' ■•O ING DIVISION IBEGIUM111111111 Other Permit: ft4 ,,,, n — eir) 23
, , ,,,, , , , ., Inspection Line; 503.63 9.4175 Data Id'/J3" LMill El See Page 2 fisr
Internet; www.tigard-or.gov Notified/Method: Supplemental Inforrreitbm
' 01:0: / /,' ''' .:M7.,,L % ,,,.L,....,,, * , a , d .010 '' 4. ' !.' ' I'' : ■ : ■' :'' 'Z:' : 1, , N.: 1 2) i ,14000k0i ,: ,.. !4 . ', W Y ■'; '. ; ;.: :; :',:
MOM check all that apply (slihnitt 2 sets of plans whims cnocked belOw) '
0 New construction 17 Addition/alteration/replacement
0 Service or feeder 400 amps Or More 0 Building over three stories,
El Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
, ,4 A a,; ,, i • ,, ,..: , ;• - • 1 . ,, execute 10,000 amps at 150 volts or 0 Flostiog buildings.
, .'......,:., .,- k. . . '. ..,,, . , -., • '",:l'.'''v;:'';:.'Y ',i'Le' ' ItAti to ground, or exceeds 14,000 ID commorciatuse sermuiturni
El 1- and 2-family dwelling is Commercial/industrial 0 Accessory building amps for all other installations. buildings.
0 Multi-family El Master builder El Other: 0 Fire pump. El Installation of 75 KVA or
,..,7 Et Emergency system, larger separately derived system,
'' ' . 0.N,;,;''',V, ' '., , ,' ,',00 . 01 . 4 1 116‘ '' ' " '''' ' '1 140 ' 4 ' \'"\ 41)': ;•40, . X. ili...1 0 Addition of now motor load of 0
100HP or more.
Job no. Job site address' 7007 SW Cardinal n Six or more residential units. 0 Recreational vehicle parks.
City/State/Z1P: El Health-cars theiltiles. 0 Supply voltage for more than
0 Hazardous locations, 600 volts nominal.
Suite/bldg./apt. no,: 185 Project name: Cricket Communication 171 senicta or anws7, Til ,.,,,
r.gi'..14E,'.::,'!..;i1*'1:0',!;:..
Cross street/directions to job site: Description 1 Qty. I Nto. I Total I •
- 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' I 500 Sq. ft. or portion 33.92 1
Tax map/parcel no,: Limited energy, residential
. . . . . .. . .. 75.00
4 ' ::1 C1' : ?:■ : :' : :•00000.# 4 : 04 P•*.0 . d . . (with above ac t' ft
Limited energy, multi-family
75,00 2
Tenant Improvement residential (with abovo sq. ft.) _
- services or feeders installation,alteration, and/or relocation
200 amps or less 100,70 2
• , , 4ka , - . 4 ,, :: :zil 2 01 am s to 400 am s
. n;:• , ," d L d T' IV !;,. 4 . .0.00000,....ialnal , 1 ':,'N':!!!? r ,.'. ., ' 01 .'' , ': H 2 amps ... 133.56 2
401 amps to 600 amps 200.34 2
Name: 2 '.
. ... 601 amps to 1,000 amps 301.04
- .
Address: Over 1,000 moos or volts 552.26 2
.. - Temporary services or feeders installation, alteration, and/or
Cily/State/ZIP: relocation _
Phone: ( ) I Fax: ( ) 200 amps or less 59.36 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 amps 168 .54 2
intended for sal; lease, rent, or exchange, according to ORS 447, 449, 670, and 701, amps to 599
Branch circuits- new, alteration, or extension per panel
Owner signature: Date: A. Fee for branch circuits with
.-------
I .•: 4 ,. ,,: . ,: z, : ceot it ; d si i i o. , : g, :: above servive feeder fee, 7,42 2
' . -. ...
R. Fee for branch circuits without
BusMcssname; Johansen Electric
...A..11.d.rtmtiN 1 $6.1856.18 2
Conteetname: Charlynn Leif sen . branch circuit
Each add'l branch circuit 5 7.42 37.10 2
_...... .
Address: 10948 SE Valley View Terr Miscellaneous (smite or feeder not included)
Each manufactured or modular 67.84 2
City/State/ZIP: Happy Valley, OR 97086 dwelling, service and/Or feeder
Phone: ( 5 0 3) 698-3417 I Fax: : (503) 698-2486 Reconnect. only _ 67.84
2
• , Pump or irrigation circle 67.84 2
E-mail:
_ ., _ Sign or outline lighting 67.84 2
.! ;. '; : 7':. j Y;j":`::,!N: gipul eirouit(s) or limited-energy ' --
prinol, ultomtion extemaion. _ Page 2 2
Business numb; Johansen Electric
....„ Each additional Inspection over allowable hi any of the above
Address: 10948 SE Valley View Terr Additional inspection (1 hr min) . .
. Investigation (1 hr mitt) 6 6 6 6: 2 2 5 5 / / hr
r
City/State/ZIP: H Valley, OR 97086 .,
Industrial plant Cl hr min) 78.18/ hr
Phone: (503) 698-3417 Pax: ( 503) 698-2486 inspetions for which no fee is
90.00/ hr
a ■ =aka!! listed 1/2 hr min
CCB Lic.: 51539 [Electrical Lic.: 3 C I Suprv. Lie.; 2053 , ,',':'.::::;.";i, ',': Yir '
Subtotal: 9 . :
Suprv. Electrician signature, required: ar A" ' - -
Plan review (25% of permit fee): ..
Priffiname Carl 0 ans en Date: 11/17/11 , State surcharge (12% of permit foe). 11 . 19
TOTAL PERMIT l'Id: 104.47
Authorized signature: ----"'.. This permit appticanon expires if a permit Is not obtained within 180
.. .
days atter It has been accepkd an complete.
Print name; Charlynn Lei. sen Date; 11/17/11 * Number of inspections allowed per permit.
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