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Permit CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2O11 -00706 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/16/2011 Parcel: 2S113AC00101 Jurisdiction: Tigard Site address: 16655 SW 72ND AVE 800 Project: Copytronix Subdivision: COUNCIL VIEW ACRES (LOTS 21 -44) Lot: 37 Project Description: (3) branch circuits for office addition. Contractor: JOHANSEN ELECTRIC INC Owner: PACIFIC REALTY ASSOCIATES LP 10948 SE VALLEY VIEW TERR ATTN: N PIVEN HAPPY VALLEY, OR 97086 15350 SE SEQUOIA PKWY #300 PORTLAND, OR 97224 P PHONE: 503 - 624 -6300 PHONE: 503 - 698 -3417 FAX: 503 - 698 -2486 FEES Quantity Description Date Amount 3 crt Branch Circuits wo /Purchase 12/16/2011 $71.02 Specifics: Service or Feeder 1 ea 12% State Surcharge - 12/16/2011 $8.52 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $79.54 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 . - •r•ance with - •= oved 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. A NTION: Oregon law :quires •u to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -O8 -0010 throw. OAR 952 - 001 -00! :. You obt -in a copy of the rules or direbt questions to OUNC by call.ea " •87 or 1.800.332.2344. • Issued By: / 0- Permittee Signat ' a < dee /�� 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' ` .e ,4/ Date: r i -�� /t=om 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. Electrical Permit Application„ C� tiro t►htl( l: 1 .si.: 0.1., \1.1 'City of Tigard 0 °' �N r 1 c\11 ���i Permit No,; 4 --, e , ,„ -b2 ,� 13125 SW Hail Blvd., Tigard, OR 97223 16 . ' I Phone: 503.639.4171 Fax 503.598.19651 -�- P i r , ,, u. t , Inspection Line; 503.639 4175 \.) GA\-- 0 'o , . 10 thr see Page 2 rot Internet: www- tigard- cr.guv 1 � , , supplemental Information v t ;,, r . 1 f 1 1 r ^� / . v,, + , . r•.. v r , ( J ,,, 1 , ,'i, ;i • ".r ' l r,id + .� ,v ,l I �. -, r �i Aiat3la ��I � 1 ''� s , . J,,,, r � ,c' „� � +.> A ,�,� va �PP, u c a� tx ':i �, t v Y' .. New c o nstruction caw t heo�C all tat app y (au. m t . sets o' p arts w/ tans cc c , now), 1 ❑ El Additi on/alterarr' epl R Service or feeder 400 amps or more 0 Building over three stories, 0 Demolition ❑ Other: where tho available fault current 17 Marinas find boatyards. •.r. ;.+a = ., .: i1A "; • ,' F ,,Till .,e, 6} 4+ y ,,, s 1 ; ;:'i ° t.h( '.7,7F,V.'; i exceeds 10,000 amps al 150 VOItS Of ❑ Floating buildings. �i `., : , ,t t: t �„ `dY • `,, T W14 'Jr; P, ' . less be ground, or exceeds 14.000 0 Colnnrcrsial -use agricultural ❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Aceessory building amps for all other installations. buildings, ❑ Multi-family El Master builder ❑ Other: [] giro pump. R Installation of 75 IKVA or ,I !F';, •'r'.d;St.ii.' 1: 1,,cr.,;`;4104"-7,;'"'"+:r x : y :, ;: ,.' ;!!. 7 ..,., N• ;>r ..;rMwv:;r ^ R G'anargcncysystem, larger separately derivtxlsystem. G�4 P fY NI I' , 1 ,I I Va `- 1 S \ 4 v f u 1 w :,;..• -,i, • , RAddlhonOf'nOWmororloadof' ©.. ..E„ ,. -2 .. ,. Job no.: Job site address; lOOHPor eecupaney. 16 6 5 5 SW 7 2n [] Six or more residential unite. 0 Reernaliunal vehicle parka, City /Statc /ZIP: ❑ Health-care facilities. ID Supply voltage for more than Ca lie/Arhus locations. 600 volts nominal. Suite/bldg. /apt, no.: 8 0 0 Project name: Copytronix ron ix Ca Service or fbcdcr 600 amps ar ml.nw. Cross street/directions to job sits: Awcr � " Yee. ,r, y ma '.1 New residential single- or multi- farnily dwelling unit Includes attached garage, Subdivision: I Lot no.: 1,000 sq. ft. or less 168.54 4 F:u. udd'I 500 sq. ft. or portion 33.92 I Tax map /parcel no.: , Limited energy, residential 75.00 2 ! N' j ,. + ! •,' .Oji,'.' r 't. a*0 "►M l�� *W; , (with above sq. ft.) Limited energy. multi - family 75.00 2 office addition residentinl (with above sq. ft.) Services or feeders Installation, alteration, and/or relocation c y� y{ 200 amps or less 100.70 2 ,l;: � J r ' i:,' 'ARM 1f 'I n�i . ; , 5 , . r '� r ;;:r S 1 , . .: 'l"'1 � � r .1 , ? ,t 201 amps IP 400 amps 133.56 2 Name: 401 amps to 600 amps 200.34 2 . 601 amps to 1,000 amps 301.04 2 Address: - Over 1,000 amps or v0Itt $52.26 2 mpor ry services ur (coders installation, alteration, and/or City/Statc/ZIP: relocation Phone: ( ) I Fax'• ( ) 200 amps or less 59.36 1 201 amps to 400 amps 1 125.08 I 2 Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2 intended for salt, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits —new, alteration, or extension, per panel Owner signature: , 7 Date: A, Fee for branch circuits with A ' .1 22 .. , , , . • : • ... ' :!4',„'i.. ; 7��"wosii ..i . i t • :;,Q ., .7. above service or fender foe, 7.42 2 wlM .t m+r> eseh brunch circuit . , Ausi Johansen Electric B.1,5afor branchcircuits without totviee dsr fog, first 1 se,it 56.18 2 Contact name: Charlynn Leif s en braneh circuit Each add'I branch circuit 7.42 ° ' , 2 Address: 10948 SE Valley View Terr Miscellaneous (service or feeder not included) Valle OR 9 7 0 8 6 Each manufnulurnd or modular 67.34 2 City /State/ZIP: Happy y dwellin: service and /or feeder Phone: (503) 698 -3417 I Fax: : (503) 698 -2486 Reeenaect 67,84 2 Pump or irrigation circle 67 - 2 E •mail „ 2 ., i 1, . , V/ ( F, i> \ w r',, • . r ? + ..r , lent " r ', , lighting 67. , ,� Sign or outline 1»n :7 .r ; ,, a . <,,. r,.. 47 . . , ,,:e.. I '. > : , •.. Si circuit or lintited.ener I3usines8name: Johansen Electric panel, alteration, ._ Peoo2 _ 2 Each additional inspection over allowable in any of the above Address: 10948 SE Valley View Terr Additional inspection (1hr 6625/ hr City /Stato/ZIP: Happy Va11e hnvesligulioa(Ihrmin) 66.25/ hr ppy y OP. 9 7 0 $ 6 Industrial plant (1 hr min) 78.18/ hr Phone: (503) 698 -3417 Fax: (503) 698 -2486 Inspeclion for which no fee is 90,00/ hr s.ccificali listed 44 hr min CCB Lie.: 51539 Electrical Lie.: 3 — 24 3 C Suprv. Lie.: 2 0 5 3 S s::'"..... • ;,; ;� ,#r"" fry t ''t'% i`,', Subtotal: 1. 02 Suprv. ElcctriCian /J Signature, required: ( �,,. A , 4 � ,,,/,,, f4., Plan review (25 "/n of permit fee): Print name: Carl Johansen t_ c , D ato: 12/16/11 , state s urcharge (12% of permit t'oo); 8 . 5 2 (7/0./L_____ , TOTAL PERMIT EMI: 79 . 54 � J Authorized signature; te r, .' This permit application expires It a permit is not obtained within 180 2( A / rtayx after It has been accepted as complete, Print name'. Charlynn Leif lien Date: 12/16/11 • Number of inspections allowed per permit. I: V: luildin8WerminVSLC- I'armrA0040c 078X/10 440.4415T(I I /O5/COM/Wfslt Z /T 'HOVd 98tZ869COS 98VZ869E0S SCH'IE NaSNVHOf WV Sb :TT TTOZ'9T'0ea