Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2011 -00702
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TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/14/2011
Parcel: 2S112DA00800
Jurisdiction: Tigard
Site address: 15055 SW SEQUOIA PKWY 130
Project: Yecuris Subdivision: PACIFIC CORPORATE CENTER Lot: 2
Project Description: (1) branch circuit for exhaust fan.
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
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PHONE: 503 - 698 -3417
PHONE: 503 - 624 -6300
FAX: 503 - 698 -2486
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo /Purchase 12/14/2011 $56.18
Specifics: Service or Feeder
1 ea 12% State Surcharge - 12/14/2011 $6.74
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $62.92
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 OA: • 2- 001 -0090. You ma o. -'. - • • oft - - • direct questions to OUNC by calling 503.232 1987 or 1.800.332.2344. -
/ 7 , t
Issued By Permittee Signature: -do.
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
Elletrical Permit Application FoR 01:11(1.. I
City of Tigard DEC 1 4 2011
SW Hall Blvd., Tigard, OR 97223
Il Fig1117 .4740:0P. _VIZEIIF __41W_A., -e6 7..
Other Permit:
' ll '
' Phone: 501.639.4171 nix: 50149.8.1NOL
II I uF TIGARD
' Da : :
hos. •
, 1( , A ; i , Butpection Line: 503.639.4175
Internet; www.tigand-or.gov BUILDING DIVISION 12ENEE111
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awn ea a that apply Oattnnti a nab o p ens wi taus o a •., • vw);
0 New construction El Addi lien/alteration/replacement
El Service or feeder 400 amps or more 0 Building over thaw stories,
0 Demolition 0 Other: what the available fault current 0 Marinas ;tad boatyards.
,,,)iNs'41.7 , r.I.AII,W. 1 6a(tIetyItiltiedilitier;•,,,,i,::N ' =Ada 10,000 amps at 150 volts or El Ploasing buildings.
Inca to ground, or exceeds 14,000 DCnmislucctgrtcultural
171 1- and 2-family dwelling El Comincrcial/induStrial Ej Accessory building amps for all other installations, buildings,
0 Multi-family 0 Master builder 0 Other: 0 Fire pump. 1:1 Installation of 75 KVA or
'-' ' ' '''' ” ' '—''' .: '
t.: t , ./.;:st,, A.,,.,v,;■'■ a l'Aborganay system. larger separately derived system.
1 .:';',K,'''z'.1.;M: , •"il , :'4.:kl , i'%:44.**00.::''''' ' I''‘;'*;'':1::'!'''''.:4.4.• 0 Addition an.. load of 1:1"A","E", "I-2'', - 1-3",
. ,.
100HP or toot°. iictoptincy
Job no.: Job site address: 15055 SW Secruoia 0 Six or more residential units, CI Bocroational vehicle parks,
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City/State/ZIP: 0 tielith.eare facilities. 0 Supply voltage for more than
0 Havudous locations. 600 voile nominal.
. .
Suite/bldg./apt. no.: 13 0 1 Project name: Yecuris L3scroo or feeder 600 amps or moro. ,
- ':'. 8 ,'',"- , '':',I.Y,'•:'':':::',';;; '
Cross street/directions to job site nouription oty. N.+. 'total
New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision: 1 Lot no.; 1,000 sq. ft. or less 168.54
. ... 4
, . En., addl 500 sq. ft. or portion 33,92 I
Tax map/parcel no.; , Limited energy, residentiel
° 7500 2
7',• ., „•.-,Y.,:•;..•,• , \ . ••; 4 `.' , ,;:) . .,,v•,;:•-.,•••• , ,: , ,7646411:68,4y1K . *00;,1,p;N:H . :`,,,7 , ,., , , ,; .i7ni . '';''::, ,, (with above sq. lt.)
. i.;:,N;,;!,:•.7 ., ;/;' , •:"...;:..,!:.•;' , :•, , ,t?!•;,.,' ,. L,... . . ... • ....1‘'. • • • - • - - • •,-. ',• - ' Limited energy, multi
73.00 2
Add exhaust fan residential (with above se, ft,)
Services or feeders Installation, oiteration, and/or relocation
200 amps or less 100.70 , 2
- . 7,,, - ' 0 Y ,:;";: ,,■,`'.::,:, .■■.,,; , ,,/,,
i4 1 201 amps to 400 amps 133.56 2
401 amps to 600 oittps 200,34 2
Name: '
601 amps to 1,000 amps 301,04 . 2
Address: Over 1,000 amps or volts 552 26 2
—
Temporary services or feeders tnitaitation, alteration, and/or
City/State/ZIP: relocation
— —
200 Amps
Phone; ( ) j Fax: ( ) r los
S').31; 1
_ o
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 to 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 700.
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date; A. Fee for branch circuits with
..,:.■',..?,,, :.!,' , ,..e .; ,,.."...:'.. ,; ,q;1 4 oi ,;04 , y : .:,:;6,1 . oho v a survice feeder fee,
7.42 2
R. PdC for branch circuits withrna
Business name; Johansen Electric service or fooder fee, first 1 56.1856,18 2
Contact name: Charlynn Leifsen branch circuit
' —
- - Each add'l branch circuit 7,42 2
Address: 10948 SE Vail ey View Terr Miscellaneouttiservice or feeder not Included)
__ ...
Each manufactured or modular 67,84 2
City/Stab/ZIP: Happy valley, OR 97086 t iw e ilit t A, sarvico and/or fcedor .
?bone; ( 5 0 3) 6 9 8 - 3 4 17 I Fax: : (503) 698-2486 Reconnect only 67.84 2
• Pump or irrigatimi circle 67,84 2
E-mail; - - _
. , line lighting 67.84 2
' ' . 4 .- ;''i•:j• . ,k' ,° *?: . 'i : '::'. , ',.' '';',..,', 77 ' . :
''',' ,.4 :Y;u::'.:',A.",' 4 ",''.;.'lg:':','!:Pr:6:;':k`:.;::.,...; Sign or out si m al 6, cuigo . i imited-euergy
panel alteration, or extension. Page 2 2
bisinessimme: Johansen Electric
Each additional Inspection over allowable in any of the abov
Address: 10948 SE Valley View Terr Additional inspeution (I ht min) 66.25/hr
Inveatigaion (1 hr min) 66,25/ hr
City/State/ZIP: Happy Valley, OR 97086
industrial piant (1 hr min) mud hr
Phone: ( 5 0 3) 698-3417 I Fax: ( 503) 698-2486 Inspections for whicb no fee is 90,00/ hr
s.ccificall listed 10 hr min
CCB Lic.; 51539 I Electrical Lie.: 3 -243 C Supra. Lie.: 2 0 53S :l;'':.V 41 771 Mii :2777"
Suprv, Electrician signature, required: C; t, '..,"')-elAW.(14t.A.4,—../ Satetal! 1 8
Flan review (25% of pennit fee):
Y
Date:
Print Ilamc: Carl __ J ne 12/14/11 State surcharge (12% of permit fec); 6.74
_
TOTAL PERMIT 1 62.92
Authorized signature; , —.. This pernMaPpiteation expires if a perrith Is not obtained within WO
• days after it has been accepted
print name: Charlynn Leifsen Date: 12 complete. 12/14/11 . Nddllfdr of impactions allowed pa permit.
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