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Permit t CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2011 -00721 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/28/2011 Parcel: 2S112DC00100 Jurisdiction: Tigard Site address: 15605 SW 72ND AVE Project: Consumer Cellular Subdivision: PACIFIC TIGARD INDUSTRIAL I Lot: 1 -2 Project Description: TI Contractor: JOHANSEN ELECTRIC INC Owner: PACTRUST 10948 SE VALLEY VIEW TERR 15350 SW SEQUOIA PKWY #300 HAPPY VALLEY, OR 97086 PORTLAND, OR 97224 PHONE: 503 - 698 -3417 PHONE: 503 - 624 -6300 FAX: 503 -698 -2486 FEES Quantity Description Date Amount 50 crt Branch Circuits w /Purchase 12/28/2011 $371.00 Specifics: Service or Feeder 1 ea 12% State Surcharge - 12/28/2011 $68.69 Type of Use: COM Electrical Class of Work: ALT 2 ea Services or Feeders - 200 12/28/2011 $201.40 amps or less Type of Const: Occupancy Grp: Total $641.09 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 0 '52- 001 -0090. You may obtain a copy of the -s or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. ` Issued By: -�i Permittee Signature: _ __ i% L� i �` / 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 DLC 2 7 rttit (coci.' l: .si'"t►.l.i City of Ti and 2011 Received Ir }�■ y Hate/il: CZ/ 1/� .. • 13125 SW Nall Blvd., Tigard, OR 97 s. Phone: 503.639.4171 Fax: 5o3.5989ATY OF TIGARD Other rca"ih i VI i %CJ! — As / . ' ' , , k , .a r r , Inspection Lino: 503.639.4175 BUILDING DIVISION IMEIMMIIII El Set Rage 2 for Internet: www,tigard- or.gov Supptmtwltallnforaturtlon • fr �rv� %' : ; , i > f > . "k` � d � t A t { l ` , '1 r fl, � ,P'L i4 ) 1 l 7 '"' ' 2 •�Y, ti , rr F>". i � l, / : ' ri, r �l�,,.. I �� 1 ., rt - 1 ° ih : " C " t 0 \f t /, t. 'd, , �, 1 < ' ...1 i�1 „f '.f' � :',,. .'� t . ., f.1 ..,.f���l Please ❑ New construction ® Addition /alteration /replacement check all that apply (sow sets of plena Whine cheoknd below); (•3 Service or feeder 400 amps or more 0 fuiidiug over throe stories, ❑ Demolition ❑ Other: where the availahlo fault current ❑ Marinas and boatyards. y ' A'G('i,irj,!.'; j;: . v; 8 e , ;1 . . p u <, , akt ' ;`.�e;; I.':' , n V,(roa;.,Y,.a" exceeds 10,000 amps at 150 volts or El Floating buildings. i c ..., A . ;s: a'i r.... ?, ' : */ !{d l,, A7,: ", 'rte - v1 �' •' i �^ � ='r ^° • lass in grnund, cn axcnarle 14,000 ❑ Commercial -use ago icultural El 1- and 2- family dwelling i Commercial/industtial El Accessory building amps for all other installations. buildings, ❑ Multi- family ❑ Master builder ❑ Other: LI fife pump. 0 Installation of 75 KVA or � {, cif n, wp ❑ Emergency system. Mager separntelY derived systnn. n y f !l ;C ^: r 4 ,t: wf c � „, i . a ( ".Y.; , d' L f % n 0 ddti f new motor 1 ad of ID "A”, "F• '1 -2" "1.3 ", IOOlIP or mom. occupancy. Job no,: Job site address: 15 6 05 ,S W 72nd (] Six or more residential units. ❑ Recreational vehicle parks. City/State/ZIP: 0 Health-care facilities. 0 Supply voltage for more then ❑ Flr ,snlous locations. 600 volts nominal. Suite/bldg, /apt,no,: I Project name: Consumer Cel lular ID Sarvieeor feeder 600 amps ormore. : r. Cross street/directions to job site: fCrMl 1l.EMMIi0 New residential tingle- or multi-family dwelling unit. Includes attached garage. Subdivision: I Lot no.: 1,000 sq. ft. or less - 168,54 EMU En, octet'! S00 sq. ft. or portion 11111 33.92 Emma Tax snap /parcel no.: Limited energy, residential �f :.;tr1F - v; ,. . ;0. n: , ., 7 a ".'.;l� ",.,;.: .,,rd I. 75.00 me %� ^"i �" �� i' �� '� ' �; ., a � 1,�'F� "� ,��1�'r''��� �� 1 `�' '„ S:c � � r � (with II" 'a • R Limited energy, multi - family ■ 5,00 _0 Tenant Improvement residential with above Il' Services or feeders Installation atterat and /or relocation 200 amps or lass Jm 100 201.4 tU ;S t , aa a ,,dr 1." .M )e ' w' Ir\ r ra oar: ; fo r a ra'' 'I ' :. �' t "' /- +i.1 r ,,? 201 amps to to 400ampa r 133.56 —© J 401 snips t 60 tun, i.m� mEm El Noma: 601 amps to 1,000: ps�I 30104 Address: Over 1,000 amps or oats raw 5$2.26 1■111:1I C' /State/ZIP: Temporary services Ilation, alteration, and/or relocation Phone: ( ) J Fax: ( ) - EFENIM 59'36 0 Owner installation: This installation is being made on property that I own which is tint 201 amps l0 400 maps 11- 125.08 B intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps =.11M1111111.13 Branch circuits -new alteration or extension >er renal Owner signature: DatC A. Fee for branch oircuitt with pp� above servi or feeder foe, 5 7 42 :,4:,„,)1..,t r r4a(rria :l .. w / ' n n ; , ,, - ? ' ' : gt z so oath branch c II A. Fee for brunch ciren wflhrnrr Business name: Johansen Electric warvice feeder fee, first . 56.18 -I Contact name: Charlynn Le z f sen branch circuit Each add'! branch circuit - 7.42 EMU Address: 10948 SE Valley View Terr Mi. ceIlanauut service or feeder n clud = Each manufactured or modular City /State /ZIP: Happy Valley, OR 97086 dwell in! service and/orfeear Phone: ( 503) 698 -3417 Fax; : (503) 698 -2486 67.84Q - . rt circle ^ or irrigation c' I e 1111 (7 84 E-mail: ri 6 7.84 or outline lighting n .:r;'y';' `,:a "'C' ""i ;111 :!.U , .,� -� ;•ca .y �.' , ii:i 'w�?,,, - ; �Tp� i �, ..�rr' Sign It 8 1111 —� ,K , � d, rr, d �/, `.F , "J.,,s�, , i'_ (: aI . J § ;I s r�� . ; '. ,"`' 1 Signal uiruui((s)or limited- euorgy MEM PI Business name: Johansen Electric ^ rot, alteration dditi n l . ins extension. Rath additional insoctlon over allowable In an of the abov Address: 10948 SE Valley View Terr Additional inspection (1 hr min) -112MIEEMEI City /Stato/ZIP: Happy Valle OR 97086 66.x8 / hr .1 ppy y r Industrial plan! (t hr min) � 78.18/ hr !'hone: (503) 698-3417 Fax: 0 3) 698-2486 inspections for which no foe la IIII 9000 / ht �. II _ . _ ... a , eciticall listed r,4 hr min) CCB Lie.: 51539 Electrical Lie.: 3 Suprv. Lie.: 2053 S ?(; a "'.�.'�,,, �t r, , f„ = s; ,? ' i � 1 y Subtotal: 572.40 Suprv. Electrician signature, Pa , required: ,r ."K s- ea:sti'4- C••rn -/ Plats review (259'0 of permit fee): Print narne: ate: State sur charg e (12% of penait fee): IIIIIIIIIMEMEMEI Car eta a rise n 12/27 64 Authorized signature: L ..... 71,18 permit application expires If a permit Is not obtained within 180 Print name: Charlynn Le i f s en Date: 12/27/11 * Jap Lion It to p been accepted as complete, of inspections allowed per penal,. 1: lnuadngTermir a\rttc- I'crmllaan,40$ 07/01 ho 440 4515T(11 /r:auw 9 /8 ' cold 98bZ869805 98t86909 IOTIE NSSMV'HOI FN ZS =0T TTOZ'LZ -Des