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Permit
/io/ /2p pert to • c- li7)a / CITY OF TIGARD ELECTRICAL PERMIT t ;. COMMUNITY DEVELOPMENT Permit #: ELC2012 -00025 TIGAR.D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/18/2012 Parcel: 2S113AA01000 Jurisdiction: Tigard Site address: 16578 SW 72ND AVE B9 Project: Spec Space Subdivision: ROSEWOOD ACRE TRACTS Lot: PTS C,C Project Description: Electrical for TI. 2/10/12, REPRINTED permit to include additional electrical. Contractor: JOHANSEN ELECTRIC INC Owner: PACIFIC REALTY ASSOCIATES 10948 SE VALLEY VIEW TERR ATTN: N PIVEN HAPPY VALLEY, OR 97086 15350 SE SEQUOIA PKWY #300 PORTLAND, OR 97224 PHONE: 503 - 698 -3417 PHONE: FAX: 503 - 698 -2486 FEES Quantity Description Date Amount 1 ea Services or Feeders - 200 01/18/2012 $100.70 Specifics: amps or less 12 crt Branch Circuits w /Purchase 01/18/2012 $89.04 Type of Use: COM Service or Feeder Class of Work: ALT 1 ea 12% State Surcharge - 01/18/2012 $22.77 Electrical Type of Const: 1 ea Services or Feeders - 200 02/10/2012 $100.70 Occupancy Grp: amps or less 4 crt Branch Circuits w /Purchase 02/10/2012 $29.68 Service or Feeder 16 12% State Surcharge - 02/10/2012 $15.65 Electrical Total $358.54 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 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 obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800 332.2344. gib Issued By: / ,:a Permittee Signature: i= A MEN 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. q CITY OF TIGARD ELECTRICAL PERMIT ` COMMUNITY DEVELOPMENT Permit #: ELC2012 -00025 TIGAR.D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/18/2012 Parcel: 2S113AA01000 Jurisdiction: Tigard Site address: 16578 SW 72ND AVE B9 Project: Spec Space Subdivision: ROSEWOOD ACRE TRACTS Lot: PTS C,C Project Description: Electrical for TI. Contractor: JOHANSEN ELECTRIC INC Owner: PACIFIC REALTY ASSOCIATES 10948 SE VALLEY VIEW TERR ATTN: N PIVEN HAPPY VALLEY, OR 97086 15350 SE SEQUOIA PKWY #300 PORTLAND, OR 97224 PHONE: 503 - 698 -3417 PHONE: FAX: 503 - 698 -2486 FEES Quantity Description Date Amount 1 ea Services or Feeders - 200 01/18/2012 $100.70 Specifics: amps or less 12 crt Branch Circuits w /Purchase 01/18/2012 $89.04 Type of Use: COM Service or Feeder Class of Work: ALT 1 ea 12% State Surcharge - 01/18/2012 $22.77 Electrical Type of Const: Occupancy Grp: Total $212.51 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 obtain a copy e rules or di ect questions to OUNC by calling 503.232.1987 or 1.800.332.2344. ti NOW Issued By: Permittee Signature: /j . 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. ** *PLEASE ADD TO PERMIT ELC2012- 00025 * ** Electrical Permit A licat o , OR 1UI I I(,''. t tie: ()N,,1. pp �, City I L " Raccived n City t) Tigard Datn/R : i/ » 13125 SW Hall Blvd., Tigard, OR 972,2; ' Phone: 503,639,4171 Fax: 503.5953•'1 t: — 9 2012 ottor Pcrmit: Inspection Tine: 503.639.4175 ce l'atie 2 for Internet; www.tigard-or.gov 1 Supptv l lntbrmatien I } ". Oki.; '.) al oV ` i. � ., Y, 'A1LAr1 ii; "' �^^w] t New construction El Addition /alteration/replacement Please cheer all and apply (submit 2 sets of plans w /{legs checked below): CI Service or feeder 400 amps M' more ❑ Building over three stories, Demolition ❑ Other: where the available fault =tent ❑ Marinas anti boatyards. , ` • t I A ; ' exceeds 10,000 amps at 150 volts or 0 Pleating builtlings- •' ; , " loss to ground, or nxcnndx 14,000 ❑ Commercial -use agricultural Q 1- and 2- family dwelling ilti Commercial /industrial ❑ Accessory building • amps thrall other installations. buildings, © m b ,r. ` Li Fire pump. Q Installatiot, n1'73 KVA or Multi - family Master builder Other, ;,t,S t, i5 ❑ Emergency apical. larger separately derived system " ti " 1 iiii4 1 ,Ltark . ,i T : ' y ; .: , . ❑ Addition anew motor load of in "A". "F" "1 -2" "1.3 ", Job no.: I Job site address: 100HP or more, occupancy 16 5 7 8 S W 7 2nd CI Six or more residential units. ❑ Revreninnial vehicle parka, City /State /ZIP: 0 Health -care facilities, ❑ Supply voltage for morn lhnu CI 1 iaxardoua locations, 600 volts nominal. ❑ Service Suite/bldg. /apt. no,: I Project name: a or fa ss der 600 mu or moss. C ross street/dire to job site: rn�,ertpoe ' Cross ; , . . ,. . n 'ft' Res, Tnwl _ New residential single- or multi-family dwelling unit, _ Includes attached garage. Subdivision: Lot no,: 1,000 sq. ft, or toss 164.54 _ 4 - — - -. lie. add'I Soo sq. ft. or portion 33.92 1 Tax map /parcel no.: Elated energy, rnsidnutiai 75.00 2 '. ,:, .. * IQ$ Q . Wizi : . ... " (with above sq. ti,) . l,irnitcd energy, multi - family 75.00 2 Add to permit #ELC2012 -00025 residential (with abeves4. Services or feeders installation, alteration, and /or relocation 200 amps or less / 100.70 /�+ 7() 2 J, T t , - 201 amps to 4110 maps 133.56 2 1iC'R`1> IkT It '. . 401 amps to 600 amps 200.34 2 Name: 601 amps to 1,000 maps _ 301.04 2 Address: Over 1,000 amps or volts 552.26 2 City /State /ZIP: Temporary services or feeders Installation, alteration, and/or relocation Phone: ( ) Fax; ( ) 200 amps or less - 1 1 5936 1 201 amps to 400 amps 125.06 2 Owner installation: This installation is being made on property that I own which is not ant amps to 599 amps 168.54 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits - new, alteration, or e5ctens1on, per panel - Owner signature: Date: A. Fen for branch circuits with ,• . — , ,, „ above aervioe Qr fonder Poo, ` ".µi II�i''+�i • . 1 :1 .�' ',P� 1 .,. 7.42 2 Hoch branch circuit , Business name: Johansen Electric B . 1''ee forbrunchcircuits wflhoni service or feeder fee, tits[ - o 5 6 9 8 2 Contact name: Charlynn Leif sen branch circuit Euvh add', branch circuit C 7.42 22 • 2 6 2 t , cog Address: 10948 SE Valley View Terr Miscellaneous (service not included) Each manufactured or modular • 67 2 City /State /ZIP: Happy Valley, OR 97086 dwellin_, service arid /or feeder Phone: (5 0 3) 6 9 8- 3 417 I Fax: : (5 0 3) 698 Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 E - mail: „� Sign or outline lighting 67.84 2 . ,;�,,. �,�ll�,A;y , . «' , • ` ' Si circuits) Of limited - energy . Bu9ittOtis1ame: Johansen Electric anal alteration or extension, Pa,n2 2 Each additional Inspection over allowable in am of the abov Additional inspection (I hr min) 66.25/ hr ' ddi Address, 10948 SE Valley View Terr �° ndust City /State /ZIP: Happy Valley, OR 97086 industri pl ali pl (1 hr min) 78. hr ant (1 he min) 78,11 8 / hr Phone: (5 0 3) 698-3417 Fax; (503) 698-2486 inspections for which no fee is 90.00 / hr specifically listed ('A hr min) CCB Lic.: 51539 Electrical Lic,:3 -243C Suprv. Lie.: 2053 :''(•: .;'''e.. ELi Ri :4e • • i,�: °..cE , : : : :r`;:•,,.';' ? -- Suprv, Electrician signature, required: ,& e Subtotal; r!�_ s!�/ 3(J , 3 r Plan review (25 /,4 of permit too); Print nanrc; C J an sen Date State surcharge (12% of fee): 4 , ' lc', (p5 2/09/12 / t � , TOTAL PERMIT FEE: 80 / 1 1 6 (y Authorized S1glrEtulC; / /G�t % /�/_l_y 'fhla.permft application a4f- a- pctmlt is not it abed within 180 Print atone: Charlynn Leif Ben �" Date: 2/09/12 daysatterit has been accepted as complete. • Number of inspections allowed per pemnt, t:t Duildinemnitnti &l,C- FOnnilApp.dnc 07 /01 /1e 44/- 4015 IItIS/COM/wr,5o Z IT - HSVd 98bZ869COS 98VZ869COS 'DE'Ia NESNVHOf InNd LS:ZO ZTOZ- 60 -qaa • Electrical Permit Application , i FoR oFFici.: 1 SE 0 \Li ' ' 'Itoceived • allEIMIIE City of Tigard , ....-- 4 13125 SW liall,Blvd,, Tigard, OR 97223 ' ' Mona: 503.639,4171 Fax 503.598,1960 1114 JAN 1 7 2012 Elate/B : Plan Review I Date/13 ; Other Permit:" 4)_— c _ 1 2 Ituspeeliun Line: 503,639.4175 Date Ready/By: Jur iv. 61 Sec Page fir Internet: i li,Atin CITY OF TIGA'T www.tigard-or.gov . i 1 Noti1iacliMothix1; ( t fe l2 Surrivownlia Information 5 4:";7;: ":' ',':"ti'''"#.4g ':!!.!...4;';',t,',0 'W:':''; i rktv0A''',i,,"!li4; 0 Now construction al A.ddition/aheration/replacement Please check all that apply (submit 1 sets of plans vt/itemS eheolIed below); 1=1.8orviec or feeder 400 amps or more D Building over three stories. Ei Demolition 0 Other: where tlic available fault current 0 Marinas and boatyards. WtignOtetrjV,iiot?.3;::'1. !,';',.: exceeds 10,000 amps at 150 volts or ID Floating buildings, 01- and 2-family dwelling El Commercial/industrial I:I Accessory building amps for all other installations, buildings, El Multi-family 0 Master builder 0 Other; IZI Fire pump. 0 Insluiintion of 75 KVA or ,.,,. . ,, . ,,..,,• „.• . . .. .. • . .. ,. DEmergeuey system. larger separately derived system ':,::';'?,;;:!'" : i ‘''!!':' : 040010144 ! .!) . °' 1.111.! ..:.!'!:,;!:'! '.!: 0 Addition of new motor load of El "A" "E", "1-r, "1-3", Job no.: Job site address: mit ir a l Z 4 I ) 100111' or more, Occupancy. ID Six or more residential unitsL CI Reeniationsi vehicle parka. City/State/Z1P: 13 Health facilities, 0 Supply voltage fix more than 0 Hazardous locations. 600 volta nominal. Suite/bldg./apt. no,nr Project name: bi et ,.., ID Service or ibcdcr 600 amps or MOM. . , . jC7.17) , : ,..:,A,;,,■;....;,..,; Cross 3n to job site; Dolicrl• Ion to . Fr, Total • New residential tingle- or multi-famibr dwelling unit, Includes attached garage . Subdivision: I Lot no,: 1,000 iii, ft, or less 101.54 4 , Ea. add' I 500 sq ft. or portion 33.92 I Tax map/parcel no,: r.im i led anaigy, residential 75.00 2 giki6W :':::::::,:;:: with above sq. ft) » Limited energy. multi 7540 2 e4 11,11 k _ra ce residential (with above ..e ft.) Services or feeders instanation,alteratlon, and/or relocation 200 amps or less 1 ... 100.70 1 0647 D 2 '17'r .:Z .. 4 7 '1'. ' : 1 ': ■ ! 0 PI AIENtOre ' / .ii,,:; ' i ' . 201 amp to 400 "I'll* — 133.56 2 - N 401 amps to 600 amps 200.34 2 ame; 601 amps to 1,000 attips 301.04 2 Address: Over 1,000 imps or volts 552.26 2 Temporary services or feeders installation, alteration, and/or Ciry/State/Z1P: relocation ' Phone: ( ) Fax; ( ) 200 amps or loss _. . . . – - , 201 amps to 400 amps 125.08 2 Owner installation: This installation is being anode on property that 1 own which is not — o intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 sotps t 590 stops 168_54 2 Branch circuits -now, alteration, or extension, Rer panel Owner signature: Date: A. Fee for branch circuits with . Alt '0 0. 44 11r t:2‘ ; "' .1!‘ ': :. ''''' '2 '::d''' . :'::-..' .! ;!''' 1 . 3 .CI:f^q iW P , . .:' , - - , . ■.- ''.':"?,',. l': each branch oircuit Z 7.42 /e/ , Cy 2 B. Fee tor branch circuits without Uus Johansen Electric M.1 OT flaXIOT fee, Aral 56,18 2 Contact name: Charlynn Leifsen branch circuit _ _ Each add'I branch circuit 7.42 2 Address: 10948 SE Valley View Terr miscellaneous (service or feeder not included) - — Such menufeetunid or modular City/State/ZIP: Happy Valley, OR 97086 dwelling, sorvice mid/or feeder 67.84 2 Phone; ( 503) 698-3417 1Fax: : (503) 698-2486 Reconnect only . ... . . 67.84 2 Pump or irrigation circle 67.84 2 E-mail: : Sign or outline li '' .. ghting 67.84 2 :)Y :',,,,, . Signal .iro„ii(9) or limilvd-an orgy — panel, alteration, or extension. Page 2 2 SligineSS name: Johansen Electric Each additional inspection over allowable in any of the above Address: 10948 SE Valley View Terr Additional inspection (1 hr min) — 66,25/ hr – In vosti gation (I hr min) 66.25/ hr City/State/ZIP: Happy Valley, OR 97086 ., Industrial plant (1 hrynin) 78,18/ hr Phone: (503) 698-3417 I Fax: ( 503) 698-2486 in spnelions for which no fee is 90.00/ hr , SpeeifiCal , ly listed 0 hr mir9 CCB Lie.: 51539 Electrical Lic.: 3-243C I Suprv. Lic.: 2053S ::;,c,v:'i.";t:,;.',,744:40,MitleAll*:,1'.';i..!.-.,!:fl,;,':().' .°74 Suprv. Electrician signature, required AgtE,00 1 09.. e .0--0414.44.." Subtotal: Plan review (25% of permit fee): Print name: Carl Johansen 11612 ,, b at9; ' . 1 1 State surcharge (12% of pennit fee): 22,71 • TOTAL PERMIT FEE: 2 /2 .,51 Authorized signature'h This permit application expires If a permit b not obtained within 1130 ' , days after it has ken accepted its (IMO*. Print name: Char lynn L sen Date: 1 /16/12 • Number of inspections allowed per permit, I: \fluading \ Permits \ TILC-ParmitApp doo 07/01 /10 440-4615TO VW/COM/WEB Z I - ESici 98T7Z869E09 98f/Z869C09 Iparia Naa\WHOf Nd LE:ZO ZTOZ'9I'Lluf