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Permit CITY OF TIGARD ELECTRICAL PERMIT 111 COMMUNITY DEVELOPMENT Permit #: ELC2012 -00040 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/26/2012 Parcel: 2S113AC00103 Jurisdiction: TIGARD Site address: 7228 SW DURHAM RD, STE# 800 Project: Spec Space Subdivision: COUNCIL VIEW ACRES (LOTS 21 -44) Lot: 25 -27,2: Project Description: 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 4 crt Branch Circuits wo /Purchase 01/26/2012 $78.44 Specifics: Service or Feeder 1 ea 12% State Surcharge - 01/26/2012 $9.41 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $87.85 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 Issued By • _ > Perniittee Signature: ✓/. �.r� 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. . Electrical Permit Application) • , -cot t,r]• �( r: 1'Sl'. ()I. City of Tigard • 1 ,11 13125 SW Hall Blvd., Tigard, OR 97223 I Phone: 503.639.4171 Fix: 503.598,1960 '�• i 1 , , is I ; Internet www tigatd or g Inspection Line: 503,G39,A175 _ e 2 f See Page ov Supplemental 2 for ronnatton � u .'.: fl ll '' �'�'', t =•o 7•aa .j :Y , ' ; ' 72 (;A ; ', ,, / { °''� '! 'r ■� 1 e �, � � ! y" "? lA;;; r„ ` 1 ` ' �, „ ? `' „rn rAJ, El Now construction ® Addition /alt+ anon/ tent 1 r Hem check all that apply (submit I seta of plans w /items chookod below); x 54 , r ' v P., 0 Service or feeder 400 slaps or more ❑ Building over three stories, 0 Demolition ❑Other L�` . t V where the available fault current ❑ Marinas and boatyards. .,:! s. 1 r t' ,4.* t. +h h't,; . `xr'” . . ' Y;o o, t " y .' a � Y • , s �, 'i " exceeds 10,000 amps ut 150 volts or a Floating buildings, .M ' less to ground, or exceeds 14,000 ❑ Conlmeroini -ura agricultural ❑ 1- and 2- family dwelling ® Commereiallindusttii� \ N) Acccssoty building amps for all other installations. buildings. ❑ Multi - family 0 Master builder b/ ❑ Other: 0 Fin) pomp in Installation of 75 KVA or r r„ ri' ;a.'^ :a . i ' t: x El Emergency system. larger separately derived ryx (OM . ib'��:fJ1'.,�ARiNV: ° •"C;�Y'.i!.:, �s',7�,r „ y ..,r 7`; ,�y� y. �,r( ”. t��� r P�.,a✓' -�: ,v „!I� ,,,����; - �S >r� .,_ ;'�,� Addition „New mot,x hum' of 0 "E-, ,.1_2., -1.1", Job no.: Job site O 7 2 2 8 S W Durham dress: 10 a armors residential units, ❑ Recreational vehicle parks. City /State/ZIP: - ❑ SIx ❑ Htlalth• facilities. ❑ Supply voltage for mote than 0 Hazardous locations, 600 volts nominal. Suite/bldg. /apt.no.:e I Project name: Vacancy ❑ Service or feeder 600ampaormore. Cross street/directions to job site: , ' Des c r i ptio n �i�,: 1 11 r I Qty Fee •retal I • New residential single -or mold- faintly dwelling unit. Includes attached garage, Subdivision: I Lot no.: 1 , 0 0 0 sq . t1 . or less 168.54 4 Ea, add'I 500 sq. ft. or portion 33.92 � 1 Tax map /parcel no.: Limited energy. residential a. 9 ,P .,., ) t al y� t ^""'� x18�.(t • �. J ' 1 , r'l' (with above gel, ft,) 75.00 2 Limited rnnrgy, muhi•furnily 75,00 2 Lighting work residential (with above sq. ft.) Services nr feeders inatallatlon, alteration, and/or relocation y�.y�. '* aM 200 amps or loss 100.70 2 A'r�r r a .,,Y.�°A* a�" n , ,ir,, v 201 amps to400 amps 133.56 2 401 amps to 600 limps 200.34 2 Nang ©' 601 amps to 1.000 amps 301.04 2 Address; over 1,000 snips or volts 552.26 2 City/State/ZIP: Temporary services or feeders installation, alteration, and/or Y 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 to 400 amps 168.54 2 intended for sale, louse, rant, or exchange, according to ORS 447, 449, 670, and 701, Branch circuits —new, alteration, or extension, Her panel Owner signature: Date: A. Fee for branch circuits with xw r abo service or feeder fee, ry / �+ ' ' ,... :��! � ` a. � T" � .. ���''���� "t hy each bnmoh oiniuit 7.42 2 Rosiness name: Johansen Electric B . Fee for branch circuits without service or tender fan, first 1 56.18 5!0 .IS 2 on Ctact name: Charlynn Le i f sen branch circuit w Each +uld'I branch circuit .. , 7,42 ;z.Z, 7e, 2 Address; 10948 SE Valley View Terr Mlscellaneoua (service or feeder not tncluded) Each manufdetured or modular City/State/ZIP: Happy Valley, OR 97086 dwelling, %ervice and /or feeder 67,84 2 Phone: (5 0 3) 698-3417 I Fax: ; (O3) 698-2486 Reconnect only 67,84 2 Pump or irrigation oimin 67.84 2 1w >11A11 r o utline (,7 84 2 r . z , r , 5t� , i, r v,,,i , c ,rr S o lighting . i ,. •i:w;:a`a , ,t, ±' s ; r : r 3 , , , y Signal circuit(s) or limited- energy a.' lit, t ^ „S�a, -�,.' .'(,, ': ^'t, � . business name: Johansen Electric panel, alteration, oroxtan Pao 2 Each additional Inspection over allowable In an,y of the above Address: 10948 SE Valley View Terr Additional inspection (I hr min) 66,25/ hr City /Stale /ZIP: Happy Valle OR 97086 investigufir +n (I hr min) 66,25! hr ppy + Industrial plant (1 hr min) 78,18 / hr Phone: (503) 698-3417 I Fax: (5 0 3) 6 9 8 - 24 8 6 inxpoctinn a for which no fee is 90 00/ hr a.vei icall listed S++ hr min) CCB Lic•: 51539 I Electrical Lic.: 3 -24 3 C Suprv. Lie.: 2 053 S ; „ " "" J ” a 5 I , slit,, , , Subtotal C Suprv_ Electrician signature, required: , ,,ar..,, Plan review (25% ofltennit fcc): Print name: Carl Johansen ` Date; 1 / 24 / 12 State anrah�tr a (12% �r permit fee): � . y / (:)/1----7—k------ TOTAL PERMIT FEE: 537 _135 Authorized signature; 'lets Ferntlt application expires Ira permit Is not obtained within 180 days after It has been accepted as complete. Print name; Chan l ynla Le i f s en Date: 1 /2 4 / 12 • Number of inspections Mimed per pulpit. 7 nui1ding1Permit ? e- PermitApp.doc 07/01 /10 440- 461.5 1/05/COMNJRn Z IT "3911d 98I 69E09 987Z869CO9 'Darla NaSMVHOr rid 99 =Z0 ZTOZ•VZ'uur