Permit CITY OF TIGARD ELECTRICAL PERMIT
$ COMMUNITY DEVELOPMENT Permit #: ELC2012 -00178
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/29/2012
Parcel: 2S113AB01201
Jurisdiction: Tigard
Site address: 16260 SW UPPER BOONES FERRY RD
Project: Game Day Subdivision: COUNCIL VIEW ACRES (LOTS 21-44) Lot: 30
Project Description: (1) service and (24) branch circuits.
•
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
PHONE: 503 - 698 -3417 PHONE: 503 - 624 -6300
FAX: 503 - 698 -2486
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 03/29/2012 $100.70
Specifics: amps or less
24 crt Branch Circuits w /Purchase 03/29/2012 $178.08
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 03/29/2012 $33.45
Electrical
Type of Const:
Occupancy Grp:
Total $312.23
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. ATTENTIO . Orego law requires you to follow the rules adopted by the Oregon Utility Notification Center. -Those rules are set forth in OAR
952 - 001 -0010 t ugh OAR 9 -0 - 0. may obtain a copy of the rules or direct questions to OUNC by callin. 51 .1987 or 1.800.332.2344.
Issued By 2 IA 4.f Permittee Signa , �
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' _ ^� J 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.
R ECEIVED
Electrical Permit ADDIIca ion i cm c lrr,i 1: I , I• O\I.1
City of Tigard MAR 2 9 2012 a A9 KetA311 ParmitNM,'. eiCGaova -5V 78
• 13125 SW Hall Blvd., Tigard, 1. 7 Plan xevkw
Phone: 503.639.4171 Fax: 1l TIGARD Dam Review r p '...
inspection ,�ti ; U!LDlNG D1i/iSIQN Noti M thod: SopplerrxMs
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sa r ",,,�rl.�,�. :�r .a' >'EV '.,� s'. � n` :':'� %•, -p••= hr��`r:i ,.r .., �.x @`.:•�. ;�f.'>< .'IFA:.i •;•4.'�� .'���.._ .. .... vre�'•
❑ New construction ® Addition/alteration/replacement Please clock all that apply (submit 2 sets of plane whom checked below):
0 Service or feeder 400 amps or more 0 Building over three stories.
❑ Demolition ❑ Other: where the available fault Garrett 0 Marinas and boatyards.
'!.`-''k .; ' '.. fi ;t{ h .:'01.41 1 °i Xr : ; '' :a 7- ► o -.6. n4 x "r .c,xpi ;J i` pi eeed.a 10,000 amps at 150 volts or 0 Floatingbuildinga.
less to ground, or exceeds 14,000 0 Commercial-ma agriculture,
0 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building amps for all other installations, buildings.
❑ Multi- family ❑ Master builder 0 Other: 0 Fire pump. 0 Installation of 75 KVA or
,. 2 M • r �r r • •. 0 Emergrotey system. largor separately derived xys!Vera V•r;''a.b;W, .x_ i r ., '' . ..D;f iL,,.. !.6 ' s"•r,t . • , ,a e.r'��p�fr1 F: ; > 41,,,' : 0Additlnn ofnowmotortoad or 0 - A ", "E ",'I 2t', "1.3
sip or more. mcupanoy.
Job no.: Job site address:
16 2 6 0 SW VW Opp/PONS O six or mere residential units, 0 Recreational vehicle parks.
City/State/ZIP: [] 11aalth - care fhailitias, 0 Supply voltage fbr morn then
01 boar'dous locations. 600 volts nominal.
Suite/bldg. /apt. no.: I Project name: Gameday 0 Service or feeder 600 snips or more.
Cross sit cot/dlreetions to job site: tlwrrlauon ao• Yee. roue '
Now residential single- or multi-family dwelling unit.
Includes attached garage
Subdivision; I Lot no.: 1,000 sq. R. or less 168.54 4
Ea. add'I 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: _ energy, residential
.,.. t yfi't': n't :yr, " , :.Y; s: Y:i "u �' a!a w' ' "P: : ( with a bove fL 75.00 2
„'..:; ry7i. '/;:, "•: .:Y r e' "t`:k /� .. v `f, ,, r1�Y�.p.+.::'+t.:. "r se. )
` � Limited energy, multi-family 75.00 2
Tenant Improvement residential (with shovel; EL)
Scrviccs or feeders tmtallatlon and/or relocation
200 amps or loss / 100,70 f jC1,iO 2
S 1; ... x+wyavwvrr�1��W'.!r .. M!r '+P`; 'i +'c:7!�
];,.:e . •'.".'.1 W 4 .,.`� "'.�i ' 1: '' ' :' . . , 7 Y `z ,Gr. - 41,:; x '/. :C 201 amps to d00 amps 13336 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 volts 552.26 2
Temporary services or feeders Installation, alteration, and/or
City /Staid JLIP:
Phone: ( ) I Fax: ( ) 200 amps or less 59.36 1
Owner installation: This installation is being made on property that I own which is not - 20 t amps to 400 amps 200
54 2
intended for sale, lease, rant, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 2
Branch circuits — new, alteration, or extension, peer panel
Owner signature: Date: A. Fee for branch oirouits with
,.;, � , ^_:.' ;°r : Rva
boeernro -td ,p
',S'r:Wi! ?Y'i' r:if i. ,., ::,:'1,: ,gi', :v: •.!.ki. ;ti ;:kg , .�.. , A;. ... - u :�,.., 111" branch edorfeo a y 7.42 I gists 2
Business name: Johansen Electric 11. fee for branch circuits Mi a it
service or feeder fee, first 56.18 2
Contact name: Charlynn Le i f sere brands circuit
Each add'I branch oirwir 7.42 2
Address: 10948 SE Valley View Terr Miscellaneous (service or feeder not lncluded)
Each l nn alovic a or modular 67.84 2
City/Statc/z1P: Happy Val ley, OR 97086
service and/or feeder
Phone: (5 0 3) 698-3417 11(503)698-2486 xeconnoct only Ci 2
Pump in irrigation circle 67.84 2
E-mail: Sign or outline lighting 67.84 2
y . . 1 , . t. e:47;
� �: N <<.. .r>v� . a : •^:J �lr.�1.5�....:C.Y+i °'S° `�.i ' " i. � �� Signal aireuit(s)or limitod-0cuergy
Business name: Johansen Electric panel, alteration, orcatentlon. Paae2 2
Each addltlonal Inspection over allowable In any of the above
Address: 10948 SE Valley View Terr Additional inspection (1 hr min) 66.25 /hr
Investigation (1 hr min) 66.25/ hr
City/Stato/ZIP: Happy Valley, OR 97086 Industrial plant (I hr min) 98.18/ hr
Phone: (5 0 3) 698-3417 I Fax: (5 0 3) 698-2486 Iaepeetioas for which no fee is 90.00/ hr
e •','call listed ,d In min
CCB Lie.: 51539 I Electrical Lic.: 3-243 C I Suprv. Lie.: 20535 :�x:,. ., :,i :=17 ; d i) i .;".,:. -: " . "t::'% -i- `-
Subtotal: 7Sa7,5
Suprv. Electrician signature, required: .., g L, Plot review (25% of peril fee):
Print name: Carl Jo ansen �. IC etc: 3 291 staw stucharEfc (l29�oofNamiitfcc): 33. 'S^
TOTAL PFdtM11' 1'L2 3/2443
Authorized signature: _ This peordt application expires tea patents not obtained within 180
days nn Leifsen i f s en � �.. D 3 2 9 / 12 Inspe Bike It has been eopecd as earrapleta
Print name: Char 1
y / • Number of inapocd p ons allowed per permit
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Z /T 'HSxa 986Z869E09 986Z869E09 iparia NaS.WHOI' NV 9T:OT ZTOZ'6Z'.EN