Permit CITY OF TIGARD ELECTRICAL PERMIT
Permit
° COMMUNITY DEVELOPMENT #: ELC2012 -00306
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/22/2012
Parcel: 2S 112DA01400
Jurisdiction: Tigard
Site address: 15350 SW SEQUOIA PKWY 220
Project: Spec Space Subdivision: 1996 -048 PARTITION PLAT Lot: 2
Project Description: (6) branch circuits for spec space
Contractor: JOHANSEN ELECTRIC INC Owner: PACIFIC REALTY ASSOCIATES
10948 SE VALLEY VIEW TERR ATTN: N PIVEN
HAPPY VALLEY, OR 97086 15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 698 -3417 PHONE:
FAX: 503 - 698 -2486
FEES
Quantity Description Date Amount
6 crt Branch Circuits wo /Purchase 05/22/2012 $93.28
Specifics: Service or Feeder
1 ea 12% State Surcharge - 05/22/2012 $11.19
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $104.47
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 5 - 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2 L '&L 344.. I
Issued By: Permittee Signature: D^+ 4PP� ( 4
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.
. i (
5
Electrical Permit Application MAY 2 2 2012 , : „IC 01 :11(1.: I si (),I.,
City of Tigard TYOF TIIGARD iRMVMMiii Permit No - . .(a,- a) y
Phone 503.6394171 T igard,
Fax: 503, v t l
fl ilG DIVISION fhte/B icw nUror Permit:
i don Lino: 503.639.4175 Osto Ready/13y, 1 w . '/� 91 See Flaw 2 for
NotiticdlMolhid: L# Supplemental information Internet: wwtv.tigerd.Or.gnv
•.,..:.., ...:....... 'tom. .....: .. .. ...
❑ New d onstruolion ® Ad d on/alteration/replacement please chock all that apply (submita sem of plans wlitenta checked below):
[I seivia or Roder 400 amps or more 0 Building Ova duce etwiva.
❑ Demolition 0 Other. ..here the available fault current 0 Marine and Mietyards.
exceeds 10,000 amps a1 150 volts or 0 Floating buildings.
.. � less to ground, or meads 14,000 0 Commmcial.uae egriadtural
❑ 1- and 2- family dwelling ® Commercial/industrial 0 Accessory building amps fbr all other instdlatlena. buildings.
0 Multi-family 0 Master builder ❑ Other: 0 Fire bump. O thrautation of 75 KVA ur
a Emergency system. larger separately dewed system.
'�C,E Q d f' ND OCA,TWH 0 Addition of now motor bad of 0 "A” "E ", "I.2 ", °1 -3 ".
/.5 l " S4i L _ 0six � raMn
Job no.: Job Sltc address: 31x or more toadential units. d Recreational vehicle parka.
❑ l lealth-caro facilities., ❑ supply voltage for more than
City /State/ZIP: 600 volts nominal,
0 11arardous locations.
Snite/btdg. /apt. tio.: I Project Moues; ,( 421a.. ❑ Service or fader 600 amps Or mere.
Cross street/directions to job site: D ot.,'t no. 'I Total I • '
• New residential single or multi - family dwelling unit.
Includes attached garage.
—
Subdivision: I Lot no.: 1.000 sq. fir or less 168.54 4
Fa. add'l 500 eq. ft. or portion 33.92 I
Tax map /parcel no.: L imited energy, residential
.) 75,00 2
(with above eq. ft
Limited energy, multifamily 7500 2
ei /, /s , fee . 54/ a residential (with above sq. fl.)
n n �� l � /L � "`
Services or feeders Irutallatton,altcrution, and/or relocation
eo &iZ4 200 amps or less _ 100.70 7
�� 201 amps to 400 amps 133.56 2
• • ' ............. 401 amps to 600 amps 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 Installation, alteration, and/or
City/Statc/ZIP: relocation
Phone: ( ) I Fax: ( ) 200 amps or less 59.36 I 1
201 amps to 400 amps 1 2
Owner installation: This installation is being mad; on property that I own which is not 401 caps to 599 amps 168,54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Breach dreuits new, alteration, or extension, r panel
Owner sig,natttre: Date: A. Fee for branch circuits with
r A — T � s above service or feeder foe
1 !' .. • .... rl �i x , Il 1 ,
each bramuh circuit 7A2 2
Businossnamc: Johansen Electric B.seviceoreeeder fee, service or feeder fee, first j 56.18 /Q 2
Contact name: Chart nn Le i f see branch drouit I
y Each addl brunch circuit 6' 7. 4.7,10 , 2
Address: 10 9 4 8 SE Valley View Terr Miscellaneous (service or feeder sot included)
Each manufactured or modular 67.84 2
City /State/ZIP: Happy valley , OR 97 086 _ dwelling, service and/or feeder
Phone: (5 0 3) 698-3417 I Fax:: (5 0 3) 698-2486 Ree0/11noet only t,7.84 , 2
Pump r,r irrigation circle 67.84 2
E-mail: Sign or aniline lighting 67,84 2
_ .... .. • • ; t' 1 d t F • Signal circuit(s) or limited-energy
usinessname: Johansen Electric pa chaddt i o n alins e ct im. en - 2
B
Each additional inspection over allowable In any of the above -
Address: 10948 SE Valley View Terr Additional inspection (1 hr min) 6625/ hr
lnvcaligetinn (I hr min) 66.25/ hr
City/State/ZIP: Happy Valley, OR 9 lndustrialplant(1hrmin) 78.18/hr
Ph nc: (5 0 3) 698-3417 I Fax: (5 0 3) 698-2486 d l� Inspections for which no fcc is 90,00 / hr
,fociflealltlistrAiLs hr mien
sittB Lie.: 5153 9 4 trrical Lie.: 3 2 4 3 C 1 Lie.: 2 05 3 5
f Subtotal: 43 ., ar7
Suprv. Electrician signature, required: . / / 1 i • fee):
-
i -A _ A , Plan review (25% of permit fee
Print name: Carl J ans en Data: 5/22/12 / 2 2 / 12 State surcharge (12% of permit fee): // . /9
TOTAL PiiitheT FEE: ZQ y. y-7
Authorized signature: This permit application agree Ifs prarnit to not obtained within 190
n Leifsen f s en Datc: 5/22/12 daps after a has been accepted penult.
complete.
Print name: Char 1
yn • Number of inspections allowed pa pertuit.
1: auildineermitiMIX- PerrnitApp.dne 07101/10 4u0- 461ST(I t/oscooewtin
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