Permit C ITY OF TIGARD ELECTRICAL PERMIT
-+- PERMIT #: ELC2005 -00110
Atop lA, DEVELOPMENT SERVICES DATE ISSUED: 2/24/2005
pT I I 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
PARCEL: 2 S 112 DA -01400
SITE ADDRESS: 06650 SW REDWOOD LN 250
SUBDIVISION: PP1996 -048 ZONING: I -P
BLOCK: LOT : 002 JURISDICTION: TIG
Project Description: Service.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 1 W /SERVICE OR FEEDER: 20 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
PACIFIC REALTY ASSOCIATES JOHANSEN ELECTRIC INC
15350 SW SEQUOIA PKWY #300 -WMI 10948 SE VALLEY VIEW TERR
PORTLAND, OR 97224 CLACKAMAS, OR 97015 -000
Phone: Phone: 503 - 698 -3417
FEES Reg #: LIC 51539
tion Date Amount SUP 3
Description ELE 3 -243C
[ELPRMT] ELC Permit 2/24/2005 $213.30
[TAX] 8% State Surcharge 2/24/2005 $17.06 REQUIRED ITEMS AND REPORTS
Total $230.36
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws.
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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503)
246-6699 or 1-800- 332 -2344.
Issued By: _ Permit Signature: /).-•.-
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'N: DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
From: Charlynn J. Leifsen To: City o Tigard Date: 2/23/2005 Time: 2:36:58 PM Page 2 of 4
E1ectr a l Permit A , 1' 'o \ \ �g \ ' t e > I< ( ) I I I ( I "cu.., I . \
City of Tigard ,fit ' - -' Received � �•� _
Dirt :. 0 %, - _ - ._ii oo /(r
13125 SW Hall Blvd., Tigard, OR 97223 Plan Revi
Phone: 503.639.4171 Fax: 503.598.1960 • "'- , , -
,, I
��� Go Dar : : Omer Permit:
� j ���' D Re ady/By: furls:
Inspection Line: 503.639.4175 � �,.1,,� ' � � RI See Page 2 for
Internet: www.citigard.or.us Notified/Method: Notified/Method: Supplemental Information
i -a ti t7, !, v 1 -T y ... . . -- .. . 7 . jt� 4l , . ,
❑ New construction Al 1 r , " 1 0 +1 i p a A g e nt _.. Please check all that apply:
CI Demolition
Other ['Service over 225 amps, comm'l ['Hazardous location
r- 7r,l ^ arT r Y r a h'e ['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
ri , 7 "�:t ,..,:,:,1y.„,,,.4'. . ti, ;; : _ <- •- ` -A_ � of 1 - and 2-family dwellings 4 or more new residential
El I - and 2- family dwelling ® Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
['Building over three stories ❑Feeders, 400 amps or more
❑ Multi- family ❑ Master builder El Other:
�{ , } ['Occupant load over 99 persons ['Manufactured structures or
: . ' tr
err- r� ttt n'' -6 , r5' , ... k , T:r:3 ..:... s. -. : - -_ r _ .. 1 ❑E g ress/Iightilrgp18n RV park
.
Job no.: Job site address: 6650 SW Redwood Ln, 250 ['Health facility ['Other:
Submit j sets of plans with any of the above.
City/State/ZIP: Portland, OR 97224 The above are not applicable to temporary construction service.
Suite/bldg. /apt no.: Project name: HSBC `4 4: ,'.e :a> - := • ,..at
.,,..' . :' , ! h ..... ; ti '
.,t .
navl0tlm Qty. F. Tet I
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
- Includes attached garage.
1.000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map/parcel no.: Limited energy, non - residential 75.00 2
:.. 4 W-2, 4 Q !"C ... ," 'A 4 f x 4 :1 SW _" '1 f '7
_u., :. . f -.1 ,' _' :∎ L 0., ; --, : r " - =" ' .,
. - 17 ` + - ;t . f 't.,',)--.;;::'.. - . _.. - Each manufactured or modular
Tenant Improvement dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 1 80.30 80.30 2
a•g;r #4iiv 'SF- , ,x - .14,41 c y t j(,Ir , r , ;. :' 201 amps to 400 amps 106.85 2
:_ 1�. .._. _. ... K:: .,;
1 �.: }, .,. _. •- aro ,re1•dt ,,ty , . , t _ :01244 401 amps to 600 amps 160.60 2
Name: Pacific Realty Associates 601 amps to 1,000 amps 240.60 2
Address: 15350 SW Sequoia Pkwy, 300 Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/ State/ZIP: Portland, OR 97224 Temporary services or feeders Installation, alteration, and/or
Phone: ( 503)624 - 6300 Fax: ( 503 ) 624 - 7755 relocation
200 amps or less 66.85 1 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 1 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
t ` �, ',� "--,::13. r 1 F IUM� J fi" a r a t`' I A Fee for branch circuits each
. ....- -: ,i ... , 2_. „, .L,� :r,.,, ,. ,...,,.w, :....:.rw.,r,,, ,,iurwa.9_ : _ . ... - JI'... .f il, , , .:i service or feeder fee, eac
Business name: Johansen Electric Inc. branch circuit 20 6.65 133.00 2
B. Fee for service odes
Contact name: Charlynn Leifsen
without service or feeder fee, 46.85 2
Address: 10948 SE Valley View Terr, each branch circuit
Each add'I branch circuit 6.65 2
City/State/ZIP: Clackamas, OR 97015 Miscellaneous (service or feeder not included) _
Phone: ( 503 ) 698 - 3417 Fax: : ( 503 ) 698 - 2486 P or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: johansenelectamsn.com p� Signal circuit(s) or limited -
x< , a.. t , d - , + ` mss- { - . F (!Ennui S * 4fl1( 'tlr� =-� energy Panel, alteration, or
.
o s. Ac .- t -. ! : : 8 -n c.,. ' :,.., Ir K, Ft ..., .._. - a,�.�. extension Descnbe erg 2 2
. Page
Business name: Johansen Electric Inc.
Address: 10948 SE Valley View Terr. Each additional inspection over allowable in any of the above
Per inspection 62.50
City/ State/ZIP: Clackamas, OR 97015 Investigation per hour (1 hr min) 62.50
Phone: (503) 698 -3417 Fax: (503) 698 -2486 Industrial plant per how 73.75
CCB Lic.: 51539 Electrical Lic.: 3 -243C Suprv. Lic.: 2053S Subtotal 213.30
Suprv. Electrician signature, required: / , 4-:-..:... Plan review (25% of permit fee)
J A.
Print State surcharge (8% of permit fee) 17.06
rint name: Carl K. Johansen Date: 2/23/05
TOTAL PERMIT FEE 230.36
Authorized signature: ) r r This permit application expires if a permit is not obtained within 180
days after it has been accepted u complete
Print name: Charlynn J. Leifse, Date: 2/23/05 • Fee methodologys tbyTri-County Building Industry Service Board
•• Number of inspections per permit allowed.
is WuildiasPermiuuELC- PermitApp.doe 12/03 440-4615T(1o/2/COM/wt7
CITY OF TIGARD • • .
BUILDING DIVISION PERMIT #: ELC2005 -0Q110
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 2/24 /2005
Phone: (503) 639 -4171 Ui4 � ill �' t,
Inspection Requests (24 Hrs.): (503) 639 -4175 °: _ I
INSPECTION WORKSHEET FOR DATE: 4/15/2005 TIME: 7:08AM PAGE: 27
SITE ADDRESS: 06650 SW REDWOOD LN 250 CLASS OF WORK:
SUBDIVISION: PP1996 -048 LOT #: 002 TYPE OF USE:
PROJECT NAME: HSBC
DESCRIPTION: Service.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503 - 698 -3417
Inspection Request Scheduled For: Date: 4/16/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 004651 -01 503 - 969-6262 N
Corrections /Comments /Instructions:
( J.:::
P ..—
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
�
Inspector: y Date: / l � � "( Phone #: (503) 718-
/