Permit � y
CITY OF TIGARD ELECTRICAL PERMIT
Per
le COMMUNITY DEVELOPMENT
Permit #: ELC2009 -00231
Date Issued: 05/21/2009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S1 I2AD01000
Jurisdiction: Tigard
Site address: 14945 SW SEQUOIA PKWY 110
Subdivision: Lot: 0
Project: Sterling Communications
Project Description: (2) 200 amp services and (10) branch circuits
Owner: FEES
PACIFIC REALTY ASSOCIATES Quantity Description Date Amount
ATTN: N PIVEN, 15350 SW SEQUOIA PKWY 2 ea Services or Feeders - 200 05/21/2009 $160.60
#300 amps or less
PHONE: 10 crt Branch Circuits w /Purchase 05/21/2009 $66.50
Service or Feeder
Contractor: 1 ea 12% State Surcharge - 05/21/2009 $27.25
JOHANSEN ELECTRIC INC Electrical
10984 SE VALLEY VIEW TERR
HAPPY VALLEY, OR 97086
PHONE: 503- 698 -3417
FAX: 503- 698 -2486
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $254.35
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 952-001-0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. V Issued By: MA Y Permittee Signature: x A pri_.7 c_A-rX'U A)
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 503.639.4175 by 7:00 a.m. for an Inspection that business day.
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.
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Electrical Permit Application _ ±-_-: ) - �' •oi o1. i.It's•: 1 .t•. r 1.1,1
City of Tigard Reorivcd. Permit No.:
IR
13125 SW Hall Blvd, Tigard, OR 97223 MAY 19 2009 1>az �c�ov _ ( te a
Plan Review
Inspection Lure: 4 CITY Ci SIG A R) Date Ready/By: kris: El see Page 2 for
Internet: www.tigard- or.gov M�Ji�I_DIVGI DI I, I,( .fficd,Methad Supplemental Information
tour � I rY hVl?1 !�/ H I' I 9 iEx t. 't. t•,* { .
+3 � I OSSME l .i.11Ali`„��R1 1 PN , i Bi iYI 491: :'t. • : 7 g � er �s C i i o::r '7741r ' .
r. 58.� ..r'IJk:lMla�l •� ^tr.t' �5�4���7lr,y.:�k�.'s �►.uaEl L�R���r.
❑ New construction ® Addition/alteration/replacement Please check all that apply (submit 2 nets of plans wliutm checked below):
❑ Service or feeder 40o amps or more ❑ Building aver three stories.
❑ Demolition C3 Other:
where the available fault current ❑ Marinas and boatyards.
+. 'I F .e • l :. alrll n4F,ti•t�i-L aefr. ' •:+r.:r , : Y s'" s; •^ n:�• exceeds 10,000 came at 150 volts or ❑ .
l r r ., y . i L i u'6 9
�ibt • °•rrl tt;�wli+i�uiulriiu�IDWataSnetor 'r Floatiug buildings.
❑ 1- and 2- family dwelling ® Commercial/industrial Ins to ground, other installations 1 n 000 ❑ Commercial-use ding. agricultural Accessory building amps for all odtst inlaallatioms. ��
❑ Multi- family ❑ Master builder ❑ Other ❑ Fire pump ❑ Installation of 75 KVA or
■ l ' . i t o i 4i . t r ?` . i` L4.. t( ` x .yI ❑E�Bency larger separately derived system.
P., ' , 1 . in lfr�iiiinF ni tt,li vad,:uan 4 Wekrd L;tul it i �� ;�.' --� ' gar ❑ Addition of new motor load of ❑ "A ",
"1:" "l•2"
Job no.: Job site address: 14 9 4 5 SW Sequoia 100HP or ertae. occreaaoy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: ❑ Health facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldgJapt no.: 110 I Project name: sterling Comm ❑ Service or feeder 600 ... ,. or more.
t •. E .w.,.r � � � t
Cross street/directions to job site: . - "„ ., 1. , a `' Hanel ii:9: `-y.�+`1 EMIN i Tee �
Jo Demiptloa Ott. Foe. Teta •
New residential single- or meld - family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 145.15 4
Tax map/parcel no.: Ea. add'I 500 sq. R or portion 33.40 I
Limited energy, residential
-.I .1 II IIMI 1(tI MIW7 ZZn .' Et EMERESI y � r 1' (with above sq. 8.) 75.00 2
Limited energy, multi - family
75.00 2
generator work residential (with above sq. ft) _
Services or feeders imtallation . alteration, and/or relocation
(�� �( 200 amps or less 80.30 I(dq.(PO 2
!, Nis i.5, I 141[1kfk.9f'ii I 1?i a 'Jrk tp , -4 ,110 201 am
' �� tl l amps to 400 amps 106.65 2
Name: 401 amps to 600 amps 160.60 2
Address: 601 amps to 1,000 amps 240.60 2
Over 1,000 amps or volts 454.65 2
City/State/ZIP: • Temporary services or feeders Installation, alteraria., and/or
✓ eloeatio.
Phone: ( ) • I Fax: ( ) 200 amps or less 66.85 1 1
Owner installation: This installation is being made on properly that I own which is not 201 amps to 400 amps 100.30 I 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel _
er s yr : ! ,' t I r s r 1, p Yiti:. A. Fee for branch circuits with
- A.6. IEM; : 1 4 1 7r r> �. I T I r�(tllig Ilia E011 Er �, r All' 1 A above service or feeder fee. G^
each branch circuit O 6.65 (I ;..#v 2
Business name: Johansen Electric Inc. B. Fee for branch circuits
Contact name: Charlynn Leifseo withou service or f fee, 46.85 2
fast branch c ircuit
Address: 10948 SE Valley View Terrace Each add'I branch circuit 6.65 _ 2
Miscellaneous (service or feeder not Included)
City / State/ZIP: Happy Valley, OR 97086 Each manufactured or modular 2
dwelling, service and/or feeder
Phone: (503) 698 -3417 I Fax: : (503) 698 -2486 Reconnect only 66.85 2
E -mail: Johansenelect(4)msacom Pump or irrigation circle 53.40 2
4 .:I 7P� i I 1 "3'.7`- F::lae aa�:irr ! N ,a
�- i � � .. 1 ' ,c 5. ��6�( �dj; �, � h 1���;jli' Sign or outline lighting 53.40 2
Business name: Johansen Electric Inc. Signal circuit(s) or limited -
energy panel, alteration, or
Address: 10948 SE Valley View Terrace extension. Describe: Page 2 2
City/ State/ZIP: Happy Valley, OR 97086 Each additional inspection over allowable in an of the above
Per inspection 62.50
Phone: (503) 698-3417 I Fax: (503) 698 -2486 Investigation per how (I hr min) 62.50
CCB Lic.: 51539 I Electrical Lic.: 3 -243C I Suprv. Lic.: 2053S Industrial .rant ..� hour � 7 3.75 y ; fi t
k '1FAIPKANliL•X1 L5i
I . p 1 141 WII to •: ildifilfr.
Suprv. Electrician signature, required:
Subtotal: �' i . IC)
Print name: Carl K. Johansen 'abate: 5 / 19 / 0 9 Plan review (25% of permit fee):
State surcharge (12% of permit fee): 2 i, 2
Authorized signature: 5
�1 �� TOTAL PERMIT FEE: �9e.4.
Print name: Charlynn J. Leifsen I Date: 5 / 19 / 0 9 This permit appikadon expires ifa penal b not obalned wdhle 180
days after it has been accepted as complete.
1: 1Buildinawermin \ELC- Ppmitapp.dsc 05M/06 440.467
• Numbs of inspations allowed pa permit.
SI' l/ts /COM/WEa
2 - d Xb3 13C2I3Slf1 dH WdLT : T 6002 61 ReW