Permit G T � OF TIGARD' ELECTRICAL PERMIT
PERMIT #: ELC2003 -00441
.Jl DEVE M S d . R 9 22 (503) 639 -4171 DATE ISSUED: 7/22/03
AL P
PARCEL: 2S 112AD -01000
SITE ADDRESS: 14945 SW SEQUOIA PKWY 110 .
SUBDIVISION: PACIFIC CORP. CENTER ZONING. I -P
BLOCK: LOT : - JURISDICTION: TIG
Project Description: JOB NO. 8184
Tenant Improvement
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: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 40 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
Reg #: LIC 51539
SUP 2053S
FEES ELE 3 -243C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 7/22/03 $346.30
[TAX] 8% State Tax 7/22/03 $27.70 Ceiling Cover
Wall Cover
Total $374.00 Elect'l Final
•
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: /� Signature:
Y� Permit Si / r./ ' 9 /J/ ✓ /ice / - ��
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 of Tigard Date: 7/18/2003 Time: 4:13:12 PM Page 2 of 3
' Electrical Permit Application , ,1 F I (I 1 NI : ()\ I.1
A.
Date received 3 Permit no. / ,_ dD L i
); j I YI__ . City of Tigard Project/appl. no.: Expire date:
City of Ti r d Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By: no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval:
111'1 Ut 1'1 10111
O 1 & 2 family dwelling or accessory ® Commercial/industrial 0 Multi - family O Tenant improvement
O New construction CI Addition/alteration/replacement ❑ Other. Cl Partial
Job address: 14945 SW Sequioa Bldg. no.: Suite no.: 110 Tax map /tax lot/account no.:
Lot: I Block: I Subdivision:
Project Dame: Sterling Communications IDescription and location of work on premises: Tenant Improvement
Estimated date of completion/inspection:
4 (\ I I t \ ( 1 4 ) 1 ( \ 1 ' 1 ' 1 . 1 ( \ I I ( ► - \ I I .I Si . 111 1)1 I
Job no: 8185 'Derr nisi
Business name: Johansen Electric Inc. BeeQ4rtlOa Qty. (ea) Total a0•urp
NewrnYradal- angle er - aeaiyper
Address: 10948 SE Valley View Terr. dwe9rgnaq.lael adesateaebedgarpcs.
City: Clackamas 'State: OR I ZIP: 97015 Savkeladaded:
Phone: 503 -698 -3417 I Fax: 503-698 -24861 E -mail: Johansenelectftaol.com 1000 sq. R or less 4
CCB no.: 51539 [Elec. bus. tic. no: 3 -243C
Each additional 500 s0,. f► or portion thereof
Limited energy, residential 2
/me lis._no.: 4896 Limited non - residential 2
�' 7/18/03 Each manufactured home or modular dwelling
Signature of electrician (required) Data Service and/or feeder 2 •
Sup. elect. name (print): Carl K. Johansen License no: 2053S Services or kedtvs— laslalJation,
alteration orretocadore
200 amps or less 1 80.3C 80.30 2
Name (print): 201 amps to 400 amps 2
Mailing address: 401 amps to 600 amps 2
601 amps to 1000 amps 2
City: 'State: I ZIP: Ova 1000 amps or volts 2
Phone: IFax: E-mail: i tteemmat only 1
Owner installation: The installation is being made on property I own Temporary seniresorfeeden
which is not intended for sale, lease, rent, or exchange according to Installation, altvadoa,orrelocation:
ORS 447, 455, 479, 670, 701. 200 amps or less 2
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 ...s 2
i \ (, I \ 1 I It Brandt eh dta - new, alteration,
or extension per panel:
Name: A. Fee fa branch circuits with purchase of
Address: service or feeder fee, each branch circuit 40 6.65 266 2
City: I State: I ZIP: B. Per fur branch circuits without purchase
Phone Fax: E-mail: service or feeder fee, first branch circuit: 2
Each additional branch circuit:
19 \\ It \ 11 \\ (l t. Ilk all 'hut :11)1111 ) Mist . (Service or feeder not Indaded):
D Servie over 225 ampgoommacial D Health —ate facility l'ach pump or irrigation circle 2
D Service over 320 amps of Itb2 D Hamrdous location tiacb sign or outline lighting 2
family dwellings D Building over 10,000 square fed four er Signal eircuit(s) or a limited energy panel,
D System ova 600 volts nominal mom residential emits in one structure alteration, or extension' - 2
U Building over three stories D feeders, 400 amps or more •Description:
U Occupant load ova 99 persons U Manufactured mrrmes or RV park Each addldoaal Inspection over the allowable la nay of dte above:
D Egtess/lighting plan U Other: Per inspection I I I I
Sabah _ sets of piaaa with any oldie above. investigation fee
The above are slat applicable to temporary construction service. Other
Permit fee • $ 346.30
Net all jueediaions accept credit ands, please call jurisdiction few mare information. Notice: This permit application
U visa D MasteiCaad expires if a pemtit is not obtained Plan review (at _ %) $
(-Neils card number. _ / / within 180 days after it has been State surcharge (8 %) $ 27.70
Expires accepted as complete. TOTAL $ 374.00
Name of cardholder as shown on credii card
S
t:ardbolder signature Amount 4401615 (6/OO/COM)
CITY OF TIGARD
BUILDING _ ine: (503) 639 -4175
INSPECTION DIVISION Busl ss Line: (503) 639 -4171 MST
BUP
Received . J s ^Z'e �r Date Requested v AM PM BUP
Location 7V 7 ` Suite //e) MEC
Contact Person 6/1,4)e p Ph ( 5 7 1- / / S PLM
Contractor Ph ( SWR
BUILDING Tenant/Owner ELC 3---O ,/ 114//
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: • SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In , C;
Water Service
Sanitary Drains Sewer /2 0/0?
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final •
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
L
Service
•-; - c 1 0 ► 11 Sl , D P IAD tYO
- Low Voltage
Fire Alarm
Fin ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
A S PART FAIL
SIT ❑ Please call for reinspection RE:
•
El Unable to inspect — no access
Fire Supply Line /
ADA
Approach/Sidewalk Date • � - �� Inspect . '% t��L - i � � Ext
Other:
Final DO NOT REMOVE this Inspection record om the J ' site.
PASS PART FAIL