Permit A.. ,,CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00052
vl- DEVELOPMENT SERVICES DATE ISSUED: 2/7/03
1,L ,� I- ' 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S112AD-01000
SITE ADDRESS: 14945 SW SEQUOIA PKWY 150
SUBDIVISION: PACIFIC CORP. CENTER ZONING. I -P
BLOCK: LOT : JURISDICTION: TIG
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Project Description: Cpmo 1 TD VOID xJ . 80 `Tlp
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 HML 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 TERRACE
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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 2/7/03 $213.30
[TAX] 8% State Tax 2/7/03 $17.06 Rough -in
Elect'I Final
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: 071./ ,h L/ et/ —moo
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: 2/4/2003 Time: 12:18:58 PM Page 3 of 3
Electrical Permit Application , ,1 1 ( I l r
Date received: 2 p j Permit no.:. [,C x003 -) 005
1,' 'll City of Tigard RECEIVED Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: Eni Receipt no.:
Phone: (503) 639 -4171 2 003
Case
Fax: (503) 598 - 1960 FEB 0 4 file no.: Payment type:
Land use approval: CITY OF TIGARD
It • , • •
I 1 1'1 OF I'I I(\IlI
O 1 & 2 family dwelling or accessory ® Commercial/industrial O Multi -family O Tenant improvement
O New construction CI Addition/alteration/replacement ❑ Other. 0 Partial
Job address: 14945 SW Seq uioa Bldg. no.: Suite no.: 150 Tax map /tax lot/account no.:
Lot: I Block: I Subdivision:
Project name: Prudential I Description and location of work on premises: Tenant Improvement /Service change
Estimated date of completion/inspection: 2/7/03
1(1 \Ii( \( 1(11( \1'1'1.I( 11111\ II. I. .(111111 I
Job no: 8096 Fete Max
Business name: Johansen Electric Inc. Deaatplloe Qty. (a.) Total no.l.rp
Newredde.Aal- stogie ormeitl- btlyper
Address: 10948 SE Valley View Terr. threiliagantt.budadesattadiedgarage.
City: Clackamas IState:OR I ZIP: 97015 Se+vke :
Phone: 503 -698 -3417 I Fax: 503 Johansenelect @aol.com 1000 sq. ft- °r less 4
Cal no.: 51539 l Elec. bus. lic. no: 3 -243C
Each additional 500 sq. it er portion thereof
Limited energy, residential 2
/me kno.: 4896 Limited maw. non resideaGal 2
2/4/03 Each manufactured home or modular dwelling
Signature of isiog electrician (required) Date Service and/or feeder 2
Sup. elect name (print): Carl K. Johansen License no: 2053S Services or feeders — l.st.lhtlo.,
• altentlororrebeatlom ' p 1U¢J)
200 amps or less �d'* .3C 2
Name (print): 201 amps to 400 amps - 2
Mailing address: 401 amps to 600 amps 2
g 601 amps to I000 amps 2
City: I State: I ZIP: Over 1000 amps or volts 2
Phone: I Fax: I E -mail: Reconnect only I
Owner installation: The installation is being made on property I own Temporary serrbceror feeders -
which is not intended for sale, lease, rent, or exchange according to Im.allatbo.,alta.dotym relocation: ,
ORS 447, 455, 479, 670, 701. 200 amps or less -g0 39--o0 30 � 2
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 ...s 2
1 N.(' 1 \ t 1 - I ( ■ra sch thrift' - new, alteratlon,
or exteamboa per panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee, Inch branch circuit 20 6.65 133 2
City: I State: I ZIP: B. Fee for branch circuits witbaS purchase
Phone: Fax: E-mail: of swig or feeder fee, that branch circuit: 2
Each additional branch circuit:
PI \\ I(1 \ II 11 II'lc:s.c check All ili:it 1111'1'', Mac. (Semite or feeder aotlnd.ded):
O Service over 225 amps- oommacial 0 Health facility Hach pump or irrigation circle 2
0 Service over 320 amps -voting of 18e2 U Hazar location Hach sign or outline lighting 2
family dwellings 0 Building over 10,000 square fed four or Signal air uit(s) or a limited energy panel,
0 System over 600 volts nominal more residential units in one structure alt ealioo. or extension' 2
0 Bur7dlog over three stories 0 Header, 400 amps or more •Description:
0 Occupant load over 99 persons U Manufactured structures or kV park Lech additional Inspection over the allowable I. any of the above:
0 Egress/lighting plan U Other: Per inspection L I I I
Submit _ sets of plco with any of the above. lovestigati® fee
The above are mat applicable to temporary cannoneeoa service. Other
Nat an jnaindddons accept credit cards, please call jurisdiction for more idbmartisn. Notice: This permit application
Permit fee - $ 21 3.30
U Visa U MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit cant number: 1 J within 180 days after it has been State surcharge (8 %) $ 17.06
Cr
B"pQ° accepted as complete. TOTAL $ 230.36
Name of cardholder as shown on credit card
S
Cardholder signature Ammar 4404613 (6/00/COM)
CITY OF TIGARD 24 -Hour . �.
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Re. uested /3 AM PM BUP
Location / L/9 Vs' i Suite /s0 MEC
Contact Person / ' / ■14 / Ph ( ) 6 ?e— 314/ 7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC — 000 5�-
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
P ASS PART FAIL r
PLUMBING 1
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole W‘D-M ` 0 D'(j4 C )f)ik
Storm Drain
Shower Pan F L i �� c)3 - < L!A t •v
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PAS FAIL
BTRICAL -
Se
Rough -In
UG /Slab
Low Voltage
Fire Alarm
PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SI E Please call for reinspection RE: Unable to inspect - no access
Fire Supply Line
ADA j �j
Approach/Sidewalk Date J / 2 `� � Inspector %� - / - - Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL