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Permit CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2003 -00557 �,4.1 DEVELOPMENT SERVICES DATE ISSUED: 9/5/03 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S112DA -00800 SITE ADDRESS: 15055 SW SEQUOIA PKWY 140 SUBDIVISION: PACIFIC CORP. CENTER ZONING: I -P BLOCK: LOT : JURISDICTION: TIG Project Description: Install 20 branch circuits. 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: W /SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 19 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 9/5/03 $173.20 [TAX] 8% State Tax 9/5/03 $13.86 Rough - Elect'I Final Total $187.06 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 -3 44 _ Issued By: Permit Signature ; 0' &-l`G 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: �:1 ivnn J. Leifsen To: City of Tigard Date: 9/4/2003 Time: 3:09:12 PM Page 2 of 3 6 1 r � 4 � . - 1 OR 01 CE USE 010 - L'�' 11ect 'eRE ion �D U ecrt,>•ttvtr.. c O3 R C�'. . :. .. Flecgicai � nateiBy: /3 ....... e - : - 7 Ci o Tigard SEP 0 4 2003 Planning ppnaval Sign DatrJBy: Permit No.: - 113125 SW Hall Blvd. - Plan Review Other Tigard, Oregon 97223 CITY OF TIGARD Date/By: : •• Permit No -: . . . . Phone: 503- 639 -4171 LO G ! ON H ; j Post - Review ' Land Use " .l ,', Dstr/B y. Case No.: t: wvv _. Internet # •r�, l , Contact Jnt'is.> .:: 6.4 See Page. 2 tor. 24 -hour Inspection Request: 503 -639 -417.5 4ame/Method: - Supplemental Information. s'.:A' - ::..w -U'. ..;�� p��. ;, :,� . yy . l ' i ' " . d'.F.{''(;�'ir�Ww•V.^5. {�M':i �x .. S :•:�'..; ,} yy yy� ::f V. 5�• #4 0•, •IM .,,A •1' ' } •1'�: S Ikcd rni r r - :5:! : ::' ': {' �,.. ;.,.,�,.; {.r.. £.x :° ''�'dF S .M.. x'!;� ',.;. {�. ...: ... ?�,�:`i +5' ...x•S' .. �. ter 4 - ... ....- _ ,. ,... New construction io n Demolition ■ Service over 225 amps- • ii •FTea1th —ate'facility. • .,,H commercial ❑ Hazardous location Additiol�/lllteratiorlh •laccment I© Other: O Service Ov.; - 320 imps - raring of ❑ Building .ovcr 10,090 square feet, ,, b • p •ta I `i. • i4 - (��IW ""' ��` "': "'r & 2 family dwellings four or more residential orbits in - I & 2- Family dwelling © Commercial/lmdustrial Accessory © Svsteru over 600 dolts -nominal -nominal wte sln,ctura ❑ Building over three stories : 0 Feeders, a00 amps mps'or more- Building Fatnil ry Bulldi g M uli i " of ❑ Occupant toad over 99 persons • ❑ Manufactured structures or kY park r Master Builder • Other: • 0 Pgressnightt. plan 0 Other ::::.:.:71J1:•;: ,.r,, y��y :',...-1:' 1`'A : 4d © X0 , 0 : rE Submit_ sets at plans with any of the above. ,� ^ .,- ' ?! Q:s lion service. .r. {:ee�r� 'j�►' _. _The above are not s• . Ileable to trm � orarY'.conclr�rc 5055 SW Sequoia : ,z m - : a � 5 n : Job site address: �r•� �f+8tk� " �; - . � -- •L. ,n..: �.e'� -:� a : _ ...:.. .. .. ... .. .... ._.. .. ,� •sr�: ^.r Suite #: 1 0 Bldg. /Apt. #: Number of Inspections per•p ertnit aflowed Project Name: GeoEngineering , Description Qty fee (ca.) NOW T New residential - single or taulti- raral'1y per Cross street/Directions to job Srte: dwelling unit. Includes attached garage . 72nd Servlee Included: . • :.. 1000 sq. ft or less ' '145.45 . 4 • Each addition-1,31500 sq. ft orportion thereof . : , • 33:40 • 1 • -. Limited enemy, residential • 75.0(1 2 SuibdiviSio.n: I Lot f / : Lim itedene1, nonresidential • ,I • . 75.00. .. 2. Tax ma rcel. #: of home or modular dwelling y � y ��� An d /f feeder eater 40.90 gin 'i ... '}.....:!:5.67-',&711' .t, '.t,1 9:74 .. 1L,1r ZIEJ : : :: : . ; S �_`, t� � ?tfy. ti N ` - _ .. , - _"' .... Cach man ro � 'service � 5ervkes or feeders - Installation, Tenant Improvement aiteratioitorrelocation: .200 amps "OP IC55 . 80.30 , 2 . • 201 amps to 400 amps 106.85' 2 4 01 anms to 600 amps . • -r -fin'? S c C '41.7 { r3.Fgr ItffleaMarrrEg ..••• 60:1 amps to 1000 amps 240'60: 2 Over 1099 amp$ or volts -• . 45065 Name; Pacific Realty Associates Reconnect only (54.85 - 2 Address: 15350 SW Sequooa, 300 Temporary services or feeders - installation, • : • alteration; or relocation: 7. City /State/Zip: Portland, OR 97224 • 200 amps orIess 6435 1 • Phone: 503 - 624 -7787 Fax: 503-624 7755 dui of amps 1'13.75 ;00..30 • 2 ' 0.. 187, ; .. '.I. �r z.,4A-'.. , :'? fi '{3 P ;if -" ti n1 - aneb circuit's- new, alteration, or • Name: Johansen Electric Inc. extension per panel: . : A. Fee for-branch with purchase of Address: 10948 SE Valley View Terr. service or feeder fee each htanch.circuit 4.65 2 City/State/Zip: Clackamas, OR 97015 B- Fee for brandh circuits without purc}tasePof ...- .•• • •••• 2 .. : . - service or feeder fee first branch circuit 411.85 " "' .. Phone: (503) 698 -3417 ' Fax: (503) 698 -2486 • ` .F.achadditional branch circuit 19 . 4.65 126.35 2 Johansenelect@aol.com • • Miac(5erviee or feeder not included). )�- r17d11 ,xr. l; xg Eaeh punter or irrigadou circle .. 53.40 • 2 't. - x V. ° c'v'� -A- 1 - 6' t .- i ce. =_ s 53.40 2 - �,sy . ` ��, .�'awi<. Each signor outline lighting Job No: 8318 Signal circuit(a) vs a limited energy panel, • alteration, or extensive Page 2 2 • Business Name: Johansen Electric Inc. . Description: Address: 10948 SE Valley View Terr. •• • • • • • Each additional lnspectlon over the allowable in an • of above: - -.. City /State /Zip: Clackamas, OR 97015 Per inspection perhou (min. l hour) 6230 Phone: (503) 698-3417 Fax: (503) 698 -2486 Investigation fee: . . _ Other, 51539 Lic. #: il, « _ • CCB Lic. # 3 -243 * . .. 4 -" " IZ 2,:: e:: , 5. r F ? Y 4 x. .' A Supervising electrician . rural: .s.1.. .2 ..................... - .............. .. -.Sub 73: 0 signature required: _ . Plan Review (25% of PemzitFee ):. ; 1... . • Print Name: Carl K. Johansen I Lie. #: 2053S State Sltreharge (8% of Permit Fee) . 13.86 -- TOTAL PERMIT FEE Authorized (, / 9/4/03 Millie; This permitapplicatioacaplres•if a permit is not obtained within Signature: i. . . - ...AL. a ' e: 180 days after Mhos been accepted as complete. *Fee methodology set by Tri- County Building Industry Service Board. Charlyn , Leifs - n (-Please print name) — . . . . i :Masts \Pe rnit Forms\F.loPermitApp.doc 91/03 CITY OF TIGARD - -24-Hour BUILDING Inspection Line: (503) 639 -4175 MST INSPECTION DI fI,S�Op1 Business Line: (503) 639 -4171 BUP Received q v3 9 Date Requested / 6 /2-1 AM PM BUP Location / 50 5 S Ati 0 j 4- Suite I <n MEC Contact Person S (n a U. (n Ph (._s..0-.3p f - 5: b2 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner 028 2 ELC 3 - 00,557 Footing Foundation Access: ELC Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT • Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing 6 . Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm / Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer 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 CTRICAL FAIL `2 2 � I N r l f% so Se Rough -In Low Volta• Fir- '•AS PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SITE ❑ Please call for reinsp= tion RE: ❑ Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date r e' 7 In ector Ext Other: Final DO NOT REMOVE this inspection record f om the Job s te. PASS PART FAIL