Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2012 -00529
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/13/2012
Parcel: 2S112DA01400
Jurisdiction: Tigard
Site address: 6650 SW REDWOOD LN 350
Project: BMP Subdivision: 1996 -048 PARTITION PLAT Lot: 2
Project Description: (2) branch circuits for TI
Contractor: JOHANSEN ELECTRIC INC Owner: PACIFIC REALTY ASSOCIATES
10948 SE VALLEY VIEW TERR ATTN: N PIVEN
HAPPY VALLEY, OR 97086 15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 698 -3417 PHONE:
FAX: 503 - 698 -2486
FEES
Quantity Description Date Amount
2 crl Branch Circuits wo /Purchase 09/13/2012 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 09/13/2012 $7.63
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $71.23
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 O ff % 952- 001 - 0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503. or 1.800.3332.2
Issued By: ' / v'� Gi.t Permittee Signature: �lll ' ` ���` I `Q�
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' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for the next available Inspection date.
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.
RECEIV
Electrical Permit Application 1 s i ft t i i i i 1 t: i a,: O\ I ,,
City of Tigard SEP 1 3 201 P- ii,No.: co- ' - Apses
• 13125 SW ]Tall Blvd., Tigard, OR 97223
Phone: 503.639,4171 Fax: 503.598.19600 U - Ttu A R 1 � ' - e tau Permit.
, , ,., i` , :, InepeotiOn Line: 503,6394175 l'f � ' i�l�a m ReadrNy. ,r M see pare 2 mr
Internet: www.tigard•tu,gov P�l�ILD! ;Pl' y te�lt l�odned/Momod: supptenrmral
,.: .,(l�: '.�.: �r�., a .. .,... .f 'A � ',-Ae- ?':•rl 1'/ - Y, ;,'•, 1- '',YV,." °�r' -' fF > fr- ;,jZ "-.k"' V..�� ';';
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0 New construction ® Addition /alteration/replacement Please check all that apply (submit j sou of pleas wfitema checked below):
CI Service or feeder 400 amps or more Q Building Over three atones.
0 Demolition 0 Other: where the available fault current D Marinas and boatyards.
1..i>.' %a "' +';^ S ;r �..,' , ,y� , ");;, ; f�'(`(x : 'y r `.,T ; . >TY-i -'} ' exceeds 10,000 amps at ISO volts or D Floating buildings.
s .- - �. ); •H ` ETA "" ^ . ^: ;: , bat to ground, or exceeds 14.000 0 Cummor.:al•uaa agricultural
❑ 1- and 2- family dwelling commercial /industrial ❑ Accessory building amps for all other insmllatione. buildings.
0 Multi - family 0 Master builder 0 Other: 17 Fire pump. D Installation of 73 KVA or
T .�a,! " . Q Eanersatey system, huger veparately derived system.
'S a r'� ,1 Y; " Ic1: ,�J', i t,,, ` f Tk .•�''"; :: 4. ��, ti^`t } %`F'
'., +�•. , ,C,;�i< 'Y •, •.niF��n= :4..Fi„ .. - a � r <�..'. '. �,,. ,c-.,. • ['Addition ofaew motor load of O..A. "1-2". "1-3",
IixHpormore.
Job no.: Job site address: 6650 SW Redwood 350 occupancy,
� Q Six w more residential units. 0 Recreational vehicle parka.
City /State/21 P: 0 Health-care facilities. 0 Supply voltage for more than
Q Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: 3 5 0 I Project name: BMP Q Service or feeder 600 am orrQmore.
Cross street/directions to job site: fkwttpoea otv. r... Tow
New residential single- or multi-family dwelling unit
Includes attached garage.
Subdivision: I Lot no.: 1,000 ea, ft, or less 168,54 4
Tax m / el no.: Ea. add'I 500 eq. ft. or portion 33.92 1
_ Limited c%%, orm m.idenhei ~ 75,00 2
r,, f •..:,/ i mt,Yl :, ,. 1 . :t : k 1 2 : :; •z r i' ' = (with above sq. it)
Limited energy, multi-family 75.00 2
Tenant improvement residential (with abovo sq. lt.)
Services or feeders Installation alteration, and/or relocation
200 amps ar loss 100,70 2
.8,titiar,,: _ s� .." "5t . x. tit, nY. .:s:. 201 em 4r n 13356 2
Name 401 amps to 600 amps 200,34 2
act amps to I /JOG amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
City/State/ZIP: Temporary services or feeders Installation, alteration, and/or
relocation
Phone: ( ) "Fax: ( ) 200 amps or loss 59.36 1 1
201 amps to 400 amps 125.03 1 2
Owner installation: This installation is being made on property that 1 own which is not 401 amps to 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits — new, alteration, or eetenabn r panel
Owner signature: Date: A. Fee for branch circuits with
.- ,r :•.; : �. _'. , „ r above satvleo rc feeder fee. T
q'd4" «re :•ti� c:�1 r n t• 5:' �•!@ 0 1 ••.M1 a.' ':...LIT `. 4 r�,;; {i !tie::. 7.42 2
::r..�:y:, ,' �'�.. :.:.. �..� ; �.� -'F; :>:. ;'• - T ���. . ; .y::,:':'. eac branch circuit
Business name: B Fee for branch circuits within
t� en Electr service or feeder fee, first
1 56,IS 6.18 2
Contact name: Charlynn Lei f sen branch circuit
Each add•► branch circuit 1 7A2 7.42 2
Address: 10 9 4 8 SE Valley View Terr Mbeellancous (service or feeder not includes) ,
City/State/ZIP: Happy Valley, OR 9 7 086
Each manufactured se rvi ce a or m modular feeder 67 s4 2
dwelling, service and/or feeder
Phone: (5 0 3) 698-3417 I Fax:: (5 0 3) 698-2486 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E -mail: _ •
N �.�,.,, �.�.�.:) ,F Jw r! `s Sr•• ;�;�y��!y y ; ; • {., r,r, . - F::..$� .:; .:�;`,.d -C "`: 'r Sign or outline lighting 67.84 2
.'SV ,. ..'E:`h`d ":..;:•:a- 4'�F•s' �!+;sr4y'i;vti " ':nr:0..;'__ . :::. x" 7, +a;.:i•: ", % Signal sitwita) -moray
- t�_• ^tie':
Business name; f Johansen Electric panel, alteration, or extensi Page 2
Each additional inspection over allowable In any of the abov
Address; 10948 SE Valley View Terr Additional inepection(1hrmitt) 66,25/hr
City /StateJ2:lP: Happy Valley , OR 9 7 0 8 6 Investigation (1 hr min) 66.25/ hr
Industrial plant (1 ht min) 78,18/hr
Phone: (5 0 3) 6 98 —3417 1 Fax(503) 698-2486 in apectinna for which on fee is 9000 / hr
• incoll bated S5 hr min
CCB Lic.: 5153 9 t Electrical Liiej'�3 -- 24 3 C I Su rv. Lie.: 2 ✓ 0 53 S „ "' "f; '.' ' `
Supry Electrician signature, required: , 42 4 . Subtotal! 63.6 s
Plan review (25 /o of permit fee):
Print name: Carl Johansen � • j Date: 9 / 13 /12 State surcharge (12% of permit fee): 7 . 63
T'O'TALL, PIIRMIT FEE: 71 . 2 3
Authorized Signature: t i This permit application expires Ire permit b not obtained within ISO
Print name: Charlynn sen I Date: 9 / 13 / 12 days otter it has berm accepted as complete.
• N of Inspections allowed per paint.
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