Permit le ELECTRICAL PERMIT
CITY OF TIGARD
PERMIT #: ELC2005 -00921
DEVELOPMENT SERVICES DATE ISSUED: 11/30/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171 PARCEL: 2S112DD - 00701
SITE ADDRESS: 15800 SW UPPER BOONES FERRY RD A -300 ZONING: I -P
SUBDIVISION: OREGON BUSINESS PARK II LOT : JURISDICTION: TIG
Project Description: TI. 10 branch circuits.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF 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: 1 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 9 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
FEES Reg #: LIC 51539
SUP 2053S
Description Date Amount
ELE 3 -243-243
C
[ELPRMT] ELC Permit 1 1/30/200: $106.70
[TAX] 8% State Surcharge 11/30/200: $8.53 REQUIRED ITEMS AND REPORTS
Total $115.23
•
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- 344. ,
Issued By: � 0_ i Permittee Signature: 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.
•
From Charlynn Leifsen 503 - 698 -2486 To City of Tigard Date: 11/29/2005 Time. 10 08.28 PM Page 2 of 3
• Electrical Permit Application,- 7 i m ell 1.1( I: l .i: l)\I:\
City of Tigard I � _ Received i�l - - ' # /
13125 SW Hall Blvd., Tigard, OR 97223 Date/0 : t 30 I r a /, --c7 ii
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960!CV J 2005 ". ` li lib' t , r at Other Permit
Inspection Line: 503.639.4175 A, • Date Ready/By. rte 182 See Page 2 for
Internet www.citigard.or.us Notified/Method J Supplemental Information
/, - r w /fie T I C A 7 1
i 1� 1 A. 'ti 7�ai :.. t K' .3A{ T v '�.�:� 1 y s7S Y•",�4 r P r •[t'2/ it
' P lay ' ifL r ' l7 i eJ M,r t ti ❑� �� t > "' '� tut x; i 'i , k" , T(` i ti I s 4
...�L,. f. +�)�, rz_ z :. >_..� ,t.v . 1, t. _.,:. .. �. 3i _i�,. » a_.... s ,..- ���{...�� �.,..: ;��nl.�r:. ... :1 ; �,1� ..�:.+'�uit}....�; .. �r.. � . �?3.,J� ,.,.i - ..,�N1.
['New construction ® Addition/alteration /replacement Please check all that apply:
❑ Demolition ❑Other: ❑service over 225 amps, comm'I ['Hazardous location
' L l r : [ - , 4 , . 1, . N ` :; .c Tyt a 2 f^ 2/ 4:, . a r m ' i r= e' i �, i i
.
ID Service over 320 amps — rating ❑ Buildng over 10,000 sq ft.,
_ ` . �. � . �: a . ia : , ._:: i � : � _. _ _� .� 4tr t ;�� ;. r, - �R. s,, , 7 of I- and 2- family dwellings 4 or more new residential
❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
Other: ❑Building over three stories ❑Feeders, 400 amps or more
El Multi- family ❑ Master builder ❑
P a 'i �'' t�': - t to ttas , S `tfL' �°;S. r � r ❑Occupant load over 99 persons ['Manufactured structures or
? 4.# - r i s d ryf I ! it 't9 tit .? e ,.? „Af^4� ' '`r , i 1+. ❑ 8n Sh g RV
. _.. -.d _ ., 3 _ ., , _ . _ � te,u � .. ...:t.��s .�� l t .- 1r
>.t�:, ',;-. ��J<r.,t.. �. �,..a. , . _ t . . - .;.:!5 E SS/II tlri Ian park
lob no.: Job site address: 15800 SW Upper Boones,300 [Wealth-c -care facility ['Other
Submit 2 sets of plans with any of the above.
City/State/ZIP: The above are not applicable to temporary construction service 77
Suite/bldg. /apt. no.: 300 Project name: Matthews Gallery
Deaetiptbe Qty. Fee. Total
Cross street/directions to job site: New residential single- or multi- family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no
Limited energy, residential 75.00 2
''a,.. ti �S parceI '” k °'� Y" r icur,c'<' - 7 - d ' '� - �.. illi;, ., :; Limited energy non- residential 75.00 2
kil6 .,._l, 1 ....,_,.__ t.....:.t ,�t; ,81.., 3. := ... 5 , .tom;' 4tl ° � .� , 6I 43,; �_. ;.: _ i Each manufactured or modular
TI dwelling, service and/or feeder 90.90 _ 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
` t E i v .1't l s F l -, r T 9 : i
. , ,,:ilt k � (t,..' r 1 � . ' i d a e : r , ... 9 4. 3 I .; ;
t t#:+� ` •. . :{: 401 amps to 600 amps 160.60 2
Name: 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66 85 2
City/State /ZIP: Temporary services or feeders installation, alteration, and /or
Phone: ( ) Fax: ( ) relocation
200 amps or less 66.85 1 I
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133 75 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per papef
°sEx.t`= i. P- .` ` a- R1, N s c J� t r s i,1 3,iii .. r ... »a .T. 'S r
a z „ ( t ,„ i "� ', 4 . A. Fee for branch circuits with
:.. �.- .r„ -� .._.. .... t.. , �F:�r s'nF �Y +..,� /. -. -� �e i;. � IJI,.:��.,y r .§=-b '� qa. .�, , .�..,� service or feeder fee, each
1 kg 6 n, 2
Business name: Johansen Electric Inc. branch circuit ' r
B. Fee for branch circuits e , , g
Contact name: Charlyno Leifsen without service or feeder fee,
each branch circuit 1.6( 2
Address: 10948 SE Valley View Terr. Each add'l branch circuit 6.65 5-q.2, 2
City/ State/ZIP: Clackamas, OR 97015 Miscellaneous (service or feeder not included)
Pump or irrigation circle 53 40 2
Phone: (503) 698 -3417 Fax: : (503) 698 -2486 Sign or outline lighting 53.40 2
E -mail: johansenelect@msn.com Signal circuit(s) or limited -
Q r 91P,,�sra” `'rr fi r t . , - - - c -I 75°-' -', i-: `I . tilt, ,r ' ,t �P 8
r..i.�.a. t�•P:rn . tit: �E:; ��k{ �. O. il�,..M..,li,..:..jr-r.k..� .. n _ J =��,��{�e�.._.a_»,,ti.'L,�s._� . a te Ig �.. aria 11CI,alterat10n,0I
extension. Describe: Page 2 2
Business name: Johansen Electric Inc.
Address: 10948 SE Valley View Terr. Each additional inspection over allowable in any of the above
Per inspection 62.50
City/ State/ZIP: Clackamas, OR 97015 Investigation per hour (I hr min) 62.50
Phone: (503) 698-3417 Fax: (503) 698 -2486 Industrial plant per hour 73.75
CCB Lic.: 51539 Electrical Lic.• 3 -243 S .rv. Lic.: 2053S Subtotal 42e106 •,70
Suprv. Electrician signature, required: .POr f~ 1■7.- Plan review (25% of permit fee)
� rJ State surcharge (8% of permit fee) - 34.26 55
G�✓fi/ ./ / , , i Date: 11/29/05 TOTAL PERMIT PEE 462.56 d3
Authorized signature: / , /� This permit application expires if a permit is not obtained within 180
� � �� days after it has been accepted u complete
- , / _ Date: 11/29/05 • Fee methodology set by Tri -County Building Industry Service Board
'• Number of inspections per pemtit allowed.
.1 Bull dio51Pennits\ELC- PctmltAyp.doe 12/03 440461ST(10/D2/COM/WEe
CITY OF TIGARD
BUILDING DIVISION PERMIT #: RCM:15 -00931
,a
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/30/7005
Phone: (503) 639 -4171 1
Inspection Requests (24 Hrs.): (503) 639 -4175 1 1 �-
INSPECTION WORKSHEET FOR DATE: 1/27/200 TIME: 7 :00AM PAGE: 4
SITE ADDRESS: 158300 SW UPPF_R :OONES FERRY RD A -300 CLASS OF WORK:
SUBDIVISION: OREGON BU SINESC• PARK II LOT #: TYPE OF USE:
PROJECT NAME: MATTHEWS GALLER
DESCRIPTION: TI 10 branch circuits.
OWNER: PACIFIC REALTY ASSC)CI' ES, PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 603-698 -::117
Inspection Request Scheduled For: II e: 1/27/2006 Pour Time:
Code # In • -ction Description on Contact # Message
199 Electrical final 0258 - 503 - 704 -1534 N
Corrections • - -• - Its nstructions:
A PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ao8 j., E Date: 1 21 `1 6 Phone #: (503) 718- 2411‘
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2_00S- 0:1921 •
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/30/200
Phone: (503) 639 -4171 �'
Inspection Requests (24 Hrs.): (503) 639 -4175 _..' IL
INSPECTION WORKSHEET FOR DATE: 1/25/2006 TIME: 1:03AM PAGE: 14
SITE ADDRESS: 15800 SW UPPER BOONES FERRY RD A -300 CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK II LOT #: TYPE OF USE:
PROJECT NAME: MATTHEW`a GALLERY
DESCRIPTION: + i 10 branch circuits.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503 - 698 -3417
Inspection Request Scheduled For: Date: 1/25/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
139 EIectiical final 026712 -02 603- 6913.3417 N
Corrections /Comments /Instructions:
U ISO \) 1 ( E C LEH RA p) C i/J FR.b,JT 6f ALL PAN/ea/m(4
,p.o. Ho , 26 .
P2,0o i 0� P i s . N G L , S� p 0 Lis IckK An Litt Li
Ntin J SSVe wrif1 occv A c
aovtDE R� ' 0A) 40F Ftoc( cigkri c\ NI k),
R-q3bF 1 u NTT z,
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL Xi CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G A O8 L Date: 1 1 Z 5 0 b Phone #: (503) 718- 2--1111 2--1111 4
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2006 -00921
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/;;0 / 00
Phone: (503) 639 -4171 • il
Inspection Requests (24 Hrs.): (503) 639 -4175 °:_.,
INSPECTION WORKSHEET FOR DATE: 1/17/2006 TIME: 8:36Am PAGE: 6
SITE ADDRESS: 16800 SW UPPER BOoNF:S FERRY RD A -300 CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARI< II LOT #: TYPE OF USE:
PROJECT NAME: MATTHE+/S GALLERY
DESCRIPTION: TI 10 branch circuits.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 603_63Q -31 1
Inspection Request Scheduled For: Date: 1/16/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
130 Ceiling cover 025033 -01 503-698-3417 N
Corrections/Comments/Instructions:
PkQAJ l Voice 0 A`1 p Pi L
6 L.
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
IN Inspector: ' 0 % Date: t c � 1 1 b b Phone #: (503) 718 -X44
i
4 ` 7) F C7I� it OF TIGARD -
BUILDING DIVISIONaaA\ AA . . PERMIT #: ELC200S -00921
13125 SW Hall Blvd., Tigard, OR 97223 013 i Aa sEr\ i a DATE ISSUED: 11/30/2005
Phone: (503) 639 -4171 i..�11 i�li 00 i Aaa\ 7
Inspection Requests (24 Hrs.): (503) 639 -4175 ...'!!� °' 013 i ga:�I3\ Fa
0E
INSPECTION WORKSHEET FOR DATE: 17J2912005 TIME: 7:00AM PAGE: 43
SITE ADDRESS: 15600 SW UPPER BOONES FERRY RD A - 300 CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK II LOT #: TYPE OF USE:
PROJECT NAME: MATTHEWS GALLERY
DESCRIPTION: TI 10 branch circuits.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503-69t3-3417
Inspection Request Scheduled For: Date: 12/29/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
125 Wall cover 024135 -01 503-209.3917 N
Corrections /Comments /Instructions:
R: ,Al 4 FL Q it wa7 Ka
SD (Li lo sTcNic (_ LiI)E bQRwiN sl.k6c,Jip1
F1 Wk.. ex. AN& / tA 6 -
- - A! ►�sti ( . d I
.� i
W ALL 0601. 6
nI PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ ' IL ❑ AL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: vi Phone #: (503) 718- Zii&-