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Permit
CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2005 -00706 DEVELOPMENT SERVICES DATE ISSUED: 9/21/2005 °V III 13125 SW Hall Blvd., Tigard, OR 97223 503-639-4171 PARCEL: 2S112DD - 00701 SITE ADDRESS: 15822 SW UPPER BOONES FERRY RD BLD.0 ZONING: I - SUBDIVISION: OREGON BUSINESS PARK II LOT : JURISDICTION: TIG Project Description: (6) 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: 5 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: 503 - 624 -6300 Phone: 503 - 698 -3417 FEES Reg #: LIC 51539 Description Date Amount SUP 2053S ELE 3 -243C [ELPRMT] ELC Permit 9/21/2005 $80.10 [TAX] 8% State Surcharge 9/21/2005 $6.41 REQUIRED ITEMS AND REPORTS Total $86.51 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: ��) , - Permittee Signature: _W.2 e 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: 9/15/2005 Time: 4:00:48 PM Page 2 of 3 II, . Electrical Permit A s �' • ' :- i I OK OIII( 1. 1 i•: nNl.1 City of Tigard VE© Receives Date/B : / 0 5 M i nu Pert No.:C I / O 1 13125 SW Hall Blvd., Tigard, OR 9 C Han Review Phone: 503.639.4171 Fax: 503.598.1 'P 1 2005 i ^� � v u OtherPeit. -' Inspection Line: 503.639.4175 ,J. I l i l ' DateB m Date Ready/By: RI See Page 2 for Internet: www.ci.tigard.or.us c8 .�. Y • t Notitied/Method' Supplemental Information a ` 3(' ,� ' ' Il i- + - ,�*v : i. i. 1 t 4 _..d' y -u r ' ]' 1 ✓VS ,. � -yam , F 7 i - r .nrYt i z., ,,.. bJ,,,,, .....� '.�z,,_..a ., t i I - ilf 1 1 f 3t �1 c n, I. a�,�� } ° 1,! . . (1?rF, r r. 4 r' _'- ' . ; ?1'1' .. -_ a'.f..4 n ..:.:1 � _ 111 : :..: & . i i ❑ New construction ® Addition/alteration /replacement Please check all that apply: ❑ Demolition ❑Other: ['Service over 225 amps, comm'1 ['Hazardous location t !it i5I t � , q , ,'� s �� ".� .Z;,'-4. OR , ,. r ,,, .' S r , , j n ❑Service over 320 amps - rating DBuildng over 10,000 sq. ft., ` 'I `'r'_..a i x ±;<..:�r ., r„ _ , i ._`'Y: t r?,, -- ,` .,. . , , �I ? Ir..z.i!:_ 'i,] - - , _ .L 't, 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 ❑Building over three stories ['Feeders, 400 amps or more ❑ Multi - family ❑Master builder ❑ Other: DOccupant load over 99 persons ❑Manufactured structures or ? fl ry _ � u ; e , t � 11 tl '$ 1 1 � 9 ',_ _ a 1 o-; to ? r . r iiH- Y - t .' q .I '` RV ark <._.�,� �.:cz i _ �: , ro„ - ..:, .: .,+ X i ... e: r�'. - � � a' . �.. -,.. ,_�, . _c.:..a5 ❑Egrcssllightv1g plan D Job no.: Job site address: 15822 SW Upper Boones ❑Health -care facility DOther: Submit./ sets of plans with any of the above City/ State / ZIP: The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: Project name: US Door & Hardware ` ` c • . ,' .;•u -, - ` • f'' t -��;~ I J! , � ^ mpe� Qb• Fee. Total •• Cross street/directions to job site: New residential single- or multi - family dwelling unit. Includes attached garage. 1,000 sq. R or less 145.15 4 Subdivision: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1 Tax map/parcel no.: Limited energy, residential 75.00 2 I ' - ns v PL i n i a 4 Yi 'IT3i!SG',�= Limited energy, non - residential 75.00 2 i Y .; L a } + , E 1 T F p �y Lx .t t� :,1- f II 1: ._._..a._.t 11.V.eA.. _ -.....:...;,;) rqo ;:a to i taeis.'",;1. ` ; :i : �_j_.._.::✓..,.. 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. F t 6 t .i 11, I r ;'r 6 ! ,, r`ir a , � ", I ry t n +:zit ' .7, inrn � L-T e2'i , ;I 201 amps to 400 amps 106 85 2 s._ .!.: r:'!. :.a:,_.. .,...tiA _ .4^;..,t,. _,� ?_ , r1 L'.f . r."'";,_;ts ..._ . . n .!s:,, , ,., - 't?.5 ..... ..: }, r 2/ {: r amps amps .__ --- � � -� 401 errs sto 600 s 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 ° relocation Phone: ( ) Fax: ( ) 200 amps or less 66.85 1 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 panel L; i' - : ,'IM: .P ,3 1- 41 701 N 11 1 E t �� df.: ' 'Z i. - J ' , x 1 5 - s... A. Fce for branch circuits with - - ;t : bit. Business name: Johansen Electric Inc. branch circuit 6.65 2 B. Fee for branch circuits Contact name: Charlynn Leifsen without service or feeder fee, 46.85 46.85 2 Address: 10948 SE Valley View Terr. each branch circuit Each add'I branch circuit 5 6.65 33.25 2 City/State/ZIP: Clackamas, OR 97015 Miscellaneous (service or feeder not included) Phone: (503) 698 -3417 Fax: : (503) 698 -2486 Pump or irrigation circle 5340 2 Sign or outline lighting 53.40 2 E -mail: johansenel�ect@msn.com Signal circuit(s) or limited - 4<i�: .. I.tt.rlr.? s.,;:, i (� �=..Y d P °' t �?'t:M .r , t i _ t 5? l' VAl rtilwt ... ±Wgi...:;illily s; energy panel, alteration, or 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 mm) 62.50 Phone: (503) 698 -3417 Fax: (503) 698 -2486 Industrial plant per hour c _ 73 75 '_ .. Rd' . 17.F. ' ,� u.1 4...,... ,i'l,ilD i r 4i IY j I fd` a?! •. CCB Lic.: 51539 Electrical Lic.• 3 -243 S 'rv. Lic.: 2053S Subtotal 80.10 Suprv. Electrician signature, required: r », / /� lrrmal Plan review (25% of permit fce) State surcharge (8% of permit fee) . 6.41 1121:74M7/ , Date: 9/ 15/05 TOTAL PERMIT FEE 86.51 Authorized signature: , .,.ieIAIIIIIIIIMIIIMIII This permit application expires if a permit is not obtained within LSO days after it has been accepted as complete _ . Date: 9/15/05 • Fee methodology set by Tri -County Building Industry Service Board •• Number of inspections per permit allowed i. \euiidle \Pamiu\erc- PcrmhApp doc 12/03 440-16 IST(10102/COMtWEB I CITY ;OF TIGARD BUILDING DIVISION PERMIT #: ELC2005 -00706 13125 SW Hall Blvd., Tigard, OR 97223 - D ATE ISSUED: 9/21/2005 Phone: (503) 639-4171 ' I Inspection Requests (24 Hrs.): (503) 639 -4175 —_-_- "'I L INSPECTION WORKSHEET FOR DATE: 10/14/2005 TIME: 7:02AM PAGE: 99 SITE ADDRESS: 15822 SW UPPER BOONES FERRY RD BLD.0 CLASS OF WORK: SUBDIVISION: OREGON BUSINESS PARK II LOT #: TYPE OF USE: C p PROJECT NAME: US DOOR 8, HARDWARE DESCRIPTION: (6) branch circuits. OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: 503 -624 -6300 CONTRACTOR: JOHANSEN ELECTRIC INC PHONE #: 503 - 698-3417 Inspection Request Scheduled For: Date: 10/14/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 018353 -01 503.969 -5717 N Corrections /Comments /Instructions: :_2` g.& ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: /O/Of Phone #: (503) 718 - Y