Permit C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00687
�i�� DEVELOPMENT SERVICES DATE ISSUED: 11/24/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S112DD-00500
SITE ADDRESS: 15860 SW UPPER BOONES FERRYRD B- I S
SUBDIVISION: IMPGON BUSINESS PARK 1 ZONING: I -L
BLOCK: LOT : JURISDICTION: TIG
Project Description: Job # 8413 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 JOHANSEN ELECTRIC INC
15350 SW SEQUOIA PKWY #300 10948 SE VALLEY VIEW TERR
PORTLAND, OR 97223 CLACKAMAS, OR 97015 -000
Phone: 503 - 624 -6300 Phone: 503 - 698 -3417
Reg #: LIC 51539
SUP 2053S
FEES ELE 3 -243C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 11/24/03 $173.20
[TAX] 8% State Surcharge 11/24/03 $13.86 Rough -in
Elect'I Final
Total $187.06
This Permit is issued subject to the regulations contained in the Tigard Muniapal 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: ic,p/fl Permit Signature: j 4, i p. _
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: 11/19/2003 Time 2 12 14 PM Page 2 of 3
' v
E lectrical Permit Application
Received ., IS ectrical ,/
Date/By / i /e7 / 4 15
_ Permit C-0-003 - 00 & g7
City of Tigard Planning Approval Si.
ti
) 3 '125 SW Ball Blvd. i*--ECEIVED ,Dmap. _
Plan Review Permit No.:
Other
Tigard., Or.?.gott 97223 . Datc/py: Permit No • _ ..... ______.
Phi on : 503-639-4 1 7 1 Fax: '1\ WN),., ,., , , • i ft, It-Rirvicw Lartd Use
Laternet wwv. d.or.us 14U ini,A .... . , ■ii-4, Date/By: Case No : ---_
-2 • '10 ul-I44 Contact _Paris.: ...t See Page 2 for
' ---
2--hour "inspection I
Request d -n-
W crE A R D i ; Name/Method: _ Supplemental Infrm
oation.
BUILDING DIVISION
,.,.., -":77, 1 .:'i=7.- =..'•= .,- •.' .,•i..
111 Nev.' construction [II j Demo-titian_ I r0 Ser./ice over 225 amps- 1 13 Health-care facility
• 1 commercial 1 0 Hazardous location
El .4,dditiontalterationireplacement n o - ti,,er: 0 s,,-vie, over 320 amps-rating of 1 0 Building over 10,000 square feel,
I i lI-..-:?.:• ''.:-;:... c:-EONSTioacriciNA .: qrw:0'... •-•• i & 2 fannly dwellings i fOUT OT MC= residential :Mita at
0
I 1 & 2-Family dwelling ' 13 commerciaiithdustrial 1 0 1 over 600 volts nominal sine ,:rt:71,oce
1 0 !Wilding Ov am
er three stories 0 Feeders, 400 amps or
Lil Aecessori Buildine n Multi-Family i f 0 Ciccopant had over 99 persons 1 0 Manufactured snucturcs or RAT park
0 laster Builder EII1 Other:
1 ' 0 13E,ressilimg id
ghtan
. i 0 Other; ......_ ..... __ . . . .
ON;g0110040.N4iiii'd_TeMial,W:NO lga-TI Submit is of plans with any of the above.
The above are not applicable to teMpolary construction sci vice.
Fhb site addreNs 15860 SW Upper Boones r----.Thr-'4.11-.1 -..
-
.- . r..7.4,41.S.V^:i!t*'4::$41Eh"'".$•-
I Suite if: j Bldg./Apt:iv Nu mber of inspections per perinitallOwed
i - • - _
I Pro lICI Nanie:-Ma - GaReY OR- Ai 2._ P cR,____, 1 , Description i Qty Fee (ell.) Tot; 1
al
' — a" New residentia-single or ;nut 6-family per f 4
Cross s:Te dwelling unit. Includes attached garage.
et/Direetions to job site: t
Set vice included:
1000 sq. ft I'd less ., 1 145,15 4
Each arlditinnal 500 siLft...ormition thereof ; 33.40 I -
---'--------------- Limited ennv residential 15.00 s •
Sitbd iv ision _____.._. i.imted en non residntial L .° I
: 1 Lot ft: _,.... ,
..._ _... i eEpg e 75 .
Tax man, )arcel #: Each m anufactured hum. or ruodular dwcillitz .
§e,RITMONRiblel„i:,•.'_:,..-A7::-;,A-4.ger...a.;:,•, serviec prid/or feeder 90.;0 1 2,
'------ Services or feeders - Installation,
Tenant Improvement alteration or relocation; I
200 amps or less 80.30 I 2
201 amps In 400 amps 106.85
____
401 ampsto 600 F.nws 100.60 I 2 i
— —
AMOURT6151kAtilar'PR:3100/40.5016;'',:.42.950i.laggrtaa 1 601 iimPs m IWO artiPs 240.60 1 2 1
' ; Over 1000 :mix or volts 454.65 1 -.
Name; I Reconnect only 00 85 2
Address: . Temporary services or feeders - Installation,
-- I alteration, or relocation:
City/State/Zip: :
. i 200 amps or less 6635 I 1
_
.-r—
I Phone: l_Fax: ! ! 201 ns to 400 amp 0 TI
L I __._. am — -- IC-O 3
-,
,r„..1,„ , 401 lo NO amps l 33.'15 .
.; egetVP:eg Branch circuits it •
- new, a..tration, or
Name: Johansen Electric Inc. __________El ext.:D.5in. per panel: .:
Pee for branch circuits with purchase ot -
Address: 10948 SE Valley View Terr. A. service or feetler fee, each branch circuit 4-?11' 6 tjs -4-357G0 2
I Cily/StaTe/ZIF Clackamas, OR 97015 ft_ Fee for brand) chcuits without run-chase of I
Phone: ( 698-3417 Fa x: (503) 698-2486 .--i service or feeder fee, first branch circuit LI 468.5 L16,15 2
I Hach additional branch circuit Tor i 6,65 1,342.35 2
1 E_ Johansenelect@aol.com mi6c.(Serviccar0edei not itIcfaded)
FTINCRWT,ir,14:190017-War,,Vatorita4t.Wyx...e,t4ptiMtI,S• ' •,_tc:, „ s'l
I_IteLart2atIr_irtirAtott circle I 40
—..... -- 1
[;..,4 t..,,,W.W.,..-- , ---=:Y= -- " — " 4' ''''' ' , Each siw. ia• outline liAl I 53.40 2
l
Job No: 8413 Signal encode) or a limited ener a. panel,
I
on I 2 .
_
1 Business Name: Johansen Electric Inc. alterationor esterist Page721 Description: --. -
— — I
Address: 10948 SE Valley View Terr. - 1 1
Each additional inspection over the allowable in any unite above:
Citv/Stateqp: Clackamas, OR 97015 _ rer inspection pet hoar (min I hour) 62.50 I
Phone: ( 698-3417 F (503) 698-2486 fee. MI i
-
CCi3 Lic.4-: 51539 Lie. 4: 3-243
Supervising electrician Subtotal $ 1 / • .20..j,
signature required: Plan Rcvtew (25% of Permit Pee) S E
Print Name: Carl K. Johansen I...ie. 4: 2053S State Surcharge (8% of Permit Fee) $ 4 /3 . Ye,
.. _... - ----- -- --------- -- I TOTAL PERMIT PEE $ ir . - ' /87. 0
,-\
A ulhonzed
WI i .r
dlk q*,,AL.THfH' 1 11/19/03 Nutiv.:: m This permit application expires if, a permit is not obtained within
i
Signalure: .s < ' . ic• 180 days after iiitus been accepted 01 complete.
• -- *Fee methodology set by 'Fri-County Building Industry Service Board.
CharlynizLY. Leifs n (..)
..,
. (Please print name)
iADstsTerrrut Points \PloPerrnitApp.cloc 01,03
! ' .'
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received X-1 7` // (-5 Z Date Requested /— 2 2 PM BUP
Location � i 'AO /11 :-% MEC
Contact Person Ph ( 9b ' 5 2 PLM
Contractor Ph ( ) SWR r�
BUILDING Tenant/Owner D r e5 ELC - (JCD h cr9
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Fi rewal I
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 PART FAIL
ELECTRICAL el a 3 _ Gc 3 g 3 - f-{ VA G C i � - •
Service !�
Rough -In L fZ G ' G 6 7 ,l]�4 ;- ij !FP
UG/Slab
Low Voltage U
cu:�.:
( PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
❑ Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line
ADA F Z 2 0
Approach/Sidewalk Date 7 Inspector E
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL