Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2012 -00591
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/11/2012
Parcel: 2S112AD01000
Jurisdiction: Tigard
Site address: 14945 SW SEQUOIA PKWY 150
Project: RTM Investments Subdivision: PACIFIC CORPORATE CENTER Lot: 1
Project Description: (1) service and (20) branch circuits for TI
Contractor: JOHANSEN ELECTRIC INC Owner: PACIFIC REALTY ASSOCIATES LP
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: 503 - 624 -6300
FAX: 503 -698 -2486
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 10/11/2012 $100.70
Specifics: amps or less
20 crt Branch Circuits w /Purchase 10/11/2012 $148.40
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 10/11/2012 $29.89
Electrical
Type of Const:
Occupancy Grp:
•
Total $278.99
Required Items and Reports (Conditions)
This permit • issued subject to th= regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable law All work will
be done accordance with approve. plans. This permit will expire if work is not started within 180 days uance, r if work is suspended for more the 180
days. TENTION •regon law - • •u to follow the rules adopted by the Oregon Util' '•n Center Those rules are set forth in OAR
952 -00 -0010 throw . OAR 952 -0 r -0090 • ay obtain a copy of the rules or direct questions to OU by callin 0343 A. • 87 or 1.800 332 344
Issu d By: //_/ Permittee Sig ure: ✓ :;
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' / i �� J i ` G Date: � /��?
LICENSE NO. ,. 5
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.
Electrical Permit A.pplic . CEIVED l t)I, t)l It l L. 11\1 1
City of Tigard OCT 11 2012 R - /o��'�� Fntmit e %? -6059/
13125 SW Halt Blvd., Tignnt, OR 97223
. I Phone; 503,639.4171 Fax. 5030 Tip Other Fermit' mate Pal / 'JI — 60 /92
r r I Lew, SU -or. g ov BUILDING.,,�w ttcd/Mothod .
lntornet' utnvw,tigard- or.ov (Atl'
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, : ,1''., p t x •'6 `'., , {i° '/ •'” y �•y ''''+'1::T,' .. _ :';f . 1- i t,:, ,,,,,YVti 1•-' , x ,.
•�, •,i . ,t r r : �Trr � ._. 'FO, y j�'l.A ''1 •�'°'�.,V. . ..'h -., ;:� ., R;:n "l ,)�Iti;
❑ New construction in Addition/alteration/replacement Planate cheek all that apply (submit 2 acts
e of plans w/itns checked below)'
❑ Serino or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: a4scre the available Cault current ❑ Marinas and boatyards.
''.F 'V -r : :: ; :1 :: , ;`,.1h_ '4.71 ,1;i`: c. t, Sr
y; t .r.,. �. y,"c , :'' V' ": ..i
y i -1/^ „a•i'• +,-i' a , ' . t �- , '' , '" •:- i, - •
. ;t'• loss tog md,or 1 4,000 0! ❑1'
�,; •L�C,�,f ..•`�•?, ;; •,,,, /: :; +;,; :• '••� r` 2 , loserogratnd,a la,nno []Cantmacaahua aarioulWral
❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps for all uatnr installations buildings.
0 Multi - family ❑ Master builder ❑ Other ❑ Fire pump, ❑ Installation ut 75 KVA ,rr
: a ., c -r r_, „i( s y - .r•j ,„ :17.7 a /, ,• . ,,,,c. , ❑ Emergency system. buses Separately dectvod system.
' , t -`" fit, ,�, ,.
- 'i�c' -1. a'+ "�`:F ,,,..���FrY�'��:CS` ,_ ,r „,,;,,•':,.a. °`' ❑Addtnon motor load of ❑"A "E". „ ,.1.
Job uo. : Job site address: )0011p,rr occupancy
14945 S W Sequoia , 15 0 - ❑ Rix er more roaldontial man. ❑ Rewraational vehicle parks.
City /Stale /Z1P: ❑ llealtlt -cerc facilities. ❑ Supply voltage for more than
❑ Hazardous locations, 600 vrdn nominal.
Suite/bldg /apt. no 150 J Project name: RTM Investments ❑ services or feeder 600 amps or more
Cross street/directions to job site: n oa• I T Fe.. i rani 1
New residential single- or mull- family dwelling unit.
includes attached garage.
^
Subdivision: 1 Lot no.: 1,000 sq ft or less 168.54 4
L• a. add' 1 300 sq. ft. or portion 33 92 I
Tax map /parcel no.: Limited energy, residential '
. y�.��..c ,, • ,,, ,; .�• , (with 2
C . ?. }:;.;, r,r,'', :h;, :,.: „ :`.. w•. , y•': P :; '';.q,,,;;4•_{i1C., ;, , with above 9 ft) .
Li mited energy, multi-family
Tenant Improvement residential (with above 49.0) 75 00 2
J ,
Services or feeders fnstallatinn,,alteratlon, and /or relocation
�!'�, _ 200 amps or lest J 100 70 IG�`i1D 2
iy ',ti, i. I1 ' F v; ') '1 %'� r , i V I , "ri�;�. i .:: ,: Y 20l mops to 400 empa 133.56 2
Name 401 amps to 600 amps 200.34 2
. 601 ample 1.000 amps 301 04 2
Address: Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and/or
City/Slale/ZIP: relocation
Phone: ( ) I Fax; ( ) 200 amps or less 5936 1 I
201 amps to 400 amps 123.08 i 2
Owner installation: This installation is being made on property that T own which is not 401 amps fn 399 amps 1 168 2
intended for sale, lease, tent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits — new, alteration, or oxtcasion, per panel
Owner signature: Oats: A Fee for branch oireuits with
y }; , ap, n ;i a , abovn snrviuo or f Coo, t�
2
_,1i. :::1; �,i'u''�3;:"� r:#0 "e` .' }t� . /yr,.2 - :: - ;a_� • ,,,,a;:****,,, ',�'),,,, . _ �„� 742 ( '
. . -1 � ;y. '•a oechbranchcircuu e
Ft l without Business name: Johansen Electric
servtee or feeder fee, first 36.18 2
Contact name: Charlynn Lei f sera branch circuit
Each add branch circuit 7.42 2
Address: 10948 SE Valley View Terr Miscellaneous (service or feeder not in cluded) -
Each manufactured or modular 67.84 2
City /Stato/ZlP: Happy Valley, OR 97086 dwelling, service and/or feeder _
Phone (5 0 3) 698-3417 J Fax:: (5 0 3) 698-2486 Reconnect only 6784 — 2
Pump or irrigation circle 67.84 2
E-mail. ,
"� _w •�` �'1Fl,c'�rk l, '�y. y�,; j-if a,��1- a ., n,�, ��,:, ,'.'� -, " ;1b'„ Sign or outline l 67.84
�_'�.�:"t .,h„ . n �.�. ^� 3 ". .. 'i :,y- . .;R �� .a ,t. + ,l -,•l ��'�r� �� Signal airoait(s)ur limited- energy
B11611Msname: Johansen Electric panel, alteration or extension. PaRe2 2
, Each additional Inspection over allowable In any of the above
Address: 10948 SE Valley View Terr Additional inspection (I 66.25/
City /State /ZIP: Happy Valley, OR 97086
Investigation plant t l min) 78 25/ hr
�py y y - Industrial pint (l hr min) 78 18/ hr
Phone' (5 0 3) 698-3417 Fax: (5 0 3) 698-2486 In apections for which no fee is 9000/ hr
•ifioall Bated 'A hr min
CCB Lic.: 51539 J Electrical lL Lie. :3- -24 Supry Lie• 20535 , -; F :'' 'D ,. ;('_.�aiw� .•'lam 7">;' :'+s ,
Suprv. Elccti'ician signature, requires , /� subtotal: 1 , tit
Plan review (25% of permit f�)' _
Print name' Carl Johansen Date; 10/11/12 State stuoharge (12% of permit fee): 2.Q1
TOTAL PE,Ittvfl FEE: C,16, £
Authorized sign al fue;C�
T hb pemtlt applkatlon aspires B a permit is not obtained within 180
Print name: Charlynn s en Date' 10/11 12 also Awn has been accepted as complete.
• Number of htepoeuona allowed par permit
•
I:1Dui)diaalPmsniiss it.r:•1'ermMrr ml(tlio 440.4615T(t1/051COMWOO
Z /T 'aova 986Z869E05 986Z869605 IO Ia 11aSNVHOr vsa 66 =Z0 ZTOZ- ET'1DO