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Permit CITY OF TIGARD ELECTRICAL PERMIT � COMMUNITY DEVELOPMENT Permit #: ELC2013 -00019 Date Issued: 01/10/2013 TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503.718 2439 Parcel: 2S113AD01800 Jurisdiction: Tigard Site address: 16716 SW 72ND AVE B16 Project: Spec Space Subdivision: ROSEWOOD ACRE TRACTS Lot: PTS 5 - 1 , Project Description: (1) branch circuit Contractor: JOHANSEN ELECTRIC INC Owner: PACIFIC REALTY ASSOCIATES 10948 SE VALLEY VIEW TERR ATTN N PIVEN HAPPY VALLEY, OR 97086 15350 SE SEQUOIA PKWY #300 PORTLAND, OR 97224 PHONE: 503 - 698 -3417 PHONE 503 - 624 -6300 FAX. 503 - 698 -2486 FEES Quantity Description Date Amount 1 crt Branch Circuits wo /Purchase 01/10/2013 $56 18 Specifics: Service or Feeder 1 ea 12% State Surcharge - 01/10/2013 $6.74 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $62.92 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 acco approved plans This permit will expire if work is not started within 180 days o issuance, or if work is suspended for more the 180 days AT ION Oregon law, re• you to follow the rules adopted by the Oregon Utilit 'otrfication Center Those rules are set forth in OAR 952 -00 010 throu • h OAR 952-001 Yo -y obtain a copy of thrules or direct questions to OU • - • Ml174i! . 32 1987 or 1 800 3 Iss - By: ` i �. y: i��� PermineeSigna =. 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 INS LI ATIO 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. RECEIVED Electrical Permit Application JAN 1 0 2013 1 . . 4 m 0 1 . 1 . 1 ( - 1 t St: 0 \1.N City of Tigard TIG ' ' , �� 1 Pt>mit 14° e : o. 'V .' e aol - II 4 13 SW liull lilvd.,'1'igard, OR 9722 IZ OF e n Review s Phone: 503 639 4171 Fax: 503 598 LDING DIVISI I N wH . other Permit: , , I, t) Inspection Lino: 503,639 4175 Date Reedy /Hy: Juris ® See Page 2 for Internet: www.tigatlt -orgov Notified/Method. Supplemental Information 0 New construction ® Addition/alteration/replacement Miles check all hat apply (submit 2 sere of plena w /items ohcokad bekrw): ❑ Service or feeder 400 amps or more ❑ Building over throe stories. El Demolition ❑ Other: where the available fault current ❑ Marinas and boatyard exceeds 10,000 an at 150 volts ur 0 Floating buildings. ,' ; e S ^' ' ''"A'EY,`'•(I G01!lli viJ „ i' -` •� " 7 ^ ,' 1 ' > , , g or exceeds 14,000 ❑ Commm'ael -ueo agricultural °"`� l• I less to ground, ❑ 1- and 2- family dwelling El Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi-family ❑ Master builder ❑ Other, 0 Fire pump ❑ iniallaho n of 75 KVA or g , . 1 •• ❑ r•.n,rrgatey ayavem 'argot 5eparatcly derived system li, -_ y'. , -',. k :`}, . h'J *0' :': : . <<s ,, :,., 4 . ;;: , ❑ Addition of now motor load of ❑ "A ", "lc", "1.2 ", "I.3 ", Job no.: I Job site address: 16 716 S W 7 2nd 100tiI' or mare, ❑ six or morn residential units- ❑ Recreational vehicle parks City/State/ZIP: 0 Health - care facililim. ❑ Supply voltage for more than 0 Hazardous locations. 600 voila nominal. Suite/bldg. /apt. no.: I Project name: SPA t om— ❑ Service or feeder 600 amps or more. Cross street/directions to job site: _De " on R ae. I T • I • New residential simile- or multi- family dwelling unit, Includes attached gars - e. Subdivision: { Lot no.: 1,000 sq. ft. or loss 168.54 4 Ea, add'l 500 sq, ft, or portion 33.92 1 Tax map /parcel no.. Limited energy, residential y}� �� 4 75.00 2 p ' ; � . •,� (with above sq. R.) Limited energy, multi- tnmily 7500 2 Lighting replacement residential (with above sq. ft.) Services or feeders installation, alteration, and/or relocation ��4r.r� .,5., ��3� 200 amps or lees 100 70 2 ' + ' , 'd � , :4a •s><! as' . ,' " l l' , '' 1 - '`'. , ° ' . ^ , <;© qu ; -. ., -''_ v i 201 amps to 400 amps 113.56 2 Name 401 amps to 600 amps 200.34 2 601 amps to 1000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 Temporary services or feeders Installation, alteration, and/or Cily/Slate/ZIP: relocation Phone: ( ) I Fax: ( ) 200 amps or less 5936 l 201 amps to 400 amps 125.08 2 Owner installation: This installation is being made on property that I own which is not intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2 Branch circuits — new, alteration, or ex tension, per panel Owner signature: Date: A. Fez for branch circuits with yyyy,, k �� � above ssr'nce Or feeder ion, 7.42 2 '�.'l f`76N = CAI�t'; `' _. ' 1' .'r,:Yta:�C�I/r'eY rA�N'ti.; + each branch circuit Business name: B Ice for bmnoh circuits without Johansen Electric service or feeder fue, Gm' Contact name: branch circuit 1 56.18 5(0, �$ z Charlynn Leifsen Each add'1 branch uirouit 742 2 Address: 10948 SE Valley View Terr Miscellaneous (ervlco or feod.cr not included) City/State/ZIP: Happy Valle Laohmnnufrofurod r feede 6784 2 ppy y r OR 97086 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: Sign or outline lighting 67.84 2 '; , ; . y > ,. .+ !', -, ' ' . , , . , � {'' I�i� , . •, • ,;�1..�, . r ,,, . �. :7'',''.2- a Sigurd uituuit(s) or limited-energy Busmoss namo: Johansen Electric panel, alteration, or extension Page 2 2 Each additional inspection over allowable in any of the above Address: 10948 SE Valley View Terr Additional inspection (lhrmin) 66,25/hr City /State/ZIP: Happy Val OR 97086 Investigation (f lu hr min) 78281hr p�y ll ley lnduvtrtalplont(Ihrmin) 78,181hr Phone: (503) 698 -3417 I Fax: (503) 698 -2486 Inspections for which no fee is 9000 /hr s -tfrcall listed 'h hr min CCB Lie.: 51539 I Electrical Lie.: 3 -243C J Suprv. Lie.: 20538 ▪ - , ., - • : 7 FRI73 .y�1', Ti+ 'a`„ subtotal g( . Suprv, Electrician signature, required: e � _ Plan review (25%of fee): Print name: Carl J hansen en e: 1 / 10 / 13 State surcharge (12% of permit fee); (as - 14 Authorized signature: /i//) �� TOTAL PERMIT PE ( hi °" This permit application er b n expires Wu permit not t I obtained within ISO rn Print name: Chart n Le i g4 Date fter It has been accepted as complete. • Number of truncations allowed per permit. IIBuddIme1Pumtta \ul.0- permeApp,dne Own MO 440.1615'rt ltro5/COM/Wl;t3 8 /E - aDVd 98tZ869COS 98bZ869E09 'Darla NHSNKHOr WV 99 :60 cTOZ- OT -uer Location: Record Type: Inspection Type: Comments: Inspection Date: Record ID: Result: City of Tigard 13125 SW Hal Blvd. Tigard, OR 97223 Tel: 503.718.2439 16716 SW 72ND AVE B16, TIGARD, OR, 97224 Commercial - Electrical 199 Electrical final 02/15/2013 00:00 ELC2013-00019 PASS - No C of O Violation Summary: Inspector Contractor