Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2013 -00152
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/06/2013
Parcel: 2S 112 DA01400
Jurisdiction: Tigard
Site address: 6650 SW REDWOOD LN 355
Project: Spec Space Subdivision: 1996 -048 PARTITION PLAT Lot: 2
Project Description: (1) 200 amp service and (15) branch circuits for TI.
Contractor: JOHANSEN ELECTRIC INC Owner: PACIFIC REALTY ASSOCIATES
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:
FAX: 503 - 698 -2486
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 03/06/2013 $100.70
Specifics: amps or less
15 crt Branch Circuits w /Purchase 03/06/2013 $111.30
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 03/06/2013 $25.44
Electrical
Type of Const:
Occupancy Grp:
Total $237.44
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through OA • _131 -109'. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Dec/ /9 7°,431 - / 65 Z - 770 A.4
Issued By: Permittee Signature:
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for the next available Inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
CEIVED
Electrical Permit AppIicatioR 1.0R 01:1:1( : l 5 t: Ors; 1.1
kecelved
City of Tigard MAR 5 2013 D ,,, e , B , 3 „ ;„ itNo.: / /3 7 /,$
11 rwr
13125 SW Ilatl Blvd., Tigard, OR 9722 pl., Review •
1'110nc: 50 ?.639.4171 Pox: 503,59$ �/ ( �.I.IG pn Datc/B . Other' - .!J � 3 �+
t 1 , ,., i , : Inspection Line; 503.639.4175 1. 1 V,* t11 " Date RoadyiBy: pi See Page 2 for
BUILDING DIVISION N �ti
Internet: www.ttgard N IQ oh od/Mettu Supplemental Information
a , , ,,;,,, ,Pl ' chock all that n ',.
El New conshuetion ® Addition /alteration/replacement
P P Y (submit seta of plena whims decked below):
Service or fbcdcr 400 amps or more ❑ Building over three stones,
❑ Demolition ❑ Other: whore the available fault current ❑ Marinas and boatyards.
<: t ts ' `' ', :,"— VekSii ?fi Q o�v' ^''T°.�: ., orTee 10 amps at 150 volts or Q Floating buildings.
::.:.,.,. ..,..•.... ,...., x�a :.•... e xceed 1400
....: ..... ,. �. ; .. • - . , . , .. . . tear to grnwrd, or e 0 ❑ C<mrmure:el -use agricultural
❑ 1 • and 2- family dwelling IN ComnlercialPmdustrial ❑ Accessory builditlg env, for all other hutallations. buildings.
0 Multi - family ❑ Master builder ❑ Other: ❑ fire pump. ❑ installation of 75 KVA or
Sy��:,,: ty °.I;j':.aa ` ` vywk s':. x:... 0 Emergency warm. Iasa separately derived system,
.,...,r :• ••:.• ^ .. :. ',!�!S'�� � �...'...., �'td�! "'' : >.t ❑addition oPnew motor lend of ❑ "A •>:•• •�1�••.
Job site address: t ` 100HPormorn. Rest occupancy,
Job no.:
6 6 5 0 SW Redwood, CS a Six or more residential units. 13 Recreational vehicle parks.
City /State/ZIP: Q Health -care facilities. ❑ Supply voltage for more than
❑ i taerdous locations. 600 volts nominal,
Suite/bldg, /apt no.: 1 Project name: Spec Q servie. or feeder 600 amps or mac.
Cross street/directions to job site: Nteripuou I Qtr. t Mee. " I Tina I, •
New residential single- or multi - family dwelling unit.
Includes attached garage
Subdivision: I Lot no.: 1,000 sq. ft. or less 168.54 _ 4
Pa add'l 500 sq. it or portion 33.92 1
Tax map/parcel no,: Y.a�ww��..��,��� y � iiww r � Limited energy, residential
•
yrS • ' �'+ri*011{,t A,1 ;a,��/• '..Or :ty�rater�' (with above all. ft.) 74.00 2
Limited energy, multi- family 75.00 2
Tenant Improvement residential (with above aq. ft)
Services or feeders installation, alteration, and/or relocation
200 amps or less ' 100.70 1CO370 2
y ,., ,, ,.K. Sf :O (3' "•:.„ ;. ` - _ :. 201 maps to 400 amps 113.56 2
Name: 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: _ Over 1,000 amps or volts 552.26 , 2
City /St,►tt /z1P, Temporary services or feeders Installation, alteration, and/or
relocation
Phone: ( ) 1 Fax: ( ) 200 amps or less 59,36 I
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 _ - 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 am to 599 sni - 168.54 2
Branch circuits - new, alteration, or extension, lrer panel
Owner signature: Date: A. Pan for branch circuits with
,' . ,; ;.: . l CO i > uh.we service d or feeder foe 1 7.42 111,35 2
each bmnah urwril ,
Business name: Johansen Electric B. Pee for branch circuits wtlhval
service or feeder fee, tint 56.18 2
Contact name: Charlynn Leif ben branch circuit
Each add'[brnnahtin:nit 7.42' 2
Address: 10948 SE Valley View Terr Miscellaneous (service orfceder not included)
Ci /Suite /7..[P: Happy Valley, Each manufactured or modular 67.84 2
ty Ha Valle OR 97086 dwelling, sarvicu mrd/rrrfuedtr
Phone:(503) 698 -3417 I Fax::(503) 698 -2486 Reormnect.xrly 67.84 2
Pump or irrigation cirulo 67.84 2
E-mail:
,as•:r:•, 7 ,, ��, �, , : , Sign or outline lighting 67.84 2
„'..:L ; - • 9r ' ., \'i'�'S .. •'t ' e r+k„r,Rtel. tt:'r' .. .k... . Signal eircuit(s) or limited-energy
Business name: Johansen Electric panel, alteration, nrextension. Page 2
Each additional Inspection over allowable in any of the abov
Address: 10948 SE Valley View Terr Additional inMxetion(1hrmin) 66.25/hr
Investigation riple l hr 66,25/ hr
City/State /ZIP: Happy Valley OR 97086
Industrial plant (1 hr min) 78.18/ fur
!'home: (5 0 3) 698-3417 1 Fax: (5 0 3) 6 9 8 - 2 4 8 6 Inspections for which no fee is 90.00/ hr
s.ocitioall listed h hr min
CCBLie,: 51539 r Electrical Lic.:3 - 243C j Suprv, Lie.; 2053S
Subtotal: 12
Suprv. Electrician signature, required: r � w Platt review (25% of permit fe mitfee):
Printnante: Carl Johansen e ,Q�s� : 3/4/13 State sutchntge(12%ofponnitIce): Z
Authorized signature: TOTAL PERMIT PEE: 4?-4 9ff/
This perndl application expires H a prmdt Is not obtained within 180
Print name: Charlynn L e i f sea Date: 3 / 4 / 13 days lion It low ban accepted as complete
* [Number of inxp0etltms allowed pa canal.
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