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Permit u CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2013 -00162 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/12/2013 TIGARD ' Parcel: 2S 113AA00700 Jurisdiction: Tigard Site address: 16432 SW 72ND AVE Project: Bridgeport Subdivision: ROSEWOOD ACRE TRACTS Lot: D Project Description: (2) branch circuits for receptacle for rooftop unit Contractor: JOHANSEN ELECTRIC INC Owner: PACIFIC REALTY TRUST 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: FAX: 503 - 698 -2486 FEES Quantity Description Date Amount 2 crt Branch Circuits wo /Purchase 03/12/2013 $63.60 Specifics: Service or Feeder 1 ea 12% State Surcharge - 03/12/2013 $7.63 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $71.23 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 OAR 5 - 001 -00 0. You may / a copy of the rules or direct questions to OUNC by calling 503.232.1987 Q 232.1987 or 1.800.332.2344. , Issued By: � (,LJ) l l.C._f Permittee Signature: Oki l 'l e/ / rTIO/- 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. \s\) I t b v'W iF Pos3' K Electrical Permit Application Ptllt(11.P1( P 1 51' (Li.) City of Tigard Permit No : Dal R0Ce1VCd a/B ; 3 y� , i l 3 '= w 13125 SW Hall Blvd., Tigatd, OR 97223 Plat Review Phone: 503.639.4171 Fax: 503.5981960 Date/B . friff , , .. , Inspection Line: 503.639,4175 Date Ready /By: ® Sra Page 2 NW Internet: www,tigai'd- or.gov Nottfud/Method: M.,1 MippletnentalInfinmation „ -.:v Vi :..;.;�,..:,• -•.., .,,, ru'r � - .;:- vi a.. .;.. , ti • r; ;r, •:F^.. -5'' ::t gfr!:A.: .�,-1 `:s i. i ='�'. : ;�):t,� r ?'� 1 , -i: ,! : ..,!k. " :q, "' !J'iti. �/,y6 ' � '>�. .1 �- `''• " - tip ., t,;, '� . P::.:..,�J:�. .,.�.•.... :,:�::', ..�....;' �.���.,:v 1 • ❑ Ncw construct ® Addition /a /replacement .. � Plaso cheek all that apply (submit a sane of plans w /items chocked baluw): ❑ Service or !seder 400 amts or more ❑ Building over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. 11 , -. , i . ">••,...4'• *,,, • ,a ' ' r '' t '" , y, . � 1uAi ;.. . r b; loss a io round. m o exceeds Of 14,000 0 Commercial-no Floating buildings. a-n a i. . '.••••• ^: t "w'• "- '; : -r'.e � �., Ices to ground. or a moods 14,000 ❑ e�anmemcial.uao agriwlmrel Ell- and 2-family dwelling ® Commercial/industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi - family ❑ Master builder ❑ Other: 0 Fire pump. ❑ Installation of 75 KVA or ", y.r . ' F K, . � , '' "•- f•�° + ' . •' :,a ' .. /..4.', ,'r+'''; : -•=1, �y,< ❑ Emageney system. larger separately derived ayetan. :Y,','14i, }'':-' .,0.7 '?Z': �.. i•,; n%.'A r ::. , 1 .., 1L�Y: .�..e ❑" li 2 ,. , .. 1 . 3 •. , M Lb.''� / . ,rl•• `l� %o� :'P, <.i.;;_, © AdditiOnofeewmetlNloadof 0"A", - 8 - . Job no.: I Job silo address: 16 4 3 2 S W 7 2 nd r Six er m more, Recreation. ❑ Six er mare rasidanlial units. ❑ Rccratianal vehicle parks. City /State/ZIP: ❑ l tealth.earo facilities. 0 Supply voltage fur more then ❑ Hazardous locations, 600 volts nominal. Suite/bldg. /apt. no.; I Project name' Br ❑ Service or feeder 600 amps to moue, `p t i c ; (car ` Pe ] ' `- otal ` > Cross street/directions to job site: Derrrl ( o �� Pee. rout New residential single- or multi - family dwelling unit. Includes attached garage. Subdivisitm: I Lot no.: 1,000 sq. ft or loss 168.54 4 Ea add'I 500 sq. ft. or portion 33.92 1 Tax map /patoel no.: _ Limited energy, residential , ; d T rs v y n. g v. •'� - , +k "%} 'a a.. '7 00 2 4sn4: ;y. I .r < S "71 s , ' ' ` �". .t, -'W( k° :U: :; ,:: ' >1:' +' "�; ,i,K4'. ;yrs (wilh abuse , ul. 0.) ..;:• : ., - °' ; ' :' Limited energy, multifamily Receptacle, ' rooftop unit residential (with above sq. ft.) , 75.E 2 Services or feeders Inatallationolteration, and/or relocation ^ 200 amps or less 100.70 2 ' ; : X, !• : r. "'o` , 7v';:�. fi.. 7. o-., _, . }'�, ,�ttk� {�; ; ±x „ 7 �//ww w. �}j � sl; ` •" _ ' 201 am to 400 am .S6 2 , � ; ` 'F:'�?. !;r:1Y ;^T4'� ' 2f • : (,4�? > '.. � 1� a t33 P Name: 401 amps to 600 amps 200 I 2 , 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 55226 2 City/State/ZIP: Temporary services or feeders Installation, alteration, and/or Phone: ( ) I Fax: ( ) 200 amps or less 59.36 1 t 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 amps to 599 amps 168.54 2 Branch circuits — new or extension, per panel - Owner signature: Date: A. Fee for branch circuits with :w :' °•'r •- , . ,« above service or feeder fee, 7A2 v,, 1. ,r r ,..�... . ;... . ., :i3= , ct�lt7ea . .'�- ' •r ';:: , 2 for ` �� each branch circuit Business name: Johansen Electric A . Feiceorfnederfeeits without ` �,/ aervicorfeooraa,6rat 1 56,18 ,5(c). It 2 Contact name: Charlynn Le i f s en branch circuit 1 Each add'I branch circuit ' 7,42 I , yL 2 Address: 10948 SE valley View Terr Mbccllancoae (service or feeder not lndude Each manufactured or modular 67.84 2 City / State/ZIP: Happy Valley, OR 97086 dwelling, service and/or feeder , Phone: (5 0 3) 698-3417 I Fax :: (5 0 3) 698-2486 Roconneel only 67.84 2 Pump or irrigation circle 67,84 2 E-mail: ' r r: + , '; Sign or outline lighting 67,84 2 . 5.;. ::J :"S'.'4 : •` ?iv'' ik' ='rl ", ; < � v. ..: ;. 'a 7 ` ` ,' l ' ,S'` ,. Signal circui or limited- energy Businesaname: Johansen Electric rarlol ,allomtirm , or axlW , sitm+ , , Page2 2 Each additional Inspection over allowable In any of the above Address: 10948 SE Valley View Tarr Additional inspee6on (1 hr min) 6625 /hr City/State/ZIP: Happy Valley, OR 97 Investigation ipl 1 mm) 66,25/ hr pPy yr Indnatrinlphmi(Ihrmin) 78.18/ hr Phone; (503) 698 -3417 I Fax:(503) 698 -2486 lnnpuutions for whiehno fee is 90.00/ hr ificall listed i4 hr min a; ."�.�� .,,. r ...',. CCB Lic.. 51539 l Electrical tic.: 3-243C I Suprv. Lio.: 2 0 5 3 S ,. '., " n:Ti'f._'.'S•t}�'a't • �,, t.;,.; ^ = '1.s <: � :;�� -� . .. Suprv. Electrician signature, required; � Subtotal: , era �� Plan review (25% of permit fee): Print name: Carl J nsen 1 Oa /12/13 State surcharge (12% of permit fee): - 1 , TOTAL PERMIT FEE: 1 ) , 2_3 Authorized signature: / a.. permit application expires If a pentdt Is not obi within 180 Print mine: Charlynn Le i f a e 11.-)mw 3/12/13 - days aver U his been accepted as complete. • Number of inspections allowed per permit. Muildii ctmitsteLC-PanoitApp.doe 07101/10 440.4615T(11105/CO.M/Wh O Z / T •aDVd 986Z869E09 986Z869E05 ioaZa N3SN HOr Pad ET: TO ETOZ • ZT -=EW