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Permit Support Document (11) CITY OF TIGARD ELECTRICAL PERMIT I COMMUNITY DEVELOPMENT t rt Permit#: ELC2016 00895 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 M Date Issued: 11/21/2016 Parcel: 2S 112AC01500 Jurisdiction: Tigard Site address: 7319 SW KABLE LN 700 Project: Superwinch Subdivision: FANNO CREEK ACRE TRACTS Lot: 23 Project Description: add receptacles. 3/21/17,REPRINTED to add(1)400 amp service. Contractor: JOHANSEN ELECTRIC INC Owner: PACIFIC REALTY ASSOCIATES LP 16869 SW 65TH AVE, SUITE 311 ATTN: N PIVEN LAKE OSWEGO, OR 97035 15350 SE SEQUOIA PKWY#300 PORTLAND, OR 97224 PHONE: 503-747-2503 PHONE: FAX: 503-972-1861 FEES Quantity Description Date Amount 1 ea Services or Feeders-201 to 03/21/2017 $128.79 Specifics: 400 amps 1 ea 12%State Surcharge- 11/21/2016 $11.19 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $139.98 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• 001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.19871987or 1.800.332.2344. // Issued By: . / .1/ �//1G/�' 7747#6 -�"�----.- 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. To: Page 2 of 2 2017-03-20 20:20:48(GMT) 15039721861 From: Charlynn Leifsen Electrical Permit A . plicltic ;tw i t �. FOR OFFICE ONLY tR City of Tigard 1 Rec lved t Permit L/Q i 1312 SW flail Blvd.,'I tgtud,(JRp Iia r, 0 r i s I E Date By - 2! I7 ; ��1 (✓ � ' Phone: S03.7I R?43<) Fay. 5(>3.j�8 l (tl Pian Review Related Henna ri J Datc fit I I G11 ll, Inspection Line: 503.639 4175 1 Reach Date'Bv: tuffs T` El See Page 2 forInternet: wwtr tigard or of Usti cdmethad 1 Supplemental Information 1I�1 rOJ 01i ,x.«...:. r j 1'('�a1' fiEVIE�+4 , ❑New construction ®Add+tion/alteration replacement Please cheek all that ripply(submit g sets of plats K items checked): ❑L7t+noliti on t � 0 Service or feeder 400 amps or more 0 Building over three stories. iJ Other: where the available fault current 0 Marinas and boatyards. +rEGOa O.F, (OI STRI'C 140ah: exceeds 10,000 amps at 1 h0 volts or ❑Floating buildings. 0 1-and 2 lalntls dwelling �( C(}nitl7c#'clttlr ItidL 5trtetl 0 Accessory building less to ground,of exceeds 14,000 0 Commercial-use.agricultural ❑ \Attltttan+Itasapsfor all ether instailations- buildings. ❑Master builder 0 Other: ❑Fire pump. 0 installation of 150 KVA or IQI8 S1'1l'i"'.1ISM MATZO' A7�D'LOC ;TIC3ts ❑Frter5uors "stent. larger-eparatrlhderived Job#: I Job site address:7319 SW Kahle 0 Addition nifty Atoror load of system, leOtif,ormore. ❑ A 'L" 1 a_ C.it't State.ZIP: �• 0 Six or more resid tidal unity. re upane) - -! ( ..._ 0 Health-care facilities 0 Pcereational vehicle parks. Suite/bldg./apt.4:700 Project name:Superwinch 0 Harardors location, 0 Supply voltage for more than -w~ job 0 SeE v�tc,e or feeder 6(n)amps or more. 000 volts nominal. Cross strectrdFtecaions to site: ; 1 p -�— r DesuSyirron _ I Qty [ Soot 1 fatal w --•-_----•— ---_ + New residential single-or multi-family dwelling unit Subdivision: floe ; Includes attached garage. Tax m Ip!pai cel*' - —1 1 ono suit ur I--ts 168.54 _....__�.k� __..._J I a add 1 SCO sq..0 or portion 1 33.92 i 1 I1*SCL.11+'1. QP k-0..g l.amited energy,residential Tenant improvement j (,with above sq.ft.) 7�.J0 2 __._.-_._..... _...._.__� . .r ! —�• Limited energy,multi-family ADDS TO PERMI r#ELC20I6-00895,as per inspector residential(with above sq.It) 75.00 2 [("P3ltt3'1 R1k;g1!"VTI is t2enettial3le[anergy 0 See Page 2 t 1 ... '` - - IE � T ____ Services or feeders Installation,alteration,artcl/ar reloeatton y Name: �j,--s7h1L,Lanapa.4c-le.as 1 100.to 100.70 2 Address: —`— _� 20 I amps to 4f)U amps 133.56 13 2 a li)1 amps to 6fk)amps I 20().34 Ctt1`Si'tie,rZI : 603 am sto i3O(H)ata s P P i 301,04 2 Phone:( ) 1 Fax:( ) Over 1.000 ramps or volts j 552.26 0 Email: " temporary services or feeders installation,alteration,and/or - relocation Owner installation This installation isbeing made on property that I own which is not. 200 amps or less 59.36 1 intended for sale.lease,rent,or exchange,according to ORS 447,449,670.and 701. 201 amps to 400 amps I I 125.08 IIMEI Owner signature Date 401 amps to 599 amps I L 168.54 113 7 © I'P ICA T CO `I.AC I. PER,r+O Frnnct(circuits-new,alteration,or extension,per panel —i I:cc for branch circuits with T.. I Business name:Johansen Electric,Inc above serviceor feeder fee, 1 i - --- each branch circuit 7.42 2 Contact name:Charlynn-Leifsen ! P.Fee lar branch circuits irarLorrr Address: 168tt9 SW 65th#311 service or feeder fee,first - — w.. branch circuit 56.18 2 1 City/State/ZIP:lake Oswego,or 97035 j Lac1,add'I branch circuit 7,42 ! - ?l — ----.._—..-. ._.__...- -1 7vliscellaneofts(service or feeder not included) I Phone:(503)747-2503 Fax::(503)972-1841Eachr i manufactured or modular d j Email:uffiee�)Iohansenetectrie,cotn welling,service and,or 2 C rfi:eder 6 r C'C)\r1i:1C F'fill2 . sG67 r --r-- � t n ct ,8=4 2 n l onlyE { Pump 4 sr n'tuon curl Ci7.84 2 t IBusiness Dank,SAME ! C+;?Ir or nutline ll�lzting $,4 2 I Address; --------------- - `` Signal cirwn(s)or limited-energy Anel alteration,or extension ❑ Sec Page 2 i 2 i Caty'Stdtl/ZII': Each addruonal inspection over allowable in any of the abate + I + Addi:tionai inspection(1 hr min) 6625_/hr 1 E > I Fax:Phone:( ) /h ) L__A W._ x:( �.-_ _________ ! Investigation(!hr min} { 9000/hr I i Email: Industrial plant(I hr min) { �7$1R/hr 1 -- ..� Inspections for which no fee is 0 ; E (CII Lie., 51539 Electrical Lie.: 3-2430 1 Supra.Lie.: 53785 f s_crlre�hated t. hrrmn) _ hr II S+pry Electrician si nature,required: Cg, 1 —I k LFCFRXC&L PI RI41.1'1�1 ': .' Print namJon Joha } Subtotal: I 100.70 1 Date: 3/20/17 1 .0 Plan Review Required(25%of permit fee) I r State surcharge(12%of permit:lee) i .144.41- f Authorized signature: 0, I TOTAL,PERMIT FEE: 1 X1.22-�R-- This permit application expires if a permit is nut obtained within t8 t Print name: Charlynn I etfsen _ I Date: 3120/17 i days after it has been accented as complefe f t^.9Q i _ rj(ajY V Number of inspections allowed per permit.�,/e_...- lanuildinf,ilerinits'1,C,J1ernai Ann El R.FRL.de., Rev 061Z'29i5 440-451i"rf I iAm.:0Mr\VG-1 ,Ob /I'DMf3 G 4/S To: Page 1 of 2 2017-03-20 20:20:48(GMT) 15039721861 From: Charlynn Leifsen FAX COVER SHEET TO COMPANY FAXNUMBER 15035981960 FROM Charlynn Leifsen DATE 2017-03-20 20:20:25 GMT RE Permit adds COVER MESSAGE Charlynn Leifsen Secretary/T(easurer Johansen Electric, Inc. P (503)747-25031M (503)830-2513 http://www.johansenelectric‘com Wvvvv.METROFAX.COM