Permit Support Document CITY OF TIGARD
�'�� ELECTRICAL RESTRICTED ENERGY PERMIT
11111
COMMUNITY DEVELOPMENT Permit#: ELC2017-00590
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/07/2017
Parcel: 2S112DC00201
Jurisdiction: Tigard
Site address: 15845 SW 72ND AVE, BLDG#C
Project: Chemwest Subdivision:HERN PACIFIC TIGARD INDUSTRIAL Lot: 3
Project Description: power to haas. 9/13/2017: REPRINT permit to correct address from 7236 SW Durham to 15845 SW 72nd Ave.
Contractor: JOHANSEN ELECTRIC INC Owner: PACIFIC REALITY 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
Description Date Amount
Specifics: Branch Circuits wo/Purchase Service or 08/07/2017 $56.18
Feeder
Type of Use: COM 12%State Surcharge-Electrical 08/07/2017 $6.74
Class of Work: NEW Misc Administration Fee 09/13/2017 $45.00
Total Number of Systems:
Audio&Stereo: Boiler Controls:
CCTV: Clock Systems:
Data&Telecommunications: Fire Alarm:
HVAC: Instrumentation:
Intercom/Paging: Landscape/Irrigation:
Landscape Lighting: Medical:
Nurse Calls: Protective Signal:
Security Alarm: Other: Total $107.92
Other Desc: 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 R 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ° Permittee Signature: ON #34-1 C'fr,-" d"V
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.
Dianna Howse
From: Charlynn <office@johansenelectric.com>
Sent: Wednesday, September 13, 2017 9:51 AM
To: #Building Permit Technicians
Subject: Permit ELC2017-00590
Somehow this has the wrong address on it. I need it to be for 15845 SW 72nd.
Thank you,
Charlynn Leifsen
Secretary/Treasurer
Johansen Electric, Inc.
P (503) 747-2503 M (503) 830-2513
http://www.johansenelectric.com
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