Permit (68) CITY OF TIGARD ELECTRICAL PERMIT
`. .. COMMUNITY DEVELOPMENT 1111
Permit#: ELC2017-00488
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/09/2017
TIGARD Parcel: 2S112DB00401
Jurisdiction: Tigard
Site address: 7319 SW KABLE LN 500
Project: Quality Custom Distribution Subdivision:"HERN PACIFIC TIGARD INDUSTRIAL Lot: 4
Project Description: Installing generator backup to 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: 503-624-6300
FAX: 503-972-1861
FEES
Quantity Description Date Amount
1 ea Services or Feeders-Over 07/26/2017 $552.26
Specifics: 1000 amps or volts
2 crt Branch Circuits w/Purchase 07/26/2017 $14.84
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 07/26/2017 $68.05
Electrical
Type of Const:
Occupancy Grp:
Total $635.15
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 0 952-001-0090. .ou 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: S'rc arb €'ca'7 C
OWNER INSTALLATION ONLY ,J
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.
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard !3ECEJVEPDace/Bedpermit#:DateBy: t ([��fIII .1 SW Hall Blvd.,Tigard,OR 972 Plan Review ?/
Phone: 503.718.2439 Fax: 503.598.1960 Date/By. 7//,� i "2 If,'elated Permit#:
Inspection Line: 503.639.4175 JUN 2 9 2017 Ready Date/By: I res: ® See Page 2 for
TIGARD
Internet: www.tigard-or.gov Notified Method: /' Supplemental Information
1 a w��i
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❑New construction ®Addition/altera 10 a Please check all that apply(submit 2 sets of plans w/items checked):
❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition 0 Other: where the available fault current ❑Marinas and boatyards.
-w ... i u t0 ' O' *MTJOrd , ,"' exceeds 10,000 amps at 150 volts or ❑Floating buildings.
❑ 1-and 2-family dwelling ®Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
0 Multi-family 0 Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
T Ql1 TION_ *L A ION ❑Emergency system. larger separately derived
Job 4: Job site address:7319 SW Kahle Ln,500 ❑100H oo of ore motor load of system.
]OOHP or more. ❑"A","E","1-2","1-3",
❑Six or more residential units. occupancy.
City/State/ZIP: ❑Recreational vehicle parks.
0 Health-care facilities.
Suite/bldg./apt.#:500 Project name:Quality Custom Distribute ❑H dous locations. 0 Supply voltage for more than
ervice or feeder 600 amps or more. 600 volts nominal
Cross street/directions to job site:
Description I Qty I Each I Total
New residential single-or multi-family dwelling unit.
Subdivision: 1 Lot#: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#
Ea.add'l 500 sq.ft.or portion 33.92 1
v. 1} 1 *1ON O •WRS . Limited energy,residential
75.00 2
Installing generator backup to service (with above sq.ft.)
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
O' Renewable Energy See Page 2
I " ' - Services or feeders installation,alteration,and/
orrelocation
Name: 200 amps or less 100.70 2
Address: 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: 601 amps to 1,000 amps 301.04 2
Phone:( ) I Fax:( ) Over 1,000 amps or volts I 552.26 552• 2
Temporary services or feeders installation,alteration,and/or
Email:
relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 I
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
111,1111101,141 AIt1R1 Branch circuits—new,alteration,or extension,per panel
C1; : 1 A ' I`I I
A.Fee for branch circuits with
Business name:Johansen Electric,Inc. above service or feeder fee, g� 7.42 14.10/ 2
each branch circuit !
Contact name:Charlynn Leifsen B.Fee for branch circuits without
Address: 16869 SW 65th Ave#311 service or feeder fee,first 56.18 2
branch circuit
City/State/ZIP:Lake Oswego,OR 97035 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(503)747-2503 Fax: :(503)972-1861 Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email:office@johansenelectric.com Reconnect only 67.84 2
- _; _ - ..< ...... ...._._ °_ .. ......... Pump or irrigation circle 67.84 2
Business name:Johansen Electric,Inc. Sign or outline lighting 67.84 2
Address: 16869 SW 65th Ave#311 Signalnel, iern or limited-energy
0 See Page 2 2
panel,alteration,or extension.
City/State/ZIP:Lake Oswego,OR 97035 Each additional inspection over allowable in any of the above
Additional inspection(I hr min) 66.25/hr
Phone:(503)747-2503 Fax:(503)972-1861 Investigation(1 hr min) 90.00/hr
Email:office@johansenelectric.com Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: 51539 Electrical Lic.: 3-243C Suprv.Lic.: 5378S specifically listed(/Y hr min)
i u
.3
Suprv.Electrician signature,required: �� _ Subtotal: Sj(,"7.10
Print name: Jon Johans; A t�• , Date: 6/29/17 _rlan Review Required(25%of permit fee): (4 .1$
State surcharge(12%of permit fee): (o g,as
Authorized signature: tti TOTAL PERMIT FEE: 17(o.q 3
This permit application expires if a permit is not obtained within 180
Print name: Charlynn Leifsen Date: 6/29/17 days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
7319 SW KABLE LN 500, TIGARD, OR, 97224
Record Type: Record ID:
Commercial - Electrical ELC2017-00488
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor