Permit Support Document (20) CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT 'Erg= Permit*: ELC2017-00726
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/03/2017
Parcel: 2S112DA00800
Jurisdiction: Tigard
Site address: 15055 SW SEQUOIA PKWY 100
Project: PacStar Subdivision: PACIFIC CORPORATE CENTER Lot: 2
Project Description: provide power to UPS unit. 11/6/2017: REPRINT permit to correct suite from 130 to 100.
Contractor: JOHANSEN ELECTRIC INC Owner: PACIFIC REALTY ASSOCIATES LP
16869 SW 65TH AVE, SUITE 311 ATTN: N PIVEN
LAKE OSWEGO, OR 97035 15350 SW SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-747-2503 PHONE:
FAX: 503-972-1861
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo/Purchase 10/03/2017 $56.18
Specifics: Service or Feeder
1 ea 12%State Surcharge- 10/03/2017 $6.74
Type of Use: COM Electrical
Class of Work: NEW 45 Misc Administration Fee 11/06/2017 $45.00
Type of Const:
Occupancy Grp:
Total $107.92
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 O•` 4-189.. 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: tf rte_ Permittee Signature: fAif '//V L_.
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 ' `S , / it/G—
From: Charlynn <office@johansenelectric.com>
Sent: Monday, November 06, 2017 6:53 AM
To: #Building Permit Technicians
Subject: Permit# ELC2017-00726
I need to change the Suite # on this permit to #100, as per inspector. Please let me know when it is
ready to pay the fee.
Thank you,
Charlynn Leifsen
Secretary/Treasurer
Johansen Electric, Inc.
P (503) 747-2503 M (503) 830-2513
http://www.johansenelectric.corn
1
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
15055 SW SEQUOIA PKWY 100, TIGARD, OR,
97224
Record Type: Record ID:
Commercial - Electrical ELC2017-00726
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor