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Permit
CITY OF TIGARD ELECTRICAL PERMIT L! - COMMUNITY DEVELOPMENT Permit #: ELC2010 -00701 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 WWI Date Issued: 12/21/2010 Parcel: 1S133DB01200 J urisdiction: Tigard Site address: 11640 SW SHEFFIELD CIR Project: Felton Subdivision: Lot: 0 Project Description: (5) branch circuits for work in garage. 1/5/11, reprinted to add (1) additional branch circuit, for a new total of (6). Contractor: MOLLENHAUER ENTERPRISES INC Owner: FELTON, JASON 11070 SW ALLEN BLVD 11640 SW SHEFFIELD CIR BEAVERTON, OR 97005 TIGARD, OR 97223 PHONE: 503 - 649 -6991 PHONE: 503 - 708 -5670 FAX: 503 - 641 -1902 FEES Quantity Description Date Amount 5 crt Branch Circuits wo /Purchase 12/21/2010 $85.86 Specifics: Service or Feeder 1 ea 12% State Surcharge - 12/21/2010 $10.30 Type of Use: SF Electrical Class of Work: ALT 7 Electrical Permit 01/05/2011 $7.42 1 12% State Surcharge - 01/05/2011 $0.89 Type of Const: Electrical Occupancy Grp: Total $104.47 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 accord- . - ith 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. ATTE∎ ' •N: Oregon aw r- fires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -01 0 throu h OAR 952 -1 • -009 ou may obtain a opy of the rules or direct questions to OUNC by calling •' . 32.1987 or 1.800.332.2 4. Issue • =y: Permittee Signature: - . ' �� ,i fi / 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. Thls 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. CITY OF TIGARD ELECTRICAL PERMIT rfill ; • COMMUNITY DEVELOPMENT Permit #: ELC2010 -00701 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/21/2010 • Parcel: 1S133DB01200 Jurisdiction: Tigard Site address: 11640 SW SHEFFIELD CIR Project: Felton Subdivision: Lot: 0 Project Description: (5) branch circuits for work in garage. Contractor: MOLLENHAUER ENTERPRISES INC Owner: FELTON, JASON 11070 SW ALLEN BLVD 11640 SW SHEFFIELD CIR BEAVERTON, OR 97005 TIGARD, OR 97223 PHONE: 503 - 649 -6991 PHONE: 503 - 708 -5670 FAX: 503 - 641 -1902 FEES Quantity Description Date Amount 5 crt Branch Circuits wo /Purchase 12/21/2010 $85.86 Specifics: Service or Feeder 1 ea 12% State Surcharge - 12/21/2010 $10.30 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $96.16 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in acc with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATT ION: Oregon r you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -00 0 through OAR 9' : 001-009'. You may obtain a copy of the rules or direct questions to OUNC by call...10.03.232.1987 or 1.800.332.2 •4. Issued , '� �/ Permittee Signet , 1 1 OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease or rent. OWNER'S SIGNATURE Date: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC' �\ "fir Date: r LICENSE NO. Call 503.639.4175 by 7:00 a.m. for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Sent By: MIKE'S ELECTRIC; 591 7847; Dec-20-10 10:14; Page 1/2 To: TIGARD At : 5035981960 , . Electrical Permit Application . F012 OFFICE'. I.ltir, ONLY - City orrigaitii 70/ 4$(.11,C Received of4teloy....... tit r,. r. e ),, :...„ .i , !semi it No'. Eke 10/ e) ••• III 11 13125 SW Hall Blvd., Tigard, OR 0 . % 1/'° Plan Review i . I • : Ph(111C: 503.639.4171 Fax: 503.59 .1960 $ °the' l'in mil: 1 Ai( t) 1 "q )Clir ' " Li 50 $,639. 4 1 75 .S)<C'' Reedy/13y: 11/11, tid See Page 2 for Internet: www,tigard 4 .) N N o I t i fi e cl / 1 e t 11 o 4 : ii-- Sttprilements1 Information l7 '',,... .::. . :.,.• 1 .,..,:::: ,.,:.:.,...,1...„_;..,.,V „..„::;;;;,:7,;J:,,,:s: /,,..1.,..:.,',..,';,;.:;0„„,;,.,:..., „..„.. „,.:„.. „i„.,.„., .,, . 0 New conStruction 0 Addition/alteratio0 einent. Plense the all that apply (submit j sets of Plans w/itetns checked below): 1:1 or feeder 400 Amp or more 1:1 Building over three stories. D Demolition Other: where the available fault current 0 Marinas end boatyards gi .60010.*g'004.4004006-kKi:;;V'P''::fiF:':.' exceeds 10,000 sinps at 130 0115 tii 0 Plwiling titrildingl, leu In grotinti, ■Ir ezceet.{$ 14.000 0 Commercolitise. nricilliiirol In 1- and 2 dwelling 0 Commercial/industrial 0 Accessory building Mr fbr all other nisi:Mations. building 0 Multi-family E1 Master builder 0 Other 0 Fire pump. 0 Installation of 75 KVA or larger separately derived sysicin. '. #0 : i'',',':0:F.F.•? : ':',:'' , 1;1 :1.! '..1' 0 Addition or ,to, iwith Inad tir Job no.: 27978 Job site address: 11640 SW She l'field Cir. , 10011P nr inure. occupancy. 0 Six nr more miflentill units. C Recreational vehicle pm kr. City/State/ZIP: Tigard , 00 97223 01-IA41th-care faciiities. 0 Supply vvlage for more 111;111 Hazardous locations. 600 volts nominal. Suite/bldg./apt. no. _LI Project name: 0 Service or feeder 600 amps or more. ........ ,. ..- - tilSetatliii Cross street/directions to job site! Description -.- 7, 7 -.......1.,..j . 011 1 . ..1 - ....... • New residential single- or multi-family dwelling tinit. • • • Inchides attached garage. , ............ Sttbilivisiu/1 1,1100 sq. ft. or less 168.54 i 1 . . Lot . - - - -- Ea. 4(41'1 500 sq. 11, or portion 33.92 1 Tax map/parcel no.: Limited energy, residential ' ' ' • ' (, .. , ...'In 1777. '!!% 11 :tVi.'0illiTh).r.Avcii i r 1."" iii 4lF/i),):r4f:::Ni`J.,-. sq. (t.1 75.00 2 L:1'1!11.;:'1:1 .;,, i'i•:' . .. , :v:;;vz/ , : ,, 2, 1,- /f-22 . Z22,:a/.: ,.. 'S:'' ''',.. 1 - .;k 5, ill"28 ,4,,, .^. - : - -''" ''''' ''"-'" Limited eneru, multi-family Electrical work in karage residential (with above sq. 11,) 75.00 2 -. .... . . Services or feeders luau:illation, Altera it relocation 200 amps or lc.s,s 100.70 2 1):1‘1.:1!"..'1.::!:n11.'irllrftbiii40.i'V. "irlli/.0, 201 atops 10 400 nillpS 133_56 2 N Jason Felton 4 01 amps to 600 amps , 200.34 - --- - , _ 601 amps to 1,000 umps 3U1.04 2 Address: 11640 SW Sheffield Cir. Over 1,000 amps or volts 552.26 2 ..,., Cy/State/ZIP: Tigard, 0* 97223 - - - 1 = e - m - p . or . a - ryserviecs orfe.aerS ins6;110km, alterat an ion, d/ril relocation Phone: ( 503) 708.5670 Fax! ( ) 200 atnps or iC5N 59.36 1 ' 20! amps to 400 amps 125.08 , - Owner installation: is installation is being made on property that 1 own which is not 401 amps 10 599 amps • 168.54 intended for sale, lease, rent, or.C:xchangc, according to ORS 447, 449, 670, and 701. -- Branch circuits - new alteration, iir extension, per panel Owner signature: Date; A. fee for branch circuits with m ...,..,.. ....., j37,','Rippe,IiKi3irgrikii40"ietygitgoN•n.!.;';:::. above service or feeder fee, 7 42 , each branch circuit R. Fcc for branch circuits without Business name: , service or feeder fee, First 1 5,5 IR 56.18 2 Co brAnch cireutt Contact name: - '- _...,____ Each pdd'I branch circuit 4 7.42 29.68 2 ______.„...,...„...._ AddreSSI Miscellaneous (service or feeder not ineluded) ......._ ..---- , --. Each Manufactured or modular C,ity/State/ZIP: tug,...pmice and/or feeder 67.84 _ ,.,...,.. 67.84 2 ..._...,-, - Phone; ( ) Fax: : ( ) Reconnect only ,• _...,..,., - Pump: or irrigation cirele 67.84 2 „ - 1::-1(1ail: Sign or outline lighting 67,84. 2 ....._..... ',,:',.,:,:l.i,,'IL'i.',::.E.':.i;:!.;::: :' z'( Signarcittuit(g) or limited -energy paneloilteration, or extension. Pa6!2 , Busir=snme: Mollenhaner EnterErises,Inc. IRA Mike's Elec,, - r; _. [nob . ,aditionatins_pection over allowable in any of the shove Address: 11070 SW Allit_ Dlvd. Additional inspectiOn ( . I hr min) 665f hr ..... ... ,, ., .„,„..._... investigation (1 hr rniii) 66,25/ hr City/State/ZIP: Beavert on OR _ Industrial plant (1 hr min) --- 78.18/ hr .■ .... .. - , -- _,_...„,.. ...... PitOlie: ( 503 649.6991 F ax' ( 503 ) 641.1902 /0//45_,. hymections for which no fee is 90.00/ hr .-- CCB Lic.: 191 094 . u\i' ai Electrical Lic.; C643 1 \ 1 \01 suprv. Lie.: 4230S specifieally ( hrjnini__ Ait. FEES . - ........., , ---H-- ,......__ Subtotal: tipp/. -"" S Electrician sn ig ture, reqttire: ,--7 Plan review (25% of perm 85-;86- Print nante: Doogla: J 7." it fee), 1 ...._............... I 11\k c: 12.20.10 . state surcharge (12% of permit fee): .Mill- ....._._.. V . . TOTAL PERMIT FEE 96 . 16 Authorized signature: A •id1 (/ c,i. Thispermit application PliPire$ 1r1 permit ix not nbtnined williin 180 . . , days after it has been accepted 45 cninplete. Print name: Darryl Mot.. nhauer Dme: 12.20.10 . • Number of inspections allowed per pomit. natlianiverasimei.(:_perrsimr.p.dtx irual/i d45-40157:01/Q5/CO5NWE8 'I , Sent By MIKE'S ELECTRIC; 591 7847; Jan -5 -11 9:57; Page 1/2 To: TIGARD At: 5035981960 ‘C' C Electrical Permit Application irs. ; ; . " ° City of Tiga rd . 1114 _.,-. " y �4 \\ Received r a . 13125 SW hall .011,41,, Tigard, OR 97 2, w 5 l• D ®tel6 r I Permit Nn / �i �I • • Phone: 503.639,4171 Fax: 503.598.1960 ^w\\ QQ Plan li°vrew �••4Lt Inspection Line; 5(3.639,4175 ,P, \`� ' p\�`O �"teB — Other Permit: t'1li p -VC • nternet: www,tigaid -or V m r ls - lid See Page 2 fur — I 4i r}Ppinr- ,.; «,l:rl • Internet .y y ,ti ay .Lt t' ``� ,.. -. uIPlemelt t tat I nPo g� Notifi¢d/Meehod: S ,,. rnla inn , ..; ' t:uo' Y,I P. e t t N J r . i P� ('e a, �.. ii�'li Iq !';', •yr^ u ,, .. ,le . .. t ,r J w.,-•.".r, :TI " ";Cry;., d q, .= .,,;'•., it, 1 / ' I4.11rIEW ❑ New COn5trtICtipn Addilion/alteration/ •placement Please el'eckall I 21 Rpply (submit as etsofplan %wlitemi'dreckevt ❑ Demolition I Other; ❑ Service or Fe . •r 400 em or mo re c ['Building over three stories. �nr ^�+ • • :' r•- ._µ,, ,, , who., the twat - le ,,,: .;a„ �: i:* '•'' ";a�' , . t Y � � �g rasniWs .r,.. fault current ❑ Marinas and boar nr •7 ',i.; 's4o. a.:'Trgin,.".f„ Y ds. dustrial , 7W ' bT� +;6 ^�. ���.__: n- : k i amps at volts ur ❑ Floating buldm _... �.: •:. � � . .,- � � .,u, - - i ... . ISO tgs dwelling II Commercial/industrial f4 "rl' Y g ercial / (_] Acccssoly building amps for all of er installations less to mound, r ¢xr;eedx tn,00a , Cammac,n •nee agricultural 1 and 2-family ❑ Multi- family Ii Master builder buildings. 'y nq 1 ❑ Other: ©Fir pump, El Installation of 75 k VA or , •; • • ia' kl • f wi . ?' t1; fkr ,∎ZFPT7r7 i 'l're 7tv � ;'a ,3 _ ; e J :;;;hr, „ ❑ tio ru, s r sy m. larger se tv rl -. rx: . rPh, " a•l:}:p'. . i ,� �• separately tknvtd SvStem. Job nn, • 27978 .lob si a addr 11640 r " ' ❑ArEllililion of net motor Icxrd of l ❑ "A” ..E -. '• I_i" ..I i" ess: 1640 SW Sheffield Cir. IDOHP o1•.more occupency - ❑ Ri,•t'or nteie,'es , Cnlial units. 0 Recrentinnel vehicle. po,kr. City /State/ZIP: Ti. gar(l , 0 97223 ID Health -¢are the i hies. _.. - 0 Supply voltage for more tlrun Nezardons loci bus, 600 volts uOminRI, Shitc/bldg. /apt. no.: Project name: C] Service nr feed.. 600 amps ot more. Cross street/directions lO job sit:; New reaidentlal in Ic or ... I ' ... Vt Fee, � TOO lti•ftmily dwelling'', nit. . Includes attach : d garage. Subdivision: Lot o no.; 1,000 sq R. or le . t fiR r Tax map /parcel En. d tl'I 500 sq. . or portion 33.92 yt ' u'ili _iuc' p, �q.. ' 9� Yl� I t Ir ,fir Limited energy, r , idential ..;; re... "'tow si l C rt a' °rim? ;.. 750 2 i '" Mite„tm(• . ,�,n :..,'::d +i i. r ... z with above . • . ft.) 0 1 L imited ener Electrical work in - a 1 Ci )P. 4 h ot sy, • m It 11 ! residenfiat wit above sty ., R.) 75011 4 - rs l e an not Srrviecg�r feed � installation slt r a nd/ y�i, f �on,, or relocation „tm,, �rF^�? ��,, , l 1 � �; 200 amps or s les 100.70 � lt t;i u'.: rye. wad ,, r r l t ?.: c ( i: „Y to . r',. id a. t :, , ° ^ ^ r "5 , 201 amps to 400: ps 133. i6 2 Nurne; Jason Felton 401 amps to 600 a ps 200.34 601 amps to , 1,000 . Address: 11640 SW Shef -field Cir. ` l m°s .301.04 2 •. Over 1.000 amps o ' vollS 552.26 2 City /5tat& 7..IP; i.gard r OR 97223 T c es or feeders installation, alteration, and /nr relocation Phone: ( 503) 7 08.5670 Fax ( ) 20 0 arttps or _n a 59.36 Owner installation: . 1 - his installa is being made On property that I own which is not zt)t amps to 4ll(> t Ps 125.08 intended for sale, lease, rent, or ea change, according to ORS 447, 449, 670, and 701. 401 amps to 599 a ps 1 68.54 Branch circuits new, alteration or extension, per panel Owner signature: Date: • e., .. — A, Fee for branch c rcuits with f ' fit ? ;Ei c , t = i1; i . , • ye. ta i � `, L t... 'TAG � , E"': above service or feeder the • . each branch t im , it 7 42 Business name: B. Fee for branch C suits uvfh(hit service or feeder fee, first Contact name: 56 56.18 branch circuit Address: Each add•I branch • teen ... 7.42 W2" Miscellaneous se vice ur feeder not included) • • City/State/ZIP: Each manufacivted F t a dwellin•, servicean or feeder (17.84 Z Phone: ( ) Fax:: ( ) Reconnect only 67.84 2 E-mail: .. -- Pump or'irrigatiort c roe 67.84 )_. n:.r., ; f'' ''g' v 4iSt�,}• a.: ;euw , ; . Sign or ourlinelight ng G7.84 2 ;; .i 'H. .:.. 1��:� .a'. . tt. . '�I ,L , 1'1r .IL F,�� 'rV M ollenhal3er Enter ri 11 ,. " " `, .. ,;• r: '' • Si circuil(s) or 1 � ut - ener Business name: es ,Inc . DBA al.e , .J 2 2 1 eR T Adduio I ino al i xt l hr min) t 6.25 e113tOn Pa• eelion Over allowable in an of the shove Address: 1 4 , 7 o sW All 13] va ., pectin ( / hr raw 1 City /State /ZIP: Beaverton, OR 97005 I (I ; hr 'n) 66.25 /hr 1 Industrial p le (h h r la n) 7R I8/ hr p er . - ..... Phone; ( 503) 649.6991 ( 50 ) . 3 641 .1902 rns fo r whic no fcc is CCBLic.: Goc s citirall listed %hrmin) 90 • hr 191094 trica Lie. C643 Suprv. Lit; 4230S " • "'" ° •' .. • Suprv. Electrician sign lure, rulttirNd Subtotal; --- � - : Plan eview(25 %ofpermirfee): 1I.1 g o /n o ( PC Print n +tmc: 1)ouglo; J Mi17 % l : e: 12.20.10 St 12f rmil fee): _ su e. bare Authorized signa ure: . O r 4'� ti TOTAL PERMIT FEE: 96.16 A hh. This permit app on expiring If a permit is not obtained within 180 Print name: Dar r y1 Mol en louse. nrtra; 12.20 , l.0 days at r It has been accepted ux complete. 1 4 pe __J • Number of inspect', us allowed pe✓ . O`M 1:\ Building \PCrrnilrlliLC- Permit, p.ecc 01N1110 4404613 t't 1 I rONCOM/14:a n `J�ti. _ t t i O N) let . p Y o d 2' 1 F4e' -- 1 or', L