Permit ,, CITY OF TIGARD ELECTRICAL PERMIT
1111 g COM MUNITY DEVELOPMENT Per #: ELC2011 -00348
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/23/2011
Parcel: 2S103CC09700
Jurisdiction: Tigard
Site address: 12280 SW WHISTLER'S LN
Project: Johns Subdivision: WHISTLERS WALK Lot:
Project Description: (2) branch circuits for hot tub and shed.
Contractor: MOLLENHAUER ENTERPRISES INC Owner: JOHNS, JERRY J & CAROL M
11070 SW ALLEN BLVD 12280 SW WHISTLERS LN
BEAVERTON, OR 97005 TIGARD, OR 97223
P
PHONE: 503 - 649 -4702
HONE: 503 - 649 -6991
FAX: 503 - 641 -1902
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 06/23/2011 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 06/23/2011 $7.63
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $71.23
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 accor e with a proved pl- s. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTEN N: Oregon law r- • res you to follow the rules adopted by the Oregon Utility Notificatio Center. Those rules are set forth in OAR
952- 001 -001 throug OAR 952 -001 -y. 90. obtain a copy of the rules or direct questions to OUNC by callin . 1987 or 1.800.332.2 44.
Issued B : 4 - J Permittee Signature. C�-
�
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' --- -1 (��
��--> 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.
06/23/2011 00:58 #0406 P.001 /002
Electrical Permit A,pplicatio)1RECEY V LiD . FOR OFI I USE ONLY .
City of Tigard ( � 1 � / � Permit No.: e�' a �p ll - g
t T q 1 UN 2 3 2011
13125 S W Hall Slvd_, 7igard OR 97 Plan Review Other Permit:
Phone: 503.639,4171 Fax: 503.598 Date/By:
Inspection Line: 503.639,4175 C 1 . 1 Y OF TIGARD Date Readyrs,': $u See Psoc z roe
TFGAfi Internet: www.tigard -or.gov BUILDING DIVISION. Notiftetl/Method: Supplemental Information
r_, '. -:,, N ,, . .. ,. ;1 ,. .. ' ; 7 ,'a, ¢' ' s �i . .247 ... r w.g,ia ,: Pt,wi•1 4f. y . i': AI 1:: �'YI�
;. �.._.. ���.': 4• �• •"':)' N� ,".
,(r •�n� ;al, ��a.� i � ' JY W "t J�Px �..t i�fT.,ctvL�:��iN�i. '( ��:: �. u:�.. �..:f� "�. .. �.:,
._:.wn: „f•. 6 7, ,., :i r.ra^_:n iia'Xi' ' t1 _ dt : ,u'''' 4 • "-- ' ''''" .
Please char all that apply (submit 2 gets of plans w/ilems checked below): 7 ❑ New construction ca Addition /alteration /replacement Q service a<feeder 400 amps ar mote ❑Building over three statics.
0 0 Other: w boatyards.
I�emolitton
here the available fault current 'Marinas m atyat
- . , �yt,�.r , ,yr^�:ra ^'r� ..."4+12.. , ;p�'h.' ;gin •+t °,:.,. ° ^+�;�' ptceeds IO,OOD amps at 154 volts o ❑Floating baitdings.
• °.i' "'d:Yi.:1 , ,, . : pg °' t {' `O�S :',w."_XA- '-• ! "- i agricultural
•
^_'y _ - ]ceald �a` ^` ,t tesx to grovmd. or esceedx !4,000 I� Commarerai - se a$
® I - and 2- family dwelling 0 Commercial /industrial ❑ Accessory building amps for all other installations. buildiuss.
❑ Multi - fami 0 Master builder 0 Other:
Emer system, ❑ la separately derived sysreur.
:,. ._;i. v b !.* c q•" ` k' " . d ' r" • 1t r ` s^ � I L M ,) „�, . ,. '� r '' t ' " r `ow '. f ' p
; .l ❑ Addition of new motor load of fi. _ �..., I __ .,
• n.n h,vry F...t. 4Gii„�„ • y � Wirv � W.: ''ti� .� ? .. �v. . ._.. ❑., A .,. ..
lo0t'iP or more. occupancy.
Job no.: 28751 Job site address: 12280 SW Whistler Ln. 0 Six or more residentiai units. 0 Recreational vehicle pmts.
• City/State/ZIP: Tigard , OR 97223 0 He facilities. 10 Supply voltage for more than
Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: ❑Set/ ee feeder 600 amps or more.
Cross strcet/directions to job site: Descriptioe 1 Qty. F a' l T I
New residential single- ur multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no,: 1,000 sq. ft. or less L 168.54 4
Ea. add'l 500 sq. ft. or portion 33.92 i
Tax map /parcel no.: Li mited energy, residential •
k• � ry fir, ,4 ° "'`= toter; ' ..: . ,. ,,; t (with above sq. it) 75.00 2
.se
�� ::2i „wr.h c i % "`.1;tC ':n• : `,'�. �. i'' . tY "' � �� $ E '�'t5 ... . /...
w .
w e ue r !'' -,'' ' ,•
�, ..,t. n . . ,,,,.�r „4 o n.ra... ,.. trn . " .xt4� '� sus .t i1,.2, 4'x,, ,vo"n.L " ,,,. M, ..: Limited energy, �'
�' y 75.00 3
Hot tub & shed circuits residential (with above sq. ft.) -I
-- - - Services or feeders installation, alteration, and/o relocat --
on
200 amps or less 100.70 2 .
i t :. n_M U x i1 ; :• i t " � yi Tt ,.. 4 s F l`Y
Z ° 'i 'rq' r,'' °7 u i 201 amp 133.56 ' s to 400 amps
S i.4; ;`4` :g; r -•• ' '"It'' -r �, t ' 4 ''' ,. �+s " r ` • e„ s ; -"" "'
401 amps to 600 amps 200,34 2
Name; Jerry iohns • 601 amps to 1,000 amps 301.04 2
Address: 12280 SW Whistlers Ln. Over 1.000 amps or vole 552.26
.. Temporary services or feeders Installation, alteration. a /o
City /State/ZIP: Tigard, OR 97223 relocation ,
200 amps or less 59.36 I
Phone: ( 503) 649.4702 Fax: ( ) _.
201 amps to 400 amps ' 125.08 2
Owner installation: This installation is being made on property that 1 own which is not 401 amps o 599 amps 168.54
intended for sale, lease,.rent, or exchange, according to ORS 447, 449, 670, and 70I. ' -^ '
Branch circuits •- new, alteration, or extension, per panel
Owner signature: _ ' Date: A. Fee for branch circuits with
'4 n „9Y:.F,' n1Y ° �q7� g sy;,,r 'n r ,., r,,t1i C, above service or feeder fee 2
..., ' ,: %' '''' ?:,�'g. fi , R v' "i.. g ;.i . (t:4 l ' R +f .. zil o . R -.. ., 7.42
:.,�. ., ... each branch circuit
Business name: B. Fee for branch circuits tvrlhorrr
service or fader fee first 1 56J8 8 56.18 2
Contact name: branch circuit
- Each add'I branch circuit 1 7.42 7.42 �
Address: Miscellaneous (service or feeder not included) _
-" Each manufactured or modular 67.84 1 2
. City /State/ZIP: dwelling service and/or feeder
Foconnect only 67.84
Phone: ( ) Fax: : ( )
1 Pump or irrigation circle 67.84 2
E -mail: 67.84 2
• "- r te , -"' . ..i.... ... ...�- - t*a^r^ .. -
, e � Y 11:,1 wan :,:
Sign or outline lighting
: •,ti ' ,,i,o .r , v\', 4P a 77 ^'hx " >G .�
� ":; I:..T�i��:C� p 1v„M!1 /.''7. t 7 "i - 'L` n0 b � �:�. �WSV� 4P0 4 '4P "..ie��P'4'� A^ A� �' L2. .. ;,�..',,. ; l , .u, a . ' .... _r; ... ...,,,y � „• .• , ,N. .+e r ,. ,� �a'. , , ; U at . Signal eirouit(s) or limited - energy
, : :.p.: i:Al:vnn�:: :rl+:r� +l:rv`u:iv.:Ann �. �...
r panel. alteration or extension. , Page 2
Business name: Mollenhauer Enterprises ,Inc DBA Mike s Elec J;ach additional inspection over allowable in antof the above
Address: J 1070 S Allen vd • Additional inspection (I hr min) 66.25/ hr _
Investigation (1 hr min) 66.25/ hr
City /StateiZlP: Beaverton OR • 7005 Industrial plant (1 hr min) 78.1 ar hr
Phone: ( 503 649.6991 Fax: ( 503 641.1902 Inspections for which no fee Is 90.00/ hr
: •
specifically listed (%z hr min)
CCB Lie.: 191094 Electrical Lio_: 0643 Supry LiC.: 4230S a� vau�� R3.0 . 0 ;10ES
•
Subtotal: b3 .6U
Suprv. Electrician sigrl =tore, requir•d: i , I, , Ze , Plan review (25% of permit fee): _
Print name: Dougla - i ' f ' ' e: : 6.
23.11 State surcharge (i2% of permit fee): 7.63
TOTAL PERMIT FE.: 71.23
Authorized signature:
v V --�� This permit applica[ ion expires if a permit Is not obtained within 150
Print name: Darryl Mal enhauer Date: days After it has been accepted as complete,
Number of inspections allowed per permit.
i. UBuildingtpennits1ELc-Pennitappdoe 07/01/10 44044 ST(11/65/COM/W5B