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Permit
,� CITY OF TIGARD ELECTRICAL PERMIT Ilii . ' . COMMUNITY DEVELOPMENT Permit #: ELC2011 -00440 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/04/2011 Parcel: 2S110BB02300 Jurisdiction: Tigard Site address: 14300 SW HAZELHILL DR Project: Schrupp Subdivision: Lot: Project Description: (4) branch circuits for installation of paddle fans. Contractor: MOLLENHAUER ENTERPRISES INC Owner: SCHRUPP, ALISON & RICHARD B 11070 SW ALLEN BLVD 14300 SW HAZELHILL DR BEAVERTON, OR 97005 TIGARD, OR 97224 P PHONE: 503 - 968 -6287 HONE: 503 - 649 -6991 FAX: 503 - 641 -1902 FEES Quantity Description Date Amount 4 crt Branch Circuits wo /Purchase 08/04/2011 $78.44 Specifics: Service or Feeder 1 ea 12% State Surcharge - 08/04/2011 $9.41 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: • Total $87.85 Required Items and Reports (Conditions) This permit ' '33 : • subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be do in accordance h 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 equires you to follow the rules adopted by the Oregon Utility Notif • enter. Those rules are set forth in OAR 952 01 -0010 thr. OAR 90 001- .' You may obtain a copy of the rules or direct questions to OUNC b 2.1987 or 1.800.33 .2344. Iss d By: / 1!�� Permittee Si gna � - r 1. `Sal 6..- 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' �f�� 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. 08/02/2011 #0503 P. 001 /002 8/02/2011 23:17 Electrical Permit Applicat C „i �, ' � FOR•OFF10E USE ONLY of Tigard Received • ermt Nt . pi q 13125 SW Hall Blvd., Tigard, OR 97223 U 3 G 0 2011 �WR �'� C�Of l � t� y �Q Plan Review Phone: 503.639.4171 Fax: 503.598 1,960 OF DateB : Other Permit: .41 Inspettion Line; 503.63975 G! I Y OF t •y^ 1GA ' mate Ready/6y: )iris, H See Page 2 for TYGARD Intettnet: www- ti�trd- or.gov BUILD D IVtsjo , Notificd/Method: Supp €tmental Information • a.e,: „::.:.:.o-;: -• .. ;n aay..�,,; SJ V - .,,,a...: #+M ,_ ' Q : -ea,, t }: _ ;:ai+ � "i:r �) . :xe,.y.:: .,. d:'' • iw T,r..:..,... ,_._ <. F ..._.,. .�•;.;;�"a;,.:: ,... ".` „ ' ,,. , :Pl�kY':,�V © � Addition/alteration/replacement r Cheek all , New construction � Add[tipnlalteration /re lacemcnt � �� - ..... , � :_.....'� plans wh[cot5 Jteckotl below): apply (sub.ic 2 sea ota ID � . 0 Demolition n Other: 400 am ❑ Building over three stories. Service or f amps or more r ,. ;, ., t.t, y-y ., ��. where the available fault current E;) Marinas and boat ards =i y •'? .,'/ :1; 'ai ... ..- n ":1".3,fGrh;�vt; r- : l ;i„'• .r. ti ._. Y " ` =:r i 0 ' �Y';''•' exceeds 10,000 at 15 � °' , � ' � - .. GPs 0 molts or ❑ Floating bnddinrs 1 - and 2-family less to ground, or exceeds 14,000 E l Commercial -use agriculnual y dwellirl g ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings 0 Multi - family Q Master builder ❑ Other, ❑ Fire pump, 9 Installation of 75 KVA or �a•1;,:,C;: .,ih "r,.;,. "''!R •� ' �"' 1; : - a',+N �"e�ti'S:`�' a , r = 0 Emergency stem. %ras.' `( , !iC. G W. ..L '� S v ;" . :,r?.. y. Y . , .. ge y sy tar .: ,N;� % T . .F4 .,:�_y'w_ . rf ltr , "S ' .. „ `f . „,, , F t .n,7..: ` t :. g� separately derived SyxtGn. -� '� : � : .:.. ..._t..: .. E] Addition of new motor load of Job no.: 28963 Job site address: 14300 SW u .,. 1 Dr . 100HF or more. occupancy, • _ ❑ Six or more residential units. ❑ Recreational vehicle parks. City /State/�l P: T i ge r d , OR g� 224 ft 7,4.1. /4- /La— El Health-care facilities. El Supply voltage for more than 0 Hazardous locations. 600 volts nominal. Suite/bldg./apt- no Project name: El Service or feeder 600 amps or more. Cross street/directions to job site: _ ngirption .0 Torsi New residential single- or multi- family dwelling unit : Includes attached garage. Subdivision; Lot no,: 1,000 sq, ft or less t 68 .5 a 4 Tax map /parcel no.: ..ii. add' 1 5000 sq. ft. or portion 33.92 i residential - �. w . Limited energy, resider i .:::fi;. ::. ,;;{S'".,1�p::' w. 3i' ',,- 5 e - � 5 'ao j a _'!QT4 9w ' ' ;" : ? ( i::�:fti- ^..:,' wi'aabo • t with at)OV 75.00 2 : Y x: �,( ^u SV , . •_ .;.1. -:wa .. r^+` "t`• 1s, .:S , "r ( • C It.) Limited energy, . multi•fatnily Installation of paddle fans residential (with above sq. f.) 75.00 2 — Services or feeders installation alteration, and/or relocation 200 amps or less 100.70 2 t R'M> ,:14iin� G` " ;' 'c� `+QED..?' ,I ,,iii �i �hr:6,5 ?f _ i$ ,.i7,- f,2Gc+:i`".w.1" :. '.':a.'.: ' ^t:e'' 201 r '.'.•. e., ... W 0 .g M a ' :.., ,•� .-, eao 4 ; ' ..,,,.,5 i,a, . ...... ? f .; ;. :, ,., rc t :,, * ; , , Y " amps to 400 amps 133.56 2 Name: Richard & Alison Schrupp 401 amps to 600 amps 200.34 2 cot amps to 1,000 amps 301.04 Address: 14300 SW Hazel Hill Dr. Over 1.000 amps or volts 652.26 Ciry /State/ZtP: Temporary services or feeders installation, alteration, and/or Tigard, OR 97224 relocation Phone: (503 ) 968.6287 Fax: ( ) 200 amps or less - 59.36 i 201 amps to 400 amps 125.08 . 2 V Owner installation: This installation is bein made on property that I own which is not intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701, 401 amps to 599 amps 068.54 Owner signature: • Date: A. circuits – new, alteration, or extension, per panel A. Fee for branch circuits with ,:..-,•.• ..,.. >,.... .. Sri ' : °' 7 -' .” . .,., ..i .,_„ ..�: s^ 1- '7u„,M ��,4�q�% >�� r + ' � above service or feeder fee, .".., °• each branch circuit 7 4 2 Business name: B. Fee far branch circuits W rrhor r service or feeder fee, first 5 6.18 Contact name; branch circuit 1 56.18 2 — Address: Each add' I branch circuit •3 7.42 177 -7.6 2 Miscellaneous (service or feeder not i City/State/ZIP: µ Each manufactured or modular 67.84 dwelling, service and/or feeder Phone: ( ) Fax:: ( ) Reconnect only 67.84 Pump or irrigation circle 67.84 E Sign or outlin kM;:,: ;- ..:Don rtirzr ?: = "w'wy x::_ ± - ag 67,84 2 .: �..- , ;.,.:a,:�, � ° E_ n ter r - ,.:..,..... ., � E14Qktii Mollenh .� -- •�.r, �,.t_.._. a: �,. �, �' z:: w�'.. c::.:. a�;„-; H+•,.r:;:r..r: <_:�:. -. Signal circuir(s) or litmted- energy BLter ,p anel, alteration• or extension. Pa_ 2 i Business name: p ises,Inc. DBA Mike's Elec 7 Each additional ins. ction over allowable in an of the above Address: 11070 SW Al i en )3lvc) , Additional inspection (I hr min) 66.251 hr -- III City /State/ZIP: Beaverton, OR 97005 Industrial p re (i hr min) min) 66.251 hr ■ - [duial punt (t hr min) 78 E 8/ hr \ Phone: ( 503) 649 , 6991 I Fax: ( 5O3) 641,1902 Inspections for which no fee is CG$ Lie.: Electric specifically listed (/r hr mil[) �., hr 191094 al Lie.: C643 t tit{ Suprv. Lien 4230S "'` »;. ' Yw -_.. " • r ..,. . , .�'. ' ti.I is Suprv. Electrician sign:tt,rr, rcqui ' d: Subtotal: 78.44 • '� • _ ` Plan review (25% of permit fee); Print name: Dougla • .1 Mill - ' : 8.3.11 State surcharge (12% of permit fee): 9.4 Authorized signature: � � { �� TOTAL PER1vII FEE: , .85 e41 This permit applitsties expires if a permit is not obtained within tap Print name: Darryl 1"(0l enhauer Daze: days after it has been accepted as complete. .3.11- Number of inspections allowed per permit. t:\ 6uiidingTert nits\ELGPermitApp.doe 07/01/10 440-40 17r( i MS/COM/WM