Permit CITY OF TIGARD ELECTRICAL PERMIT
° COMMUNITY DEVELOPMENT Permit #: ELC2012 -00344
T [ G ; p 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/06/2012
Parcel: 2S114BB03500
Jurisdiction: Tigard -
Site address: 10130 SW KENT PL
Project: Borst Subdivision: PICK'S LANDING NO.1 Lot: 49
Project Description: (2) branch circuits for master bedroom
6/12/2012: REPRINT permit to add (1) branch circuit for garage door opener.
Contractor: MOLLENHAUER ENTERPRISES INC Owner: BORST, ANDREW
11070 SW ALLEN BLVD 10130 SW KENT PL
BEAVERTON, OR 97005 TIGARD, OR 97224
•
PHONE: 503 - 649 -6991 PHONE: 503 - 336 -0784
FAX: 503 - 641 -1902
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 06/06/2012 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 06/06/2012 $7.63
Type of Use: SF Electrical
Class of Work: ALT 1 crt Branch Circuits w /Purchase 06/12/2012 $7.42
Service or Feeder
Type of Const: 0 ea 12% State Surcharge - 06/12/2012 $0.89
Occupancy Grp: Electrical
Total $79.54
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 OAR 95 001 -009 You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.8 I
Issued By: V 6 Permittee Signature: O`�1 t'i 4'r .3 � �"T� L)&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' 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.
CITY OF TIGARD ELECTRICAL PERMIT
• • COMMUNITY DEVELOPMENT Permit #: ELC2012 -00344
T t G A D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/06/2012
Parcel: 2S114BB03500
Jurisdiction: Tigard
Site address: 10130 SW KENT PL
Project: Borst Subdivision: PICK'S LANDING NO.1 Lot: 49
Project Description: (2) branch circuits for master bedroom
Contractor: MOLLENHAUER ENTERPRISES INC Owner: BORST, ANDREW
11070 SW ALLEN BLVD 10130 SW KENT PL
BEAVERTON, OR 97005 TIGARD, OR 97224
PHONE: 503 - 649 -6991 PHONE: 503 - 336 -0784
FAX: 503 -641 -1902
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 06/06/2012 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 06/06/2012 $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 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 OA 952 -001- 90. You may �J► obtain a copy of the rules or direct questions to OUNC by calling 503.23 or 1.800.332.2344. /,
Issued By: �V lid al Permittee Signature: 4 k./ (�T /ALL
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.
_ 5
06/03/2012 21:19 cc #1205 P.001/002 �; /
Electrical Permit A.pplicationR- t l �c FOR OFFICE LSE O NLY o(.�l/
II City of Ti JUN 0 4 2012 1 R°""ed _'.
Y /,/
- stew: f oti m Permi riaL i a, So tAyp '
13125 SW Hall Blvd., Tigard, OR 07223 . Plan Review
Phone: '
e: 503.639.4171 Fax: 503.598.1 ;� By . J Otter Per,nir
TIGARD
Inspection Line: 503.639A175 ATV OF TIGA bate (ie/ ReadyBy. 1 Jura 8 � See Page 2 for
Internet: t: www- tigard -or.gor VI otrfied(Method: ntorma anl no
❑ New construction ® Addition/alteration/replacement 1 I PI S check an don ap ply (s , a5tttit b sets of plays wrran, checked beluu
1 Demolition ❑ 01her I ❑ Service or feeder 400 amps or more ❑ Building ova. tbree stoma,
_ . _ _ _ -- ' where the available fault current 0 Marinas and boatyards
. .' : � _ , :F•s ...1 `.el(R..' .::... '"3: ...i : . -; •... -
::.;::, .., ...- . . .. : : , :.. i exceeds 10,000 amps at 150volsor ❑PI oat builds
Floating : . .:
ti I - and 2 -famil d
less to ground, or m a .ri, ! 4,000 0 Cummeteta■- a cui, w
y wellin g ❑ Commercial /industrial 0 Accessory building ! i apps for all othc.• installations. buildings. !? e.
■
❑ Multi- family ❑ Master builder • ❑ Other: t 0 Free PAP• ❑'- >rstaitatiaa or 75 f:vA el
C p _ a p 2 c '> : ❑ Emergency system. larger separately derived system
a'", - '��� ^wit. ❑ Addition anew atm , load of ❑ A _� 1 !.
30425 i
1001-1P or sore. oe v
Job no.: lo b site address: 10130 SWKent P1.
City /State/ZIP
`Tigard , OR 97224 O s i; a a >tf ca s residential
facilities. l coss. ❑ Recreational .chick pat4, i
❑ volts noOu for more than I
❑ )Iatardou6 600 vo 600 lts ; nominal.
Suite/bldg. /apt. no.: Project name: ❑ s� or fader ti0o amps a more
i Cross street/ditutions to job site: 7.; - .rc,. :, : ? :.
aftrni 1 ncrcrmsroa Qtr'• , P , T ast • i ^l
New residential single- or multi - (amity d welling noit
Includes attached garage
•
Subdivision: 1 Lt7t no.: I .coo sq. ft. c less
! 16 ?�
- _.i.__......... Ea. add'l 500 sy. ft. or portion MI 33.92
Tax map /parcel no.:
t ,:...: .. ..,�..,. _ area
0M . ... .... - .... -: ' = a Limii nerd, multi• family I
• f ;' 1 • .. residential (with above .. ft. I 75.00 2 1
2 d NCty el 2C.f/t..c rs nRs or installs on,a,tva , relocati4)
• — — Services or feeders ' a tioa and/or a .
O / 200 am ltss 10(190 ,
rem: _ • ... 1 201 amps ps a 400 a ��
i ... - ,..... ;.... �. �.... 1' ,�. - = �'�r<..�. . _ r mP t 133 56 i 2
401 amps to 600 am ps 200 3 ; ,
Name: Andrew Borst ,---1
6ol amps to1.000amps 301.04 ► z
Address: 1 n1 In ;w :a Ka r pl j over 1,000 amRS or voIC4 t L_ 552.26 ! ? !
- 1
C.i /State/ZIP: Temporary services or feeders i
Tigard , OR 97224 _ relocation aswltaaoa, alteration, and/or
Phone: ( 5 336.0784 Fax: ( ) I 1 200 amps or less j 59.36 j i
201 amps amps to 40o am 1 Z5 (18 `l
Owner installation: This installation is being made on property that I owto which is not — , 2 i
intended for sale, lease, rent, or exchange, accordingito ORS 447, 449, 670, and 701. aol amps 10 599 amps ! )� i a
6raach circuits - new, alters ��
Owner signature: Date: I alteration or exteaaioa per pans
A. Pee for branch cirars wuh 1
' ! above serer ice or feeder fee, i
' :''',.,......,,:. :._.. .. i O '`. esc2l branch circuit t 7. i 2
Business name: B. Fee for branch circuits w;ihow ,,,_f_ 1
- - - - --- -- service or feeder fee. firmer i , 1111
Contact name:
circuit 1 ' 1 g . $5. j$ i 2
• Each add'I branch crrtatit 1 I 7.42 7 / i
Address: Miscellaneous (service or feeder not included) i2
City/State/G1P: • Each manufactured or modular T1
dwelling service and/or feeder ` 67 8 l 1 i
•
Phone: ( ) Fax:: ( ) Reconnect only ` 67.84 2 i
I
Put or irrigation
E -mail: _ 67.84 84
.
... .�... •�.:.?.. .. Sign or outline ligJr i 67.
N:.. shed -cner
1
. .... _ ..... ,_ > : -:,., si cttcum(s) v 2 { .'.
Business name: Mollenhauer Enterprises,Inc. DBA Mike's Elec panel, alteration, or extension. I l'age2
i Each addiooaa) ins aim over ono, bte 10 any of the strov
Address: 11070 SW Allerl Blvd. Additional i+upeedon (t hr nit 66.25/ ix
rC ity /StateJZ1P: '• - -- Investigation (1 lu min) 66.25/h I
r �
B eaverton 0' 9700. .
Industrial plant (i ter min) 78.18/ hr
i
Phone: ( 503) 649.6991 Fax: ( 503 ) 641,1902 - Inspections for which no fez is E -�—^
s �oci8c ally li tad '/_ h mi 90 00 / iV
CCB Lic.: 191094 ectrical l I i.i
.ic.: 0643 rv. o 4 2305
`.' . - - r ?
n
Suprv. Electrician sign: c rcqui d: S
� " �
/ r Plan review (2j% of permit fee): _
Print name: Dougla - J Mill - j i c: 06.04.12 State surcharge (t 2%, of permit fee): 7.63
Authorized signature: ./ � d ` O r e j .,1 TOTAL PERMIT FEE. 71.23 ';j
Thin permit application expires if pest is out obtained within t$0
days
i Print name: Darryl Mol enhauer Dale: 06.04.12 l I • Numbs' o f a'i`r `t h's a, permit complete. nib . ed per permit.
1•lauilonave7mhskk1A- PtrtmtApp doe 07/01 /■0 a I'-M <Tr r t rnc,rv,.. , u re
0 Al226 P. 001/002
6/11/2012 03:02
R pp>a I
Electrical Permit A lieatio 1 j FOR OF ICE USE. 9\ �'
City of Tigard Re
II 13125 SW Hair Blvd., Tigard, OR 97223 JUN 1 1 201 �� /Z /0 ? %pis/ pmmr N°'62-a2
1 .. Phone: 503.639.4171 Fax. 503.598.1960 Pun Review _ v 7003 y
TICA.RD In Pectio Line: 503.639.4175 CITY OF TIGAF Y: ""` — _
Internet www.ti d-or, I 1 See p
BUIL ING �I V1�1 C 1 Dtrfxd/Metbod. I A �� a for
�_., I ,. t�oaeagr Information
Q New constructio ®Additi /alteration/: lacement
1:1 Demolttion 1 I ,'lease ebeck >al ,... appl (su 2 sea of D whims theca ea bet,,. ; !
_ . ❑O ther: or more
..•.; ,. _.�,. , ,-r- tee
I Service or feeder ao ar ses Q Building s
wh ere t available fault current '°'`t share
-': ' :< • • ., . - eaorads 1 0,000 ID and fl ings
I -and 2- family dwelling ❑ Commerciali;ndustrial 4 e " 150
, 0 or ❑ Fl"„'"
❑ Acce ssory building amps ground, a e►eoeas c0 is. t r buildings
0 Multi- family ❑ Master builder buil din r �1 p r once a1 - iii: eazrcmur ra;
- ' �
rttstiltara«r
Other:
( • ^ 4 ^ � t:._ > : if. r..` � '_�7 - -� w< .'.:'::•!' - - Q � llazwno :SKYnu:
i ❑ Fire pump.
❑ Addition of new motor scum-4.0y derived ayce,n i
Job no.: 30425 1 Job site address: 10130 SW • - • • t oo n'D`6r d of d '. A.. „`
Kent P l , rtr or more
0 Re
aeatoal
Ci /StatelZiP Six Dr more �
h Tigard 0� resdential ”nits ❑ Re,o den tk
9 722 4 0 Heattt— rt,poy. 1,2.4•. ID Supply potta� for more :hen
Suite/bldg./apt no.: Project name: p liaz,rdo,g Iorat,om:. 600 volts rani yl
❑ Service or feeder 600 amps or more. i
Cross street/directions to jub site: _
—� , ideal residential single. or tnplfi- • dwelling Teal T,
Subdivision:
----�� I Tntltfdcs attached garage.
�`� u tit
1 At no.: 1.000 sq. R. or less
Tax map/parcel no.: Ea. WW1 1 '68.}: 1 Tl rt
500 sq. ft of portion I —rte
Y ;: 1 I 7 . 92 • .
I
" Limited ewer 1
- c _* 6' (with above sq. ft.)
75.0oo �
—
Garage door opener Limited ester I `
> , muhi- fanuly
q� ` _ residential (with above set f.) 1 75.00
, / A' -- �D Eleae A —r 031 Services nr feedet8 iostallatlon a) relocarYOn�'
. ..... _ : 'St' . a _. ; e• .• f ��/ a x : � . 200 a
amps ps o. kss 1
1005
TJarne: .... _ .. - � 1 turps ro app 3rrrps , 3Z �
Aj ` - . e 401 amps to 600 amp 2 r
s ,
2003.1;
address; 10133 SW Ken P1. -1 ' 601 amps to 1,00Uamps -- - 301 04: i � 1
Over 1 ,000 ;nips or volts SS2 .Z6' 1 T 2 1
Ciry/s►atr'ZlP: Tigard, OR 97224 ~~ f Temporary services or feeders t
relocation t+om.altteaRop. and/or
Phone: (503 ) 336.0784 Fax: ( ) 200 amps o —
Owner instull�t;oa This inssaliat;on ;s being trade on pro — s I I ' •
P pett that I own which is trot , 201 amps to 400 amps 128i ,
intended for sale, lease. rem, or exchange, according to ORS 4 47.449.670, and 701. 4 91 m 599 amps
Owner signature: 13raneh l� -
remits pew, alteration e T- - - o p 1
-_
�� Date: a, p �
,: r. ; „a : � - „ , ; A . Fee for branch arcuirs with l 1--{ • _ . . i ' ?r r ; above Ser
vice w fear fee. I I
Business name: branch circuit I 1 7.42! '• i
B. Fee for bfartch circuits wifhW --I
Contact name: service Or fender fee. lust f p�
btandt i[r sit 56.18; I J r i
- C 1 2 i
Address: Each add'16wrich circuit '' 7.421 El
City/State/ZIP: Miscellaneous (service or feeder not loci d)
_ Each manufactured w modular r r .
Phone: { ) dwellin service and/or feeder I 6 � t -
I Fes:: ( ) LRrcalrtect only 6714 .
-
E -mail:
I-Puump or irrigation circle
.r_ 1 Sign or outline f 67.x r 2 I
y., • , ^ ..7.''- .
.y;� .� ..:,.: ::� , r »;1litrag 67.841 2
Business name: , .._. = � Sigr
' �' id circu;gs) or limited��, '
Mollenhauer Enterprises,Inc. DBA Mike's Elec ' � t C7at1pn•0r.1On
Address: 11. Eac a i • allowable la d on over a ll : of t 9e ab~
70 SW A len A�yd _ 1
�� Additional inspecti (1 hr min) 6, )
Ciry /State/ZIP: $eaverton. OR 97005 O r
Investigation (i hr min) 66]S / fir
Plsorte ( 503) 649.6991 pax: ( ) plant (1 hr min) 7818/hr 1 ,— y
�� 503 641. ] 902
Inspections for which no fee is
CCB Lic.: 191094 ` Electrical Lie.: C Suprv. Lie.: 42303 , s- ecifia■u� listed (f hr mial 9000i hr 't i I
Suprv. Electrician sign.,, re. trim :
��,� Subtotal: i 7.421
Print name: Doti la _ Plan review (25% of permit foe): I 1 �
g ; '''' e: 6 .11.12 State surcharge (129e of
1 txtmrc fee): .89
Authorized Signature. v ' • Of ' TOTAL_ PERMIT FEE. 1 '•
._ , T6:a permit avDl�rloa =As it 4 pvwir is 1 4106fat ' Red witWn
I Print name: Darryl Mol enhauer i Date: 06.11.12 I days after at has bee" accepted as pleia
� ' Number of inspections allowed ocr permit
i �H�w:O�?v PtrmitApp D1NVrp • /,...:141., ,: o