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Permit CITY OF TIGARD ELECTRICAL PERMIT a . COMMUNITY DEVELOPMENT Permit #: ELC2012 -00369 T [GA [GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06118/2012 Parcel: 2S112CC12200 Jurisdiction: Tigard Site address: 15714 SW 82ND AVE Project: Johnson Subdivision: LANGTREE ESTATES Lot: 54 Project Description: (3) branch circuits for outside lighting and outlets Contractor: MOLLENHAUER ENTERPRISES INC Owner: JOHNSON, DAN 11070 SW ALLEN BLVD 15714 SW 82ND AVE BEAVERTON, OR 97005 TIGARD, OR 97224 PHONE: 503 - 649 -6991 PHONE: 503 - 701 -0685 FAX: 503 - 641 -1902 FEES Quantity Description Date Amount 3 crt Branch Circuits wo /Purchase 06/18/2012 $71.02 Specifics: Service or Feeder 1 ea 12% State Surcharge - 06/18/2012 $8.52 Type of Use: SF Electrical Class of Work: OTR Type of Const: Occupancy Grp: 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 hot 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 0 952 -00 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. ' I Issued By: � Q Permittee Signature: !/ APP (.!_4 7 D a'V 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. 0 #1240 P. 001/002 6/17/2012 23:45 Electrical Permit Application R .ECE� ' RECEIVED FOR OFFICE USE ONINi D City of Tigard Rocerved tribe/P-- � 140 . SW Hall Blvd . Tia O 97 223 201 r �o�l , ` 3h? • Ph one: 13125 503 Fax: 503.598. UN 1 8 h Review TIGARD l `�� on Line: 503.639,x175 iT`' T� pD� Nai IBy Permit: Date • Internet www.tigard vr.000s Cld d l F lIGApij Ciewmct ni t S See • 2 for ."; 7, � (S°ppkmea 1lolormario° J ,.. ❑ wow construction al A dditiotl /altetatfonhepiacerrteul Please clod( an that apply (submit 2 sets of plan; write �, ❑ Demolition ❑Other CI saYice or fader 400 amps or more D g — _ _ where the available !salt s o rhea stones. " „ E : �; , :- q. : =rent p boal.�ds fj •1t: ;: . r ' -- ''. '`;' ^ :. ; , t: :: . aceccds 10.000 amps at 150 volts 0( Q floating Dui dt 1- and 2-family dwelling n leis to ground. or emceed; 14,000 'tip Y g ❑ Commerciayindus ial ❑ Accessory building a �omn,ctc,al use a�,cn,Itur°I - _ amps all other r in Multi- family Master i d iatiiota. 1 _ - Other i n Dumb. ❑ Masi( bu I cr ❑ Oth � � . . 34 �.= - .. , .� .- .�.- :.; -• ..._ ❑f ❑ t a srallauon„f)5 v :9 \`f Y;p; .� - I Q bntrgtnc� System K A v- •. :.: ._:.:r':'.t' ?.,A47a`/__ �s tl1FS.az ( i• 1 e5 .; , y : r I ❑ Addition of new motor ,.:. • ely derived err aet,. Job t1o.: 30527 • I Job site address: 15714. . . ;ouuP Of More. olor load of SW 82nd Ave, I MOM oocuparley City /State/ZIP: Tigard, OR 97224 � N e x i le h�sr residential " " °:. ❑items, vehicle s 1:1 SOppir vol - for mote than $Ulte/btd L r10.: ❑ 1lazau,do,a locations. 600 .01tn rots! &!ap _ Project name: ❑ S _ ervice or feeder 600 amps of r Cross street/directions to job site: a. omse ,. t.ifilliEne. Talx1 • New residential single or multi - family dwelli,•_ unit . ----- Includes attached garage- Subdivision: Lot no.: ! .o0 sq. fl. or less 1 ! � — _ Tax map/parcel no -_ Ea add' Limited energy, residential :: ;rte.; .. 3 s ° ,t" i (with above .. R.) 75 2 Outside li htin & Limited energy, multi- family III ); outlets residential (with above . ft. 75.001 2 Service; or feeders installation, alteration, an d/„ _ relocation ,c _ , � Sts ; q ; � � z . :.:. amps or less r 100.70 �y, ^• <' 2° amps t0 400 amps ~ m - '� "''• ',:�A ":::. ;� 133.56 2 Ell Name: Dan •Johnson 401 amps to 600 amps I 200.34 t 601 amps to 1,000 amps i 301.04 r� Address: 15714 SW 82nd Ave. Over 1,000 a • mps a' volts 552.26: -, City /StateJ'LIP: 24 Te m po rary services or feeders installation. alt • bon and/or re l ) 0: Phone: ( 503 ) 701 . 0685 Fax: ( ) acne; or less �� 1 i Owner installation: This installation is being made tin ro 201 amps to moo amps 165.5 { P Pony that I own which is not 2 401 amps intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. e ir 599 168.54 , Owner signature: Braneh c ircuits– new al ration, extension, ,x.....s:, .. -as : r.• — A. branch ci( panel . y ' R _ = • . .. — ., • :. ;..._, xa service « r fee' each I circuit . , Business name: — B. fee for branch circuits without service or feeder fee fast 1 56.18 56 i 2 Contact [tame; branch circuit Address: — - �R 2 _ Miscellaneous service or feeder not included) City/State/ZIP: Each manufactured or modular dwtllin • service and/or feeder 67 84 2 • Phone: ( ) I Fax: ( ) Reconnect only 67.84 2 l -mall: Pump or irrigation e MI 2 i .. _:. " "i"•w= + *. _ _ Sigh «outline ..... :, •_. ,;:.. •-:,.r Signal c or lie ited:eaugY MINI I Businesz name: Mollenttauer Enterprises ,Inc . DBA ! mutation exterts A Mike's Elec a Each additions) Or i r , . . over aitowa in sit, of the above Additional inspection (ihrmin) Address: 1 1070 SW Aiken lv Ciry/StatcJZIP; — ) Investigation (1 hr rein) ~ © Beaverton OR 97005 �u/ r Industrial plain (1 hr min) MEM Phone: ( 503) 649.6991 Fax ( 503 641.1902 _ - Inspections for which no fee is r CCB LiC.: 191094 I Electrical Lie • ifican listed V.T. hr rain) I 90 OO/ r I -- r - 1 . 1 0643: Suprv. l ic.: 4230S _ ;.. ; :.',..: _..,__I a . um r r s � '' e u ,� ` •c � / `�+ ` Subtotal: I Suprv- Electrician si Plan review (25 °h of permit foe): Print name: Dou le g - J 11- J !;;06.18.12 State surcharge ( 12 % ofl , amn ftx): I 8.5 • Authorized signature: /� '� (� AL d,.._ TOTAL PERMIT FEE: This permit application ehplres if a peruat is not 9 :. _. within 180 { P rtn � t tlame: bares! Mol enhauer Dale:06.18.12 1 vin„y�ofi after � �`° accepted as cam - M. 1 tBuild , ngTetsaiissn- C- PumirApp. 01(51/19 per "1f