Permit CITY OF TIGARD ELECTRICAL PERMIT
I:: COMMUNITY DEVELOPMENT Permit #: ELC2013 -00244
T [ GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/30/2013
Parcel: 2S104DC08600
Jurisdiction: Tigard
Site address: 13267 SW WOODSHIRE LN
Project: Vorwaller Subdivision: MORNINGSTAR NO.2 Lot: 23
Project Description: (1) branch circuit to install car charger
Contractor: MIKE'S ELECTRIC Owner: VORWALLER, DOUGLAS F &
11070 SW ALLEN BLVD KARYN A
BEAVERTON, OR 97005 13267 SW WOODSHIRE LN
TIGARD, OR 97223
PHONE: 503 - 649 -6991 PHONE: 503 - 524 -8154
FAX: 503 - 641 -1902
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo /Purchase 04/30/2013 $56.18
Specifics: Service or Feeder
1 ea 12% State Surcharge - 04/30/2013 $6.74
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $62.92
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 0 R 52 -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. , /
Issued By: CJ`_CG�1 Permittee Signature: 01(1 tPPUC./fTI o1J
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.
04/29/2013 1 1 : 0 9 #1860 P. 001/002
RECEIVED
Electrical Permit Application FOR OFFICE USE ON1.Y
City of Tigard APR 2 9 2013 , Rcctivd
I Da:e•liv. L ILLWII S Sr .
Itiunt No • 01 ej0/3.- 09, i
. --' • 131 SW Hall Blvd.. Tigard. OR 97223
1 'km . ta.ie..
___ .------
: I Phone. 303.711.2439 tax. 503 59 , 1. inn GF TIGARD
I
_,_____
1 Other Parma. i
1
TIC.ARII ItnsPelitrt Line: 303 639.4! 75 BUILDING DIVISION '. , ii. la sm Pate 2 far 1
TE OF
iiiift att. , A . WW tigard • Ninined.1.1
i...---:. i I I try ! Supplemental Information
_____ ..- ---- , LAN REVIEW
;S WORK I
ll'i ... ,:asi; dicak all :hwi apply (submit /set:: of plans , ...iretoS clu tte;Cm).
0 New construction . Vidditionialteration/ropiacement
D Service or feeder 4 011 amps ot inure 0 iimiciing rmer !time Rorie.
0 Demolition 0 Other:
- —.
%here the A% 4.1ablt fault eioi cat in Nihrj71;b1 AM L io . yan k
--.
CATEGORY OF CONSTRUCTION es.:.e..,as i0.000 aino hi 150 volts of 0 Floating buildings
H leas to ground. O. i.vicredr. 14.000 in Commercial agneuirisfal
I. and 2 dwelling 0 CommercialTindustrial 0 Ace; ssory building amps for all othur installations. hut IrliA,...,.
0 Multi 0 Maier builder Other: 0 Fire pump 0 lustallation of 75 Ki,',N ct.
.-.-.
--- -- -. 0 17thoiginicy syairarn. la' arate4 diamed systems.
JOB SITE INFORMATION AND LOCATION
0 Addition uf am mocut icad or
Job no.: 'S/410
Job site address: . ' ' % • n .
3 iX , e . MOM residirmial units nalipars:y
0 Iti.v:earional whicle patLa.
---, _
r,rj I lealrh-CEN (=dries. 0 VO:i3v lir more than
City/State/ZIP:1 _ t7c2a3)_
__ suppb !
. ._ 0 i lasaoloos likations oldl vOltS nominal
Suite/bldg./apt. no.: Pr0,142CI itame: ! 0 S.TVICC or feed*, (ion amp:: iir mole. .—j
.. _i
FEE SCHEDULE
Cros.s street/directions to job _ site; I I , I g...-1, •
i New residential Mingle- or multi-family dwelling unit.
Includes attached garage.
. ..... — — .
` . 'CO 1 , N. ft. ,)! ;vs i 17778 s4 I 1 4 I
Sulxlivision•
1 Lot Jai.: 1—
• -- i
1
--- , ' La. add': 50(i Ai; It. Of pOilion
Tax map/parcel no.: '1"'''
!dinned energ. residential
- —
I i 7 i I 1
DESCRIPTION OF WORK • ih abo .1.00 7
ve sq. r••1 I
' I . ' _ I
—_______. initio.1 energy. mulli-amily 1 1 75.(x) 1 1 - 21
__incet)kk C Z (C14-4--ciaC 1 rc s i c114_ m in ._.t _L._
—CAC--CIACIRatar-- . Services or feeders installationa *moo' audior relocation
. 1 200 amps Or ICS.; 100.70 I 1
_--
Eir OWNER ---
—
! * 0 TENANT , amps to 400 amps I—
1 lot L..33..16 I
I r 200 2 i 1---, . 2
, , .,,,, ..ps I
• __L_
Name- • OA .___\,/G.c.‘00a,S,,,e,r— — I 1
.., • otr. amps :01.000 amps I I lni.o.: I i -71
1 1- ---i,
.Addre.ss:
. 1 i Over 1.000 amps or voila I I 35216
Temporary services or feed rrs installation. Alteration. and/or
City/State/ZIP ! :
relocation ...
..
! . ! ---7 — 1 - 39.31 - 17 1 2
Phone: •' )q15 Fax : M O amps or ICSS ( )
— — . rm-Lc , 400 an Ips. I I .01 Q_ 1 2 1
Owner installation: This installation is being made on property !h ti
at 1 wi which is not _01 a rc • ., - I
1 s . 1, l_t
intended for sale. lease. rent. or exchange. according to ORS 4417. 4.19. 670. and 701. : 40amp to 599 amps 1 I 161.54
tirinchcircuits - new, alteration extension, per panel - ■
nu0 . er signature: _ . . __ _ Date: . _ 1 A Fe c for blanch eirg.
eu wirn 1 i • ;1
t
" ---- I
:move .--er or fctater ii.v.
0 APPLICANT 1 0 CONTACT PERSON 4., 1 2 I
— .._. _...... .. ......_1 i vach blanch circuit L . i .
- .
- - 1717 tisr branch circuit.% :owl?, .i7 I i I ?it
Business name:
— ----1 2 set% ii.e Of haider foe., lira;
I 1 56.1s 940 40 1 ,1
i b citcuir
Contact name: ranch
• ._,._.
--I i Each add 1 branch eircuil i ,.. ; 7.42 1 711
. -I
Address:
1 Miscellaneous (service or feeder oot included) i
...
— • • --- Etch iyanufactured or ino(67s71—.
City/StateZ IP:
— ,■1 service anctor feeder 1 ! I
-- —
I Reconnect Onlv
it
Phone: ( ) rax: : ( )
. — 1 Pump or irngation cimic
• . ! • 67.84 • 2
I .
ii-nsuil:
____ Sign or outline 1141ting 1 67 114 , 2
CONTRACTOR
I SiErial areutos) Of lmitoO.coorg --r—
1 I
. 2 •
2 ,
Business name: Mollenhauer Enterprises. loc. DISA VIike's
Dane!. alteration Cr or cmcrision Pa w
— _- __ 1 Each additional ii sis over allowable in airy of the anrive
- ...
Address: 11070 SW Allen Blvd
t Additionisi f !hr min) 66.2: hr
,--.
1 r .,tigation ( 1 hr min) 1 66.25. hr ' • I 1
City/State/ZIP: Beaverton, OR 9700S
•- r - 1
industrial littli (I hr Mim I 7R 2 v ..,.
_
____
— • • •----; ' . u hr _
Phone: (503) 6491,991 ; Fax: ‘ 53) 641.1902 ; 1 ;nspeetiorts for which no co! is ;
. i • • ., 1 90...".0 hr 1 1
1—^ — —• _.: I r , socciiicai,% listed 1'-': it: =IL • . i
CCB Lic.: 191094 i nearical ..ii.. 064: i Supn.. Lic.: 4230 1.. ELECTRICAL PERMIT FEES 1
i
—1.....
_,
••• ...
AG S t , ( 493
Suprv. Electrician sig ,
nature. requireTT2 ... ' i le
.._ Pion revtew 1.':!`ve of permit !ec).
AI i I
Print namc: Dogulas J. Miller 4 .... 1)61e: ( . 2 97 - ; 1... Sure succlout...a (17% of TOTAL PERMIT E
permit ubiot o ___.;
-- • • • I 1 1 FE
Autborized signature: - _ . ........,' ;,, '— r. . .
. I This permit application aspires if a permit is nor obtained . i thin 140
data after it has been =clued as com p It I.
Print name: Darryl Mollenhaucr ' Da•c•
_ .._ ' • ( 7/13 4 -31/3
, • s.u771 Of inSailsthoft Si:Owed per ooi nu;
___
_
1.11.:din5 An. 0 0: It
•:, : .'.' CO% i\si.ii
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
13267 SW WOODSHIRE LN, TIGARD, OR,
97223
Residential - Electrical
199 Electrical final
05/03/2013 00:00
ELC2013-00244
PASS - No C of O
Violation Summary:
Inspector Contractor