Permit CITY OF TIGARD ELECTRICAL PERMIT
;'�; COMMUNITY DEVELOPMENT Permit #: ELC2010 -00703
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/22/2010
Parcel: 1S133DA07100
Jurisdiction: TIGARD
Site address: 12980 SW HAWKS BEARD ST
Project: KRUSE Subdivision: Lot: 0
Project Description: (3) branch circuits for sump pump and other work.
Contractor: MOLLENHAUER ENTERPRISES INC Owner: KRUSE, KARL RICHARD
11070 SW ALLEN BLVD 12980 SW HAWK'S BEARD ST
BEAVERTON, OR 97005 TIGARD, OR 97223
PHONE: 503 - 649 -6991 PHONE.
FAX: 503 - 641 -1902
FEES
Quantity Description Date Amount
3 crt Branch Circuits wo /Purchase 12/22/2010 $71.02
Specifics: Service or Feeder
1 ea 12% State Surcharge - 12/22/2010 $8.52
Type of Use: SF Electrical
Class of Work: ALT
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 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 `et forth in OAR
952 - 001 -0010 through OA' • 2- 001 -0090. You may o oft - • - . •r direct questions to OUNC by calling 503.287 or 1.800.332.2344.
Issued By..' .
40 - —
Permittee Signature: l/
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.
Sent By: MIKE'S ELECTRIC; 591 7847; Dec -20 -10 15:17; Page 1/2
To: TIGARD At : 503 '4&CEI \/ ED
Electrical Permit Application C 2 1 2010 1't.31& 1 wI I G 1. tie ()NIA'
•
City of Tigard Received
Deters : l _ Permit No.:
Blvd,, Tigard, OR Y ,I Permit _! It) , 1���
4 13125 SW hall Blvd,, TIGARD Plan Review Other Permit.
Fax: 50,L5 D ateBy:
Inspection Linc: 503.639.4175 D NG DIVISION �' -- Julia - ............... __..
Phone; 503.639.41
Date Ready /By: Luria: to See Page 2 far
'1' I C'i,1 f> Notified/Method: Supplemental Information
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El New construction 111101 Addition/alteration/replacement
Please check all that apply (submit 1 sets of plans whim, checked below):
IN ❑Service or leader 4W amps or more [] Building over uuee arories.
ID Demolition � II Other: where the available fault etll'1'ent 0 Marina, and bualynrdfl.
y r i ” F ! r G r rc '' P,7 R 0 4� r f • r 4 , , , I )i pl : i ,, " r , , 1 rr M exceedF IO,ODU amps at 150 volts OY 11 Floating buildings.
,;,e �� l
nm a tilt ?r 4 i , l' J f. iTd, .•.),;,A,,, O Co oring b aLnse nbrituhwal
,�'- , 1 .. . ,. , .. „,, ,. � ... ' . � � t* to Itround, Or exceeds 14,000
1J 1 and 2- family dwelling I■ Commercial /industrial ❑ Accessory building amps for all other installations. buildings
❑ Multi family II Master builder ❑ Other: 0 Fire pump. 0 Installation of 75 KVA ur
{�! t 0 emergency system, lag gw separately derived .ny.cte,n,
.l', 44 i ,.0 F1,k l ' J e ' dry d 1+ r " y 1 �F Q ^f `lIr 9) ' '6 It { i:tlik 'r { .4 rNr b ' IIeW MOtOr load of ❑ •• „ )., 1 _�.-
o a,,.,e.:,:,1 akki.. 'zIalat a of added' S ∎ ∎KIrou11 d , t.., i ,.iii 0 A4ditioo Of
2 7984 12980SW Hawks Beard St. - IOOH.P occupancy.
Job no.: Job s to address: ^ r 0 Recrcmional veli.cI
0 $IX Or MOM reSldenttll units. OAS.
City /State/ZIP: Tigard, 'IR 97223 — 0 Hlralth -care facilities. ❑ Supply vollaae for mole lhau
0 Nimmons locations. 600 volts nominal.
Suite/bldg./apt. no.: ., Project ntune 0 service or feeder 600 amps or more.
`tli,ilyn '.r.'it',;,;T''wJ1
" ,, Ol M
Cross street /direvtiw i i to job sit : oeeertptlon I QIY- i u hee Total )
, °” " New: residential single- or multi-family dwelling snit.
Includes attached garage,
• Subdivision: • Lot no.: 1.0(10 sq. R. or less 168 54 4
.. Fa. add'I 500 sq. R. or portion 33.92 I
- lax map /parcel no Limited energy, residentia
I
r . r , a g nq � + 1 ", reran 75.00 2
'' l 4, x of �'` i i? k r) 4i � lift 1 , ,t )i tii „? ' nor r�'f r p b trllib d ,tqk�' l: s aabove yq. lti
.,.,., ,,,,.k k ,,, ; : t4c„ag i *.
o4 , .aa, , y r,, ,,. r rof , .1, o ' ..,
xM7 , 9v11r1 , e r
>t, n rr,a_J "r� d .d.al:.gvv1, ; , ..
L energy, multi- family 7j 00 2
Sump pump & var ion.- elec Lr.cal work residential (with above 59. fl.)
- — - Servjc 01' fe eders installation alterali011, and /or relocation
y
� ' . 2001lmps or less 100.70 2
.,, w e„ ". " , ` 'i n 44 rlrgG .''k f:t „ riliLli' ',r S S `i1^ ' i ii' :,09+ rli r ( 'r 'ii 201 amps to 400 amps 133.56 . 2
a,kl•rinxn rd y, iRio 114 T ' r: 41 "n't• * tt I'y .lSb 8
ri .14IM.raAl..,_u+. u - „ '' nx l ., ". _.
401 amps to 600 amps 200.34 2
Name: Nick & Michel- e Frost 601 amps o (,00 a mps 301.0
ps 2
i --- — --
Address: 12980 SW Hawks Beard S'i . over 1,000 amps Or volts 552.26 2
Temporary services or feeders installation, alteration, and /or
City /State/ZIP: Tigard, OF 97223 relocation
Phone: (503 ) 372,6861:1 mm Fax: ( . - 200 amps or less $9.3e I
1 201 amps to 400 amps 125.08 2
Owner Installation; This installation is being made on property that T own which is not 401 imps to 599 amps 168.54
intended for sale, lease, rent, o r ; exchange, according to ORS 447, 449, 670, and 701.
Braden circults -- new or extensio , CI' panel'
. .
Owner signature;
r
h a t e A. PGc for branch circuits' with
r , , ,, '
'4 , i .,:"1,4t ,=, r ' r utr, r•1 }dly, f to FI ,h r a� 7.42 2
" t above service or feeder fee,
e 8ch branch circus
Business name: 1 Fec for branch circuits rvrrhorrr
., service or feeder fee, first 56.18 56 2
Contact name: '' .
branch circucircuit - • — Bach edd'i branch circull W
7.42 .. T4:84 7 7
Address; • Miscel s ervice o r f eeder not „ included)
.- _' Each manufactured or modular 07,84 1
City/Wit/7,w: dwelling, service atic/or feeder _
} fax::( ) Reconnect only = 67,84 ,'.
Phone: ( romp or irrigation circle 6 2
F. -mall Signor o lighting 67.84 2
�^. , e :, < t n=x' ',ry. 7.l y i�F ,toy 11;1 {,i.r;.1 - ' 1
y,.a 1 f'l::l l e hiA 4i 4 r .��.
1 r' l,fSYrr }, K G �lr .r
., ,r;•' t if 4Z t4 r � !9 S ? ,� nd I "� ! "� ":+d�• ,
.. : I�llS117e55 Ratne: � [r pa to � ' ' °w. Si -. alteration, Of li m i te . .
d- energy .. .
panel, alteration, Or extension.
Page 2 3
Mo7.:Lenha er Enterprises, Inc . DBA Mike's Elec. , t,ach additional inspection over allowable in any of the above _.
Address: 11070 SW 1 Additional inspection (1 hr min) 66.25/ hr
Investigation (I hr min) 66.25/ hr
City /State /ZIP: Beaver OR 97005 „„ -- Industrial plant (I hr min) 78.18/ hr
Phone: ( 503 649.6991 : Fa ": ( 503 ) 641.1902 inspections for which no fee is S 90 00/ fir
►ft,e I e d
,r
CCB Liu • 191094 electrical Lie.: C643 Suprv. Lie., 42305 ;�tY,ut;rl: ± > II';:5gir � t {1 ► ' �1 02
.. ..._._ _ Subtotal:
.
Suprv, Electrician sign= tare, rat aired: Plan review (25% of permit fee):
Print name: Daugla� Mill; � •I. e: 12.20. ].O Slate surcharge (12% ofperttlit Fee): _ -. 5.52
.- 't >� TOTAl,. PERMIT PEE: 79.54
Authorized signature: �� V 6. 4 %_, _ J 'f� Thin permit application expires if. p ermit Is not obtained within ISO
12.20 days after it has been accepted as complete. •
Print name: Darryl Mod_, enl:tauer Date. t Number of inspections allowed per permit.
I: SaultdingUrern ,iim \Em.C- PbulitApp.doc 07 /OI /i0 440.4015111 I /65/COM/WEB