Permit CITY OF TIGARD ELECTRICAL PERMIT
• o COMMUNITY DEVELOPMENT Permit#: ELC2022-00201
T i GA R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 3/28/2022
Parcel: 2S 107AA26300
Jurisdiction: Tigard
Site address: 14450 SW RIVER TERRACE BLVD
Project: Polygon at Roshak Ridge Subdivision: ROSHAK RIDGE
Lot: U
Project Description: Electrical for swim center
Contractor: ALAMEDA ELECTRIC Owner: TAYLOR MORRISON NORTHWEST LLC
3415 NE 44TH 703 BROADWAY ST STE 510
PORTLAND, OR 97213 VANCOUVER, WA 98660
PHONE: 503-319-2192 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 03/28/2022 $100.70
Specifics:
amps or less
1 crt Branch Circuits wo/Purchase 03/28/2022 $56.18
Type of Use: COM
Service or Feeder
Class of Work: NEW ! 1 ea 12%State Surcharge- 03/28/2022 $36.63
Type of Const: Electrical
Occupancy Grp: 20 crt Branch Circuits w/Purchase 03/28/2022 $148.40
Service or Feeder
Total $341.91
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 throuoh OAR 952-001-0090. You may obtain a coov of the rules or direct auestions to OUNC by callinc 503.232.1987 or 1 800.332.2344.
Holly Va4 De,Wegr
Ort A Issued By: Permlttee Signature:
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'N 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.
Electrical Permit Application
FOR OFFICE USE ONLY
City of Tigard Received
--.113125 SW Hall Blvd.,Tigard,OR 97223 Date Bp: 3' l2Z °nn ���'Cj0 ZOI
Phone: 503.718.2439 Fax: 503.598.1960 plan Review
Inspection Line. 503.639.4175 Dare,By: Related Permit a.
TIGARD PReady DateBS p Suns a Interne' wwq tigard-or.gnv Notified/Meih«I3kleVi2 ` Supplemental
See Page 2 for
Supplemental Information
TYPE OF WORK PLAN REVIEWIN.New construction ❑Addition'aiteration rep acement Please check all that a I - -pp y(submit secs of plans wmems checked)
❑Demolition ❑Other: 0 Service or feeder 400 amps or more ❑Building over three stories.
where due available fault current 0 Marinas and boatyards
CATEGORY OF
exceeds 10,000 amps at ISO volts or 0 Floating buildings.
❑ I-arid 2-farnilxdwelling ®C'omrnereial'industrial ❑Accessur+ building ass to ground,or exceeds14,000 �Commarccai-useagneultural
❑ [vlul[i-fattlil� ❑ Master builder ❑Other amps for all other installations buildings
JOB SITE INFORMATION AND.LOCATION D Eire pump. 0 Installation at 150 KVAor
❑Emergency system larger separately derived
Job# lob site address: 14450 SW RIVER TERRACE BLVD Addition of new motor load of system
I00HP or more ••E"..(2""1-3"
City/State/ZIP: Tigard.OR 97140 :Igo,or more residential units occupancy
Suite bid is I.#: ❑Health-care facilities 0 Recreational vehicle parks
g- p I Project name: Polygon at Roshak Ridge ❑Hazardous locations. 0 Supply voltage for more than
Cross street/directions to job site: ❑Service or feeder 600 amps or more 600 lulls nominal.
FEE SCHEI)tJLE, ,
Derc,iption IQit. 1 Earl I Total I +
Subdivision: New residential single-or multi-family dwelling unit.
Polygon at Roshak Ridge Lot#: Tract U Includes attached garage.
Tax map'parcel#; — I,000sq.ft.or less 16854 4
DESCRIPTION OF WORK Ea.add 500 R or depxtion 33.92 I
Limited energy,residential
Electrical permit for new swim center construction in subdivision (with above sq.ft.) 75.00 2
Polygon at Roshak Ridge. Parcel: 2S107AA26300 Limitedeid nt al(with multi-family
iq
residential above sq.ft.) 75.00 2
® PROPERTY OWNER Renewable Energy
0 TENANT 0 Sex Page 2
Name: Services or feeders installation,alteration,and/or relocation
Taylor Morrison Northwest LLC 200 amps or less 1 100 70
Address: 703 Broadway St.,Ste 7t0 2
20I amps to 400 amps 133.56 2
City/State/ZIP: Vancouver,WA 98660 401 amps to 600 amps 20034 2
Phone: ( 360 )946 8674 601 amps to 1,000 amps 301.04 2
Fax:( ) Over 1,000 amps or volts 55226 2
Email: pAlamiAbuuhafs.a taylormortison.cum-PermitSubmittals i 4rylormorrison.com relocation
Temporary services or feeders installation,alteration,and/or
Owner installation: This installation is being made on property that I own which is not 200amps or less intended for sale, lease,rent,or exchange,according to ORS 447,449,670,and 701. 25.08 I 1
1 201 amps to 400 amps 125.08 2 i Owner signature Date: 401 amps amps
168.54 2
❑ APPLICANT I 0 CONTACT PERSON Branch circuits-new,alteration,or extension, , r panel
Business name:Taylor Morrison Northwest l,l.(, - A.Fee for branch circuits with
above service or feeder fee,
Contact name: Omar Mimi Abouhafs each branch circuit 1 7 a2 2
B.Fee for branch circuits without
Address: 703 Broadway St.,Ste 710 service or feeder fee,first
branch circuit 1 56,18 2
City/State/ZIP: Vancouver, WA 98660 Each add'I branch circuit
19 7.42 2
Phone:(360 )946 8674 i Fax, :( ) Miscellaneous(service or feeder not included)
Each manufactured or modular
Email:O.AlamiAbouhafsr'ita}lom)orrisun.cola-PermitSubmittalsuaaylonnorrison.cum dwelling,service and/or feeder 67 84 2
CONTRACTOR Reconnect only 67.84 2
/�
Pump or irrigation circle 67.84 2
A
I Business name: _a ill E --)Pr E- t7YTat 1 ��
It-a 0.♦ Sign or outline lighting 67 gq 2
Address: 3.1 1 C n tE LiLi,{.,_ ,r ,£ Signal circuit(s)or limited-energy
1 J t�a ill �'"I t/ panel,alteration,or extension. 0 See Page 2
City/State/ZIP.ZIP: PG�� L �p ! v q Zr 3 Each additional inspection over allowable in any of the above
Phone ( 5 _3 3 y, Z) l Fax:( ) Additional inspection(1 hr min) 66.25/hr
` Investigation(I termini 9000/ter
Email: G ^�
L rTe`r°)c M uLoM Inspectiolslfr which hr min)) 78.IS/ter
CCB Lie.: I Q Electrical Lie.: Inspections fur no fee is
LI s( Suprv.Lic.: Li 15� specifreal!v listed('/-hr min) I 90(N)/ter
Suprv.Electrician signature,required: ELECTRICAL PERMIT FEES
Print name:12AyFSubtotal
S—rr tz, Date: lit.-5-21 0 Plan Review Required(25%of permit tee):
State surcharge(12°6 of permit fee):
Authorized signature: To tAl.PERMIT FEE. $ 341.91
Print name: 1714 D S Oh. l Date: This permit application expires if a permit is not obtained within 180
Io^5-2l I days after it hos been accepted as complete.
t tauildinglPerminlEL-PermrtApp EUt ERE doe Res G6i1 7rzol5 ' Number of inspections allowed per permit
44n-46157(1105,COWWEB