Permit (37) tCITY OF TIGARD ELECTRICAL PERMIT
I ` COMMUNITY DEVELOPMENT Permit#: ELC2023-00511
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 8l23/2023
Parcel: 2S107DA03700
Jurisdiction: Tigard
Site address: 16659 SW CHETCO CT
Project: South River Terrace Subdivision: SOUTH RIVER TERRACE PHASE 2 Lot: 92
Project Description: Street light service installation located near the intersection of Perth and Chetco.
Contractor: NORTHSTAR ELECTRICAL CONTRACTORS Owner: TAYLOR MORRISON NORTHWEST LLC
11055 SW CLAY STREET 703 BROADWAY ST STE 710
SHERWOOD, OR 97140 VANCOUVER, WA 98660
PHONE: 503-612-0840 PHONE:
FAX: 503-612-0891
FEES
Quantity Description Date Amount
Specifics:
1 ea Services or Feeders-200 08/23/2023 $100.70
amps or less
Type of Use: COM 1 ea 12%State Surcharge- 08/23/2023 $12.08
Electrical
Class of Work: OTR
Type of Const:
Occupancy Grp:
Total $112.78
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 952-001-0090. You may oh in a rules or direct Questions to Ol1NC by calling 5 232.1987 or 1.800.332.2344.
Issued By: 0�.+ r Permittee Signature: .
TTJJ 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 RECEIVE FOR OFFICE USE ON 1
City of Tigard R«rived
• 13125 Sly'I loll 131xd.,Tigard,OR 07223 !yeti I3 ' / /,� "al": .% L,, t—
�� Phone: 503.718.2431 Fax: Sn±.59S.191d1 AUG 2 3 Plan Reins - - -
hryxctiem Line: 503.639.4175 Dale OY; Rclned Prnnil
TIIiARf) CI`^/ He:uly Iknc/13y: )nn;
Internet: wwa.ligard-or.gw 1 11 OF TIGAR \, ilirdaf¢.td,. �J ®ice Page 2 for
/+mot/ roppkinental tnformatiun
TYPE OF WORBBUILDING DIVISI N PLAN REVIEW
liti New eonstraclimt ❑Addition/alteration replacement I'Icn.e cbeel.an that a xrp led,mh 2 se is of plan,rl:items elr:rkcdl:
❑Service i t leerier 41x)amp,.,t Inure ❑Budding meet three slimes.
0 pCnaditiun 0 1)11ur
Where lire mails lc lull swami ❑,IJ,ma+and Sul link.
CATEGORY OF CONS'17tf)(TW\ nceedl 1011010 amps al L>a soh,or ri ing building,DI_and 2-family dwelling SiCommercial/industrial ❑Accessory building T1 u')glH„nL eHe xcnf.14sxai ❑t n,Man,r al-uv atikubnnal
an
0 Multi-familyy,rot all whet insiallalioin. building..
❑Master builder ❑Oilier: ❑1'im puma,
_-. JOB SITE INFORMATION AND LOCATION ❑L gee •1srlof I5U randK VA UI
❑rnwrgrm�)'system lager ulv,r:xeh',kr,vod
.10b#: I'� JOb she address:G1.\ F.�! . I&/- 4J,lilinn of neu nanny iced or a1>kni.
l.Y (/� r)W Hp Donor �..�1....1:....1 ,...1_y.
C'11y5late'ZI P: �- �. Six,x none um lilies. line.. etaul,ana.
n f eR �ii�o 0 Ilcalllocare lOOdilie1. ❑Serte:,inmdl i chicle r:nln.
" `\• — ❑Supply u+ILehfiH nurrhmStite/bldg./apt.it: Projectnarne' 1�hRiuer` r ruLePh� ❑xa ntadcaas1k d.unsian p,.x mole /b w,h mnaiwl.Croxs street;directions como.,—T r �_ - s.,.. FEE SCIIEDfn.E
a>ritmw fork rwT-- i
f, � New residential single-or multi-family'duelling unit.
Subdiy-ision: V�Ci+C..0 I Lot l/: Includes attached garage.
fax map/parcel 4: Idxx)n 1.g.or less 168.54 4
DESCRIPTION OF WORK — rat.eddy 51x)sq.h.or familial 3}92 I
IArye p., 1�rv� �y {, r� I)anted energy.residential -
461. i lir11Liil Or J1i Ii)�j> (.` 1tilh:those y.fi.1 75.Ix1
I United energy,multi-family
viikmtinl(wise alone sq.list 75.Ix) -
n
0 PROPERTY OWNER r---0 TENANT Renewable Energy 0 See Page 2
Name: Services or feeder installation.alteration.and/or relocation
200mp a .or ka'v I I Ixl.7n IoO:i 2
;-Address:
_Olreporn400amps 133.56
City/State/ZIP: 401 amp.to 00 amps 201.1-1 2
--- -- --- ---- Inn amps lu 1.000 amps 3111.1H 2_
111t11iC:( ) Pus:( 1 Os cr I.OIW)am or% _ —__-__
ps or robs 55d.'J, -2
Email: Temporary services or(milers installation,ulierati n,and/or
relin
Owner installation:'I his installation is being nail:an property that I own which is not 200a q,s or less 50 36
intended tier sale,lease.rent.or exchange.according hi ORS 447,449.67i).and 701. 1
01 amps In 4fxl amp. I 25A% 2
Owner signature: Date: 401 an o599 am
7's amps I6/354 2
APPLICA\T --- 1 ❑ CONTACT PERSON Branch circuits-news,alteration.or extension,per panel
I3U%1]1C5x name: -- A.Rie tier brunch ciicuits n ith —'
�J'��7 r 7 1 f�ttr L_t('1;Y]_Lf ll I~(yl'}'- .0 S[-lf e alxlre service or!caber fir. _
Contact name-ru "'' arch branch circuit 4-' 2
• u _J-t R.Fee Mr branch divans Irithout
Address: Ii G t tors ice Or feeder fee.first
J .�1 _ brchnu ciir 56.IS 2
CityiStateiZIP_ ps' G-J Q unEach;idd'l burneli circuit - 2
r -- "- --- Miscda laaau service or feeder not included)
Phone;
_ _(50 LJ a,-o�y o I Fax::( ) Fitch maitulaclmodularul or modular
En1aiL dwelling saxiON:and la Belle /s '%4 mtxriltiil,J A( IAitffirYailepc it arelw r ,t Rmnnnect only
_Coln rRArroR - _ <`'•> 2
Pump or irrigation circmk k1,2.4 ,
131i:ilk:se iilnll•: `5- �. t -r F.CJl r - _1 ct
'lam- )f lt\ �Z [Jt'iYf l (•y-t-� tiign.0 rwdilre lighting 67.S4 .-.
Address: IIO�f; �{, - Vitt" c.si -- SignalcircuiQ.luriislersamu. v
W ' panel.altl'nlli,m,to intension, 0 See Paget 2
Cily'Sttue'ZlP: pyc, . _J ,(f �PY�+t y Filch additional inspection over allocable in any of the above
t.+s.+.�l S�1.t' `'1 -t Add tuna l inspeetim 11 hr nun) 1i625 hr
PhD c:(F ) Frc r
133 a-0240 I I Investigation I 1 hr mini 911.110 lir _
Lmail: NV tell .t, kt.M�n� � 'r Indu.uiai plum fl lit Min) %.Ix In
(Ill Lic.: n In:To:lions fix which no fee is
A Electrical Lic.: _ � Suprv.Lic.:r ` r= specifically lispry/17 hnnin) 'ALtNI hr
Suprv.Electrician signature,required:av,or — kf,Er1'RICAI, PERMIT FEES
I krelier
Sub "10
Prim name: Subtotal:Subtotal:Jt—*I LLIr) I I)ale:RI IL'( •3 0 Plan Review Required(25%of permit lie):
t' "� n Stale mircharge(12'.of permit fee): I a.Q td'
Authorised signature' fit i2 s '1OTAL PERMIT I'LL:
11 Il�.�
Prim name: ''fir• 1 I This permit application expires If a permit is not obtained within80
az� . , I Date' J I l iP I -a3 J flay%after It has been accepted in complete.
I IlmWny!'P.xnps 1 t 1'14mmoily,I-I li IKl mJ.: k:r jr,I R_"n5 IL ' Nuinhen,r',unisex inn allnKcd pet pennin.
4441-4415Ii 11 CO 1 i CO WI,n