Permit (251) ilL
CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2016 00887
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/17/2016
Parcel: 2S 108DB06400
Jurisdiction: Tigard
Site address: 15108 SW 154TH AVE
Project: Polygon at Bull Mountain, Lot 62 Subdivision: POLYGON AT BULL MOUNTAIN Lot: 62
Project Description: (1)branch circuit for A/C.
Contractor: ALAMEDA ELECTRIC Owner: POLYGON WLH LLC
3415 NE 44TH 109 E 13TH ST, STE 200
PORTLAND, OR 97213 VANCOUVER,WA 98660
PHONE: 503-319-2192 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo/Purchase 11/17/2016 $56.18
Specifics: Service or Feeder
1 ea 12%State Surcharge- 11/17/2016 $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 .2-001-0090. 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: -'L.'-I r //.¢'.` ...--- Permittee Signature: i 1 1971,L 'e17•7e?
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.
RECEIVED
_Electrical Perynit_ppA lication
11 City ofTigard NOV 14 2016 iteca.. /„
DateV7 il?(P/V Pm°°47:4-eL.:Te -ee9eP 7
13125 SW HA Blvd„,Tigard OR 97224-.1-Iry ,-,,,c. nr.,-.4,- RD ph.Review k —
Phone 503 7182439 Fax: 503,3981AV 1 1 v."' ' `‘-''" Rtbd4d Penall f4f66R0/6 ---.0O',?
Inspection Line: 503.639A 175 BUILDING 1)1\11S10. hois sV--et Pir— ----.4or
Internet: www.tigani-or,gov Nottnedth4ohod- Supplemental latarntatioa
Ci New construction 0 Addition/alteration/replacement Please check aft that apply(submillsers= plasm w/derris checkcal
°Service or feeder 400 amps or more El Buttilitacover three storms
1-3 Demolition 0 Other: where the available fault current 0 Marinas and boatyards
" ., It, ',.„'":„ ',',,,-.,f,'''-:-* " ':, 7 iii,• •.i-';',„:1%;::Wri 1::;:;,r;iiizy exteeds 10,000 amps at 150 volts ca 0 neon bliikkoP
072 1 I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building tew to Pound,Or exceeds 14,000 0 Commercial-se agricultural
amps for all other iestallations buildings.
0 Multi-family 0 Master builder 0 Other 0 Fire PutuP, 0 Installation of ISO KVA or
Ziii.;:: 4,;:—.:-,di':: Z',LFIZtv::::.::;::TkfZ::;%::.... .',.::ili#11 (35nn`ncY„ of load larger separately derived
Job 6: Job site address: S)0 11 C iAi j SZ4.111-R\ie.._. 111100BPAdthtj7r mnoerew.gmlor of 13;TA67-r,-1-r,-1-3^,
0 six ix inore residential units, 00suPatteY
City/State/ZIP:Tigard,0R97224
0 flealdi-care faerhties. 0 Reereationid vehiele parks.
Suite/bldg./apt./1: voltage for more than
Project name?°111M clit bilit 1\houl)trui\ Enark:=700..„ °s6rott......,t
on.,
Cross street/directions to job site: ...ii3OZ 0;i:::::3:‘,k4i;zi...8.,:-.:i..",.' .:':°‘..",!.;.':',:. ';:•3:-,•„"finli-,',..A,1.<,:
Description Qty. gam Tatra .
New residential single-or multi-family dwelling unit.
Subdivision: Po,tyrioll. at &ILI fil Atilt*in I Lot g:k a Includes attached garage.
Tax map/parcel 41: 1,000 sq.ft or less \j j16834 4
a addi$00 sq.ft,or portion 33 92 1
Limited energy,residential 75,00 2
(with above so,11„)
Limited energy.multi-family
75.00 2
residential(with above sq.ft')
Name:ADVL Land Holdings,LLC Renewable Energy 0 See Page 2
Services or feeders Installation,alteration,and/or relocation
Address:7600 E Doubletree Ranch Road
200 amps or less 100.70 2
City/State/ZIP:Scottsdale,AZ 85258
201 amps to 400 anips 133.56 2
Phone:(602)694-4031 I Fax:( )
Email: 401 amps to 600 amps 200.34 2
Owner installation:This installation is being made on property that I own which is not 601 amps to 1,000 amps 301,04 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701.
over 1,000 amps or volts 552.26 2
Owner signature: Date:
services or feeders installation,alteration,antl/or
Business name:William Lyon Homes,Inc. 200 amps or less 59.36 I
Contact name:Angela Grajewski
201 amps to 400 amps 125.08 2
Address:109 East 13th Street
401 amps to 599 amps 168 54 2
City/State/ZIP:Vancouver,WA 98660
Branch circuits-new,alteration,or extension, it-r panel
Phone:(360)695-7700 Fax::(360)693-4442 A.Fee for branch circuits with
1 ' '
above service or feeder fee,
7.42 2
Email:Angela.Grajewski@polygonhomes.com each branch circuit
B.Fee f:re borra=rfteni;Uvit" ( 56,18 2
Business name:*lamed*electric branch circuit
Each addi branch circuit 742 2
Address:3415 De 44th
, Miscellaneous(service or feeder not included)
City/State/ZIP:MIRO gr•br91 ZotiNoie or 12. /407 2 02„./3 Each manufactured or modular ...,im 2
dwelling,service andire feeder , --- -
Phone:(503)3192192 Fax:( ) '
Reconnect only 67 84 2
Email:solarpdi@me.com
Pump 01'ier11910co circle 6784 2
CCB Lic.: 199188 Electrical Lic,: c923 Suprv.Lic,: y g 7/5
Sign or outline lightmg 67,84 2
Suprv.Electrician signature,required:
, Signal circuit(s)m limiled-etmegY
Print name: k,ic /72,004./C I Date: riz3,,,,;(4/ Panel,alteration,or extension 1-, *'‘e rage 4 .
Each addidonal inspection over allowable in any of tbe above
Authorized sigria :Nc Additional inspection(I hr nal 66251 hr n
a 1
Investigtion(I hi' un) 0
90 01hr
14341601014.06watc_Pyravtatt_tria_EREAce Res 06(17)3415 440-46151131/051CMWEB
= M111•11111111 • •=1MI
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
15108 SW 154TH AVE, TIGARD, OR, 97224
Record Type:
Residential - Electrical
Inspection Type:
199 Electrical final
Result:
PASS- NoCofO
Comments:
Tel: 503.718.2439
Inspection Date:
Record ID:
ELC2016-00887
Inspector:
David Young
Electrical to disconnect box for AC ok, no AC installed at time of building final inspection.
Violation Summary:
Inspector Contractor