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Permit (137) I IIIIIICITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit#: ELC2017 00158 13125 SW Hall Blvd.,Ti Date Issued: 03/08/2017 T f Ta1'i�.D and OR 97223 503.718.2439 9 Parcel: 2 S 106 DC06900 Jurisdiction: Tigard Site address: 13718 SW SABRINA AVE Project: Polygon at West River Terrace,Lot 69 Subdivision:POLYGON AT WEST RIVER TERRACE Lot: 69 Project Description: (1)branch circuit for NC unit. Contractor: GARNER ELECTRIC WASHINGTON LLC Owner: ADLV LAND HOLDINGS LLC 402 VALLEY AVE NW, SUITE 106 7600 EAST DOUBLETREE RANCH RD, STE PUYALLUP,WA 98371 SCOTTSDALE,AZ 85258 PHONE: 253-872-6051 PHONE: FAX: FEES Quantity Description Date Amount 1 crt Branch Circuits wo/Purchase 03/08/2017 $56.18 Specifics: Service or Feeder 1 ea 12%State Surcharge- 03/08/2017 $6.74 Type of Use: SF Electrical Class of Work: NEW 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 OAR 952-001-0090. 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: Gey y,,Q Permittee Signature: t! 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. Iv °�. te : - Electrical Permit Application FOR OFFICE USE O\LY a.. � 7•-cam ‘57g. 5. City of Tigard 1 Received RIA / � rests: 'e 13125 SW Hall Blvd.,Tigard,OR 97223` �atWB ' � "��� i 1 l , Plan Review _ Phone: 503.7182439 Fax: 503.59849R-„, ,a 1• Related Permitil: 1. 1 i , nau/B : .1� 7 �� 1 TI GARD Inspection Line: 503.639.4175 i y 2 r” * Ready Date/By: EA See Page 2 for • kitctnek www.figard-or.gov A -v. ? 47otlliad/Method: NMI Supplemental Information i'' ''....i':: ..-..?_r K,5r .t'51;%tea "4 -?, h"�r, "s :.-.. 4; 1A � . �.4 ''Le.t�. t �l%. . :�'L,+ti'"� ; r* ,h: j' SJSAI � po..`.. 10'v...C` r',z,`^,�.�'-ia;=*ATVs: �F.a' ®New construction 0 Addition/alteration/replacement Please check all that apply(submit 1 sets of gloms-Whom checked): Q Demolition D Other: 0 Service or feeder 400 amps or mora 0 Building over three stories. aggryv * +� « ; ., �� where the available fault current ❑Iviarines and boatyards. A a mo i_,. iib 5 rt, tatN...;:,,,6-.#1,...4-. `"'� a,07.r exceeds 10,000 amps at 150 volts or Q Floating buildings, ►:. 1-and 2-family dwelling 0 Connnercial/indtistrial 0 Accessory building toss to ground,or exceeds 14,000 ❑Commercial-use agricultural 0 Multi-family 0_Master builder amps for all other installations. . buildings. _ 'Other: ❑Fite pump. ❑installation of 150 KVA or Me:-Mie;+. _:.",:. *F: ... t :ofe a L 'S2 1:.,,,�,: :..s s „�:�; w .. O ` ��?t�;_�g ;�,�rs,�fi ❑Emergency system, larger separately derived rsfS 32/8. C R C tel_.,, ❑Addition of new motor toad of system. Job It: Job site addressf �7 J �'�rl IOOHP or more, [3'A","z","1-2 1-s", 0 City/State/ZIP:Tigard,OR 97224 ❑Six or more residential units occupanoy. 0140th-oars facilities. 0 Recreational vehicle parks. Suite/bldg,/apt,#: Project name:Polygon at West River Ter ©Hazardous locations. ❑Supply voltage for more than 0 -.. Cross street/directions to job site: 0 Service or der 600 amps or more. 600 volts nominal Description Qty. I Eich Total '' . . New residential single-or multi family dwelling unit. Subdivision:Polygon at West River Ten-race Lot#: 6.01 Includes attached garage. - Tax map/parcel#: 1,000 sq.R or less 168.54 4 ti `- ';'*3.0,::,..::j .,iYt# � .�- e,f `�� Ea.add'1500sq.ftorportion ..i ' 33.92 1 ''*. ,...T_- -i s, ,e= :,:� _. ..,,R Limited energy,residential /V_..�0 q.. (with above sq.R.) 75.00 2 �R Limited energy,multi-family i ' jP-r---LM`" �/.-•t!1 '772-ear. ee t)a residential(with above sq.R,) 75.00 2 y _ Renewable Energy ❑ Sec Pa ,"----'1''`".y`a ''' ,-.t. '�' "+'Flea "1F t-:.�..:4 . r" . 'Arg >;e 2 Services of feeders installation,alteration,and/or relocation Name:ADVL Land Holdings,LLC 200 amps or less 100.70 2 Address:7600 E Doubletree Ranch Road 201 amps to 400 amps 133.56 2 • — 401 amps to 600 amps 200.34 2 City/State/ZIP:Scottsdale,AZ 85258 601 amps 101,000 amps 30I.04 2 Phone:(602)694-4031 .1 Fax:( ) Over 1,000 amps or volts 55226 2 Email: Temporary services or feeders installation,alteration,and/or relocation Owner installation:This installation is being made on property that I own which is not 200 turps or less 5936 I 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. • 201 amps to 400 amps 125.08 1 2 Owner signature: Date: • 401 amps to 599 amps 168.54 2 'jail( 't; e?:_ t .1% ,t`j., «1l -,,,,,,,,;.,.,:w., H e: Yexa Branch circuits-new,aiteration,or extension,per panel ° A.Foe for branch circuits with Business name:William Lyon Homes,Inc. above service or feeder fee, each branch circuit 7.42 2 Contact name:Angela Grajewski B.Fee for branch circuits without 1 >!! Address:109 East 13th Street service or feeder foe,first b56.18 t 2 ranch circuit My/State/2R:Vancouver,WA 98650 „s ac ada'r�ranca circuit 7,42 2 Miscellaneous(service or feeder not included) Phone:(360)695-7700 ' 1 Fax::(360)693-4442 Bach manufactured or modular Email .A,ngelaGrajewska@polygonhomes.com dwelling, �+iceand/orfeeder 67'84 2 ,a kx°�. -4,4'. .. s Reconnect only 67.84 2 u�t.ss!: :t ss ,. -4• 4'..-',-- `*F0.--.,, .,.°_, li-'' 9_ ',' 'Y.',1" ;,-'5 3 v 3 : City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 13718 SW SABRINAAVE, SHERWOOD, OR, March 10, 2017 at 10:13:43 97140 AM Record Type: Record ID: Residential - Electrical ELC2017-00158 Inspection Type: Inspector: 199 Electrical final David Young Result: PASS - NoCofO Comments: Electrical final for AC only ok. Violation Summary: Inspector Contractor