Permit CITY OF TIGARD ELECTRICAL PERMIT
`•111/1COMMUNITY DEVELOPMENT Permit#: ELC2017-00166
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/09/2017
Parcel: 2S106DC07000
Jurisdiction: Tigard
Site address: 13702 SW SABRINA AVE
Project: Polygon at West River Terrace,Lot 70 Subdivision:POLYGON AT WEST RIVER TERRACE Lot: 70
Project Description: (1)branch circuit for A/C installation.
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 03/09/2017 $56.18
Specifics: Service or Feeder
1 ea 12%State Surcharge- 03/09/2017 $6.74
Type of Use: SF Electrical
Class of Work: OTR
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 9 1- 0 . You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344..8
Issued By: ' . Permittee Signature: •471,A/c'177'
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 603.639.4175 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 Ap>pliicati - ,. " _, " FOR OFFICE'USC.ONLY
City of Tigard Received •Q' �7�.#. / e,,z?,7r1 j/64,
1,1 - �R 9 2017 Deceive: .., �rrr,itx:
• 13125 SW Hall Blvd.,Tigard,OR 9722g3 Plan Review
Phone: 503.716.2439 Fax: 50339f-1014' t } ?. ,,,-.:.:‘,744r)
Drays),; Related Permit eir'4 /7--eV/z j
Inspection Line: 503.639.4175 _ i , a ' Ready DateBy: ;uric: Ed See Page 2 for
TIGARD- Internet: www.tigard-or.gov ":;3'1,,e L l p i t „M1 ;, r` N Notiflcd/Method: Supplemental Information
_
..%- +Jiy -Wi{�• � P7t. ,j"`yi•.j:�•..'b .� !i. *., m.a ,.:bCrt:�+.��"� "Aik+Cz'°a«�'i,',,'ti' -'fiN4X.i?h+`«=•�"'-��'�^�,ri�"�:`s
®New construction 0 Addition/alteration/replacement Please check all thatappiy(submit,a sets of ptans w/items checked):
❑Demolition 0 Other: • Service or feeder 400 amps or more 0 Building over three stories.
ra whore the available fault current El Marinas and boatyards.
gap`<`I ,t,,I.° o'...� ®,1,...-,,7(Qz.6 •II dot a^ 60 'jr.-4-g:,. '- , ', exceeds 10,000 amps at 150 volts or ❑Floating buildings.
®1-and 2-family dwelling ❑Commerciai/indestrial 0 Accessory building leas to ground,or exceeds 14,000 ❑Corium/vial-use agricultural
El Multi-family ❑Master builderamps for all other installations, buildings.•
❑Other: ❑Fire pump. 0 Installation of 150 KVA or
y,'ru.,-m`>r:: fieri OPINRO(':y rj , (trZi ;`;Sf."t,+waet 0 Emergency system' larger separately derived
Job#: Job site address —7 ❑Addition of new motor load of system.
;1 1 b ' L!v j,� /(s(Gli 100HP ormuro. a"A","E"..1-2",'1-3",
• ❑Six or more residential units. occupancy.
City/State/ZIP:Tigard,OR 97224
13 Health-am facilities. 0 Recreational vehicle parks.
Suite/bldg./apt 4: I Project name:Polygon at West River Ter °Hazardous locations. ❑Supply voltage for more than
13 Service or feeder 600 amps or more. 600 voile nominal.
Cross street/directions to job site: Javr s ,a: ,,--_4`
Deeetipdon 00. 1 Each I Total
New residential single-or multi-family dwelling unit.
Subdivision:Polygon at West River Terrrace Lot#: ,0 includes attached garage.
Tax map/parcel#:
1.000 sq.ft.or less I68,54 4
5, a. qe Ss ",;.r ,p °...,_ ' °Art�t'f :4, ' , x ;;N1. Limited eneraddl 560 sq.esorportion 33.92 1
9°. :�, . : . n� X' energy,residtattiai
R 'c' / (with.above sq.R.) 75.00 2
Limited energy,multi-family
r- • 1 1 in ± 1 C-C residential(with above sq.ft.) 75.00 2
Y - v Renewable Energy ❑See Page 2
.n''%'D< �.5 'ria' 3,L,,,`:44>'N :ivy' :,-,364,4,&..,,,,,,,,,,1Services or 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 to 1,000 amps 301.04 2
Phone:,(602)694-4031 1 Fax;( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email:
•. relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: • 401 amps to 599 amps 168.54 2
V`,; 'qi •, '7;.ta , r#. i - i{V � ; ` n , 2i ,, Branch circuits-new,alteration,or extension,per panel
A.Fee for branch circuits with •
Business name:William Lyon homes,Inc. above service or feeder fee,
7A2 2
•
each branch circuit
Contact name:Angela Grajewski 13.Fee for branch circuits without C
service or feeder fee,first I
Address:109 East 13th Street '1 56.ia 2
biarach circuit
GZtyl3lutcfZXP:Vancouver,WA 98660 t '110.11alltt I beam h WWII 7,42 2
Miscellaneous(service or feeder not included)
Phone:(360)695-7700 ' f Fax::(360)693-4442 Each manufactured or modular
67.84 2
Email:Angela.Grajewsid@polygonhomes.com dwelling,service end/orfeeder
Reconnect only 67.84 2
7-*kms f rru'�`r*.P " : Z.a Z o; 1'`-e1-0 r . . ,",f�..Yy a`a a _ , . C 2 mow:,.'k,2, Pump or irrigation circle 67.84 2
Business name:Garner Electric Washington,LLC Sign or outline lighting 67,84 2
Address:6101 NE St Johns Rd Signal circuits)or limited-energy 1:1 See rage 2 2
panel,alteration,or extension.
City/State/ZIP:Vancouver WA 98661 Each additional inspection over allowable in any of the above
Additional inspection(I hr min) 6625/br
Phone:(253)320-1657 Fax:( ) Investigation(1 hr min) 90.00/hr
Email:bdaniels@gweusa,com Industrial plant(1 hr min) • 78.18/hr
CCB Lic.: C1158 Electrical Lic.: 208174 Suprv.Lie.: 44968 Inspections for whichno fee is
pacifically listed('h hr min) 90.00/hr
Suprv.Electrician signature,required: 6,
f 1_ -.:11.).-/� . Subtotal:
Print name: Joan P Albert •- Date: 4/26/2016 ❑Plan Review Required C25%of permit fee):
•'- - State surcharge( 2%of permit fee):
_ �- -'---'71-17=.7.:.7..-..7-...-_-,.._,, TOTALPERMI FEE:sigoaAre: ,...•
This permit application expires if a permit is not obtained within 180
;f,".'•; Print name: Bill Daniels Date: 4/26/2016 days after it has been accepted as complete. -
"' ` * Number of inspections allowed per permit
-••• •.•l:ieuddingWe;miuV7.0 PermitApp EGR,ERE.doe Rae 06117/2015 4404615T(t1/05/COb9WE0
i(i,7i?tr.'
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13702 SW SABRINAAVE, SHERWOOD, OR, March 23, 2017 at 11 :27:11
97140 AM
Record Type: Record ID:
Residential - Electrical ELC2017-00166
Inspection Type: Inspector:
199 Electrical final David Young
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor