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Permit (135) CITY OF TIGARD ELECTRICAL PERMIT r COMMUNITY DEVELOPMENT Permit#: ELC2017 00266 T€G ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/19/2017 Parcel: 2S1060002900 Jurisdiction: Tigard Site address: 13714 SW 175TH AVE Project: Polygon at West River Terrace,Lot 105 Subdivision: WEST RIVER TERRACE Lot: 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 E DOUBLETREE RANCH RD PUYALLUP,WA 98371 #150 SCOTTSDALE,AZ 85258 PHONE: 253-872-6051 PHONE: FAX: FEES Quantity Description Date Amount 1 crt Branch Circuits wo/Purchase 04/19/2017 $56.18 Specifics: Service or Feeder 1 ea 12%State Surcharge- 04/19/2017 $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•'R 95 -001-0• 0. 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: / ir Permittee Signature: 5 cc i6w7l7 j OWNER INSTALLATION ONLY �O 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. , CEIVE1) ..' -,....:1.i.V..,..,.::.:•:',-'i).;;I.:2,.::... Electrical Permit A plac,► i 1rorz•orr;c� L S) oil a • l3125rsw all Tigard�a.,Tigard,ox }} 2 017 Date/I3 :Received ,_♦ /Ii,_ . Platt Review / Phone: 503.718.2439 Fax: 503.598.1960 Dam/B : Related Permit 4- Sri/i,"a9,/3`� Inspection Line: 503.639.4175CITY OF TICARD Ready Date/ 13y:y: iiiMINSu plemegeZfnf interact www.ugard or.gov NoLfied/Method: Information r ' 1 Supplemental .,k� fs- rc,`�, i�C:ra:� ,;n,;�.,�tr- s� 't.,�.e.,a,. C�',�y,-,^,�.vn a<' „e 5:zt�`.. -"�-�'. : .r`.`-� ,�,�'�v.t»•,�4'�'ro,,-r7.�r�„ "� a ®New constructionr� ❑Addition/alteration/replacement Please aback all that apply(submit a sets ofplans Wares checked): Ci Demolition 0 Other: Et Service or feeder 400 amps or more 0 Building over three stories. whore the available fault current 0 Marinas and boatyards. ,a n .., 1 i , 4.c.�'jg p .4k,....._,..... 3,14, ta t f. i-s,� y_ exceeds 10,000 amps at 150 volts or l 1 Floating buildings. ®1-and 2-family dwelling Q Commercial/iridiistt'ial 0 Accessory building less to ground,or exceeds 14,000 ©Commercial-use agricultural Multi f 0amps for all other installations, buildings.• Q -anti y s El Master builderOther: 0 Fire pump. E1Installation of 150 KVA.or �1 e _ t'i'a,'xty (j 11 0"' o <�3l At tiVi" ;;,::_'; t^me 0 Billet-Mc,' stem. far "�."�.z• �'� � . ._ It�lr• � -.�. ._ 1!>'��� �� .;::s.:•,v,."TtS�s;.�isY Bea'sepaisielyderived Job#: Job site address: 13-1 i� cw 1-7 sm (c, 0 Addition more.f new motor load of system. ✓ __I r +vv 100HPotmaro. 0<•A",•B'•,••1-2"."1-3", City/State/ZIP:Tigard,OR 97224 O Six or more residential units. occupancy, []Iiealth-care facilities. ❑Recreational vehicle parks. Suite/bldg./apt,#: Project name: ©Hazardous locations_ El Supply voltage for more tbau �"�7 wr •'`�S� 7�/M Q Service or fonder 600 amps or more, 600 volts nominal. Cross street/directions to job site: Description I Qty• I Each L Total �I• New residential single-or multi-family dwelling unit. Subdivision: e i,.,pit.• t 4 • i _ / ex • 1 ace Lot#:10S— Includes attached garage. I,000 sq.R.or less 168,54 4 Tax map/parcel#: Ea.add'!500 sq.ft.or portion 33.92 1 :" x`44,, # ;-:.:,.2": 0 .",si. '.-;,- lx;e .: •-- . . �,?�: � �'�. �.��:� Limited energy,residential 75.00 2 417 f/ J- rt A/c-`/ /0 ---4 /'/---- (with above sq.ft.) f'� Lr • Li ited energy,multi-familyaabove q. residential(with above aq,ft.) 75,D0 2 0 ll�a�/.iii / %j pr, li ' -09. 'i&.!:'I 'a `� W n. •4:...;.1 5 t'= .k.; � S enewable feedersnergy ❑Sce Pa$c 2 Services or 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/ZTP:Scottsdale,AZ 85258 601 amps to 1,000 amps 301.04 2 Phone:(602)694-4031Fax:( ) 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 5936 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 :':4;1.c'4-'14'1'741. �+ . 0 3R ss� iA:• Branch circuits--new,alteration,or extension,per panel ri .rlxa1 A.Fee for branch circuits with Business name:William Lyon Homes,Inc. above service or feeder fee, 7.42 2 each branch circuit /� Contact name:Angela Grajewski B.Fee for branch circuits without service or feeder fee,first Address:109 East 13th Street branch circuit I 56.18 Sz..,/. 2 City/State/ZIP:Vancouver,WA 98660 Each add'i branch circuit 7,42 2 I Miscellaneous(service or feeder not included) 1 Phone:(360)695-7700 • Fax::(360)693-4442 Each manufactured or modular 67 84 2 Email:Angeta.Grajewski®polygonhomes-cora dwelling,service and/or feeder yy� �,a, _�Y'y a Reconnect only 67.84 2 .'fib 23 xa K +z'z4 ".C t�r9 ''sSg!.,.01: . i"3 1'S11.4 • a.> j-•'ti�^.,;,,�,: Pump or irrigation circle 67.84 2 Business name:Garner Electric Washington,LLC ' Sign or outline lighting 67.84 2 Signal circuits)or limited-energy g Address:6101 NE St Johns Rd ❑ See Pa e 2 2 panel,alteration,or extension. City/State/ZIP:Vancouver WA 98661 Each additional inspection over allowable in any of the above Additional inspection(1 lir min) J 66.25/hr Phone:(253)320-1657 Fax:( ) Investigation(I hr min) 90.0W hr Email:bdaniels®gweusa.com — Industsial plant(I hr min) 78.18/lir Inspections for which no fee is 90.00/hr CCB Lic.: C1158 Electrical Lic.: 208174 1 Suprv.Lie.: 44965 specifi listed(i4 hr mm _ x�. Suprv. Subtotal: 5-4,.ar- Electrician signature,required: 's . a I:-0 a:-- -NOWA -asA t. Print name: loan P Albert Date: 4/26/2016 Cl Plan Review Required(25%of permit fee): G A 7‘../ State surcharge(12%ofpermit fee): Authorized signature: .._^." •�- — TOTAL PERMIT FEE: 6,2*5 This permit application expires if a permit is not obtained within 180 Print name: Bill Daniels Date: 4/26/2016 days after Ii has been accepted as complete. - �:e'!' * Number of inspections allowed per permit 1:1nuildiralPermits\ELC PennitApp MLR ERE.dec Rev 06/17/2015 4404615T(I7/OS/COM WER _ 00.0';':':', �. '3 J --- ,,A /'l2i ycaA/ amu!-c e'-'4. icd '• (7 7,2 `I7 7 dot-9 X771,6/2-4--z-J7------2/0'•`7 7-.u Si e*e d'7"-- _ 7- City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 13714 SW 175TH AVE, SHERWOOD, OR, 97140 April 20, 2017 at 1 :19:38 PM Record Type: Record ID: Residential - Electrical ELC2017-00266 Inspection Type: Inspector: 199 Electrical final David Young Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor