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Permit (58) CITY OF TIGARD ELECTRICAL PERMIT ° 2, ' COMMUNITY DEVELOPMENT Permit#: ELC2017-00476 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/27/2017 �f71 9 Parcel: 2S106DC13200 Jurisdiction: Tigard Site address: 17066 SW JEAN LOUISE RD Project: Polygon at West River Terrace,Lot 132 Subdivision:POLYGON AT WEST RIVER TERRACE Lot: 132 Project Description: (1)branch circuit for A/C 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 06/22/2017 $56.18 Specifics: Service or Feeder 1 ea 12%State Surcharge- 06/22/2017 $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. ATT I .. •regon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001 $010 through 0•' 9 $01-1$90. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issue' By: ���1 / Permittee Signature: r ' cc.--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. Electrical Permit Application �' - . _ . FOR OFFICE USC O\LY< It_ l Received /f /�I Cityof TigardAatclB . ��/7 /�. titt �t 13125 SW Hall Blvd.,Tigard,OR 97223 2 it t( plan Review t Phone: 503.7182439 Fax 503.598.1960 U 2 Date%B ; Related permit G �. Inspection Line: 503.639.4175 _. Ready Date/By: [21 See Page 2 for TIGAAD Internet: www.tigard-or.gov NotifediMethod: NM Supplemental Information �ia- F 4 `ail '^. " ''�'.•. ,.-,QO- t� KA '4 N`t'''ut, '�y'�`i,,'; A3�'rr,r.�•, gat Mc``,�,,S ;F� .y"..`5` •J�,'a4-r G « t F, 4`^'�:��- �S�s;r.S's,er�'.vti'�•.��, `,.�. '�,..«. .. 'Sx���"n�:�.•a��.n.-. '�' r.r_._"�.�^'-r�� '`7. S« ®New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): 0 Service or feeder 400 amps or more 0 Building over three stades. ❑Demolition 0 Other: where the available fault entreat 0 Marinas and boatyards. falai, s M ;tiTtAt` {gtj a'F (j gigi ,:�`r�I& r., Kms"' exceeds 10,000 amps at 150 volts or ❑Floating buildings. 1-and 2-family dwelling ❑Corrunercial/indtistrial 0 Accessory building tars to ground,or exceeds 14,000 D Commercial-use agricultural amps for all other installations. buildings,• ❑Multi-family - 0 Master builder Cl Other: D Fire pump, D Installation of 150 KVA or •,^I; ?rxatk-g• A" V g..IN,>b a nYfir•"•ZAVi (f]�r .,T� ,} y, °Emergency system, larger separately derived �,- '' ❑Addition of new motor load of system. Job it; I Job site address:1 loofa,or more. ©'A'"F.."1•z^«I.3.. El Six or more residential units. occupancy. City/State/ire.Tigard,OR 97224 0 Health-care facilities, 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name:Polygon at West River Ter OHazm'dons locations. 0 Supply voltage for more than D Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: ;leu a 4,rrr �r:``.r 'y�"�'; , Yr' '4 f 1 P ;.-t��h t.�w� s,.�.rr,c�zi?r'cr -,„�_,�`?-�a�"s-r �ce� .n' Description I Qty I Each I Total New residential single-or multi-family dwelling unit. Subdivision:Polygon at West River Terrrace Lot#: j 32_, Includes attached garage. 1.000 sq,ft.or less 168,54 4 Tax map/parcel#: Ea add'l 500 sq.ft.or portion 33.92 1 �2aTifi� � �,m�i itSCW�M;Wrst, ;taltat Or" at Limited energy, residential 75.00 2 MY l (�r,.}-t r�i 4) — D^ thabove sq.ft.) J' } Limited energy,multi-family 75,00 2 residential(with above sq,ft.) i , g Renewable Energy D See Page 2 y3:.p MET , 3 ex :7:� ,,,,s"tVrDVi a0".` Services 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/Z)P:Scottsdale,AZ 85258 601 amps to 1,000 amps 301.04 2 Phone:(602)694-4031 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!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 a. uO x, � yr •4e,‘,...:101,-.14',',24';*: X11� . iirr kF ndmL _f,mtkroBranch circuits-new,alteration,or extension,per panel T ,e4; ,A : h, t .e.1c. 'ie t s, - .,-,, xaF444,4 A.Fee for branch circuits with Business name:William Lyon homes,Inc. above service or feeder fee, 742 2 each branch circuit Contact name:Angela Grajewsin B.Fee for branch circuits without ' service or feeder fee,fust 1 56.18 2 Address:109 East 13th Street branch circuit City/State/ZIP:Vancouver,WA 98660 Each add')branch circuit 7,42 2 Miscellaneous(service or feeder not included) Phone:(360)695-'7700 ' ' Fax::(360)693-4442 Each manufactured or modular 67.84 2 dwelling,service and/or feeder Email:Angela.Grajewsld@polygonhomes.com - Reconnect only 67,84 2 v4• rrr }=? `." r ' aM ' C<u r yy. ay _ te Pump or irrigation circle 67.84 2 Business name:Garner Electric Washington,LLC Signor outline lighting 67.84 2 Signal circuit(s)or limited-energy D See Page 2 2 Address; n6101 NE St Johns Rd panel,alteration,or extension. City/StateJZIP:Vancouver WA 98661 Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 6625/hr Phone:(253)320-165'7 Fax:( ) Investigation(1 lir min) 90.00/hr ' Industrial plant(1 hr chin) 78,18/hr Email:bdaniels@gweusa.com rwirt 90.00/lir COB Lie.: C11SS Electrical Lie' 208174 Suprv.Lica: 4496S Inspections fo ch no fee is specifically listed CA hr min) ligNerattittWaindatitetkOS 1 . l4 Suprv.Electrician signature,required: � v.4 _ I, iSubtotal: , Print name: Joan P Albert Date: 4/26/2016 0 Plan Review Required(25%of permit fee): --� State surcharge(12%of pernrit fee): TOTAL PERMIT FEE: Authorized signature: --""'^- --- J -� ` 411.________-5—r------'--:::: --• This permit application expires if a permit is not obtained within I80 Print name: Bill Daniels Date: 4/26/2016 days after it has beet accepted as complete. i - * Number of inspections allowed per permit •i.:4:11hiildinglPermitrUK.0 PenaitApp_ELR ER5,doc Rev 04/17/2015 44046151111/05mCotsswEB i.` ^is City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 17066 SW JEAN LOUISE RD, SHERWOOD, OR, June 27, 2017 at 3:28:22 PM 97140 Record Type: Record ID: Residential - Electrical ELC2017-00476 Inspection Type: Inspector: 199 Electrical final David Young Result: PASS - NoCofO Comments: Electrician on site to switch breaker in panel to 25 amp max as noted on outdoor unit. Violation Summary: Inspector Contractor