Permit (107) CITY OF TIGARD ELECTRICAL PERMIT
s�.n COMMUNITY DEVELOPMENT Permit#: ELC2017-00833
Date Issued: 11/08/2017
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 2S08/201 7200
Jurisdiction: Tigard
Site address: 13230 SW AUBERGINE TER
Project: River Terrace Northwest,Lot 172 Subdivision: RIVER TERRACE NORTHWEST Lot: 172
Project Description: (1)branch circuit for A/C.
Contractor: ALAMEDA ELECTRIC Owner: ADLV LAND HOLDINGS LLC
3415 NE 44TH BY FORSUM, MICHAEL
PORTLAND, OR 97213 7600 E DOUBLETREE RANCH RD STE 1
SCOTTSDALE,AZ 85258
PHONE: 503-319-2192 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo/Purchase 11/08/2017 $56.18
Specifics: Service or Feeder
1 ea 12%State Surcharge- 11/08/2017 $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 throug ` ' 2-001-1090. 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: ;• �n"�^---- Permittee Signature: eliej
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.
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Electrical.12sppjvirm it A Heat 'i---(,;t.77 i V , t I u.p:(JI I I(
City of Tigard „- ,n i; , iri 9 FA i r ra Permit rgi0/7-40e6F9.3
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13121 SW Hall Blvd,Tigant OR 972217 `•1 'II '(.,,U 1-,
Phone: 503.711.2439 Pam 503.5911.1, IRrialliMill Reload Posit Oita jc20,1",„ ,fe9A1,
inspectioa Liam 503.639A 173 ,.,;,•,••N,,, , , i ..,•.:,--.,•;•,-..•',,'7 huh
lutenist www.tigard.ecuov 1,,„ 1 i 1 .,,,.., , '',Al ...
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111111.111111111111,11111111111=11
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New construction 0 Addition/. den/replacement Please check all So apply(arisii a acts_plow wanes duckadt
D Semi,*or nein 400 amp or more DI anikana awe Mee atones.
0 Demolition El Other Aloe the avolable fault const 0 Marinas md boom&
' _ :''. • - ', • , - - um&10,000 asps at 150 volts or 0 ilothias Malays
! . •and Itanuly dwelling 0 Commercial/industrial 11 Accessory Wilding rew to Fund,armee&1000 0 Comparcithome mricolmal
amps for A other itotalladoits buldiass
P.' Muld-ennil ri Master builder El Other: CI Fin pimp. 0 lialagadoi of ISO KVA or
.• - .:.. ,,, _ -_ST , .,- T.: -- Mama. imlOcaspowaly doived
0 Adthrica°flow moor load of tOwars.
Job 0: lob site whims:
• I Elsie at more maidosial writs. oompony. .
• City/Statts/ZIP.:Tigard,OR 97224 - 014rala-care tacilitiM. 0 Raamtioad vehicle yob.
le=aril
Project name: ' If, /. 0 flassokos location. 0 Supply voltage tar more duo
1 ' 0Smits or feader600 Nam armee 600 velts aomiust. -
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CAMS stmet/directions to job site: .
I ploriggimeI OM I each Total •
New reeldendal single-or mild-family dwelling unit.
Subdivision I 1 , A , reflinell Inciades attached prime. I
4E4 R A .4411 , r r-
. 1,000 sqft.cr Is
1. 161_54 4
33.92 1
. .. - -.... I
IIMBRIEN/MMIligre— M/S/ I/-i--'F-•- s Limited energy,reside:Mid 7100 2:
(with above so O.)
' . /9-6702--. t-z-6-c- -7-- //tis/3 MA-s't=7) Limited maw.muld-tanthy .
7500 2
. - . . - _ • _ - residential(with above sq,ft.)
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Name;ADVL Land Holdings,LLC -Renewable Emery 0 See Page Z •
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Services or feeders installation,altered,.,sad/or relocalloo
Address:7600 E Donhietree Ranch Road. .
200 amps erten 100.70 2
City/State/ZJP:Seottsdale„.AZ1152511
201 amps to 400 amps 133.56 2•
Phone:(602)0+41131 . her( )
..
Email: - 401=mos 600 amps 200.34 2 •
Owner installation:This installation is being made on property that!own which is not 601 imps to 1,000 amps301.04 2
intended for sale,lease,tent,or exchange,according to ORS 447.449,670,and 01.
Over 1,000 amps or volts 552.26 2
Owner signetur5 .--
- ..L..., - --•. - ..---.---_,—----,----... -.-,—...„,,,,----..-„-.- 'Temporary services or feeders installation,alteratiox,and/or
• : rcic*doii
Business name;William Lyon Homes,Inc.. . ... — .• • • 7,00 amps Or less 59.36 I
Contact name:Angola Grajewsid • 201 amps to 400 amps • 125.06 2
Address:109 East 13th Street . .
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' 401 amps to 599 amps 161.54 2
City/State/ZIP:Vancouver,WA 30660 • - Biaach cinisiti-new,alteradon,or admits*,reveled
Phone:(360)695-7700 Fax ;(360)03-4442
, . show service or tinder fee.
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• Email:Angela.Grajewslapolygoahomes.com , • 7.42 2 each branch circuit •
i ., , ' -- .' ' • -- , ' -. „service or feeder fee,lint 56.11 2
Business name.:slimada.eketrie .. broach circuit
_
Eachbatch circuit 7A2 2
Ackiress:3413 ne44th - - • . •
. Mtseellancons(service or feeder sot latiadtd)
City/State/ZIP:NNW A, 1„ .0/Z. o'y 1.1-/ . Each manufactured or mochdar _
6114. .•• 2
-dwelling servka sadiar Ender I
Phan=(503)3192192 Fax:( ) Emormect tMly :'
. ..
I Emall:solspdrat)ute.com
Pump or lapdog circle •
6714 ' -.
Cal Lie.: 199118- Electrical Lie,: c923 SuPly•Lie.: its7/5 . '
signif.a.ligbdog , 67.54 _ 2
Supra.Electrician signature,required:
Signet CIICII0or limbad-orany
Print name:
L. ,0,,,,c, Date: 13Affill panelotheration.or emossion. 13 Sorra:et - -:” -';-••!- '
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Each addithanal inspection over alloWible la anY of tie abriii. ••..1
Authorized ' .p.,./ .,,...-,,,p,__,...z..., manaliacinspection(I far min) 662.St hi‘."••• °••:': •
. .,I Print nem= ' psi re,SY 2.3r/t4 love:Mission(I Marin) 90.00/hr
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At Mix lar•IWIMIS 44046131111/DSCOWWFX •
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City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13230 SW AUBERGINE TER, SHERWOOD, November 13, 2017 at
OR, 97140 12:21 :58 PM
Record Type: Record ID:
Residential - Electrical ELC2017-00833
Inspection Type: Inspector:
199 Electrical final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor