Permit (77) CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2019-00421
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/25/2019
T I(.;E I+.f� g Parcel: 2S115AB00500
Jurisdiction: Tigard
Site address: 11147 SW GABRIEL ST
Project: Willow Brook,Lot 26 Subdivision: WILLOW BROOK SUBDIVISION Lot:
Project Description: Adding AC.
Contractor: GARNER ELECTRIC WASHINGTON LLC Owner: PACIFIC LIFESTYLE HOMES
402 VALLEY AVE NW, SUITE 106 11815 NE 99TH STREET SUITE 1200
PUYALLUP,WA 98371 VANCOUVER,WA 97682
PHONE: 360-573-8081
PHONE: 253-872-6051
FAX:
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo/Purchase 06/24/2019 $56.18
Specifics: Service or Feeder
1 ea 12%State Surcharge- 06/24/2019 $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 OAR 52-001-0 0. You ay obtain a copy of the rules ordi ect questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: / .f/�(//%U!� 'C`l�wt 'Permittee Signature:
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 11111111===111111111111111
City of Tigard .,.-, , Da B .
II 14 13125 SW Hall Blvd..Tigard,OR 9741lialt i 4;!1"...1‘i ....*, Plan Review
Received
.Q,- )Q)\k C't S‘--- Permit M E_I-C-?,-C.NiiCx- Wk- -1
Related Permit 4
: II Phone: 503.718.2439 Fax 503.598.198 Dater13y
Inspection Line. 503.639.4175 Ready Date By tuns Ed See Page 2 for
I I GA RI) Internet: www,tigard-orgov j tj N '2 0 71)19 N°4fiedimethed supplemental Information
' —-''''4'''''°c;'c';'Ws'cW:'719?4f":•W"rrEi,7;Vir,'WPM W3Varlig471X471,i574=11177.7674gerirarn
rwnir;tyxiwtz.pargfWl7F :*'I'f'l ''':.--'....,.....,....,„„,' ;.:•''''''''''#;::, ,.,::'t:' v:I' ked)
r New construction 0 Addition/alSerrani/MMV 1,7)1t,..)N Please check all that apply(submit 1 sets of plans /toms checked).
4
Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition Ej Other where the available fault current 0 Marinas and boatyards
51grP"ati%IZPV;4f7C1: :?;".17721:177; ::r:Alidjili i'V:114 1 E
1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building :77,:isg::::nlePxsc:dts5(1)4'710:°' (21FC:(0),a,:zr:iu:litg:gricultural l
1 amps for all other installations buildings
0 Multi-family 0 Master builder p Other: /.., 0 Fire pump, 0 installation of 150 KVA or
larger separately derived
V45'XZ.CftgtlffirllaiatMiI7155:ririglli'rlrTit174*1/FAL?At:.:#4 E EZtgitey:c:fsaYes:::otof load of system ,
Job#: Job site address: \\‘‘,.....it -. ZA, ct• i 00HP or more 0"A",-1E1',-1-2-,-1-31,
City/State/ZIP:
I0 Health-care facilitles 0 Recreational vehicle parks.
Suite/bldg./apt.4: Project name: 1 0 Hazardous locations. 0 Supply voltage for more than
0 Service or feeder 600 amps or more. 600 volts nominal
Cross street/directions to job site: ifir":1477,1111711,7117111111.11.12N,
Description Qty, Each Total
New residential single-or multi-family dwelling unit.
Subdivision: I Lot 4: .2, , Includes attached garage.
1,000 sq ft or less 168.54 4
Fax map parcel 4: Ea,add'1500 sqft or portion 33,92 1 '
(with ththtq.ft.) 75.00 2
/4 -CJ ( ).Q_(__-MU Limited energy,multi-family 75 00 2
residential(with above sq,tt) ,
Renewable Energy [ 0 See Page 2
,e,**91401:,,;4R(F,T4,61`iyitr), ;1;1"iiiTOW.:4;;Wey,,i5i4341,:tkIt,;B:39i2NNI:;IrAf/,/r6444 Services or feeders installation,alteration,and/or relocation
Name: 200 amps or less 100 70 1 2 1
Address: 201 amps to 400 amps 133.56 2
401 amps to 600 amps 20034 2 .
City/State/ZIP: 601 amps to 1,000 amps , 301.04 , 2
Phone:( ) Fax:( ) Over 1,000 amps or volts 552,26 ' 2
Temporary services or feeders installation,alteration,and/or i
Email; relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701, 201 amps to 400 amps , 125.08 , 2
401 amps to 599 amps , 168.54 2 '
Owner signature: Date: ,
Branch circuits-new,alteration,or extension, ter panel
A Fee for branch circuits
with
Business name:Pacific Lifestyle Homes above service or feeder fee,
7.42 2
each branch circuit ,
Contact name: Permit Coordinator 13 Fee for branch circuits without
service or feeder fee,first
I
Address: 11815 NE 99th Street,Suite 1200 branch circuit 56 18 2
'
City/State/ZIP:Vancouver,WA 98682 Each addI branch circuit 742 2
Miscellaneous(service or feeder not included)
Phone:(360)573-8081 Fax: :(360)574-6401 Each manufactured or modular
67.84 2
dwellin!,service and/or feeder
Email:permits®buildplh.com Reconnect only 67 84 2
Aln,,INION,R,44,0VA1X51'.:'!g1:7rj.:*,7.,;'..421V1f:4444,WAtrirlt%/..,;:fr.;;,/:1146, Pump or irrigation circle . 67,84 2
Business name:Garner Electric WA LLC Sign or outline lighting , 67.84 2
signal circuit(s)or limited-energy 0 See Page 2 2
Address:402 Valley Ave NW Ste 106 panel,alteration,or extension.
Each additional inspection over allowable in any of the above i
('ity/SrateiZIP-Puyallup,WA 98371
Additional inapixtion ll ter min) '66.25/hr
Phone:(253)872-6051 Fax:(253)872-1801 Investigation(1 hr mm) 90.00/hr
Email:cgentele®gweusa,com Industrial plant(1 hr mm) 78 18/hr
Inspections for which no fee is
90.00i hr
CCB Lie,: 208174 Electrical L'i:4;121158 Supry„.., ,,;,L1 „..,..)--,f-', lms;ilftcaIIvM1„?f,lAlt;;ti;,r.frrr,r:„:r7m,r7v7r47:r:jrm
Subtotal:
Print name: Russell Magnuson —....„1 Date: 0 Plan Review Required(25%of permit fee):
Authorized signature: X 1/71117 lia.------) , State surcharge(12%of permit fee):
TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 1110
Print name: Bill Daniels I Date: days after it has been accepted as complete.
* Number of inspectionatilowed-perpormit
I diuilding\PermitstELC_PermitApp_ELRERE.doc Rev 06/17/2015 440-461ST(11/05/COM/WEB
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
11147 SW GABRIEL ST, TIGARD, OR, 97224
Record Type: Record ID:
Residential - Electrical ELC2019-00421
Inspection Type: Inspector:
199 Electrical final David Young
Result:
PASS - NoCofO
Comments:
Electrical final for ac ok.
Violation Summary:
Inspector Contractor