Permit (70) CITY OF TIGARD ELECTRICAL PERMIT
III COMMUNITY DEVELOPMENT Permit#: ELC2019-00418
T-t C_;A R ID 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/25/2019
Parcel: 2S115AB00500
Jurisdiction: Tigard
Site address: 11297 SW GABRIEL ST
Project: Willow Brook,Lot 21 Subdivision: WILLOW BROOK SUBDIVISION Lot:
Project Description: Adding AC.
Contractor: GARNER ELECTRIC WASHINGTON LLC Owner: MISSION HOMES NORTHWEST LLC
402 VALLEY AVE NW, SUITE 106 PO BOX 1689
PUYALLUP,WA 98371 LAKE OSWEGO, OR 97035
PHONE: 253-872-6051 PHONE: 360-573-8081
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 952- 01-0090. You ma obtain a cop of the rules or 'rect questions to OUNC by calling 503,232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: //?GL�G/
C
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 OFF1LE I SE()N 11
City of Tigard Received
‘VCI DaeB
A \T Permit trN13125 SW Hall Blvd.,TigardOR3
Ptan Review
; 3 Phone. 503.718.2439 Fax 503.598,1960 Date/By Related Penn ti
TI C Ai(D
Inspeetton Line: 503.639,4175 ': \I 20 ?019 Ready Date By hats Id See Page 2 for
Internet: www.tigard-or.gov '' ' Notified/Method I i Supplemental Information
t,Oni,i'40,2nAAN:gitpeit4.50At:c.N,1;;;7,-ri..'-t, .,:-'?•;.:':',-,::Ya,,..:4 k',i120124,4+iiteat4Klijf•Aft :inn'f'eP444,44-4P-0;:;°:'::1.:6;'17'..:':14.'44*4*::-'Y'4.1,1**41::.:1
r New construction 0 Additionliketta ion/ TO iirle** I '4 Please check all that apply(submit 1 sets of plans wiitems checked):
0 Service or feeder 400 amps or more 0 Building over three stories.
CD Demolition 0 Other' where the available fault current 0 Marinas and boatyards
fltgVTZflifMVA,PT71'r:rirr'i77:777775WWM exceeds 10,000 amps at ISO volt"' 0 Floating badding's
I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building la:sptsofrauntic(,th:eaMetti1041;(s" 0 IC=e;al-use agricultural
0 Multi-family 0 Master builder 0 Other 0 Fire pump 0 Installation oft50 KVA or
Buzz:of
:::motor load of Isayrsateerinsimarately derived
Job#: Job site address: \\7,-4-Cr+c9C.2`i '•‘c-s -te- C3\--.- 1 1001-11,or more
Es:I:::r:siCity/State/ZIP: I i :Ifacilities 0Recreationalveh.leparks.
Suite/bldg./apt.#: Project name: i 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: 'P,*;:,, ,Ai;l,t;',.; ''?.;i:;Q:r:0', .::,„.Ojf':;,j,iTO,f',74!.?:;',` .4T•tet ,
Description Qty. Each Total 1 "4
' New residential single-or multi-family dwelling unit.
Subdivision: Lot#:ai , Includes attached garage.
1,000 sq ft or less 1 168 54 4
Tax map/parcel#: Ea.add'l 500 sq ft or portion 33 92 1
r- . ' ':-...;; ,,Zligiglang;:75tfii.grA Limited energy,residential
75 00 2
(with above su ti)
Limited energy,multi-family 1 75 00
2
residential(with above sq.tt) 1
Renewable Energy 1 0 See Page 2
4,;',/'-'103/'4,4ty-''"0-'°-0,&)=4•';'-''''-';Nj'1.7,', ''''r''''''''fr'4''''''T'T*0'''''W:/$744.1''''4''''%'''''''''43*'''''-'",-'';A-"':,70.47,4",e,-7 -,,,,,- Services or feeders installation,alteration,and/or relocation
Name: 200 amps or less 100 70 2
1
Address:
201 amps to 400 amps 133 56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: 601 amps to 1,000 amps 301 04 2
Phone:( ) Fax:( ) Over 1,000 amps or salts, I 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 f 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 1 168 54 1 2
_
)52,40,44))4',':;t;:4,07.0c11;;',;;FftWi.5.:1 ,;, .:;-.!,N90',,,,,p,,,,,,,4a,P;•,',2t'-,,,,,P).;,,,:!,:`,A,',;01"','-`''''''Ir A Fee for branch circuits with I
Business name:Pacific Lifestyle Homes above service or feeder fee,
7 42 2
each branch circuit ,
Contact name:Permit Coordinator B Fee for branch circuits without
service or feeder fee,first ' 1 56 18 2
Address: 11815 NE 9961 Street,Suite 1200 . Each add'l branch circuit 7 42 2 branch circuit
City/State/ZIP:Vancouver,WA 98682
Miscellaneous(service or feeder not included)
Phone:(360)573-8081 Fax: :(360)574-6401 Each manufactured or modular
67 84 2 1
dwelling service and/or feeder
Email:permits@buildplh.com
Reconnect only 67.84 2
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 See Page 2 2
Address:402 Valley Ave NW Ste 106 panel,alteration,or extension 0
Each additional inspection over allowable in any of the above ,
City/Ctatei/IP:Puyallup.WA 98371 1
ENC./W.11(7MA itINVIA1011(t hr min) 66.25/hr
Phone:(253)872-6051 Fax:(253)872-1801 Investigation(I hr min) 90 00/hr
Industrial plant(I hr mm) 78 18/hr
Email:cgentele@gweusa.com
Inspections for which no fee is
_ 90 00/hr
CCI3 Lie.: 208174 Electrical Lii.: C1158 Suprv.Lie li,A,):::),.C.-R.C.,..., ss;1.:(tvInlk.,,„ ;;:,
. Suprv.Electrician signature,required: ed,0AA ---------- "'”) \liCk ' Subtotal:
Print name: Russell Magnuson , Date: 0 Plan Review Required(25%of permit fee):
I
Authorized signature: X 71,4< .- ---) State surcharge(12%of permit fee):
TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Bill Daniels Date: days after it has been accepted as complete.
* Number of inspections allowed per permit,
1 03uildineermes1ELC_PenTutApp_ELR_ERE.doc Rev 06/17/2015 440-461ST(11/05/COWWER
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
11297 SW GABRIEL ST, TIGARD, OR, 97224 June 28, 2019 at 7:33:28 AM
Record Type: Record ID:
Residential - Electrical ELC2019-00418
Inspection Type: Inspector:
199 Electrical final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor