Permit (69) CITY OF TIGARD'IN ELECTRICAL PERMIT
' ' COMMUNITY DEVELOPMENT Permit#: ELC2019-00417
7-i G AR 0 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/25/2019
Parcel: 2S115AB01400
Jurisdiction: Tigard
Site address: 16293 SW 113TH AVE
Project: Willow Brook,Lot 18 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 952-001-0090. You ma obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: %, �� _ ,.��. if�-«���_ Permittee Signature: r5r?::
-e./-y1
.4e
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 IIIIIIIIIE=IlallillIl
City of Tigard .,, 1,-(eact:`,3'e:
). ul.A. \A, ,-v Permit# Upt,(QAN-A-
li 4* 13125 SW Flail Blvd.,Tigard,OR m- -i- Plan Review
' I Phone: 503.718.2439 Fax 503.5ri.111/4!) „.!i,k,,,
1.I GA R i) Inspection Line. 503.639.4175 Ready Date/By tuns RI See Page 2 for
Internet: www tigard-or.gov
Notified/Method Supplemental Information
'''' '''.'"
74Pti‘•,;2,1*,;-,;2‘. .,c;:n'it:?°;?1,'"Ire,fr:r',,.;,'"•'‘ ,••• , , 1:44: l'44' 1)i'.'il;:eil:a afftfuriappi;(sehniti sets of plans c1, 1,.i):
k.i New construction 0 Addition/alt-(1,411 k 'r-1. e o-•ti)es t t'l ,',,
Other: BUILD1 II 11,--"V" 0 Serme or feeder 00 amps or more 0 Building over three stories,
0 Demolition 0 - where the available fault current 0 Mannas and boatyards
'il,'0-**I'We5fa„4,>111,4kla exceeds 10,000 amps at 150 volts or 0 Hosting buildings
less to ground,or exceeds 14,000 0 commercial use agricultural
4 1-and 2-family dwelling 0 Commercial/industrial Ej Accessory building
snips for all other installations buildings
0 Multi-family 0 Master builder 02111r: /, 7„,,,,, , El Ft ter p system 0 Installation of 150 kVAor
larger separately derived
JaPgrarigifiggriraninIct,),:::;:nl'nillitaAajir;0144&,,Z , E EA:firtte:0Yf new motor load of system
Job#: Job site address:\\ '4C..6 c'W liy). -.0k.- vN ....., 10011P or more 0-A","I" :1-2 ,
.
o Six or more residential unit,
City/State/ZIP: 13 Health-care facilities 0 Recreational vehicle parks
Suite/bldg./apt 0 Supply voltage for more than
#: Project name: v.)1 14....,. le,......" ,
k‘O -/b/Ot, 1...i Service or feeder 600 amps or more 600 volts nominal,
Cross street/directions to job site: 34F.licAa4111:s'I;IV.C.,',..i irP:;:'''AVVII.)Z,
Description Qty, each f Total I *
New residential single-or multi-family dwelling unit<
Subdivision:
Lot 4; i ES Includes attached garage. ._I
' 1,000 sq ft or less 168.54 4
Tax map/parcel#: „ __ ,,,_,. „ „_,..,,„, Ea.add'I 500 sq.ft or portion 33.92 , 1
',-,',',7'W7777,7,11,7AnSiY7.7.:iStiftt Limited energy,residential
'''..' '''''''''el'e..'4'.''''''.'''''''''''''.'''''''' '''''' tssIth abri!Lq.It) 75 00 2
A-0 .)2 tini 1'1' Limited energy,multi-family 75 00 2
residential(with above sq it) i
Renewable Energyninstallation, 0 See Page 2:11,0;fP,:,,,,M.„7:UV,1,7,70'0;Wp.7,,,,a,iirff ,Vin,34?",4311,401:6:141,11r.7.0;1,,,,,,A4r,,,0 Services or feeders alteration,and/or relocation 0070 2,
Name: 220(X)1 aanmiPsps ot 10'less 400 amps
133 56
Address: . 2
401 amps to 600 amps , 200.34 2
City/State/ZIP: 601 amps to 1,000 amps 1 301 04 2
I
Phone:( ) Fax:( ) Over 1,000 amps or volts i 552.26 1 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 7 59.36 ' I
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
4.7-,4rwilrizt..emmr.r 7;:we, Branch circuits-new,alteration,or extension.per panel
ri AffiairiEff7TI:05:A%'!L'.'ft. •5:;a:A?5,iiifi:riiillAik.-44.ks:14,,,, ,,y,.,,,';:,Ag.' A.Fee for branch circuits with
Business name:Pacific Lifestyle Homes above service or tdeder fee, 7 42 2
each branch circuit
Contact name:Permit Coordinator
B.Fee for branch circuits without
service or feeder fee,first
Address: 11815 NE 99th Street,Suite 1200 branch etrcuit 56 18 2
'
City/State/ZIP:Vancouver,WA 98682 Each addI branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(360)573-8081 Fax: ,(360)574-6401 Each manufactured or modular
I
67 84 2
dwelling,service and/or feeder _
Email:permits@buildplh.com Reconnect only 67 84 2
.44:24,0,tRgitiai;50:- IN2,70:4;,`,11:,',..,:.".:A;-:;;,;;*;,:,,iii44;ifil'3451M".&°.? "--041/40 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 t panel,alteration,or extension,
Each additional inspection over allowable in any of the above
City/State/71P-Puyallup.WA 98371
Additional inapotanin(t hr mull 66,25/hr [ 1 I
Phone:(253)872-6051 Fax:(253)872-1801 Investigation(1 hr min) . 90(X/hr
Email:cgentele@gweusa.com Industrial plant(I hr mm) 78 181hr
Inspections for which no fee is 90 001hr
CCB Lie,: 208174 Electrical Li Cl 158 Suprv.Lic,I.-147 -t-5„S r.;,,::.;VI) 1isted- :.,.....;../i hr... ..711,,,,,,:/„,,,,,,,relr?„,,,....n.,..7,.....,7,7tryffyg.,,fs....,q,
Suprv.Electrician signature,required: /1/''' iq k 1‘Ct '-'.---- - - ' ' - Subtotal:
Print name: Russell Magnuson___-- -_ Date: 0 Plan Review Required(25%of permit fee):
(7- State surcharge(12%of permit fee):
TOTAL PERMIT FEE:
Authorized signature: X 77.< 7
This permit application expires if a permit is not obtained within ISO
Print name: Bill Daniels Date: days after It has been accepted as complete.
e--Number of isepeotiores allowed-per-pectnit.
I‘BuilciengWermitalELC_PcmatApp_ELR_ERE doe Rea 06/17/2015 440-4615TO 1/051COWWER
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
16293 SW 113TH AVE, TIGARD, OR, 97224 June 28, 2019 at 7:30:04 AM
Record Type: Record ID:
Residential - Electrical ELC2019-00417
Inspection Type: Inspector:
199 Electrical final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor