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Permit „ CITY OF TIGARD ELECTRICAL PERMIT it ' COMMUNITY DEVELOPMENT Permit#: ELC2016-00730 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/26/2016 Parcel: 2S106DC11800 Jurisdiction: Tigard Site address: 17302 SW JEAN LOUISE RD Project: Polygon at West River Terrace, Lot 118 Subdivision:POLYGON AT WEST RIVER TERRACE Lot: 118 Project Description: (1)branch circuit for A/C. 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 09/26/2016 $56.18 Specifics: Service or Feeder 1 ea 12%State Surcharge- 09/26/2016 $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 -0 - 0. 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: t/�T --- Permittee Signature: 6IA/ --1°,4/e''91 0, 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. , ,tECFIVEP ' • • • - Electrical Permit A t II licati® FOR OFFICE USE ONLY City of Tigard Received n E� II x 13125 SW Hall Blvd.,Tigard,OR 97223E P 2 PlatB : 7 ��p Permit�: C'�`� - ��9'�� Phone: 503.718.2439 Fax: 503.598.196 2 6 Date/By: V Date/By: RelatedPecmi[l /4,p.©06 eFe Inspection Line: 503.639.4175 , Internet: WWW tlgard or gov tl �j V t x Ready Date/By S See Page 2 for TIGARD Notified/MethodEMI Supplemental Information - PLANREVIEW ®New construction 0 Addition/alteration/replacement Please check all that apply(submit I.sets of plans w/iterns checked): ❑Demolition D Other: ❑Service or feeder 400 amps or more ❑Building over three stories. CATEGORY OF,Ct71+lb'11tUC1fON where the available fault current 0 Marinas and boatyards. `� exceeds 10,000 amps 150 volts or "` ""' P Q Floating buildings. ® 1 and 2-family dwelling ❑Commercial/Industrial 0 Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural 0 Multi-family ❑Master builderamps for all other installations. . buildings.• ❑Other: ❑Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND rLOCATION 0 Emergency system. larger separately derived Job#: Job site address: / / i ❑Addition of new motor load of system. 7 30,2 < - ,ea,�, 4,,,,i‘7.. 100F1P or more. 0 "E",••1-2„ "1-3", City/State/ZIP:Tigard,OR 97224 ❑Six or more residential units- occupancy. ❑Healtlrcare facilities. ❑Recreational vehicle parks. Suite/bldg./apt.#: I Project name:Polygon at West River Ter ❑Hazardous locations. 0 Supply voltage for more than ❑Service of feeder 600 amps or more 600 volts nominal Cross street/directions to job site: 4/JS"- t, .o/‘ — G C7j 9 ) FEE SC17Ebm Description I Qty. J Each .i_. . Total I k_ New residential single-or multi-family dwelling unit. Subdivision:Polygon at West River Terrrace 1 Lot#: //t" Includes attached garage. Tax map/parcel#; 1,000 sq.ft.or less 168.54 4 t'� ... , DESCRIPTION.OF WORDportion Ea add'1500 sq.ft or 33.92 1 -\ 1 Limited energy,residential (with above sq.ft.) 75.00 2 Limited energy,multi-family residential(with above sq,ft.) 75.00 2 ®.PR(- - f4 .' R O .TNA1T• RnweasboEnergy installation,al❑eraSeonP,aagnd2/o r 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 City/State/ZIP:Scottsdale,AZ 85258 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Phone:(602)694-4031 i Fax:( ) Over 1,000 amps or volts 552.26 2 Email: Temporary services or feeders installation,alteration,and/or relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less I 59.36 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 ams 1 p 125.08 Owner signature Date 401 amps to 599 amps 168.54 I22 15,p,:tEgml.t�PLrCANT,,; Branch circuits—new,alteration,or extension,per panel w,.� �•:,..- . .Q>CON'L'ACT'PEIrSON .� A.Pee for branch circuits with Business name:William Lyon Homes,Inc above service or feeder fee, Contact name:Angela Grajewski each branch circuit 7.42 2 B.Fee for branch circuits without Address:109 East 13th Street service or feeder fee,first branch circuit 56.18 2 City/State/ZIP:Vancouver,WA 98660 Each add'l branch circuit 7.42 2 Phone:(360)695-7700 Fax::(360)693-4442 Miscellaneous(service or feeder not included) Each manufactured or modular Email:An ela.Gra ewski dwelling,service and/or feeder 67.84 2 g 1 @polygonhomes-com Reconnect only 67.84 2 . ali t r„.... cON OTOR -• - - - -.4.`. •r.. ..... Pump or irrigation circle 67.84 2 Business name:Garner Electric Washington,LLC Sign or outline lighting 67.84 2 Address:6101 NE St Johns Rd Signal circuit(s)or limited energy panel,alteration,or extension. 0 See Page 2 2 City/State/ZIP:Vancouver WA 98661 Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:(253)320-1657 I Fax:( ) Investigationl hr min ( ) 90.00/hr Email:bdaniels@gweusa.com Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is CCB Lie.: CI158 Electrical Lie.: 208174 1Suprv.Lie.: 4496S specifically listed('t4 hr min) 90.00/fu Suprv.Electrician signature,required: 7 %� ELECTRICAL IPERMIei `FES,,gliallegMg • ___`., s_ � ,..:..: Subtotal: Print name: Joan P Albert Date: 4/26/2016 ❑Plan Review Required(25%of permit fee): -- < State surcharge(12%of permit fee): Authorized signature: TOTAL PERMIT FEE: IPrint name: Bill Daniels _ I This permit application expires if a permit is not obtained within 180 Date: 4/26/2016 J days after it has been accepted as Complete. * Number of inspections allowed per permit I:eaildinglpermits\ELC PermitApp_ELR ERE-doe Rev 06/17/2015 440-4615T(11/05/COM/WEB Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 17302 SW JEAN LOUISE RD, SHERWOOD, OR, 97140 Residential - Electrical 199 Electrical ﬁnal PASS - No C of O ELC2016-00730 David Young Violation Summary: Inspector Contractor