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Permit (82) CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit#: ELC2017 00856 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/22/2017 TIGARD 13125 2S106DA13800 Jurisdiction: Tigard Site address: 13009 SW REDFOX TER Project: River Terrace East,Sales Trailer,Lots 137&138 Subdivision: RIVER TERRACE EAST Lot: 138 Project Description: (1)200 amp service feeder and(15)branch circuits for modifications to manufactured structure on(2)lots at site address 13009 and 13019 Contractor: GARNER ELECTRIC WASHINGTON LLC Owner: ADLV LAND HOLDINGS LLC 402 VALLEY AVE NW, SUITE 106 BY FORSUM, MICHAEL PUYALLUP,WA 98371 7600 E DOUBLETREE RANCH RD STE 1 SCOTTSDALE,AZ 85258 PHONE: 253-872-6051 PHONE: FAX: FEES Quantity Description Date Amount 1 ea Services or Feeders-200 11/22/2017 $100.70 Specifics: amps or less 15 crt Branch Circuits w/Purchase 11/22/2017 $111.30 Type of Use: CMS Service or Feeder Class of Work: ALT 1 ea 12%State Surcharge- 11/22/2017 $25.44 Electrical Type of Const: Occupancy Grp: Total $237.44 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 may obtain a copy of the rules or direct questions to OUNC by calling e7/If503.232.1917.4°,.4 877 or 1.800.332.2344. / Issued By: - ► e Permittee Signature: e7/If1/o,.-/6 N 70 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 A Ip➢iLaLIl®1n Cityri,i1 -,:i ofTigard RcE1Vr,( $� edf'r 13125 SW Hall Blvd.,Tigard,OR 97223 terry;i/73//7 < 'smut#;Eta%' j/7,-. /j s'0 s 'RV., Plan Review Stmt o Phone: 503.718.2439 Fax: 503.598.1960 y Related Perm'. f ���,.��'`} Date/By:; Inspection Line: 503.639.4175 /° Ready Date/By:,q J / "� Iuris I El See Page 2 for I TIGARD' NOV .3 ?� oU 7 G Internet: www.tigard-or.gov cit.' �yNoptified/Methhoe. '< Supplemental Information 1 fi:Ala ._r•.: r TYPE Of 1Cgtge 1f`Y/011 11*,*ARO, -. ,'4 - -:: � I N R /[EiV ®New construction ❑Addition/alteratio£ r a t V i CI ON Please check all that apply(submit 2 sets of plans w/items checked) ❑Demolition 'BUIL t 0 Other: 1 ❑Service or feeder amps s or more ❑Building over three stories. where the available fault current ❑Marinasand boatyards. CATEGO Y OF CONSTRUCTION exceeds 10,000 slops at 150 volts or ©Floating buildings. & 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural 1. ❑Multi-family • 0 Master builder 0 Other: ❑ amps rept%p h other installations. ❑buildings. of 150 KVA or . ;JOB'Sri% INFORMATION AND.LOCATION ❑Emergency system. larger separately derived Job#: Job Site address' �q ❑Addition of new motor load of system. I /3 OM - 13 1 S�f ed . . .v.v." lOOHP or more. ❑"A, E","1-2","3-3", 1 City/State/ZIP:Tigard,OR 97224 0 Six or more residential traits_ occupancy, ❑Healtlr-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: I Project name gitJ.e lr I-VOrGace P.. .),,si ❑Hazardous locations. ID Supply voltage for more than I l ❑Service or feeder 600 amps or more. 600 volts normnat 1 Cross street/directions to job site: FEJ SC13Ep[JLE - i Description I..Qty. I Each ] Total I a $ New residential single-or multi-family dwelling unit. Subdivision: v SQ�V►rrAt'_L5� Lot ii:13�4'7 p Includes attached garage. Tax map/parcel#: t 70 1,000 sq.ft.or less 168.54 4 Ea.add']500 sq.ft.or portion t 33.92 1 :`DESCRIPTION;OR WOR(.IC Limited energy,residential 75.00 2 it (with above sq.ft.) Limited energy,multi-family 75.00 2 residential(with above sq.ft.) 4'PROP.I KTY OWNER % Q:fiENANT rgy ❑ 2 - Renewable Services or feedersEnteinstallation,alteration,SeePage and/or relocation Name:Polygon W LH,LLC 200 amps or less I. 100.70 2 Address: '1 201 amps to 400 amps 133.56 2 -1 03 W 0 SA--- C -'' Si ` `Q J- cVQ 401 amps to 600 amps 200.34 2 City/State/ZIP:Vancouver,WA 98660 601 amps to 1,000 snips 301.04 2 Phone:(360)695-7700 I Fax:( ) Over 1,000 amps or volts 552.26 2 1 Email: � Temporary services or feeders installation,alteration,and/or ` n�kP, 1 `t `� 1, � \l% eS (�(�!� relocation t Owner installation:This installation is being don pr that own which is not 200 amps or less 59.36 t r; 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 <_,;® APPISIGANT: D CONTACT PERSON Branch circuits-new,alteration,or extension,per panel i A_Fee for branch circuits tpi/h Business name:`Polygon WLH,LLC above service or feeder fee, ' / 7 42 Contact name N\ /� — each r branchnch circuit 5 1 Y l B.Fee for circuits without 1 Address:10i)0i) �I.r�n c1 ��� lk f-1 1. service or feeder fee,first 56.18 2 6 F�' �`�'L >`L) branch circuit City/State/ZIP:Vancouver,WA 98660 Each add'l branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(360)695-7700 I Fax::(360)693-4442 Each manufactured or modular f Ly) orae dwelling,service and/or feeder 67.84 • 2 Email N �iV 1 v�1! v ! �,r t tCf t C L�II� Reconnect only 67.84 2 "' i Q�;., .. Pump or irrigation circle 67.84 2 Business name:Garner Electric Washington,LLC Sign or outline lighting 67.84 2 Address:402 Valley Ave NW Ste 106 Signal circuit(s)or limited-energy ❑ See Page 2 2 panel,alteration,or extension. City/State/ZIP:Puyallup WA 98371 Each additional inspection overallowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:(253)872-6051 I Fax:(253)872-1801 Investigation(1 hr min) 90.0W hr Email:bdaniels@gweusa.com Industrial plant(1 hr mitt) 78.18/hr Inspections for which no fee is CCB Lic.: C1158 Electrical Lic.: 208174 I Suprv.Lie.: 4496S specifically listed('h hr min) 90.00/hr / ,, - - Subtotal:16LEECTRI AL PERtNIT F]flS Suprv.Electrician signature,required: .,.b:111,/ tom/ A�h.e„c l^ ' �i/oGt �� Print name: Joan P Albert I Date: 0 Plan Review Required(25%of permit fee): --- .._..___>.-- _ ------,...-_--,-........a,_ State surcharge(12%of permit fee): ms �j s, r f Authorized signature: E -C -�__ � :_� TOTAL PERMIT FEE: , '37, /y 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. f Number of inspections allowed per permit. LSBuilding'Perariitnl.0 PeraritApp_ELR nREdoc Rev 06/1712015 440-'l6£5T(£1/O5/CO&I/WE6 ", T , =- / ' e'er ctAi7 /96,z „,,,e,#e e t c- i// j/94404-,c01-74-