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Permit CITY OF TIGARD ELECTRICAL PERMIT r711 Permit#: ELC2018-00027 COMMUNITY DEVELOPMENT T[CGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/16/2018 Parcel: 251060001500 Jurisdiction: Tigard Site address: 13464 SW BEACH PLUM TER Project: River Terrace Northwest, Lot 201 Subdivision: RIVER TERRACE NORTHWEST Lot: Multiple Project Description: Adding(1)branch circuit for NC. 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 crt Branch Circuits wo/Purchase 01/16/2018 $56.18 Specifics: Service or Feeder 1 ea 12%State Surcharge- 01/16/2018 $6.74 Type of Use: Electrical Class of Work: 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 9 -001-0090. Y u may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. [ Issued By: Permittee Signature: S'TL_ .1(0/leo-7 ?! 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. m w a xu.t�r�yuao�wu•R il -1 ^Pr—1TT ^ Ct t y o,�'riga-d J A d 1 2 2018 Itecflryed / - -. r 13125 SW Hall Blvd.,Tigard,OR 97223 17 rte/By: !/ (/ ��� Permit!f: �` �� ^� �- r] Phone: 503,718.2439 Fax: 503,59 .W e. 1 Date Review j t��- 3 i�h,•�,''-i,!�� LlatelB ; Related Permit!1; r '1 Inspection Line: 503.639.4175 .l./ J, , .�t; l.R•1)j 1 ^� : , Ready Pate/By: ,lexis: See Pa�a 2 far Internet: www tigard or gov U J L O s j'ij ,1 L.b V S 0' Notified/Method: k S r �(�U OIt„WORTS metttnllnfonmatson uttpple 1J New construction 0Additioll/atteratiotr/replacement Please check all that apply(submit 1sets ofplans villeins checked,) 0 Service or feeder 400 amps or more 0 Building over three stories. ❑Demolition ❑Other: t r> where the available fault current Marinas and boatyards, s t.'.:4}, 10::",OlY.Oji CONST22TIC,I7�. ;'�” _ :r=s;:: exceeds 10,000 amps at 150 volts or 1 +.1-and 2-familydwelling � . ,: `. ' 0 Floating building ❑Commercial/industrial Accessory building less to ground,or exceeds 14,000 [a Commercial-use agricultural ❑Multi-family builder amps fir all other installations, buildings. ❑Other: 0 Fire pump, 0Installation of 150 KVA or .<. dB<kS E PINI OR1k ATION AlVU I-16-4 IOPI ©Etnergency system. larger separately derived Job 4: Job Site address:I ?t # i 0 Addition of new motor load of system. F `' , co- (., Pi •e"` , e 100Iiiyormore. D..A„«Ev .<1-2»"1-3 >, City/State/ZIP:Tigard,OR 97224 °Six or more residential units. occupancy, Suite/bldg./apt. i1 °IIeahl)-care facilities, °Recreational vehicle parks. : s Project name: ,r T1.,,rc r,��r t�\o. 1 0Hazardous locations. O.Su 1 voltage for more than. �IV� 1111 t s-A.� .. t Vt,rt S>:`1,w ti- G00 volts ttorninat. Cross street/directions to job site: ❑Service or feeder b00 amps or mora, PP s ,A I?11 4C10(JGF` Deesri,Hon ar �, Taint "-_ —• New residential single-or multi-family dwelling unit. Subdivision:iZ-l\1er -'e)r&ce, t)br-k b1,Wec-- ) Lot it: " ,) Includes attached garage. s000, 1 Tax map/parcel# q.ft.or less 11 1 68 54 II -- Ea.add'1500 sq.ft.or portion 33.92 *;$0041:0. oto:wozz>rr.::. ,.., .._. ,. ,:.. Limited energy, •':: '" ' gY,residential (with above sq.ft,) 75.00 Limited energy,multi-family residential(with above sq.ft.) 75,00 +`t a??f Ol?1;R1I1"Ot�ULVLt� RenewableEnct a .-.a _ ., . . .:.W(:1.` :0IM1Ix.:.. . Cl See Pa e2 ""' Services or feeders installation,a[terat9on,and/or relocation Name: s`1� 200amps or less n �-•. 100.70 2 Address:�`V/O0 Gil,A1 a)' a ► f 201 amps to 400 amps 133.56 2 City/State/ZIP:' ^p, ! r s 401 amps to 600 amps 200.34 2 t‘,00, qlJ .r _ . tr 601 amps to 1,000 amps 301.04 2 Phone:\V V `L9"t-1 4031 Fax:( ) Over 1,000 amps or volts 552.26 2^ Email: V 1 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 59.36 intended.for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701, 201 amps to 400 amps 125.08 Eii Owner signature: Date: 401 amps to 599 amps 168.54 Q x. _ ' `;'�"r,F .-,e1 -fit ;LY •.,r .,._ ..,.', mr 46:to SpT circuits Branch circui —new,alteration,or extension,per panel Business name:Polygon WLI1,LLC ' • A.Pee for branch circuits arid: above service or feeder fee, 17 42 Contact name: ` (e. each branch circuit A 0 I B.Fee for branch circuits without Address deiservice or feeder fee,first _ 4r 0 branch circuit 56.18 2 City/State/ZIP:Vancouver,WA 98660 Each add'i branch circuit 7.42 2 Phone:(360)695-7700 Fax::(360)693 9442 Miscellaneous(service or feeder not included) Each manufactured or modular Email: dwellin: service and/or feeder G7. 4 • 2 C A1111.110/Cit} s q (" , i/i1� ' Reconnect only riu„,...R"'a;' � ,� 1•. 'l. z 67.84 2 r tib?, ,i�...t r _„: I .V... ?s ,..-r„aft }:.:,:'°,. I: , ., Pump or irrigation circle 67.84 2 Business name:Garner Electric'Washington,LLC Sign or outline lighting _ 67.84 _© Address:402 Valley Ave NW Ste 106 Signal circuits)or limited-energy 0 gee Page 2 2 panel,alteration,or extension. City/State/ZIP:Puyallup WA 98371 Each additional inspection over allowable in any of the above Additional inspection(11]r rain) _ 66,25/hr Phone:(253)872-6051 1 Fax:(253)872-1801 Investigation(1 g hr min) 90,00/hr Email:bdaniols@gwensa.com Industrial plant(1 hr min) 78,18/hr II Inspections for which no fee isII CCB Lie.: C11S8 Electrical Lie.: 208174 I Suprv.Lie.: 4496S 'Beall listed 14 hr min ■ 90 00/hr Suprv.Electrician signature,required: ELECTRICAL ['1 i1V 19tiGt rl ! � Subtotal: Print name: Joan P Albert • I Date: 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): Authorized signature: L____4000° TOTAL PERMIT FEE: Print name: Bill Daniels This permit npplicaliec expires ifs permit is notohtained�rifhin 180 Date: clays aneritls si been accepted ss complete. Number of inspections allowed per permit, L18aildinglPeratits\ELC AcanitApp ELkHRn.dee ken 06/17/2015 440-06i 5T(11/05/COtvrllvEa