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Permit CITY OF TIGARD ELECTRICAL PERMIT .' COMMUNITY DEVELOPMENT Permit#: ELC2018_00099 TIC;A It.f) 13125 SW HaII Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/13/2018 Parcel: 2S 106DB 15500 Jurisdiction: Tigard Site address: 13110 SW AUBERGINE TER Project: River Terrace Northwest,Lot 155 Subdivision: RIVER TERRACE NORTHWEST Lot: 155 Project Description: Adding(1)branch circuit for the addition of A/C. 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 Specifics: 1 crt Branch Circuits wo/Purchase 02/13/2018 $56.18 Service or Feeder 1 ea 12%State Surcharge- 02/13/2018 $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 0 952-001-0090. (S . u may obtai .copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. i 4j= — � 5 1 Issued By: ,f Permittee Signature: ' /` GC c -7 ivy 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. Elleetricall PerPliei A 11' f` roorccic c)N�L << 't 13125 SSV Hull Blvd„TigartE,OR 972Received rj y P B 12 2018 Date/II : oC. / ) d` Phone: 503.718 2439 Pax: 503.598.1 /41..........______P auni!N:�G� 96� pian Review / U0� T1CA7Z1) IuspeefionLine; 503.639.4175 •y• Date/8 Interna: Line:: 03.639,4v C�TY OF 1 t M1 D ReadyDate/By: i _ rim .;'.:, I V i V NoHfed/Ivlethod: �pS ie Peg`2 ts�rri•'�, �'�i � '<„�?i"'z; ...; '•a:f;�it�'r�'i 1 l for ® WCO =:.,,:�ec.;;ts>"�f"7i '�.., r�� Tfw ... ..l..;�....':.�. ,,)::.. - Supplemental allnformstion construction [�Addition/alteration/replacement .: .. `•a��.%;""`=°��rY?�:1�4 .•.-�.. _ _ _ D Demolition _ Please check all that apply.. _,.. _ ..p�Vsn•i.. d)` r:" 1 ,,D ;of 0 Other: tsnbmit Z cels of plans w/items checked): :+;,t:=<;.•tA- ..;;,. ❑Service or feeder 400 amps or more .+,`.�;�<<z;tY=.e9rs� , , P ❑Building over three stories. ❑xOt'':l?I� IiC IQI�.}+;T,. t:: where the available fault current Ma I-and 2-family dwelling . _ t"'r ,'1''W•'.`;:".`.:: ` ` ❑Marinas and boatyards, 0 Commercial/industrial .' ;d: exceeds 10,000 amps a 150 volts or C]Floating buildings, 0 Multi-family0 Accessory building less to ground,or exceeds 14,000 0 Master builderamps for ail other installations, build❑Coldings.nal-use agricultural - F,famil: :Jp- y,�,; 0Other: , .: ,.�' :;,+Y' T,1; ORM " ' -•. ❑Firepump, OG'tiT fob#: -"_' ••>QiV , •: fr=:;.; ❑hnslatlatiottof150KVAor ❑Hrnergen¢ysystem' larger 5eprateIy derived Job site address: � S ;r, ix . ❑Addition anew motor load of system. City/State/ZIP:Tigard,OR 97224 mill o01m or more, ❑,A•,•B,„1.2„ 1.3 ❑Six or snore residential units. occupancy. Suite/bldg./apt.#: OIiealut-care facilities, Project name: ,2,: 0 SuppRecrledo ltal a for more than Tr ,` i - Hnzardons locations. Cross street/directions to job site; ❑Supply voltage for more than .. Li Service or feeder 600 amps Torgmore, 600 volts nominal, _ •Descri,Xfimt ����'` .;-` Subdivision: New residential single-ormulti-far t dwelling unit anal '1111 e a ' k i(A 'S•-¢ Lot if: .includes attached garage. Tax map/parcel#: :3.:-• a%:`. ::],?'ip:-.M1. -.- :Irsns ,:` 1,000 sq,ft,or less :. `' t!**I ti '<1Q?t Q1. Ba.add'I energy, sq.residential 111111.32111111111111 �i TC ` portion ief L. %.vi d energy,.,ft widraboves.,tt, ■ 75.00 -e • p }{D?� Limited energy,multi-family 1i'r•�,4}•�c twV.`0.,. 311?' i.©,.,`�- i.�. ;"ia^,•r:.•. - � %'r:`: :`l}c::tri residential with above s.,$, il 75,00 IMO �+ = =:'i%[ i=??p.NT%`< ,i`, Renewablolrner: ❑ See Pa;e/ —■ a ,,. ._ r Services or feeders installation,alteration and/or relocation Addrea 1 ,i 1 Oa e, 200 amps or less - 201 amps to 400 amps 100.70 _© City/State/ZIP:' - IN 133,56 MID �,� tLZ"3 C� „ 901 amps to 600 amps - Phone �3 C. 200.34 _© t D - - Fax:( ) 601 amps to 1,000 amps 301.04 �© Email: Over 1,000 amps or volts 11111111=111111113Owner installation:This installation is being made on property that I own which is not 200 amps otr less vices or feeders installation,alteration,and/or Teocation intended for sale,lease,tent,or exchange,according to ORS 447,449,670,and 701, Owner signature; 201amps to ®=© D 400 amps 125.08 y;Osvn✓rr signature: y r; ► rc'.S..„ :.,:: , ::l;; ;r. ::,>; - ate: 401 amps to S99 amps .., ., 0.., t8.54 11111111E1 . . 16on r; 'i�";,;.a ii`;;:y;i a: t.>C N n"; A.pee circuits- Business name:Polygon 7:'.",, p-'• eTri .O1V';`: i;s: new alteration or extension, ,er aanel Yg WLH LLC A.Pee for branch circuits nee, Contact name; E above branch or feeder fee, v®■1 / ,,� ,� each branch circuit Address: 9 B.Fee for branch circuits without A��+1 0 service or feeder fee,first City/State/ZIP:Vancouver,WA 98660 branchciranc ®�© Phone:(360)695-7700 Bach add'1 branch circuit - Fax: EM 13 :(360)693-4442 141iscellnueous service or feeder not included Email 1 � Each manufactured or modular IIIIIIIIII a- `d`( { fit d e ,se r:E rrnl �" ;'"t `l : t) FF (3t s w]lin: rviceund/orfeeder ��© :. Q� %H4 }., tmi nnect only - L3uSIhesS name: �.iii...:.a. :�:,.r-.1:�,:1;r;>x3.-.r,;;i.4s:i:;i":'i�l' ''`c�; Garner Electric Washington,LLC Pump or irrigation circle - 67,84 �© Address:402 AveSign or outline lighting 67 89 �� *Valley NW Ste 106 Signal circuit(s)or limited-energy City/State/ZIP:Puyallup WA 98371 'anal,alteration,or extension, ❑ See Page 2 -ge 1 Each additional ins.action over allowable in any of the above minsi Phone:(253)872-6051 Additional inspection(1 hr min) Fax:(253)872-1801 Email:bdaniels Investigation(1 hr min) all9Q®�. @gSYeusa.cOm Industrial phut(1 hr min) CCB Lie.: C1158 Electrical Lic,: 208174 Inspections for Which no fee is 11111111103111111111111 Suprv.Electrician Suprv.Lie.: 44965 s Meal! listed VA Iran 90.00/hr �11 i signature,required: ` O. vX:., ,.; ; I Print name: Joan P Albert • w �• 1 .�'.''�' '" !.�`�•i.' Date: Subtotal: —>i_ 0 Plan Review Required(250 of permit fee): Authorized signature: .r•� ��, , State surcharge(12%ofpermit fee): 111111111111111 TOTAL PERMIT FEB: IMMO thin Iso Print name: Bill Daniels This pormit npplicntion expires if a permit is not obtained wi, Date: 11BuildinatparmifslEt C pennitApp_III R BIUs.dvo Rev 06/11/2015 bays after it has been accepted as complete, • Number of inspections allowed per permit. j 440.4615T(11/05/COMfIwaE City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 13110 SW AUBERGINE TER, SHERWOOD, February 15, 2018 at OR, 97140 12:12:15 PM Record Type: Record ID: Residential - Electrical ELC2018-00099 Inspection Type: Inspector: 199 Electrical final Aaron Cillo-Gobel Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor