Permit (20) CITY OF TIGARD ELECTRICAL PERMIT
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~■ COMMUNITY DEVELOPMENT . Permit#: ELC2018-00306
Date Issued: 06/06/2018
T f 1.1 Ail f-: 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S1060001400
Jurisdiction: Tigard
Site address: 17077 SW APPLEDALE RD
Project: River Terrace East Apartments,Building B Subdivision: RIVER TERRACE EAST Lot: None
Project Description: Building B: Electrical for new 22 unit apartment building.
Contractor: THREE PHASE ELECTRIC Owner: POLYGON WLH, LLC
11490 SE JENNIFER ST 703 BROADWAY ST, SUITE 510
CLACKAMAS, OR 97015 VANCOUVER,WA 98660
PHONE:
503-760-8522 360-695-7700
FAX: 503-762-1823
FEES
Quantity Description Date Amount
1244 sf Permit Fee-Elect(SF or 1st 06/06/2018 $202.46
Specifics: MF dwelling unit)
2126 Each Add'I Unit(Multi-Family) 06/06/2018 $2,125.83
Type of Use: MF 1 ea Limited Energy 06/06/2018 $75.00
Class of Work: NEW 1 ea Services or Feeders-200 06/06/2018 $100.70
Type of Const: amps or less
30 crt Branch Circuits w/Purchase 06/06/2018 $222.60
Occupancy Grp: Service or Feeder
1 ea Plan Review Electricial 06/06/2018 $681.65
1 ea 12%State Surcharge- 06/06/2018 $327.19
Electrical
Total $3,735.43
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 OA 952-001-0090. 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: ✓./ L��. Permittee Signature: g—C C-- 617fif
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.
911(
Electrical Permit Applicati ECEIVED FO12 oil wE: i.SF ONL.1
Received y� s
City of Tigard Date/By:v // /t •/ P-, it# L`, 1P etij j
114 q 13125 SW Hall Blvd.,Tigard,OR 9722MAY 9 2018 ��'
Plan • , •elated Permi /� �e7a 0
16 Phone: 503.718.2439 Fax: 503.598.1960 Date/By:
16 t � 7w;s: ® See Page t for
1 1 v A R ll Inspection Line: 503.639.4175 CITY OF11GRAD Notafi Date/By:
(v�// A ,��
Internet: www,tigard-or.gov BUILDING DIVISION Supplemental Information
TYPE OF WORK 4/L /t//Adfc'GE-FLAN REVIEW
®New construction 0 Addition/alteration/replacement
Please check all that apply(submit 2 sets of plans w/items checked):
®Service or feeder 400 amps or more 0 Building over three stories.
oDemolition 0 Other: where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
less to ground,or exceeds 14,000 0 Commercial-use agricultural
El1-and 2-family dwelling ❑Commercial/indusMal 0 Accessory building amps for all other installations. buildings.
®Multi-family 0 Master builder ❑Other: 0 Fire pump. ❑Installation of 150 KVA or p
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
❑Addition of new motor load of system. tt
Job#: Job site address: /70 7:1 _5" ,i ,,3'i 4._.S,9-4F rS 100HP or more. ❑"A","E","1-2","1-3",
El Six or more residential units. occupancy.
City/State/ZIP:Tigard,OR 97224 ❑Health-care facilities. 0 Recreational vehicle parks. 1^
Suite/bldg./apt.#: Project name:River Terrace East
0 Hazardous locations. ID Supply voltage for more than
,�e727n /',7S ®Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site:Roy Rogers FEE SCHEDULE ,
Description I Qty. I Each I Total I * q
New residential single-or multi-family dwelling unit.
Subdivision:River Terrace East BLDG B Lot#: Includes attached garage. t
• I
1,000 sq.ft.or less _ 1 J 168.54 168.54 14
Tax map/parcel#: Ea.add'1500 sq.ft.or portion -/ .I3 7.1 i_x,3,7,`,2 1
-
F
K
New 22-unit building DESCRIPTION �WO�n2��-f! - ���. �� ����L��*41/•::ls% �/ �L!f 2,� �/;�5�;�3
of
g O Limited energy,multifamily 1 75.00 75.00 2
Largest unit=1244 square feet 0,./)
'� ,)lhrv'//3� ,Z. elf- •s-� _� /o f.01.3 residential(with above sq.ft.)
/ Renewable Energy 0 See Page 2
® PROPERTY OWNER 0'TENANT Services or feeders installation,alteration,and/or relocation
Name:Polygon WLH,LLC 200 amps or less 1 100.70 100.70 2
201 amps to 400 amps 133.56 2
Address:703 Broadway st Suite 510 401 amps to 600 amps 200.34 2
City/State/ZIP:Vancouver WA 98660 601 amps to 1,000 amps 301.04 2
Phone:(360)695-7700 Fax:( ) Over 1,000 amps or volts 552.26 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 59.36 1
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
APPLICANT ❑ CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name:Polygon WLH, LLC above service or feeder fee, 30 7A2 222.60 2
each branch circuit
Contact name:Nichole Thorpe B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Address:703 Broadway St Suite 510 branch circuit
Each add'1 branch circuit 7.42 2
City/State/ZIP:Vancouver,WA 98660 Miscellaneous(service or feeder not included)
Phone:(360)695-7700 Fax::(360)693-4442 Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email:Nichole.Thorpe@polygonhomes.comReconnect only 67.84 2
. CONTRACTOR Pump or irrigation circle 67.84 2
Business name:Three Phase Electric Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy ® See Page 2 75.00 2
Address: 11490 Se Jennifer St panel,alteration,or extension.
Each additional inspection over allowable in any of the above
City/State/ZIP:Clackamas,OR 97015 Additional inspection(1 hr min) 66.25/hr
Phone:(503)908-8058 Fax:(503)762-1823 Investigation(1 hr min) 90.00/hr
Industrial plant(1 hr min) 78.18/hr
Email:permits@threephaseelectric.com Inspections for which no fee is
90.00/hr
CCB Lic.: 162368 Electrical Lic.: 3-332C Suprv.Lic.: 3398S specifically listed('A hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Z4// ,wubia-e.--4Subtotal: 557
Print name: Dennis Welch Date: 05/03/2018 El Plan Review Required(25%of permit fee): 3 .42
State surcharge(12%of permit fee): 1 . 2
j TOTAL PERMIT FEE: 139.
Authorized signature: �I te.---
This permit application expires if a permit is not obtained within 180
Print name: Robert Lane Date: 05/03/2018 days after it has been accepted as complete.
Number of inspections allowed per permit.
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(lI/05/COM/WEB
Electrical Permit Application–City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
Fee for all residential systems combined: $75.00 nese Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
[1 Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva(fee in accordance 552.26 2
with OAR 918-309-0040)
E Heating,Ventilation and Air Conditioning
* Solar generation systems in excess of 25 kva:
System
Each additional kva over 25 7.42 3
H Vacuum Systems* >100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
n Other: Each additional inspection is 66.25/hr I
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed(%2 hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 Subtotal(Enteron Page 1):
(SEE OAR 918-309-0000) * Number of inspections allowed per permit.
Check Type of Work Involved:
E Audio and Stereo Systems
❑ Boiler Controls
n Clock Systems
® Data Telecommunication Installation
E Fire Alarm Installation
(� HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
[—I Landscape Irrigation Control*
❑ Medical
—I N• urse Calls
❑ Outdoor Landscape Lighting*
Fl P• rotective Signaling
Li Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
1:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
17077 SW APPLEDALE RD, SHERWOOD,
OR, 97140
Record Type: Record ID:
Commercial - Electrical ELC2018-00306
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor