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Permit CITYIGARD O F T ELECTRICAL PERMIT 114-. - COMMUNITY DEVELOPMENT Permit#: ELC2018-00454 Date Issued: 07/09/2018 T I G A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S106D623700 Jurisdiction: Tigard Site address: 17390 SW SABRINA AVE Project: River Terrace Northwest Swim Center Subdivision: RIVER TERRACE NORTHWEST Lot: X Project Description: Installing(1)200 amp service panel and(3)branch circuits for meter base&pole for irrigation beside swim center. Contractor: GARNER ELECTRIC WASHINGTON LLC Owner: RIVER TERRACE COMMUNITY CENTER A 402 VALLEY AVE NW,SUITE 106 109 E 13TH ST STE 200 PUYALLUP,WA 98371 VANCOUVER,WA 98660 PHONE: 253-872-6051 PHONE: 602-694-4031 FAX: FEES Quantity Description Date Amount 1 ea Services or Feeders-200 07/09/2018 $100.70 Specifics: amps or less 3 crt Branch Circuits w/Purchase 07/09/2018 $22.26 Type of Use: COM Service or Feeder Class of Work: ALT 1 ea 12%State Surcharge- 07/09/2018 $14.76 Electrical Type of Const: Occupancy Grp: Total $137.72 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: Oregonr ���-w requires yo� to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OA001-009' ou y obtain a co!,/of the rules irect questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: 466--/..6.-Ai4 Permittee Signature: 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 Application s ,.. ,— FOR OFFICE LSE ONLy 'v` '`-- ?:— Received City of Tigard DateB �� Permit#:-` •f t -'6,X) i I u 13125 SW Hall Blvd.,Tigard,OR 97223 /t Phone: 503.718.2439 Fax: 503.598.1960 JULJ Ut'. 10 DateB V1ew Related Permit#: Inspection Line: 503.639.4175 I - Ready Date/By: Juris: H See Page 2 for TIGARD Internet: www.tigard-or.govE. Notified/Method: Supplemental Information W9.... 27.. 2; l ,ill.. �� pL . �� ID New construction WAddition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): D Demolition ❑Other: ❑Service or feeder 400 amps or more ❑Building over three stories. where the available fault current ❑Marinas and boatyards. t, 4,hi,.. % ,,, 424TEGORY OE, 010TRUCTIOIWI,p/)%A, ,; ,, „ exceeds 10,000 amps at 150 volts or 0 Floating buildings. ❑ 1-and 2-family dwelling Commercial/industrial D Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family ❑Master builder 0 Other: ❑Fire pump. El Installation of 150 KVA or �, " ❑Emer enc system. lar er se aratel derived .�Q)�,'�X�' INF '� i,�;', Q�'�r�TT �I �`..: g Y Y g P Y Job#: Job site address: 1 7 3 l b A $ AQ Rue ❑Addition of new motor load of 0 system. V iQ I /t v y 100HP or more. "A","E","1-2" "1-3" ❑Six or more residential units. occupancy. Clty/State/ZIP: ❑Health-care facilities. ❑Recreational vehicle parks. Suite/bldg./apt.#: Project name: �) �'VT �}(,� ❑Hazardous locations. 0 Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: M a SCHEDULE ,. Description I Qty. I Each I Total I * New residential single-or multi-family dwelling unit. Subdivision: N W k1 j E r Lot#: Includes attached garage. L 1,000 sq.ft.or less 168.54 4 Tax map/parcel# j; Ea.a 500 sq.ft.or portion 33.92 1 ....,s ., -••, ,,, �!,,,.,,. Limited energy,residential /ev3 Ol I A 5e 0-PO LE frit �nr`, TIO 1 (with above sq.ft.) 75.00 2 IJ /���T.� rpx I` f0�, ��+ Limited energy,multi-family 75.00 2 f5e4'®e 51,/!)N& CC,r 1` residentiaRenewablelEnergy above sq.ft.) 0 See Page 2 i ' lOPERTY OWN R ,` , , Services or feeders installation,alteration,and/or relocation Name: A D v L (,Aiv.e. (.1, _iO,63/ (.SLC 200 amps or less ' 100.70 2 Address: 7 G('7 c P o I)o(,Es r" ,W 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP: 5C. 17YO4'LF //�q, 45 cl SF 601 amps to 1,000 amps 301.04 2 Phone:(6962) GR Y C'D3 t / 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 j\ OIR5©1Branch circuits-new,alteration,or extension,per panel � T " kr A.Fee for branch circuits with Business name: ebt-I&ON GI H (-Lc above service or feeder fee, 3 7.42 2 each branch circuit Contact name: T&rwk D I C_14,V1 JD B.Fee for branch circuits without Address: ibet F7R Sr service or feeder fee,first 56.18 2 /3 branch circuit City/State/ZIP: V4NcOV IJ6' , ',(/4 t $I(o0 Each add'l branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(5-63) 5-7 7 11(60 Fax: :( ) Each manufactured or modular dwelling,service and/or feeder 67.84 2 Email: IbM b DiC/4NNO ePVL.y oNHorNer.cc Reconnect only ,67.84 2 'Fi,�.�,TRA 'OR4��:•. Pump or irrigation circle 67.84 2 j Business name:6q /lel' 5Iec4n e_ 6F- was 111-1/07\._ Sign or outline lighting 67.84 2 ,` n /� /1/14) �/ 1 tf( _• ` Signal circuit(s)or limited-energy El See Page 2 2 Address: /-/b Z Y u(/e t/ /%itC /v s't4 f T e- /0 p panel,alteration,or extension. g City/State/ZIP: u�/4/jie� 9{�� 7/ Each additional inspection over allowable in any of the above 0 Additional inspection(1 hr min) 66.25/hr Sc3) S'7 Z - (�o 5 / ( f5) x'72 — f$ g ( ) Phone: Fax: Z 0 I Investi anon 1 hr min 90.00/hr Email: J 14EN500 4 WA Col" Industrial plant(1 hr min) 78.18/hr ZO 5 Inspections for which no fee is 1 CCB Lic.:le fe / Electrical Lic.:. Suprv.Lic.: '- specifically listed(%hr mm)EL90.00/hr /� tib�r � p xr:�Z.�--�- Suprv.Electrician signature,required:/ /4"''I'� ECTR 4� FEES f, V;/"...----' Subtotal: Print name:RE'5.5 el 1 Ai i:("i O( N. Date: 7 -1--6- 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): '- TOTAL PERMIT FEE: Authorized signature: ..." This permit application expires if a permit is not obtained within 180 Print name: / h 4., P jC./A,/4/.44o Date: 111111 days after i ihas been accepted as complete. * Number of inspections allowed per permit. t_\Building\Permits\ELC PermitApp_ELR_ERE.doc Rev 06/17/2015 4415T(11/05/COM/WEB