Permit CITY OF TIGARD ELECTRICAL PERMIT
N ......
1 ` COMMUNITY DEVELOPMENT Permit#: ELC2019-00419
I t;A R f7 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/25/2019
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Parcel: 2S115AB01400
Jurisdiction: Tigard
Site address: 16309 SW 113TH AVE
Project: Willow Brook,Lot 20 Subdivision: WILLOW BROOK SUBDIVISION Lot:
Project Description: Adding AC.
Contractor: GARNER ELECTRIC WASHINGTON LLC Owner: MISSION HOMES NORTHWEST LLC
402 VALLEY AVE NW, SUITE 106 PO BOX 1689
PUYALLUP,WA 98371 LAKE OSWEGO, OR 97035
PHONE: 253-872-6051
PHONE: 360-573-8081
FAX:
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo/Purchase 06/24/2019 $56.18
Specifics: Service or Feeder
1 ea 12%State Surcharge- 06/24/2019 $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 OAR 952-001-0090. Yo may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: a tt+ ,f/l Permittee Signature: eV/ 1-1 G
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.
1
Electrical Permit Application IIIMIIIIIIMMMIIIIIIMIIIII
PRE:ecaattlemiRvae:view
, SW Tigard,OR 97223
City13125 offiTalilgBalyrdd.,
; II. Phone: 503.718,2439 Fax 503.598.1960
11
Date .(LI'X'A 1Cv C AT Perm"li'.E. -.C''- '\q"'W\''''‘,\,Cit
7
Related Permit a
,TI('A R D Inspection Line. 503.639.4175 ,.„., _ ., Ready Date/By Jun s Fa See Page 2 for
Internet: www.tigard-or:gov H, r ;__ _,1,-,_4strtified/Metliod Supplemental Information
ei New construction 0 Additionialterationirep**e2t 0 2 0 19 Please check all that apply(submit a sets of plans whtems checked).
0 Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition 0 Other ,, - .„_ ,, .. „ where the available faith current 0 Marinas and boatyards
144074,41.44ZZ4140`,(727:77"C`cnrnr4: :',":"A:::7 7.7:w exceeds 10,000 amps at 150 volts or 0 Floating buildings
1-and 2-family dwelling 0 Commerciallindatbat— Mt Al. . , ., ,i(g less tofgroulnd'or exceeds 14,000 0(t- use agricultural
amps oral other
0 Multi-family 0 Master builder 0 Other: 0Fire pump 0 Installation of 150 KVA or
EEzzgi:.:fs:::otor load of isayrsgteerlY denved
Job#: Job site address:tki.'"S.,`‘Ot W t\D-1:11,_ ‘'‘.\,/v , 100HP or more
City/State/ZIP: 0 Six or more residential units oCCiipaIiCy
1 0 Health-care facilities 0 Recreational vehicle parks
Suite/bldg./apt,4: Project name: 0 Hazardous locations 0 Supply voltage for more than
0 Service or feeder 600 amps or more 600 volts nominal '
Cross street/directions to jot)site:
3f2f.riiWSrlZrj,7rZ4O4r,
.....
—
New residential single-or multi-family dwelling unit. ;
Subdivision: Lot 4: C) Includes attached garage. i
1,000 sq ft or less 168.54 4
lax map parcel 4:
. . ,„ ..,...„. . La.add'i 500 sq ft or portion 33 92 1
:::::'1, ,:, ..:..i..'"'...;.:!2:7::!'t;WitirtgaC4VM,V Limited energy,residential
75 00 2
4 (with above soft.)
pe-civi.r
Limited energy,multi-family
2
residential(, ith above sq.ft) 1 75 0°
Renewable Energy 0 See Page 2
fiAttiO;WITiVr55VT4;:.)TA.4.0.$41Cj-i i':te:f- PtS4iVft':'*to. (,-;'":<ikit Services or feeders installation,alteration,and/or relocation
Name: 200 amps or less 007011 2 1
Address: 201 amps to 400 amps 133 56 2
401 amps to 600 amps 200,34 2
City/State/ZIP:
601 amps to 1,000 amps 301 04 2
Phone:( ) Fax:( ) Over 1,000 amps or volts 552.26 i 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 I 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 1
ii3Jt;:l•ftberitt;euictisk-,;new,rctitalteration,ior extension,per panel 1 i
Business name:Pacific Lifestyle Homes
above service or feeder fee, 7 42 2
each branch circuit
Contact name:Permit Coordinator B Fee for branch circuits without
service or feeder fee,first
Address: 11815 NE 99th Street,Suite 1200 ranchh circuit i 56 18 2
City/State/ZIP:Vancouver,WA 98682 Each add'l branch circuit 742 2
Miscellaneous(service or feeder not included)
Phone:(360)573-8081 Fax: :(360)574-6401 Each manufactured or modular 1 67 84
2
dwelling service and/or feeder
Email:permits®buildplh.com '
Reconnect only 67 84 2
MilligieriagrikataPCZU;a1 :11-2:latilafflaW2tellart• Bump or irrtgattoo code ' 67 84 2
Business name:Garner Electric WA LLC Sign or outline lighting 67.84 2
Signal circuit(s)or"mired-energy 0 See Page2 2
Address:402 Valley Ave NW Ste 106 panel,alteration or extension
Each additional inspection over allowable in any of the above
City/State/71P-Puyallup,WA 98,371
Additional inspection ft hi-inim 66,25/hr
Phone:(253)872-6051 Fax:(253)872-1801 Investigation(1 hr mm) 90 00/hr
Email:cgentele@gweusa.com Industrial plant(1 hr mm) 78 18/hr
Inspections for which no fee is
„. 90 00/hr
CCB Lie.: 208174 Electrical L14;21 158 Suprv.Ijc,..:, _-- 4.,!;:iAVI;4:,,, 244;mmrwf.”.,,,,,,,,tlemmovwconffm,5
,_7 ,,., ,..,_ ,,.., ,..,,,,, ,,, ,, ..,
Suprv.Electrician signature,required: „1/14A....„----"---- %CA A\Ct Subtotal:
Print name: Russell Magnuson -. Date: 0 Plan Review Required(25%of permit fee):
(--7
---) State surcharge(12%of permit fee):
Authorized signature: `FOTAL PERMIT FEE;
X" rafeA
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.
*
Nuanbar of inspootiono allowed per permit,
1\BuildingWermitskELCPermitApp_ELR_EREdoe Rev 06/i 7/2015
1
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
16309 SW 113TH AVE, TIGARD, OR, 97224 June 28, 2019 at 7:31 :20 AM
Record Type: Record ID:
Residential - Electrical ELC2019-00419
Inspection Type: Inspector:
199 Electrical final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor