Permit (16) CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2019-00671
T[G A R.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/07/2019
Parcel: 2S107AA25600
Jurisdiction: Tigard
Site address: 14301 SW RIVER TERRACE BLVD
Project: Polygon at Roshak Ridge Neighborhood Park Subdivision: ROSHAK RIDGE Lot: N
Project Description: Installing(1)200 amp meter for park irrigation controller.
Contractor: ALAMEDA ELECTRIC Owner: POLYGON WLH LLC
3415 NE 44TH 703 BROADWAY ST SUITE 510
PORTLAND, OR 97213 VANCOUVER, WA 97223
PHONE: 503-319-2192 PHONE: 360-695-7700
FAX:
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 10/07/2019 $100.70
Specifics: amps or less
1 ea 12%State Surcharge- 10/07/2019 $12.08
Type of Use: Electrical
Class of Work:
Type of Const:
Occupancy Grp:
Total $112.78
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 • follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR,. m 1-0090. You ma `.tain a cop�• •- . -s or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: it� / .� mittee Signature: rr w / /'GbGd /
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.
RCLIEIVED
A . i" ,,Electrical Permit Application t rs IOR OFFIcTusEOrf-,-
i4"
.: .r..a-'. '.�'`k `
:'tom ` City of TigardOCT47
3 2019 DateBLd .��
'� 13125 SW Hall Blvd.,Tigard,OR 9 Plan Review /
Phone: 503.718.2439 Fax: 503 . X90/ OF r�GA�o Date/13 : fif]i
TIGARDI Inspection Line: 503.639.4175 LDING DIVISION Ready Date/By: Allis: 63 See Page 2for
aa-...'G''.'Do. Internet: www.tigard-or.gov "�'��V 11 Gid? Notified/Method: Supplemental Information
TYPE OF.WORK . -
®New construction ❑Addition/alteration/replacement Please check all that apply(submit2 sets of plans w/items checked):
0 Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition ❑Other.
• where the available fault current 0 Marinas and boatyards.
.:`)r';''' '=- ' •-CATEGORY._OF:CONSTRUCTION „-•,: : ..,,'- '....i-,. exceeds 10,000 amps at 150 volts or 0 Floating buildings.
® 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
0amps for all other installations. buildings.
Multi Tamil
y 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
._s n,'• JOB SITE iINF.ORMATION.'AND LOCATION•';?i- 0 Emergency system. larger separately derived
kc so bvoe,teg 13l-V� 0 Addition olmoew motor load of system.
Job#: Job site address: `1 Ch, mole or more. ❑"A^,"E","1-Z","1-3",
City/State/ZIP:Tigard,OR 97224 ❑Six or more residential units. occupancy,
0 Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Polygon At Roshak Ridge 0 Hazardous locations. 0 Supply voltage for more than
-
0 Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site , M'(N) 1 I yea FEE SC IRDIJLE• ..
Description I Qty. I Each I Total 1 *
New residential single-or multi-family dwelling unit.
Subdivision:Polygon at Roshak Ridge Lot#: Includes attached garage.
�„ 1,000 sq.ft.or less 168.54 4
Tax map/parcel#: Ea.add'l 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK '' Limited energy,residential
�j' (J� N, y (with above sq.ft.) 75.00 2
` ' �� �' "`r VlP Q "' Limited energy,multi-family
t RRA G 0.t- `+ �+ r' 0l l R_ residential(with above sq.ft) 75.00 2
Pal \ Renewable Energy 0 See Page 2
®.PROPERTY OWNER-•.,`_ 0 TENANT- Services or feeders installation,alteration,and/or relocation
Name:William Lyon Homes,Inc. 200 amps or less , 100.70 2
Address:703 Broadway St Suite 510 201 amps to 400 amps 133.56 2
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:(360)693-4442 Over 1,000 amps or volts 552.26 2
Email: 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 ee. 59.36 I
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:William Lyon Homes,Inc. above service or feeder fee,
7.42 2
each branch circuit
Contact name: P - ucm 0 B.Fee for branch circuits without
Address:703 Broadway St Suite 510 rance rfut fee,first
branch circuit 56.18 2
b
City/State/ZIP:Vancouver,WA 98660 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(360)695-7700 Fax::(360)693-4442 Each manufactured or modular 67.84 2
Email: {�`,&c �T A,,, , dwelling,service and/or feeder
`J � � �'�qq, �,"' �S' wY v , Reconnect only 67.84 2
CONTRAC'P9Y Pump or irrigation circle 67.84 2
Business name:Alameda Electric Sign or outline lighting 67.84 2
Address:3415 NE 44th Signal circuit(s)or limited-energy See Page 2 2
panel,alteration,or extension.
City/State/ZIP:Portland,OR 97213 Each additional inspection over allowable in any of the above
Additional inspection(I hr mut) 66.25/hr
Phone:(503)319-2192 Fax:( ) Investigation(1 hr min) 90.00/hr
• /( `.. Induscrionsfot(1 Armin) 78.18/hr
Email:solarpdx@me.com CO
I / Inspections for which no fee is 90.00/hr
CCB Lic.: 199188 Electrical Lie.: c923 Suprv.Lic.: 48715 specifically listed(%hr min)
. - ' ELECTRICAL PERMTT FEES
Suprv.Electrician signature,required: Subtotal:
Print name: Kilo Rood Date: 03/08/2019 0 Plan Review Required(25%of permit fee):
- State surcharge(12%of permit fee):
Authorized signature: f�" -"� TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Kile Rood Date: 03/08/2019 days after it bas been accepted as complete.
* umber of inspections allowed per permit.