Permit Support Document CITY OF TIGARD ELECTRICAL PERMIT
_ * COMMUNITY DEVELOPMENT Permit#: ELC2020-00313
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 / Date Issued: 06/17/2020
TIGARD y Parcel: 1S136AA01202
l•� Jurisdiction:
Site address: 6921 SW OAK ST
Project: Sw oak Subdivision: None Lot: None
Project Description: Wiring for new service and adu. 6/24/20:REVISED to change address.
Contractor: VIKING ELECTRIC INC Owner: CULBERT, PATRICIA LEIGH
4326 SE WOODSTOCK BLVD SUITE 518 HILLMAN, ELIZABETH LUTES
PORTLAND, OR 97206 5000 MACARTHUR BLVD PMV 9914
OAKLAND, CA 94613
PHONE: 503-775-3479 PHONE:
FAX: 503-772-0105
FEES
Quantity Description Date Amount
1 ea Services or Feeders-201 to 06/17/2020 $133.56
Specifics: 400 amps
10 crt Branch Circuits w/Purchase 06/17/2020 $74.20
Type of Use: ADU Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 06/17/2020 $24.93
Electrical
Type of Const: 45 Misc Administration Fee 06/24/2020 $45.00
Occupancy Grp:
Total $277.69
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: Orego 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 2-001-00 You m obtain he rules or • ct questions to OUNC by calling 503.23 87 or 1.800.332.2344./
Issued By: /eif i Permittee Signature: C.. 4: /�
OWNER INSTALLATION ONLY r�
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.