Permit CITY OF TIGARD ELECTRICAL PERMIT
''- Permit#: ELC2020-00432
..- COMMUNITY DEVELOPMENT
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 9/3l2020
TIGARD Parcel: 2S 103DA05700
Jurisdiction: Tigard
Site address: 10634 SW COOK LN
Project: Sholes Subdivision: FANTASY HILL Lot: 11
Project Description: To get inspection for work done w/o permit for bathroom conversion
Contractor: OWNER Owner: SHOLES, LANCE M &KRISTIN A
LANCE & KRISTIN SHOLES 106334 SW COOK LN
10634 SW COOK LN TIGARD, OR 97223
TIGARD, OR 97224
PHONE:
PHONE: 503-307-7577
FAX:
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo/Purchase 09/03/2020 $63.60
Specifics: Service or Feeder
1 ea 12%State Surcharge- 09/03/2020 $7.63
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $71.23
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. Thi .ermit 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 952-001-0090. Y. obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987�/87 or 1.800.332.2344.1.� / r,/
Issued By: ��'li,' / Permittee Signature:
�/u /7/�PG`C UN
OWNER INSTALLATION ONLY
The installation is being made on. .perty 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.