Permit Support Document CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
III COMMUNITY DEVELOPMENT Permit#: ELR2021-00006
Date Issued: 1/15/2021
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S112AC01900
r I , Jurisdiction: Tigard
Site address: 14941 SW 72ND AVE �t.
Project: Rose City Confections y if /y Subdivision: FANNO CREEK ACRE TRACTS Lot: 47
Project Description: Install Low Voltage
Contractor: ADVANCED COMMUNICATIONS SERVICES INC Owner: HONEY LLC
8184 SW DURHAM RD LGH II LLC
TIGARD, OR 97224 9400 SW BARNES RD STE 400
PORTLAND, OR 97225
PHONE: 503-598-7082 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Restricted Energy Permit 01/15/2021 $75.00
12%State Surcharge-Electrical 01/15/2021 $9.00
Misc Administration Fee 04/20/2021 $45.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio&Stereo: N
Security Alarm: N
Garage Door Opener: N
HVAC: N
Vacuum System: N
Other: N
Other Desc: Total $129.00
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. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1,800,332.2344.
Issued By: �' G-�� f- Permittee Signature: �1{
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.