Permit Support Document t • CITY OF TIGARD ELECTRICAL PERMIT
11 COMMUNITY DEVELOPMENT Permit#: ELC2021-00195
GAR 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Date Issued: 4/14/2021
Tom' Parcel. 2S112AC01900
r f Jurisdiction: Tigard
•
Site address: 14941 SW 72ND AVE 1
Project: TI-New Panel BrAr " j Subdivision: FANNO CREEK ACRE TRACTS Lot: 47
Project Description: Tenant Improvements 200A Panel
Contractor: BULL RUN ELECTRIC INC Owner: HONEY LLC
PO BOX 1147 LGH II LLC
SANDY, OR 97055 9400 SW BARNES RD STE 400
PORTLAND, OR 97225
PHONE:
PHONE: 503-668-4800
FAX: 503-668-5045
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 04/14/2021 $100.70
Specifics: amps or less
15 crt Branch Circuits w/Purchase 04/14/2021 $111.30
Type of Use: COM Service or Feeder
Class of Work: NEW 1 ea 12%State Surcharge- 04/14/2021 $25.44
Electrical
Type of Const:
Occupancy Grp:
Total $237.44
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 a ules or direct questions to OUNC by calling 503.2 2.1987 or 1.800.332.2344.
Issued By: �.�/_ Permittee Signature: t'��/L-e- e
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.