Permit Support Document lik CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2021-00248
y Date Issued: 5/11/2021
T r G A R u) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 zoU l�•
G 1 Parcel: 1S136DD05300
t7✓� Jurisdiction: Tigard
Site address: 11850 SW 67TH AVE, STE# 110
Project: THRIVE Subdivision: WEST PORTLAND HEIGHTS Lot: 9
Project Description: Tenant improvement-100 amp sub panel and adding lights and outlets
Contractor: WINNER ELECTRIC INC Owner: PNWP LLC#2
17087 SE WILEY WAY PNWP LLC
MILWAUKIE, OR 97267 6600 SW 105TH AVE#175
BEAVERTON, OR 97008
PHONE:
PHONE: 503-638-5028
FAX: 503-638-4242
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 05/11/2021 $100.70
Specifics: amps or less
8 crt Branch Circuits w/Purchase 05/11/2021 $59.36
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 05/11/2021 $19.21
Electrical
Type of Const: 45 Misc Administration Fee 05/12/2021 $45.00
Occupancy Grp:
Total $224.27
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 ns. 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 re i s you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-00 -0 . You ma obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987, �/� ro-r 1.800.332.2344.
Issued By: _ /4' Permittee Signature: #N2l.a/L
OWNER INSTALLATION ONLY
The installation is being de 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.