Permit Support Document 'Nki NsufN ue"AilsidiillhfruiifauuriYt4YlaF.:. :."rn i11s::. SitutfH lulil.ti }uifillfl i t "sekaiourrulYaa.i
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CITY OF TIGARD ti� Z' `Zt ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELR2021-00111
Date Issued: 10/1/2021
TIGARD 13125 SW Hall Blvd,Tigard OR 97223 503.718.2439 Parcel: 2S 101 AD00100
Jurisdiction: Tigard
Site address: 12725 SW 66TH AVE 201
Project: 6908 MSP Accounting Subdivision: WEST PORTLAND HEIGHTS Lot: 9
Project Description: Add 12 data locations in suite 201
Contractor: TRITON COMMUNICATIONS, LLC Owner: MILLER, RICHARD ALAN TRUST
PO BOX 1091 50 VULCAN STAIRWAY
HILLSBORO,OR 97123 SAN FRANCISCO, CA 94114
PHONE: 503-615-5800 PHONE.
FAX: 503-628-5689
FEES
Quantity Description Date Amount
1 ea Restricted Energy Permit 10/01/2021 $75.00
Specifics: 1 ea 12%State Surcharge- 10/01/2021 $9.00
Electrical
Type of Use: COM 45 Misc Administration Fee 10/25/2021 $45.00
Class of Work: ADD
Type of Const:
Occupancy Grp:
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 throuah OAR 952-001-0090. You may obtain a coov of the rules or direct ouestions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Hou,y Va.w De,We.ye, Permittee Signature: Ow Apri,i44.4-Eavt.
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'N 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.