Permit Support Document CITY OF TIGARD ELECTRICAL PERMIT
a ELECTRICAL
ELC2022-00512
COMMUNITY DEVELOPMENT
T f G AP T) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 8/1/2022
Parcel: 1 S 136DD03800
Jurisdiction: Tigard
Site address: 11675 SW 66TH AVE
Project: Mountain wood homes office Subdivision: WEST PORTLAND HEIGHTS Lot: 4-8&27
Project Description: Tenant improvement: REPRINT address corrected.
Contractor: MOUNTAINWOOD HOMES INC Owner: TANGLEWOOD DEVELOPMENT LLC
frit
PO BOX 2257 ATTN WOOD, ROBERT
BEAVERTON, OR 97075-2257 8324 SW NIMBUS AVE
BEAVERTON, OR 97008
PHONE: 503-746-7338 PHONE:
FAX:
FEES
Quantity Description Date Amount
42 ort Branch Circuits wo/Purchase 08/01/2022 $360.40
Specifics: Service or Feeder
1 ea Signal circuit or Limited 08/01/2022 $75.00
Type of Use: COM Energy Panel
Class of Work: ALT 1 ea 12%State Surcharge- 08/01/2022 $52.25
Type of Const: Electrical
Occupancy Grp: 45 Address Fee 11/17/2022 $45.00
Total $532.65
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 0 952-001-0090.� ou��r\ mjfv oyt n a coov of the rules or direct auestions to OUNC by callina 503.232.1987 or 1.800.332.2344
Issued By: �1 C '„� W` l - Permittee Signature: -�' G\‘ i
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale,lease or rent.
OWNERS 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.