Permit Support Document (38) li ti 1 ' �
CITY OF TIGARD ELECTRICAL PERMIT
X ,, COMMUNITY DEVELOPMENT Permit#: ELC2023-00583
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 9/28/2023
Parcel: 1 S133DC15000
Jurisdiction: Tigard
Site address: 13163 SW TAMERA LN
Project: Eldridge Subdivision: VILLAGE AT SUMMER LAKE PARK Lot: 5
Project Description: Wiring for furnace replacement.10/2/2023 REPRINT:Add(3)branch circuits for lighting.
Contractor: OWNER Owner: ELDRIDGE,CHARLES R AND DEBRA E
13163 SW TAMERA LANE
TIGARD, OR 97223
PHONE: PHONE:
FAX:
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo/Purchase 09/28/2023 $56.18
Specifics:
Service or Feeder
1 ea 12%State Surcharge- 09/28/2023 $6.74
Type of Use: SF Electrical
Class of Work: ALT 3 crt Branch Circuits w/Purchase 10/02/2023 $22.26
Type of Const: Service or Feeder
Occupancy Grp: 0 ea 12%State Surcharge- 10/02/2023 $2.67
Electrical
Total $87.85
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: a -itlaw requires you to follow the rules adopted by the Oregon Utility Notification Center. Those 2�rules are set forth in OAR
952-001-0010 throuah'• ♦!r 1-0090. You ov of the rules or direct auestions to OUNC by callin0 50323;Z,1987 or 00.33z2�44.
4111111111111
Issued By: Permittee Signature:
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.