Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit#: ELR2023-00055
Tigard OR 97223 503.718.2439 'T
13125 SW Hall Blvd.,Ti Date Issued: 5/3/2023 L t1RD 9
� ' Parcel: 1S135BD00100
Jurisdiction: Tigard
Site address: 9600 SW OAK ST 410
Project: Ikigai Wellness Subdivision: ASHBROOK FARM
Lot: 5
Project Description: LOW VOLTAGE FOR HVAC
Contractor: LATIMER HVAC LLC Owner: KING CAPITAL INVESTMENTS LLC
11230 SW MORGEN CT ATTN KING,THOM
TIGARD, OR 97223 19250 NE PORTAL WAY
PORTLAND, OR 97230
PHONE: 503-290-1085 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Restricted Energy Permit 05/03/2023 $75.00
12%State Surcharge-Electrical 05/03/2023 $9.00
Type of Use: COM
Class of Work: ADD
Total Number of Systems: 1
Audio&Stereo: 0 Boiler Controls: 0
CCTV: 0 Clock Systems: 0
Data&Telecommunications: 0 Fire Alarm: 0
HVAC: 1 Instrumentation: 0
Intercom/Paging: 0 Landscape/Irrigation: 0
Landscape Lighting: 0 Medical: 0
Nurse Calls: 0 Protective Signal: 0
Security Alarm: 0 Other: 0 Total $84.00
Other Desc: 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. You may obtain a c of the rules or direct questions to OUNC by calling 503.23�2.1998 87 or 1.800.332.2344.
Issued By: �_ Permittee Signature: c' '_ ti
7
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.