Permit (30) CITY OF TIGARD ELECTRICAL PERMIT
" COMMUNITY DEVELOPMENT11 ., Permit#: ELC2023-00303
1 Date Issued: 5/15/2023
T f G A i.L7 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 rfin M Parcel: 1 S 135BD00100
11AA�� Jurisdiction: Tigard
Site address: 9600 SW OAK ST 410
Project: Ikigai Wellness Subdivision: ASHBROOK FARM Lot: 5
Project Description: branch circuits for T.I.
Contractor: R C COSTELLO ELECTRICAL CONTRACTING INC Owner: KING CAPITAL INVESTMENTS LLC
PO BOX 336 ATTN KING,THOM
AURORA, OR 97002 19250 NE PORTAL WAY
PORTLAND, OR 97230
PHONE: 503-982-7400 PHONE:
FAX: 503-982-7400 _.....,. .,
FEES
Quantity Description Date Amount
5 crt Branch Circuits wo/Purchase 05/15/2023 $85.86
Specifics:
Service or Feeder
1 ea 12%State Surcharge- 05/15/2023 $10.30
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $96.16
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 av obt e v of the rules or direct auestions to OUNC by calling 503.2332.2.19�87.or 1.800.332.2344..er�. ,,
Issued By: £✓.Permittee Signature: of• I _t l/
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.