Permit (7) CITY OF TIGARD ELECTRICAL PERMIT
11111 s ' COMMUNITY DEVELOPMENT Permit#: ELC2021-00157
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 3/30/2021
T I G A R T] 9 Parcel: 1 S 136CC00100
Jurisdiction: Tigard
Site address: 12244 SW GARDEN PL
Project: mannahouse Subdivision: None Lot: None
Project Description: miscellaneous electrical work
Contractor: JOHANSEN ELECTRIC INC Owner: WESTSIDE CHRISTIAN HIGH SCHOOL INC
16869 SW 65TH AVE, SUITE 311 BY DAVIS, DANIEL A, PRESIDENT
LAKE OSWEGO, OR 97035 8200 SW PFAFFLE ST
TIGARD, OR 97223
PHONE:
PHONE: 503-747-2503
FAX: 503-972-1861
FEES
Quantity Description Date Amount
12 crt Branch Circuits wo/Purchase 03/30/2021 $137.80
Specifics: Service or Feeder
1 ea 12%State Surcharge- 03/30/2021 $16.54
Type of Use: COM Electrical
Class of Work: ALT 45 Misc Administration Fee 04/06/2021 $45.00
Type of Const:
Occupancy Grp:
Total $199.34
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.Tis 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 y, to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952 001 009 -l'eti may obtain a copy of the rules or direct questions to OUNC by calling 503.232.198877jorrJ81.800.0.33332.2344.
Issued By: i�` Permittee Signature: Z'el/-
OWNER INSTALLATION ONLY
The installation is being mon property I own which is not intended for sale,lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR.ELEC' 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.