Permit Support Document CITY OF TIGARD
ELECTRICAL PERMIT
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COMMUNITY DEVELOPMENT 4�Qj Permit#: ELC2014-00198
Aft)TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/28/2014
Parcel: 2S 101 AA03800
Jurisdiction: Tigard
Site address: 12259 SW 69TH AVE
Project: Bldg B Fire Alarm Upgrade Subdivision: WEST PORTLAND HEIGHTS Lot: B
Project Description: Reprinted 6/17/14 to correctproiect description to branch circuits for TI.Original description:Fire Alarm
Installation per proposal(Bldg B-job#532109)
Contractor: MCKINSTRY ELECTRICAL LLC Owner: TIGARD CORPORATE CENTER LP
16790 NE MASON STREET SUITE 100 15325 SW BEAVERTON CREEK CT
PORTLAND, OR 97230 BEAVERTON,OR 97006
PHONE: 503-278-3954 PHONE:
FAX: 503-331-6907
FEES
Quantity Description Date Amount
5 crt Branch Circuits wo/Purchase 04/28/2014 $85.86
Specifics: Service or Feeder
1 ea 12%State Surcharge- 04/28/2014 $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 i - • •• to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done i -ccordance with apgyed 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. • ENTION: Oregon law\req ' ou to follow the rules adopted by the Oregon Utility •1 - '•• enter., Those rules are set forth in OAR
952-00 -0010 thro h OAR 952-001- 0. Yo y obtain a copy of the rules or direct questions to• NC by ca' '?-' .1987 or 1.800.112.2344
Iss =d By: i Permittee Signa i -. cr
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' 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.