Permit (117) CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2016-00023
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Datelssued: 01/14/2016Parcel: 1 S135AA90004
Jurisdiction: Tigard
Site address: 10307 SW 87TH AVE
Project: Moon Creek Homes Subdivision: DEODAR CONDO,THE Lot: 4
Project Description: Electrical reconnect
Contractor: N/A Owner: MOON CREEK HOMES INC
10940 SW BARNES RD, PMB 340
PORTLAND, OR 97225
PHONE: PHONE: 503-970-7362
FAX
FEES
Quantity Description Date Amount
Specifics: 1 ea Reconnect Only 01/14/2016 $67.84
1 ea 12%State Surcharge- 01/14/2016 $8.14
Electrical
Type of Use: MF
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $75.98
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 actor approved plans. This permit will expire if work is not stared within 180 days of issuance, or if work is suspended for more the 180
days. ATT ON'. Grego law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set fern in OAR
952-001-e 0 throurg�h OAR 95 0 You may obtain a copy of the rules or direct questions to OUNC bycalling 503 211810111101 22340.
Issuetl y: ° \ //� Permitloe Signatures 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' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m.for the next available inspection dale.
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.
Electrical Permit Application
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