Permit II
CITY OF TIGARD ELECTRICAL PERMIT
1 le; — COMMUNITY DEVELOPMENT Permit#: ELC2016-00059
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/27/2016
Parcel: 2S 113AA00200
Jurisdiction: Tigard
Site address: 16364 SW 72ND AVE B8
Project: General Parts Subdivision: ROSEWOOD ACRE TRACTS Lot: C
Project Description: Tenant Improvement. 2/4/2016: REPRINT permit to correct address from 16360 to 16364.
Contractor: JOHANSEN ELECTRIC INC Owner: PACIFIC REALTY ASSOCIATES LP
16869 SW 65TH AVE, SUITE 311 ATTN: N PIVEN
LAKE OSWEGO, OR 97035 15350 SE SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-747-2503 PHONE:
FAX: 503-972-1861
FEES
Quantity Description Date Amount
5 crt Branch Circuits wo/Purchase 01/27/2016 $85.86
Specifics: Service or Feeder
1 ea 12%State Surcharge- 01/27/2016 $10.30
Type of Use: COM Electrical
Class of Work: ALT 45 Misc Administration Fee 02/08/2016 $45.00
Type of Const:
Occupancy Grp:
Total $141.16
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. ATTENTI : Or on law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 rough OAR 5 -0 0. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By. Permittee Signature:
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.
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
16364 SW 72ND AVE B8, TIGARD, OR, 97224
Commercial - Electrical
199 Electrical final
PASS - No C of O
ELC2016-00059
Chip Barnett
Violation Summary:
Inspector Contractor