Permit (24) n CITY OF TIGARD A� � ELECTRICAL PERMIT
g COMMUNITY DEVELOPMENT LCA apair
Permit#: ELC2016-00200
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/15/2016
Parcel: 251060001500
Jurisdiction: Tigard
Site address: 17255 SW HOLLY RIDGE LN
Project: River Terrace Northwest Subdivision: RIVER TERRACE NORTHWEST Lot: Multiple
Project Description: Remodel job site sales office/trailer.3/16/16,REPRINTED to correct address
Contractor: GARNER ELECTRIC WASHINGTON LLC Owner: POLYGON WLH LLC
6101 SAINT JOHNS RD 109 E 13TH ST STE#200
VANCOUVER,WA 98661 VANCOUVER,WA 98660
PHONE: 253-872-6051 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 03/15/2016 $100.70
Specifics: amps or less
20 crt Branch Circuits w/Purchase 03/15/2016 $148.40
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 03/15/2016 $29.89
Electrical
Type of Const: 45 Misc Administration Fee 03/16/2016 $45.00
Occupancy Grp:
Total $323.99
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 sGspended for more the 180
days. ATTENTI••: = -••n 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 9' -001 •'90. You may obtain a copy of the rules or direct questions to OUNC by calling 503. .1987 or 1.800.832.2344.
Issued B : /� i�L � 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
8005 SW HUNZIKER RD, TIGARD, OR, 97223
Commercial - Electrical Limited Energy
198 Low voltage final
PASS - No C of O
ELR2016-00200
Jeff Grove
Violation Summary:
Inspector Contractor