Permit Support Document (21) CITY OF TIGARD •_ ; °,, <, ELECTRICAL PERMIT
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■' COMMUNITY DEVELOPMENT M Permit#: ELC2017-00052
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/23/2017
T t i;;�I./-) 9 Parcel: 2S111 BA00701
Jurisdiction: Tigard
Site address: 9880 SW MCDONALD ST
Project: Shapiro Subdivision: TIGARDVILLE PARK Lot: 25
Project Description: Replace storm damaged service.1/31/17,REPRINTED to correct address from 9910 to 9880 SW McDonald.
Contractor: AMERICAN ELECTRIC SERVICE Owner: SHAPIRO,ANDRE C&DEBORAH
PO BOX 1057 9910 SW MCDONALD ST
SHERWOOD, OR 97140 TIGARD, OR 97224
PHONE: 503-537-2121 PHONE: 503-624-5780
FAX: 503-554-8506
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FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 01/23/2017 $100.70
Specifics: amps or less
1 ea 12%State Surcharge- 01/23/2017 $12.08
Type of Use: SF Electrical
Class of Work: ALT 45 Misc Administration Fee 01/31/2017 $45.00
Type of Const:
Occupancy Grp:
Total $157.78
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. ATTEN : Orego law re.uires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-00 .through OAR 952-.I .190. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued :y: /- / 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.
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
9880 SW MCDONALD ST, TIGARD, OR, 97224
Record Type:
Residential - Electrical
Inspection Type:
199 Electrical final
Result:
PASS- NoCofO
Comments:
Violation Summary:
Inspector
Tel: 503.718.2439
Inspection Date:
Record ID:
ELC2017-00052
Inspector:
Jeff Grove
Contractor