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Permit Support Document ?t ELECTRICAL PERMIT CITY OF TIGARD • x / COMMUNITY DEVELOPMENT Mani Permit#: ELC2017-00092 Date Issued: 02/13/2017 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S104AA06400 Jurisdiction: Tigard Site address: 12715 SW WILLS PL Project: Sanders Subdivision: BELLWOOD NO.2 Lot: 85 Project Description: Reconn AC, Reconn ODU GFI.2/13/17,reprinted to correct to(4)branch circuits without service. Contractor: BEAR ELECTRIC Owner: SANDERS, JEFF PO BOX 389 PO BOX 230052 DONALD, OR 97020 TIGARD, OR 97281 PHONE: 503-678-1355 PHONE. FAX: 503-678-1108 FEES Quantity Description Date Amount 4 crt Branch Circuits wo/Purchase 02/13/2017 $78.44 Specifics: Service or Feeder 1 ea 12%State Surcharge- 02/13/2017 $9.41 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $87.85 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 .1: Oreg•• law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-00 •through OAR 95 .01-' I. Y. may obtain a copy of the rules or direct questions to OUNC by c- .1987 or 1.800.332.2344. Issued •••y: L_ ��, � � Permittee Signat ' e 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. City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 12715 SW WILLS PL, TIGARD, OR, 97223 March 3, 2017 at 8:59:44 AM Record Type: Record ID: Residential - Electrical ELC2017-00092 Inspection Type: Inspector: 199 Electrical final David Young Result: FA I L Comments: Provide access for inspection R109.3 no answer at door 8:58 am Provide approved electrical rough in for branch circuits. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 12715 SW WILLS PL, TIGARD, OR, 97223 Record Type: Record ID: Residential - Electrical ELC2017-00092 Inspection Type: Inspector: 199 Electrical final Jeff Grove Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor