Permit Support Document (10) CITY OF TIGARDIii ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT r1.61'' Permit#: ELC2017-00237
T I GA tt D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 4411111 Date Issued: 04/05/2017
Parcel: 1 S134BC00300
Jurisdiction: Tigard
Site address: 12262 SW SCHOLLS FERRY RD
Project: Advantis-Greenway Subdivision: None Lot: None
Project Description: TI-4/27/17,REPRINTED to correct address from 12220 SW Scholls Ferry Rd
Contractor: HILLSBORO ELECTRIC LLC Owner: FW OR-GREENWAY TOWN CENTER LLC
21185 NW EVERGREEN PKWY#110 PO BOX 790830
HILLSBORO, OR 97124 SAN ANTONIO, TX 78279
PHONE: 503-439-9666 PHONE:
FAX: 503-601-3680
FEES
Quantity Description Date Amount
12 crt Branch Circuits wo/Purchase 04/05/2017 $137.80
Specifics: Service or Feeder
1 ea 12%State Surcharge- 04/05/2017 $16.54
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $154.34
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 rdance wi .pproved 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. A,,ENTION: Oregon la, r-• -s you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-0 -0010 through OAR 952-4:i-0090. u y obtain a copy of the rules or direct questions to OUNC by calli . 32.1987 or 1.880.332.2344.
Iss d By: ` ��.1L(._,4...—C,i Permittee Signatur : — se–it (/J�c�
----_____ OWNER INSTALLATION ONLY C
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 603.639.4175 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:
12262 SW SCHOLLS FERRY RD, TIGARD, OR,
97223
Record Type: Record ID:
Commercial - Electrical ELC2017-00237
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor