Permit CITY OF TIGARD ELECTRICAL PERMIT
1111
: COMMUNITY DEVELOPMENT Permit#: ELC2017-00794
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/24/2017
Parcel: 2S 111 CC21700
Jurisdiction: Tigard
Site address: 10290 SW GREENLEAF TER
Project: Sky Pilot-Mary Hart Subdivision: SUMMERFIELD NO.5 Lot: 275
Project Description: Ground panel with ground rods(non metallic water pipe, kitchen remodel,outlets,cans,new micro,washer and
dryer circuits,relocate switches and cables due to wall demo.
Contractor: GENESIS ELECTRIC NW Owner: HART, MARY KAY
3753 KIENTHORPE WAY 10290 SW GREENLEAF TER
WEST LINN, OR 97068 TIGARD, OR 97224
PHONE: 503-303-8056 PHONE:
FAX: 503-303-8605
FEES
Quantity Description Date Amount
Specifics: 1 ea Services or Feeders-200 10/24/2017 $100.70
amps or less
8 crt Branch Circuits w/Purchase 10/24/2017 $59.36
Type of Use: SF Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 10/24/2017 $19.21
Electrical
Type of Const:
Occupancy Grp:
Total $179.27
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. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 throu.• •AR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
41 �
Issued By: '
v / _ Permittee Signature: 44/ -//LI
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:
10290 SW GREENLEAF TER, TIGARD,
OR, 97224
Record Type: Record ID:
Residential - Electrical ELC2017-00794
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor