Permit Support Document (42) CITY OF TIGARD ELECTRICAL PERMIT
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COMMUNITY DEVELOPMENT Permit#: ELC2016-00534
Date Issued: 07/01/2016
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 IO
Parcel: 2S112AA01000
Jurisdiction: Tigard
Site address: 14100 SW 72ND AVE 100
Project: Logan Labs Subdivision: 1992-007 PARTITION PLAT Lot: 2
Project Description: Tenant Improvement. 12/12/17: REPRINTED permit to correct address.
Contractor: A&J ELECTRIC Owner: WILLIAMS CONTROLS INDUSTRIES INC
PO BOX 330 14100 SW 72ND AVE
FOREST GROVE, OR 97116 TIGARD, OR 97224
PHONE: 503-359-5891 PHONE:
FAX: 503-359-1981
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 07/01/2016 $100.70
Specifics: amps or less
20 crt Branch Circuits w/Purchase 07/01/2016 $148.40
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 07/01/2016 $29.89
Electrical
Type of Const:
Occupancy Grp:
Total $278.99
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 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 through OAR 952-001-0090. You ma obtain a rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: f1(1& Permittee Signature: C�
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:
14100 SW 72ND AVE, TIGARD, OR, 97224
Record Type:
Commercial - Electrical
Inspection Type:
105 Underground/slab cover
Result:
PASS
Comments:
Violation Summary:
Inspector
Tel: 503.718.2439
Inspection Date:
Record ID:
ELC2016-00534
Inspector:
Jeff Grove
Contractor