Permit Support Document (35) CITY OF TIGARD ..pELECTRICAL P
. . s, ,114 COMMUNITY DEVELOPMENT Permit#:ELELC2018-00016ERMIT
'TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/09/2018
Parcel: 2S 103DD05500
Jurisdiction: Tigard
Site address: 10895 SW GARDEN PARK PL B
Project: Demaree Subdivision: GAARDE PARK Lot: 38
Project Description: Reconnect Electric Furnace. 1/29/2018: REPRINT permit to correct suite address.
Contractor: BEAR ELECTRIC Owner: DEMAREE,THOMAS E&JUDITH A REV
PO BOX 389 LIVING TRUST
DONALD, OR 97020 PO BOX 23944
TIGARD, OR 97281
PHONE: 503-678-1355 PHONE:
FAX: 503-678-1108
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo/Purchase 01/09/2018 $56.18
Specifics:, Service or Feeder
1 ea 12%State Surcharge- 01/09/2018 $6.74
Type of Use: SF Electrical
Class of Work: ALT 45 Misc Administration Fee 01/29/2018 $45.00
Type of Const:
Occupancy Grp:
Total $107.92
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 0 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: o f✓ /51-7`'/06:-/64-77 C7Ai
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.