Permit Support Document (29) *� fY .
CITY OF TIGARD gr,247ELECTRICAL PERMIT
. ' COMMUNITY DEVELOPMENT Permit#: ELC2018-00732
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/07/2018
T[ "G � O g Parcel: 1 S 126DC03300
Jurisdiction: Tigard
Site address: 9900 SW GREENBURG RD 290
Project: Nursingale Subdivision: LEHMANN ACRE TRACT Lot: 5
Project Description: DEMO AND ROUGH IN. 11/28/2018: REPRINT permit to correct suite number from 225 to 290.
Contractor: FRONTIER ELECTRIC OF WASHINGTON INC Owner: MEADOWS 196 LLC
7217 NE 99TH STREET 5665 MEADOWS RD STE 140
VANCOUVER,WA 98662 LAKE OSWEGO, OR 97035
PHONE: 360-892-4342 PHONE:
FAX: 360-892-1559
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo/Purchase 11/07/2018 $63.60
Specifics: Service or Feeder
1 ea 12%State Surcharge- 11/07/2018 $7.63
Type of Use: COM Electrical
Class of Work: OTR 45 Misc Administration Fee 11/28/2018 $45.00
Type of Const:
Occupancy Grp:
Total $116.23
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 R 952-001-0090. You may obtain a copy of the rules or direct questions to OU NC by calling 503.232.1987 or 1.800.332.2344.
Issued By: >- - Permittee Signature: eA/z.PV t
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:
9900 SW GREENBURG RD 290, TIGARD,
OR, 97223
Record Type: Record ID:
Commercial - Electrical ELC2018-00732
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor