Permit Support Document (41) CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT A Permit#: ELC2019-00148
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AR.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 ®ATIENI Date Issued:Parcel: 2S103DD00500
103DD0S103DD00500
Jurisdiction: Tigard
Site address: 13727 SW PACIFIC HWY 300
Project: TIGARD DANCE STUDIO Subdivision: MELROSE Lot: 8
Project Description: TI WIRING. 3/14/19:REPRINTED to correct address.
Contractor: WEST SIDE ELECTRIC CO INC Owner: VPT LLC
1834 SE 8TH AVE 610 SW ALDER ST STE 1221
PORTLAND, OR 97214 PORTLAND, OR 97205
PHONE: 503-231-1548 PHONE:
FAX: 503-736-0677
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 03/07/2019 $100.70
Specifics: amps or less
6 crt Branch Circuits w/Purchase 03/07/2019 $44.52
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 03/07/2019 $17.43
Electrical
Type of Const: 45 Misc Administration Fee 03/15/2019 $45.00
Occupancy Grp:
Total $207.65
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 may obtain a _rules or direct questions to OU NC by calling 503.232.1987 or 1.800.332.2344.
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Issued By: c .e-ea—. -permittee Signature:
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
Tel: 503.718.2439
Location: Inspection Date:
13727 SW PACIFIC HWY 300, TIGARD, May 3, 2019 at 10:17:14 AM
OR, 97223
Record Type: Record ID:
Commercial - Electrical ELC2019-00148
Inspection Type: Inspector:
199 Electrical final Chip Barnett
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor