Permit Support Document CITY OF TIGARD ELECTRICAL PERMIT
` r` Permit#: ELC2019 00780
' COMMUNITY DEVELOPMENT
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Pr/7 24ui lj' Date Issued: ELC2 10/31/2019
Parcel: 2S 101 CB00400
Jurisdiction: Tigard
Site address: 12700 SW HALL BLVD H
Project: 323419 Subdivision: None Lot: None
Project Description: Suite H, Phase 1 Transformer and panel. 1/17/20: REPRINTED permit to correct address from Suite G2 to H.
Contractor: BOONES FERRY ELECTRIC INC Owner: MCLELLAN ESTATE CO
PO BOX 628 BY CHRISTOPHER M CAVE ESQ
WILSONVILLE, OR 97070 707 OLD COUNTY ROAD
BELMONT, CA 94002
PHONE: 503-682-4936 PHONE:
FAX: 503-682-7946
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 10/31/2019 $100.70
Specifics: amps or less
• 1 ea 12%State Surcharge- 10/31/2019 $12.08
Type of Use: COM Electrical
Class of Work: ALT 45 Misc Administration Fee 01/17/2020 $45.00
Type of Const:
Occupancy Grp:
Total $157.78
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 A 952- 09 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: 1 "��___ Permittee Signature: 6-2"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.