Permit ' , i, I CITY OF TIGARD ELECTRICAL PERMIT
IL
'a COMMUNITY DEVELOPMENT Permit #: ELC2009-00572
,1 �' Date Issued: 10/27/2009
T [ GAR' 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
, I; , , „ '^h Parcel: 2S104AD03101
Jurisdiction: Tigard
Site address: 12976 SW WALNUT ST
Subdivision: Lot: 0
Project: Layton - Weihrauch
Project Description: Install (1) 200 amp service for generator. ADDED (11) branch circuits to permit.
Owner: FEES
LAYTON, ELIZABETH F Quantity Description Date Amount
12976 SW WALNUT
TIGARD, OR 97223 1 ea Services or Feeders - 200 10/27/2009 5100.70
amps or less
PHONE: 1 ea 12% State Surcharge - 10/27/2009 $12.08
Electrical
11 crt Branch Circuits w /Purchase 11/13/2009 $81.62
Contractor: Service or Feeder
PACWEST ELECTRIC, INC. 0 ea 12% State Surcharge - 11/13/2009 $9.80
P.O. BOX 856 Electrical
BATTLE GROUND, WA 98604
PHONE: 360- 921 -8761
FAX: 360- 573 -6755
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $204.20
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 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
1
Issued By: V t1 I. - A.: .../ • 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' Q Q �,n p , Date:
LICENSE NO. `�
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.