Permit Support Document y q CITY OF TIGARD ELECTRICAL PERMIT
"'1I COMMUNITY DEVELOPMENT Permit#: ELC2014-00503
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/04/2014
Parcel: 1S134BC00200
Jurisdiction: Tigard
Site address: 12186 SW SCHOLLS FERRY RD
Project: Mud Bay-LL Work Subdivision: GREENWOOD TERRACE CONDO Lot: 17
Project Description: Relocating electrical panel,hook ups to RTUs,two restrooms,manager's office&breakroom. 10/9/14,reprinted to
correct address from 12180 to 12186 SW Scholls Ferry Rd.
Contractor: INDUSTRIAL COMMERCIAL ELECTRIC COMPANY Owner: ATLAS GREENWAY LLC
PO BOX 21282 333 NW NINTH AVE, STE 1009
KEIZER, OR 97307 PORTLAND, OR 97209
PHONE: 503-981-2383 PHONE:
FAX: 503-981-0053
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 09/04/2014 $100.70
Specifics: amps or less
6 crt Branch Circuits w/Purchase 09/04/2014 $44.52
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 09/04/2014 $17.43
Electrical
Type of Const:
Occupancy Grp:
Total $162.65
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 ordance with a•• •ved 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. ATT NTION: Oregon law equi•=- ou to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0 10 through OAR 952-001-It•0. Yo - obtain a copy of the rules or direct questions to OUNC by callin 232.1987 or 1.800.332 2344.
Issued s Permittee Signatur ) �T� �c� "
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.