Permit p CITY OF TIGARD ELECTRICAL PERMIT
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III ''' COMMUNITY DEVELOPMENT Permit#: ELC2015-00665
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 UM= Date Issued: 08/20/2015
Parcel: 2S103DA00300
Jurisdiction: Tigard
Site address: 13210 SW WATKINS AVE
Project: DODSON,FRANCESCA Subdivision: DERRY-DELL Lot: 3
Project Description: (5)CIRCUITS FOR OUTLETS. 8/27/15:Reprinted permit to show change of address from 13120 to 13210 SW
Watkins Ave.
Contractor: WEST SIDE ELECTRIC CO INC Owner: FRANCESCA DODSON
1834 SE 8TH AVE 13120 SW WATKINS AVE
PORTLAND, OR 97214 TIGARD,OR 97223
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PHONE: 503-341-4500
PHONE: 503-231-1548
FAX: 503-736-0677
FEES
Quantity Description Date Amount
5 crt Branch Circuits wo/Purchase 08/20/2015 $85.86
Specifics: Service or Feeder
1 ea 12%State Surcharge- 08/20/2015 $10.30
Type of Use: SF Electrical
Class of Work: ADD 45 Misc Administration Fee 08/27/2015 $45.00
Type of Const:
Occupancy Grp:
Total $141.16
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 copy the s or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: � Permittee Signature:
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.