Permit CITY OF TIGARD ELECTRICAL PERMIT
°� COMMUNITY DEVELOPMENT ` Permit#: ELC2015 00691
R Date Issued: 08/25/2015
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 t ffiv Parcel: 2S101DC03700
Jurisdiction: Tigard
Site address: 7095 SW SANDBURG ST
Project: UFCW LOCAL 555 Subdivision: ROLLING HILLS NO.2 Lot: 44
Project Description: JOB#95494 ADD POWER FOR HVAC AND RECEPTACLES. 9/24/15:Added(6)branch circuits.
Contractor: CHRISTENSON ELECTRIC INC Owner: UNITED FOOD&COMMERICAL WORKERS
111 SW COLUMBIA ST, STE 480 UNION LOCAL#555
PORTLAND, OR 97201 PO BOX 23555
TIGARD, OR 97281
PHONE: 503-419-3300 PHONE:
FAX: 503-419-3695
FEES
Quantity Description Date Amount
9 crt Branch Circuits wo/Purchase 09/24/2015 $115.54
Specifics: Service or Feeder
1 ea 12%State Surcharge- 09/24/2015 $13.86
Type of Use: COM Electrical
Class of Work: ALT 45 Misc Administration Fee 09/24/2015 $45.00
Type of Const:
Occupancy Grp:
Total $174.40
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 oft l direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ittee Signature: cp 4..-„,7
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 503.839.4175 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.
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
7095 SW SANDBURG ST, TIGARD, OR, 97223
Commercial - Electrical
199 Electrical final
PASS - No C of O
ELC2015-00691
Jeff Grove
Mechanical permit required
Violation Summary:
Inspector Contractor