Permit CITY OF TIGARD ELECTRICAL PERMIT
11111 a , COMMUNITY DEVELOPMENT '/�; Permit#: ELC2015-00818
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/09/2015
Parcel: 2S101 BB01400
Jurisdiction: Tigard
Site address: 12178 SW GARDEN PL
Project: office TI Subdivision: CROW PARK 217 Lot: 2
Project Description: Minor remodel of office space. 10/12/2015: REPRINT permit to correct address from 12176 to 12178.
Contractor: ERTELL ELECTRIC LLC Owner: ICON OWNER POOL 1 WEST LLC
PO BOX 279 BY RYAN
FOREST GROVE, OR 97116 PO BOX 460169
HOUSTON,TX 77056
PHONE: 503-841-4511 PHONE:
FAX: 503-359-5652
FEES
Quantity Description Date Amount
10 crt Branch Circuits wo/Purchase 10/09/2015 $122.96
Specifics: Service or Feeder
1 ea 12%State Surcharge- 10/09/2015 $14.76
Type of Use: CMS Electrical
Class of Work: ALT 45 Misc Administration Fee 10/12/2015 $45.00
Type of Const:
Occupancy Grp:
Total $182.72_
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 0 - -009 . 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: Permittee Signature: Q/JL/47E—
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 603.639.4176 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
12178 SW GARDEN PL, TIGARD, OR, 97223
Commercial - Electrical
199 Electrical final
PASS - No C of O
ELC2015-00818
Jeff Grove
Violation Summary:
Inspector Contractor