Permit Support Document (167) CITY OF TIGARD ELECTRICAL PERMIT
`` ! COMMUNITY DEVELOPMENT Permit#: ELC2016-00528
t
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 1 t Date Issued: 06/28/2016
Fr Parcel: 2S 1016 D00100
Jurisdiction: Tigard
Site address: 7650 SW BEVELAND RD 200
Project: Women's Healthcare Lab Subdivision: None Lot: None
Project Description: New subpanel and circuit wiring for lights,general receptacles,and equipment. 7/25/16:Reprinted permit to show
change of address from 7650 SW Beveland Rd Suite 100 to Suite 200.
Contractor: WRIGHT 1 ELECTRIC Owner: PNWP LLC#2
11490 SE JENNIFER ST PO BOX 2206
CLACKAMAS, OR 97015 BEAVERTON, OR 97075
PHONE: 503-760-8522 PHONE:
FAX: 503-762-1823
FEES
Quantity Description Date Amount
Specifics: 1 ea Services or Feeders-200 06/28/2016 $100.70
amps or less
18 crt Branch Circuits w/Purchase 06/28/2016 $133.56
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 06/28/2016 $28.11
Type of Const: Electrical
45 Misc Administration Fee 07/26/2016 $45.00
Occupancy Grp:
Total $307.37
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.yn "ny nh in�of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ��77 .e -. Permittee Signature:
/400
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.