Permit (48) CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2017-00378
T[ ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/25/2017
Parcel: 2S108DB05900
Jurisdiction: Tigard
Site address: 15361 SW SEINE DR
Project: FELL Subdivision: POLYGON AT BULL MOUNTAIN Lot: 57
Project Description: Alter branch circuit for a/c unit install
Contractor: GARNER ELECTRIC WASHINGTON LLC Owner: FELL, CHRISTINA M&JORDAN A
402 VALLEY AVE NW, SUITE 106 15361 SW SEINE DR
PUYALLUP,WA 98371 TIGARD, OR 97224
PHONE: 253-872-6051 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo/Purchase 05/25/2017 $56.18
Specifics: Service or Feeder
1 ea 12%State Surcharge- 05/25/2017 $6.74
Type of Use: SF Electrical
Class of Work: ALT 90 Investigation Fee 05/25/2017 $90.00
Type of Const: 11 Investigation Electrical 12% 05/25/2017 $10.80
Occupancy Grp: State Surcharge
Total $163.72
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 i - or.a - ith 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. r TENTION: Orego law requires you to follow the rules adopted by the Oregon Utility •' -'o. enter. Those rules are set forth in OAR
952-e a 1-0010 thro gh OAR 95 ou may obtain/ a copy of the rules or direct questions to OUNC .y calli --- 9987 or 1.800.332.23
1 La/. •. ,
Is ued By: % _/� _ ��:�L Permittee .. �J I '% 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' ), , - a -eSM
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.
45'24(2017 17:04 3508912515
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