Permit Support Document (23) •
CITY OF TIGARD7 :
rar. - ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2017-00825
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/03/2017
Parcel: 25111 CC22900
Jurisdiction: Tigard
Site address: 10410 SW GREENLEAF TER
Project: Panel Replacement Subdivision: SUMMERFIELD NO.5 Lot: 287
Project Description: Replace Panel. 11/7/2017: REPRINT permit to add(2)branch circuits.
Contractor: CONDUIT ELECTRIC Owner: GERR, MARVIN S&JUDITH S
19461 SW 89TH AVE 10410 SW GREENLEAF TER
TUALATIN, OR 97062 TIGARD, OR 97224
PHONE: 503-692-1428 PHONE:
FAX: 503-692-3652
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 11/03/2017 $100.70
Specifics: amps or less
1 ea 12%State Surcharge- 11/03/2017 $12.08
Type of Use: SF Electrical
Class of Work: ALT 2 crt Branch Circuits w/Purchase 11/07/2017 $14.84
Service or Feeder
Type of Const: 0 ea 12%State Surcharge- 11/07/2017 $1.78
Occupancy Grp: Electrical
Total $129.40
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 R 952-001-00 0. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
i
Issued By: $''Y` Permittee Signature: 6/V1
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.
FOR OFFICE USE ONLY—SITE ADDRESS:
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
• Transmittal Letter
TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: DAN NELSON DAT �.�L:> to. k.,
DEPT: BUILDING DIVISION
FROM: KYLE CHILDERS, P.E.
CITY OF TIGARD
COMPANY: OTAK, INC. 3UILDING DIVISION?
PHONE: (503) 415-2408 CrIal"11-
RE: 13240 SW ROY ROGERS RD. PLM2016-00618
(Site Address) (Permit Number)
RIVER TERRACE EAST MULTI-FAMILY
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
Additional set(s) of plans. 2 Revisions: REVISED UTILITIES
Cross section(s) and details. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(explain):
REMARKS: SITE UTILITY PLANS ARE BEING RESUBMITTED TO REFLECT RAISED SITE
GRADES. STORM WATER AND SANITARY SEWER SYSTEMS WERE RAISED
TO ACCOUNT FOR RAISED GRADES.
FOR OFFICE USE ONLY
Routed to Permjt Technician: Date: Initials:
Fees Due:)<Yes ❑No Fee Description: Amount Due:
/—h. z cpar V� i/s J'' �: 4e S $ qd . d�
$
Special
1 nstructions:
Reprint Permit (per PE): n Yes n No n Done
Applicant Notified: Date: if/7/17 Initials: l3 )
I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10410 SW GREENLEAF TER, TIGARD, November 16, 2017 at
OR, 97224 2:22:31 PM
Record Type: Record ID:
Residential - Electrical ELC2017-00825
Inspection Type: Inspector:
199 Electrical final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor