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Permit Support Document (15) CITY OF TIGARD '# ELECTRICAL PERMIT • COMMUNITY DEVELOPMENT Permit#: ELC2018-00324 and OR 97223 503.718.2439 13125 SW Hall Blvd.,Ti Date Issued: 05/18/2018 TIt„k)t.(� 9 Parcel: 2S113B000600 Jurisdiction: Tigard Site address: 16580 SW 85TH AVE Project: Clean Water Services-O&M Subdivision: None Lot: None Project Description: JOB#70581 NEW CONFERENCE ROOM. 8/7/18:REPRINT to correct address. Contractor: CHRISTENSON ELECTRIC INC Owner: CLEAN WATER SERVICES 17201 SACRAMENTO ST 2550 SW HILLSBORO HWY PORTLAND, OR 97230 HILLSBORO, OR 97123 PHONE: 503-419-3344 PHONE: FAX: 503-419-3695 FEES Quantity Description Date Amount 2 ea Services or Feeders-200 05/18/2018 $201.40 Specifics: amps or less 37 crt Branch Circuits w/Purchase 05/18/2018 $274.54 Type of Use: COM Service or Feeder Class of Work: NEW 1 ea 12%State Surcharge- 05/18/2018 $57.11 Electrical Type of Const: 45 Misc Administration Fee 08/07/2018 $45.00 Occupancy Grp: Total $578.05 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 a= forth in OAR 952-001-0010 through OAR 952-001-0090. 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: a �GG2�l1i Permittee Signature: af 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.