Permit Support Document CITY OF TIGARD ELECTRICAL PERMIT
IN • COMMUNITY DEVELOPMENT . '� �t�t Permit#: ELC2018-00325
*' Date Issued: 05/18/2018
T r LI r4 R f) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 I ,
111
Parcel: 2S113B000600
Jurisdiction: Tigard
Site address: 16580 SW 85TH AVE
Project: Clean Water Services-O&M Subdivision: None Lot: None
Project Description: JOB#70581 REMODEL EXISTING O&M BLDG CONFERENCE ROOM,LABS AND BREAK 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
1 ea Services or Feeders-200 05/18/2018 $100.70
Specifics: amps or less
61 crt Branch Circuits w/Purchase 05/18/2018 $452.62
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 05/18/2018 $66.40
Electrical
Type of Const: 45 Misc Administration Fee 08/07/2018 $45.00
Occupancy Grp:
Total $664.72
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 OARd952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987.1 r 1.800.332.2344. l�
Issued By: ��ifi �C�%. ty Permittee Signature: 6/r' � �
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.