Permit (181) CITY OF TIGARD ELECTRICAL PERMIT
:4 4 ' COMMUNITY DEVELOPMENT Permit#: ELC2018-00551
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/30/2018
T I C.A It Dg Parcel: 2S101DA02101
Jurisdiction: Tigard
Site address: 6958 SW VARNS ST
Project: CIC Portland Subdivision: VARNS ACRES Lot: 4
Project Description: Demo non-load bearing walls and existing restrooms for new ambulatory medical clinic TI. New interior walls,
plumbing,electric,and HVAC.
Contractor: FIVE STAR ELECTRIC, INC. Owner: AVANOA, LLC
756 SW BAILEY AVE 4904 S POWER RD STE 102-203
HILLSBORO, OR 97123 MESA,AZ 85212
PHONE: 503-324-0948 PHONE:
FAX: 503-324-0973
FEES
Quantity Description Date Amount
12 crt Branch Circuits wo/Purchase 08/30/2018 $137.80
Specifics: Service or Feeder
6 ea Info Process/Archiving-Lg 08/30/2018 $12.00
Type of Use: COM $2.00(over 11x17)
Class of Work: ALT 1 ea 12%State Surcharge- 08/30/2018 $16.54
Electrical
Type of Const: 1 ea Restricted Energy Permit 08/30/2018 $75.00
Occupancy Grp:
Total $241.34
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. Yoh,may obtain a opy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: _/' 4 I.ft11:a * Permittee Signature: aetjC-.
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.
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
6958 SW VARNS ST, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Electrical ELC2018-00551
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor