Correspondence • CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
RECEIVED
IMPORTANT PERMIT NOTICE MAY 0 6 2002
FRAHLER ELECTRIC CO PRANCER ELECTRIC CO.
11860 SW GREENBURG RD
TIGARD, OR 97223
Electrical Signature Form
Permit #: ELC2002 -00061
Date Issued: 5,2!02
Parcel: 2S114A0 -01500
Site Address: 17005 SW 92ND AVENUE
Subdivision:
Block: Lot:
Jurisdiction: TIG
Zoning: R - 12
Remarks: Picnic Shelter - Phase II of Cook Park Master Plan expansion.
Your company has been indicated as the electrical contractor for the permit indicated above. In order for the
electrical permit to be valid, the signature of the supervising electrician is required. Please have the
appropriate individual from your company sign below and return this Electrical Signature Form prior to the
start of the work to the address above, ATTN: Building Dept.
No electrical inspections will be authorized until this completed form is received
OWNER: ELECTRICAL CONTRACTOR:
TIGARD, CITY OF FRAHLER ELECTRIC CO
13125 SW HALL 11860 SW GREENBURG RD
TIGARD, OR 97223 TIGARD, OR 97223
Phone #: Phone #: 639 - 4627
Reg #: LIC 37410
SUP 1816S
ELE 34 -13C
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X
Signature of Supervising Electrician
If you have any questions, please call (503) 639 -4171, ext. # 310