Permit , CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
` COMMUNITY DEVELOPMENT Permit #: ELR2012 -00080
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/26/2012
Parcel: 151260000300
Jurisdiction: Tigard
Site address: 9573 SW WASHINGTON SQUARE RD B06
Project: The Limited Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: 108
Project Description: Data /telecommunications for TI
Contractor: DIGITAL CONNEX LLC Owner: PPR WASHINGTON SQUARE LLC
1915 EAST 5TH ST SUITE A BY THOMSON PROPERTY TAX SERVICES
VANCOUVER, WA 98661 ATTN HILARY RAYMOND
2235 FARADY AVE, STE 0
CARLSBAD, CA 92008
PHONE: 360 - 823 -0514 PHONE:
FAX: 360 - 823 -0516 '
FEES
Description Date Amount
Specifics: Restricted Energy Permit 04/26/2012 $75.00
12% State Surcharge - Electrical 04/26/2012 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio & Stereo: N Boiler Controls: N
CCTV: N Clock Systems: N
Data & Telecommunications: y Fire Alarm: N
HVAC: N Instrumentation: N
Intercom /Paging: N • Landscape /Irrigation: N
Landscape Lighting: N Medical: N -
Nurse Calls: N Protective Signal: N
Security Alarm: N Other: N Total $84.00
Other Desc: 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. 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: /� /
Permittee Signature: 6/s/ ��G �����' v
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 503.639.4176 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.
04-26-12;12:35 ; .
, # 1/ 2
i •
RECE WED
APR 26 2012
..,
CITY OF TIGARD -
• . BUILDING DIVISION . .
. .
, Electrical Permit Application Volk til'I.'Wl... LI.;
City of Tigard EgiffOrilin7rAll Pa"*" - 2500 /6 '
11123 SW Hall ad. Tlge rim - .
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Name:
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401 annictn 500 taw I 60.54
intended let Sale, lease, rent or excluage, according in ORS 447, 449, 679, and 701.
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7/ pi .-- Plan Miler 1.25K orpremk fto):
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