Permit t
CITY OF TIGARD egi ELECTRICAL RESTRICTED ENERGY PERMIT
IIIII B .- COMMUNITY DEVELOPMENT Permit#: ELR2014-00198
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/08/2014
Parcel: 1 S 126BC01506
Jurisdiction: TIGARD
Site address: 9020 SW WASHINGTON SQUARE RD 170
Project: C14629 SAF Design CC Subdivision: 2005-035 PARTITION PLAT Lot: 3
Project Description: Installation of Comcast coax. 9/10/14: Reprinted permit to show change of address to 9020 SW Washington
Square Rd Suite 170.
Contractor: CAPITOL DATA&COMMUNICATIONS Owner: WISCO REAL ESTATE EQUITY FUND I
11401 NE MARX ST 1501 SW TAYLOR ST STE 100
PORTLAND, OR 97220 PORTLAND, OR 97205
PHONE: 503-255-9488 PHONE:
FAX: 503-257-7121
FEES
Description Date Amount
Specifics: Restricted Energy Permit 09/08/2014 $75.00
12%State Surcharge-Electrical 09/08/2014 $9 00
Type of Use: COM
Class of Work: ADD
Total Number of Systems: 1
Audio&Stereo: 0 Boiler Controls: 0
CCTV: 0 Clock Systems: 0
Data&Telecommunications: 1 Fire Alarm: 0
HVAC: 0 Instrumentation: 0
Intercom/Paging: 0 Landscape/Irrigation: 0
Landscape Lighting: 0 Medical: 0
Nurse Calls: 0 Protective Signal: 0
Security Alarm: 0 Other: 0 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 co of the rules or direct questions to OUNC by calling 503,232.1987 or 1 800.332.23$4
Issued By: Permittee Signature: v �.4-P
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.