Permit S I
CITY OF TIGARD ®® ' ELECTRICAL RESTRICTED ENERGY PERMIT
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COMMUNITY DEVELOPMENT Permit#: ELR2015-00079
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/18/2015
TIGARD Parcel: 1 S 1260000300
Jurisdiction: Tigard
Site address: 9650 SW WASHINGTON SQUARE RD G15
Project: IVIWA Subdivision:VASHINGTON SQUARE ESTATES NO Lot: S
Project Description: Installing Camera System. 3/25/2015: REPRINT permit to correct site address.
Contractor: 3 GUYS ELECTRIC LLC Owner: PPR WASHINGTON SQUARE LLC
2062 NW 15TH CT PO BOX 847
GRESHAM, OR 97030 CARLSBAD, CA 92018
PHONE: 503-729-1522 PHONE:
FAX: 503-661-7378
FEES
Description Date Amount
Specifics: Restricted Energy Permit 03/18/2015 $75.00
12%State Surcharge-Electrical 03/18/2015 $9.00
Type of Use: COM Misc Administration Fee 03/23/2015 $45.00
Class of Work: OTR
Total Number of Systems: 1
Audio&Stereo: 0 Boiler Controls: 0
CCTV: 0 Clock Systems: 0
Data&Telecommunications: 0 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: 1 Total $129.00
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 R 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: L —s Permittee Signature: e)4/
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:
9650 SW WASHINGTON SQUARE RD G15,
TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Electrical Limited Energy ELR2015-00079
Inspection Type: Inspector:
198 Low voltage final Chip Barnett
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor