Permit • 1
CITY OF TIGARD 1 PAVAN ELECTRICAL RESTRICTED ENERGY PERMIT
• COMMUNITY DEVELOPMENT Permit#: ELR2015-00094
T!GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/03/2015
Parcel: 151260000300
Jurisdiction: Tigard
Site address: 9530 SW WASHINGTON SQUARE RD H10
Project: Athlete Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: S
Project Description: low voltage sound system wiring. 9/15/15,REPRINTED to correct address for 9585 to 9530 SW Washington
Square Rd. —
Contractor: OHM SYSTEMS LLC Owner: PPR WASHINGTON SQUARE LLC
124 SE 11TH AVE SUITE B PO BOX 847
PORTLAND, OR 97286 CARLSBAD,CA 92018
PHONE: 503-484-5700 PHONE:
FAX: 503-258-0382
FEES
Description Date Amount
Specifics: Restricted Energy Permit 04/03/2015 $75.00
12%State Surcharge-Electrical 04/03/2015 $9.00
Type of Use: COM
Class of Work: NEW
Total Number of Systems: 1
Audio&Stereo: 1 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: 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. ATTENT . on law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-001 hrough OAR 2-0 090. You may obtain a copy of the rules or direct questions to OUNC by calling 3.29P.1987 or 1)800.332.2344.
Issued B • 4 Permittee Sig na re` B f( ter
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.