Permit Support Document (112) CITY OF TIGARD ELECTRICAL PERMIT
'. COMMUNITY DEVELOPMENT • Permit#: ELC2016-00318
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/18/2016
t r..3 A R. 9 Parcel: 1S1260000300
Jurisdiction: Tigard
Site address: 9569 SW WASHINGTON SQUARE RD B04
Project: Godiva Subdivision: None Lot: None
Project Description: electrical connection of(2)LED illuminated signs.5/26/16, REPRINTED to correct address from 9585 to 9569 SW
Washington Square Rd.
Contractor: QUICKSILVER NEON AND SIGNS LLC Owner: PPR WASHINGTON SQUARE LLC
2325 NW 154TH PL PO BOX 847
BEAVERTON, OR 97006 CARLSBAD, CA 92018
PHONE: 503-626-7020 PHONE:
FAX:
FEES
Quantity Description Date Amount
2 ea Sign or Outline Lighting 04/18/2016 $135.68
Specifics:
1 ea 12%State Surcharge- 04/18/2016 $16.28
Electrical
Type of Use: COM 45 Misc Administration Fee 05/26/2016 $45.00
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $196.96
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. ATTEN - •. c =•n law re.uires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-00 •through OAR 95 00 •490. • may obtain a copy of the rules or direct questions to OUNC by • . 2'1987orr1.800.332.2344.
Issued By: / �� -L� - Permittee Signat •
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.
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
9569 SW WASHINGTON SQUARE RD B04,
TIGARD, OR, 97223
Commercial - Electrical
140 Sign installation
PASS
ELC2016-00318
Jeff Grove
Violation Summary:
Inspector Contractor