Permit Support Document (20) 1
CITY OF TIGARD ELECTRICAL PERMIT
.1111
" . COMMUNITY DEVELOPMENT Permit#: ELC2017-00787
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/20/2017
gr' y Parcel: 1S1260000300
Jurisdiction: Tigard
Site address: 9493 SW WASHINGTON SQUARE RD A03
Project: PlayLive Nation Subdivision: None Lot: None
Project Description: Replace panel and install circuits for TI in Space A03. 10/26/17:REPRINTED permit to show change of address.
Contractor: ERTELL ELECTRIC LLC Owner: PPR WASHINGTON SQUARE LLC
PO BOX 279 PO BOX 847
FOREST GROVE, OR 97116 CARLSBAD, CA 92018
PHONE: 503-841-4511 PHONE:
FAX: 503-359-5652
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 10/20/2017 $100.70
Specifics: amps or less
22 crt Branch Circuits w/Purchase 10/20/2017 $163.24
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 10/20/2017 $31.67
Electrical
Type of Const: 45 Misc Administration Fee 10/26/2017 $45.00
Occupancy Grp: ,
Total $340.61
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 youto
tffoollllow the rules adopted by the Oregon Utility Notification Center. T ose rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. Ypue " a copy• tt a n le�or direct questions to OUNC by calling 503.2 ;:7.r 1.84��.331 344.
Issued By: :- - �� Permittee Signature: Z 1� a ,�tsl�
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.