Permit Support Document (19) CITY OF TIGARD ELECTRICAL RESTRICTED ENPERMIT
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` � COMMUNITY DEVELOPMENT PermitRICTE#: ELR2019-00056ERGY
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/25/2019
t ,e� Parcel: 1S135AD01303
p s f ' Jurisdiction: Tigard
Site address: 8920 SW OAK ST
Project: Oak Street Apartments � � ubdivision: ASHBROOK FARM Lot: 13
Project Description: Audio Video-Common Spaces
Contractor: OHM SYSTEMS LLC Owner: OAK STREET AGS LLC
124 SE 11TH AVE SUITE B 10100 TRINITY PKWY 5TH FLOOR
PORTLAND, OR 97286 STOCKTON, CA 95219
PHONE: 503-484-5700 PHONE:
FAX: 503-258-0382
FEES
Description Date Amount
Specifics: Restricted Energy Permit 03/25/2019 $75.00
12%State Surcharge-Electrical 03/25/2019 $9.00
Type of Use: MF Misc Administration Fee 05/08/2019 $45.00
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 $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 OAR 952-001-0090. You may obtain a co• • e rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: AM..'—41—..-.___ ' Permittee Signature: 6%..c..,, e.."illee......e„.2 .,..:
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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.