Permit 7 CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
tt COMMUNITY DEVELOPMENT Permit#: ELR2015-00214
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 1' ti Date Issued: 09/10/2015
Zy 40;. Parcel: 1S1260000300
Jurisdiction: TIGARD
Site address: 9540 SW WASHINGTON SQUARE RD H15
Project: See's Candies Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: S
Project Description: install one VAV, 1 thermostat. 9/24/2015: REPRINT permit to correct address from 9585 to 9540.
Contractor: GREY WOLF HVAC INC. Owner: PPR WASHINGTON SQUARE LLC
7306 NE 37TH AVE PO BOX 847
VANCOUVER, WA 98665 CARLSBAD, CA 92018
PHONE: 360-635-6117 PHONE:
FAX: 360-326-8506
FEES
Description Date Amount
Specifics: Restricted Energy Permit 09/10/2015 $75.00
12%State Surcharge-Electrical 09/10/2015 $9.00
Type of Use: COM Misc Administration Fee 09/24/2015 $45.00
Class of Work: ALT
Total Number of Systems: 1
Audio&Stereo: 0 Boiler Controls: 0
CCTV: 0 Clock Systems: 0
Data&Telecommunications: 0 Fire Alarm: 0
HVAC: 1 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•t.- • -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.
/LW
Issued By• 111 I/. Permittee Signature: /1/C.../h/t✓
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
9540 SW WASHINGTON SQUARE RD H15,
TIGARD, OR, 97223
Commercial - Electrical Limited Energy
198 Low voltage final
PASS - No C of O
ELR2015-00214
Jeff Grove
Violation Summary:
Inspector Contractor