Permit CITY OF TIGARD
ELECTRICAL RESTRICTED ENERGY PERMIT
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COMMUNITY DEVELOPMENT Permit#: ELR2016-00078
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 . Date Issued: 03/29/2016
T r c A r.�� g I Parcel: 1S135BA00102
Witlerffil Jurisdiction: Tigard
Site address: 10154 SW WASHINGTON SQUARE RD
Project: Pier One Imports Subdivision: OAKBURG Lot: 9
Project Description: Low voltage control wiring.4/28/16,REPRINTED to correct address.
Contractor: HVAC INC Owner: PPR SQUARE TOO LLC
5188 SE INTERNATIONAL WAY PO BOX 847
MILWAUKIE, OR 97222 CARLSBAD, CA 92018
PHONE: 503-462-4822 PHONE:
FAX: 503-462-6555
FEES
Description Date Amount
Specifics: Restricted Energy Permit 03/29/2016 $75.00
12%State Surcharge-Electrical 03/29/2016 $9.00
Type of Use: COM
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 $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• . . .•. law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-00 •through OAR 952-i 01-'•-'. •u ay obtain a copy of the rules or direct questions to OUNC by calling . .1987 or 1,800.332.2344.
Issue. By: l 1dZ4 _1 Permittee Signatu ! '
dre.:4A-.
- 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.
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Location:
Record Type:
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Inspection Date:
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Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10154 SW WASHINGTON SQUARE RD,
TIGARD, OR, 97223
Commercial - Electrical Limited Energy
198 Low voltage final
PASS - No C of O
ELR2016-00078
Jeff Grove
Violation Summary:
Inspector Contractor