Permit Support Document (9) CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT ; Permit#: ELC2017-00374
T E CARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 w Date Issued: 05/24/2017
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Parcel: 1 S 1260000300
Jurisdiction: Tigard
Site address: 9710 SW WASHINGTON SQUARE RD F01
Project: 17-410 Subdivision: None Lot: None
Project Description: See Scope. 6/21/17:REPRINTED permit to show change of address from 9585 SW Washington Square Rd.to
9710 SW Washington Square Rd.
Contractor: BRIDGETOWN ELECTRIC Owner: PPR WASHINGTON SQUARE LLC
5701 N LOMBARD ST PO BOX 847
PORTLAND, OR 97203-4113 CARLSBAD, CA 92018
PHONE: 503-621-7122 PHONE:
FAX: 503-621-7123
FEES
Quantity Description Date Amount
Specifics: 20 crt Branch Circuits wo/Purchase 05/24/2017 $197.16
Service or Feeder
1 ea 12%State Surcharge- 05/24/2017 $23.66
Type of Use: COM Electrical
Class of Work: ADD 45 Misc Administration Fee 06/21/2017 $45.00
Type of Const:
Occupancy Grp:
Total $265.82
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 0 ' 952-001-0090. You may obtain a co. of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: I�iL _ Permittee Signature: g._
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.
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9710 SW WASHINGTON SQUARE RD F01 ,
TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Electrical ELC2017-00374
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor