Permit Support Document 1111 CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT � % ` ' y Permit#: ELC2018-00270
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 ffirlWM Date Issued: 04/30/2018
Parcel: 1S1260000300
Jurisdiction: Tigard
Site address: 9315 SW WASHINGTON SQUARE RD T03
Project: Lovesac Subdivision: None Lot: None
Project Description: T.I. 5/1/2018: REPRINTED to correct site address.
Contractor: ADVANCED WIRING SERVICES INC Owner: PPR WASHINGTON SQUARE LLC
PO BOX 644 PO BOX 847
CLACKAMAS, OR 97015 CARLSBAD, CA 92018
PHONE: 503-310-3655 PHONE:
FAX: 503-698-6372
FEES
Quantity Description Date Amount
24 crt Branch Circuits wo/Purchase 04/30/2018 $226.84
Specifics:, Service or Feeder
1 ea 12%State Surcharge- 04/30/2018 $27.22
Type of Use: COM Electrical
Class of Work: ALT 45 Misc Administration Fee 05/01/2018 $45.00
Type of Const:
Occupancy Grp:
Total $299.06
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 9 6090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: k, Permittee Signature: G"/VG//✓�
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.