Permit Support Document (24) CITY OF TIGARDELECTRICAL PERMIT
IN
Permit#: ELC2018-00677
s COMMUNITY DEVELOPMENT �/� ;,.�
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 �(/� Date Issued: 10/15/2018
TI[;riRi� 9
Parcel: 1S1260000300
Jurisdiction: Tigard
Site address: 9650 SW WASHINGTON SQUARE RD G15
Project: Oakley Subdivision: None Lot: None
Project Description: 25 ckts+(1)signal ckt. 11/5/2018: REPRINT permit to correct address from 9585 to 9650.
Contractor: JC ELECTRIC INC Owner: PPR WASHINGTON SQUARE LLC
118 NW 184TH STREET PO BOX 847
RIDGEFIELD,WA 98647 CARLSBAD,CA 92018
PHONE: 360-887-7889 PHONE:
FAX: 360-887-5584
FEES
Quantity Description Date Amount
25 crt Branch Circuits wo/Purchase 10/15/2018 $234.26
Specifics: Service or Feeder
1 ea Signal circuit or Limited 10/15/2018 $75.00
Type of Use: COM Energy Panel
Class of Work: NEW 1 ea 12%State Surcharge- 10/15/2018 $37.11
Electrical
Type of Const: 45 Misc Administration Fee 11/05/2018 $45.00
Occupancy Grp:
Total $391.37
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: 0 egon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 throw, •' - • -+01-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
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Issued By: 4 f t-- Permittee Signature: e3/1/Z//•/
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:
9650 SW WASHINGTON SQUARE RD G15,
TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Electrical ELC2018-00677
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor