Permit CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
I. DEVELOPMENT SERVICES PERMIT #: ELR2001 -00092
� '� L 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/30/01
SITE ADDRESS: 13535 SW 72ND AVE PARCEL: 2S101 DC -00300
SUBDIVISION: 72ND AVE OFFICE BUILDING ZONING: C -P
BLOCK: LOT: JURISDICTION: TIG
Project Description: Security Cable rough -in for entire building
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL: X
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
PACIFIC NW PROPERTIES C3 // COMMUNICATION CNNCT CNTR
9965 SW ALLEN BLVD 10950 SW 5TH
SUITE 115 SUITE 110
BEAVERTON, OR 97005 BEAVERTON, OR 97005
Phone: Phone: 503 - 643 -1922
Reg #: LIC 0117658
ELE 24 -373E
FEES Required Inspections
Type By Date Amount Receipt Ceiling Cover
PRMT CTR 3/30/01 $75.00 2720010000 Wall Cover
Elect'I Final
5PCT CTR 3/30/01 $6.00 2720010000
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
Issued by Permittee Signature 1
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'N DATE:
LICENSE NO:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
I P iN - .. -,.. .
r Ele•ctricalPermitA lication
= .J,�. - 4i City o f Tigard Project/appl.no.: Expire date: ,
City ogard Address: 13125 SW Hall Blvd, Tigard, OR 9722 Date issued: By: Receiptno.:
Phone: (503) 639 -4171
Fax: (503) 598 - 1960 Case file no.: Payment type:
Land use approval: •
TYPE OF PERMIT
• O 1 & 2 family dwelling or accessory a Commercialrndustrial ❑ Multi - family 0 Tenant improvement
O New construction 0 Addition/alteration/replacement 0 Other: 0 Partial
JOB SITE INFORMATION
Job address: 13 5 3 S 5 — 12 . No , Bldg. no.: Suite n�.: Tax map/tax lot/account no.:
Lot: Block: (Subdivision: .
Project name: 3 t , ` „ re. . I Description and location of work on premises: S ,, , -; C V 4 _ 0 4
Estimated date of completion/inspection: . A . ,, _ - • • - -
CONTRACTOR APPLICATION FEE SCIIED14,E
Job no: Fee Max
Business name: L 3 Ct�tNIMU i (,�� -j ON S �q L. Description Qty. (ea.) Total no. insp
Address: /01 S - c f - k e • mi 4-, j 1 p New residential -single or mid-family per
dwelling unit. Indudes attached garage.
City: Kt t! r1 I State: p� ZIP: 9`10 0 C Servt «included:
Phone: (ptl S- 14LZ I Fax: 0/1 103 I E -mail: 1000 sq. ft. or less 4
Each additional 500 sq. ft or portion thereof
CCB no.: 111 (.Sig I Elec. bus. lic. no: ZN -3'73 Gl E Lirnited energy, residential 2
City /metro lic. no.: - Limited energy, non- residential ) 15.b0 2
2itur Each manufactured home or modular dwelling
o peldisb required) Date
Service and/or feeder 2 • Sup. : Sere .3-Le Services or feeders - Installation,
P (P�nt) p (, License no: alteration or relocation:
PROPERTY OWNER 200ampsorless 2
Name (print): 201 amps to 400 amps 2
Mailing address: 401 amps to 600 amps 2
601 amps to 1000 amps 2
City: I State: I ZIP: Over 1000 amps or volts - 2
Phone: I Fax: I E -mail: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary services or feeders -
which is not intended for sale, lease, rent, or exchange according to Installation, dteration,orrelocation:
ORS 447, 455, 479, 670, 701. 200 or less 2
Owner's amps to 400 amps 2
's Si
gnature: Date: 401 to 600 , . . 2
ENGINEER Branch circuits- new, alteration,
Name: or extension per panel: • A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: I State: I ZIP: B. Fee for branch circuits without purchase
Phone Fax: E service or feeder fee, rust branch circuit: 2
Each additional branch circuit
PLAN RE1'IE11' (Please check all that apply) Misc. (Service or feeder not included):
O Service over 225 amps-commercial 0 Healthcare facility Each pump or irrigation circle 2
O Service over 320 amps - rating of 1&2 0 Hazardous location Each signor outline lighting 2
family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
O System over 600 volts nominal more residential units in one structure alteration, or extension* 2
O Building over three stories 0 Feeders, 400 amps or more *Description:
O Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
O Egress/lightingplan 0 Other. Per inspection 1 1 1 1
Submit sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other �•
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ •00
O Visa O MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card number: / 1 within 180 days after it has been State surcharge (8 %) .... $ 4.00
ExinrCS accepted as complete. TOTAL $ g 1 .0 Ip
Nance of cardholder as shown on credit card
S
Cardholder signature Amount
440-46I5 (t■00/COM)
3 -zoo
=:PITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
' BUP
Date Requested d AM PM BLD
Location /3.4":35- Sw 7Z.- Suite MEC
Contact Person Ph 90-7) a i PLM
Contractor 3 7/ nowt vvt . Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR `e, -( —GV
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: n
Slab S 2 C v /`I QL SIT
Post & Beam /'
Ext Sheath /Shear foie .P�41/4f
Int Sheath/Shear
Framing -
Insulation -
Drywall Nailing
Firewall / /
Fire Sprinkler Ar.;
Fire Alarm /
Susp'd Ceiling - _ _ - _ — -
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary qewer •
Rain Draiiiik
Final
PASS PART FAIL
MECHANICAL •
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
Service
Co
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final -
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk Date 4/— /o— !2/ Inspector � Ext
Other
Final • -
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.