Permit CITY OF TIGARD ELECTRICAL PERMIT
RESTRICTED ENERGY
*44 t101 4 DEVELOPMENT SERVICES PERMIT #: ELR2002 -00016
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 2/7/02
SITE ADDRESS: 15862 SW 72ND AVE 200 PARCEL: 2S112DD -00200
SUBDIVISION: OREGON BUSINESS PARK III ZONING: I -P
BLOCK: LOT: JURISDICTION: TIG
Proiect Description: Installation of voice /data cabling. Job No. M55
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
PACIFIC REALTY ASSOCIATES ALLPHIN COMMUNICATIONS INC
15350 SW SEQUOIA PKWY #300 -WMI 23220 SW BOSKY DELL LANE
PORTLAND, OR 97224 WEST LINN, OR 97068
Phone: Phone: 503 - 698 -9000
Reg #: ELE 3- 406CLE
LIC 107548
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
5PCT CTR 2/7/02 $6.00 2720020000 Elect'I Final
PRMT CTR 2/7/02 $75.00 2720020000
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of, issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law,
requires yo follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -00 -0010 th ugh OAR 952 -001 -0080. You may obtain copies of these rules or direct questio to OUNC at (503)
246 -1 87. 4;
Issue by � k , C6C sik 4 Permittee Signature, 4 e A °
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale. lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
P .1
Electrical °n
Daterecoivcd: /142— Permit tw.:&.. ,y , . -,xt'/ i
2A52 lko)ecdappl.no.: Explredate:
r;pji City of 'x'igard �R3 a Receipt no.:
Ciry ofTigard Address; 13125 SW Hall BI Dat eissucd: y'
Phone: (503) 639.4171 ,�.y� tai Cave file no.: Payment type:.
Fax: (503) 598 -1960 ant O
TVa++ IVISION
Land use approval.
TYPE OF PERMIT .
O Multi family want improvement
O 1 & 2 family dwelling or accessory O Commercial/industrial 0 Multi
• - 0 Partial New construction 0 Addition/alteration/replacement
. JOB SITE INFORM11ATION
,Ir� Bldg. no.: • • Sultc no.:, 00 Tax map /tax lot/account no.:
Job address: S t 6 9-- "41— �
Lot: Block: Subdivision: LI,U (-7 Description and location of work on premises: VD /cc DA-7#-
Protect name: a$ Q
Eaumate4 date of completion/inspection: . FLG SCHEDULE . CONTRACTOR APPLICATION
Job Pet
Go: SS DraulPtfoa Qty lea) IMO
Business name / . A .. • i r fi 0 i v , o I residentil - ' owned - family per
Address: 3 „_p S' G o'v
t 1 1.-Cli dwelling unit Indudesinaemed �..
Stare: 6 7 ZIP: O (o I Serriccmeludod: 4
rift b1 1000 sq. R. or lets
Ca ry rtionehenaot �_
PPhone: , • -- f 5. • Fax: a Elec. (00 PAch a bona! 500! or _
D J • 7 - P i Elec. bus. tic. n0: 3' o e- -E umi ; ra' I :-=
City /metrolic. no.: • : _ pach manutacturedhorrte or motluludwelltng 1111111.111 2
%/_:-. � d Z Service sod/or feeder
n (r wired) Date anon, 1111111 Signature of su• - is ( Ser • d-
i Liccnccno:<3SB" allerationorrelocation: 2
Sup. elect dame (Print): ,� ri 100 amps or less
rnurc[1r1} o���lvcR ��� 2 • ': � � r 201 m 400 amps 2
Sou cvlS
Name (print): ht 3 � • , �' ,. his. � 601 a 401 amps to 600 amps � 2 are •s to 1000 amps _
iiiiiii; dress: _ t - • A '' 2
State: 0 ZIT: r - Ovcr 1000 amps or volts = _ 1
iitco E -mail: ■
°wil c ' Fax: � � ' Z Teropornry anima or tec -
pvmet installation: The installation is being made on property I own rtladryv
o e g (trivia:
allow 2
which is not intended f or sale, least, tent. or exchange according to 200 unp er leas
ORS 447, 455, 479, 670. 701. 201 amps W 400 amps • MI�= 1 • Dale: 401 to 600 amps
Ovmu's :. '' cue: araneb'elreulu- ocw,atrenttoa
ENGINEER orexlcusten per penal:
A. Fee for branch circuits with pvrchaac of 1
Km= or rt:odcr fee, oath branch circuit 1111111111 ti. Fee. for branch circuits without purchase 1111111111 EMI of service or feeder (ce, first branch circuit: 11111.111111.11111 2
Email: �e ■■-
Phone: 1 : Misc. (Service or roe
erc deraor Included):
?LAL' REVIEW (Please 'check all that apply) ' 2
0 Health -carefseility Each pum• or ltrig circle �- 2
O Service over 210 amps-commercial t•r t g (0 lfasuncut location °n 111111111111 D Service over J 10 amps ruing of lea 0 Building 000 square (e
g over 10.ct four of Signal eircuit(s) or a tintlred energy V
faintlyd Over altu/uon,orectenslon•
O Sys em over 60 0 volts nomind more realdenusl units (none rwtxure
0 Redcas. 400 amps or mom •Dc cri.tion: _ o(tM above:
Occu Building over them stories p Ea& • Motu! utspection over the allowable In any
p Occupust load Duct 99 persons Cl tvtartuteeturcd structures a RV park __�
0 Other. Per inspection
0 e tnvesti:scion • '
Submit _ sets of Mans with any (tithe above. Offer
Ilse above are not applicable to temporary eoastrUl aoa seTVice,
permit fee 5
liwtion
one az<pt crrdi(eardr. please WI jurtadituon for m oot nfarmaecc. Notice: This permit app Plan review (at %) $
0 at i j k 1 expires if a permit is not obtained Suite Surcharge (890) $
p Vua Maat� ud OWO�7 fl within 180 days after it has been
_ • (/(.1/ Y�r 2 . P •MI — TOTAL $
cram' c • • n t� � •• - • • accepted as complete.
Ht('7 l
• • ` M M c veri, ndit card - oD • y��15 (6�ONC0M)
574.:T�1�' "si
l
CITY OF IGARD 24 -Hour = _
BUILDING - - Inspection Line: (503) 639 - 4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested AM PM BUP
Location / J c-- Rio Z . 7 d /a- e-)-e-Suite ac, v MEC
Contact Person (L&l ` �( Ph ( ) 8° 7 / " 1 Z— PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR goon A7 04.
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
In=aiIing S a 1--t>0 J s 1 t, (
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
acnri
Fire Alarm
4Z PART FAIL 111 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
S 0 Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line
ADA Approach/Sidewalk D l '� G --� -= Ext
Other:
Final DO NOT REMOVE this Inspection record f om the • b site.
PASS PART FAIL
CITY OF TIGAR 24-Hour
BUILDING Inspection Line: (503) 639 -4175 ==
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested 3 AM PM BUP
Location 15 '?4 �7 2- .'Z Suite 2 0 MEC
Contact Person /k C . Ph ( ) x(00 - PLM
Contractor Ph ( ) SWR 32,
BUILDING Tenant/Owner .. ELC
Footing ELC
Foundation Access:
Ftg Drain P /rnEc._ Q ELR - COO I (o
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation AA
Drywall Nailing _ r
Firewall VITA) JP ��Ala� 1 1 �1 � �
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
Low olt
Low Voltage a
Fire Alarm al...,
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
iha PART FAIL
$ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Dated .q inspectir Ext
Other:
Final DO NOT REMOVE this inspection record from -e Job site.
PASS PART FAIL