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Permit - A CITY OF TIGARD ELECTRICAL PERMIT - RESTRICTED ENERGY , DEVELOPMENT SERVICES PERMIT #: ELR2001 -00279 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/7/01 SITE ADDRESS: 15905 SW 116TH AVE PARCEL: 2S110CD -00107 SUBDIVISION: KING CITY NO. 2 ZONING: BLOCK: LOT: JURISDICTION: KIN Project Description: Installation of data drops and patch panel. 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: NORTH SHORE CORP, THE POWERCOM INC BY BANK OF AMERICA OREGON PO BOX 3205 PO BOX 6400 -UNIT #2814 SPOKANE, WA 99220 -3205 PORTLAND, OR 97228 Phone: Phone: 509 - 535 -5533 Reg #: LAC 148214 ELE 37- 391CLE FEES Required Inspections Type By Date Amount Receipt Low Voltage Inspection PRMT CTR 11/7/01 $75.00 2720010000 Elect'I Final 5PCT CTR 11/7/01 $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 -01 :: : • ough OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503) 246 " 987. AIIPP Issu . by �;� a Permittee Signature �L �— 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 11; 02/2001 12:47 PAX 5035031980 CITY or TICIRD ICUUZ / �°ct�:.I Permit Application / \ 1�.. u � i. �-t as l ` �y Dattrucarcd. // 7 a/ i PEPretno Ez-- te�.ce /� ;7 `• f ' r.i ca tb 1 E tc hoot: Cuy,y Toed At5c41 :71 1312S 3VN Ha.il ?IVe, ? 1 it OR 91223 1---- - — 1 ' Wre lisued: By I Rrcc+p, t.o 1 PhorlC (5031639-417: t rte: 150)) 598 -0G0 ` Cmc ntc (Y!•Y'tlrr,:type Land use approval: " "_ • - — 1`1-11L (0- F'13t1 \}11 - - - -- - -.__ 1 a2 2 Itf"►t1y dwelhag, of avocs'ory AC ommercial /industrial 0 ,Multi- f4mtlY 0 Tonans lmptprt•nent Vsw .iva.QUcLien J Aallucrivaltcristiontisvacertient Q Other. — Q faillbi — _,IOrt. Sl'17. INa tikl►1 'i 111!\ lob adSliAl 0 L'// • Th • .. - Bld• no.: Suitt no.: ITgtx eta* tn>; lotixcpset no.: M ' lee .. I ✓ ° u••lvieioft: _ name: ` ©f _ r Ohl Deatrivion and 1ozw4cci of - -rock oo reggaes: hl p1 J ',ea ° ,4' / 7' < Esdnlated date of coca • ciroQyinevecbOn: • 11'\'1 t.l Wt. %A'I'LS( . \I34I\ 11.1. 11 J11DPI 1. . 30► no: he 1 I Mu l3trpnc'cs acme: �'/ u/ G r _ . - - ft 1 - i rrz) Tomt i no. e. }yr11 . 1... _ !Y •- „ ,. 1. „l rltltlttiSS f .t∎lla1m•l1- Iweistsealua )mop. . n • AgIA -71 ! � • • 'lZ d sorviaew i Phone , 2f71 Fox 2S7/2f E•msl: *000ro.ft orlat I j 4 j { Cali 1, no.: f " / Elct. ben e_ or.: 3 7- 6), / L'L/,' tia.lc .dd,Jord 500 x • ft el panws durmot I j T.4 Ve , rc.4ta 1 "I �— lit* i� _ U tR11t+a Ge r�, eeItutdvCs; ----- I 2 I . . �: �. F� mem,raclunO hone et two dwdhes I : I 2 S, • ntlr,E of 31. /Vr;, FroBt, AA r ;•-, ,,- .,; J , �`'-'�j uric — - = str.,.z G y r ....r. ^.'� �I I T �'ritra ._ :rm ty /6t 7. fte ► . 9n ' _ .'_ flied r I hn or tYtata+yotl ' r1 14 :-I'le :^e of ! i I .ltarn I. Nzns (pmni): sZ44 i y,- /4/►1eA'fe4 _ �.�.__ f _ i fi 2 -. Miiliag lddre :t' 5 �O1 • Ip�4n .. r 1 G1ry- -m _ •/,.', Stae :0/� T� 7 Zy (hu)(bC•rr�or. kt 2 Mona .it:. E-mLil: Rwr„ruo r]r IMAM utv I ntt inlainnr�n. iniUiitoa, nt -tltt i -. - en pcopetry I own �: sr°Y ••• =--- =° j j saute) •t r.et :.1Knd^C (cts S .k. lease, !Mi.. tic t m c atterdieg to beelr+ll"t)Itl. NQn'Mnt o► srborae 1 1 ORS & 4 5 a. 479, 610 1D1 40 uryw 11,1 033 I JJI:tTU+:I+s:le:a� ? O1 stencilrt Dust rp ►f z c 1 •(l1f • ehciM • -aeW. .. .;, - .r 0 /tr pa,t & , (damo. .g` Pz mt brtoc..;...a'. _.u, : L A•4dre PA- )trust or holes ha •sell be %MI, c:+,,,:' i f I 1 Ctry Slurs' j 2u': g• • tear bttioltz:na.;r.. p.rt<i t ` ( - 7".. - of e�vkk or !creaser he. �rsr l - -.-t J I -.;u!c 1 I z t�Fres}e tap . - )nape: EXcalli enJ 144,14 E -- e�� -- . >1c - Il'.'i+- ww..a-= alu..;- .tit- ttt zt-.tllPt ,- 1 - Mvc (9srstaeart+:ks aostmod:. r _ 0 S•rv:er cer 211 amps corn Grr1! O Nrhl um: fte:Lt} Each cum; e: u7oVIcet ;trod 1 ! I 1 J i s Sofiae o•er 310 lanipi-nkusg 3 1 o 4 ( ) � . 1 G Ntsatdavl Iexiasn ' A no 6..11∎4.lapbdsu 1 t 2 1 empire da,riittit} 0 Eivlldln& o• 10600 40,4,01, We 'roe Sloilai Oral(11) et 0 1.1110100 ew,•tr t..nr1 1 D Stittem o we600 volts ooe:..e1 Marlasl4�nu ll•,r.r.+...d ► .,.r ehn�tiee•er >eautorr' I � ; I J 2 o t1mt6Sng over )))tile f10AG 0 F. ADO c.noe or :tors . 011: - - Orman iota ova ye pertor u FMangier a•t rnd urvco m kw poet - r?r a to any .ttb dlaro s a 3 arro 1,01∎ i'3nlolen O flee -r .- : . — rw wf rsm., f---:.-- —J.. - . t %U6talt sail 61 crux∎ with arm of the ■Lor I.. ' gist f.. P TM alms tree set opplitable to trfIVO 'ary cow ea rrtca • t, r- L...ete .....4we.. ✓r+w• .... . e ..& .Ie r • o. ............, gar owl �,•.�•,.. i Kara.• Tens pr cede %ppl 1[lrloo Permit t RI: - -.. . Y - �_�___ 1 C Kg,. U M a r,Cva ! axpiret If a 'Kno'Knoll ta — if not obtarri pll. cult•:: _,__ %) € _ - C.tSt rAtY - __ .1 ' • +, WV ?the: ;3C ?ski ∎.rtes :) k_ he.= glue -curcNifgf Celt') 3 ` - - ° I acoeptsdetcomplete TOTAL .. S ..— 1 ti..., ,� ...u,iww n - 0— dA ,nuii Cjii■ 11/07J2001 16:01 5036393771 CITY OF KING CITY PAGE 02/02 Af KING CITY 15300 S-W, 116th Avenue, King City, Oregon 97224-2893 Phone: (803) 639 -4082 • FAX (503) 639.3771 Notice To Contractors Working In • b .fin a b City Due to an interoovern,znentaI agreement with the City of Tigard, many building related permits for projects in King City are issued and inspected by the City of Tigard. If your permit application DOES NOT REQUIRE PLAN REVIEW, simply complete the appropriate application legibly and submit it to the King City staff The King City staff will collect all fees and fax the application to the City of Tigard. City of Tigard staff will then create the permit, issue the permit, and perform inspections. Please indicate on the permit application whether you would like the Tigard staff to call you when the permit is ready for issuance or whether you prefer it to be mailed without any notification. Any incomplete or illegible application will be returned to King City staff for correction and no processing will occur until a complete, legible application is received. If your permit application DOES REQUIRE PLAN REVIEW, this form must be signed by a King City staff person. King City staff will simply sign this form indicating land use approval. Take this signed form to the City of Tigard Development Services Counter located at 13125 SW Hall Blvd, Tigard, to submit applications and plans. Development Services Technicians are available at 639 -4171 Ext. 304 should you have any questions concerning submittal requirements. All permit fees will be assessed and collected at the City of Tigard. The City of King City hereby authorizes applicant to pursue permits at the City of Tigard Building Department for the following project: • located at:_ i // 7 ^ U / King City Represe tative D5T5KC[NsTDOC CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested / / --- t i ) -- Or AM PM BLD Location / 5� 0 5, ,, 9, 1 1 6 iit Avc.. Suite MEC Contact Person ErR ,A ? ) A A -I F /V (0 Ph PLM Contractor p --,p ( - Ph -, ®r , 7 SWR BUILDING Tenant/Owner ELC Retaining Wall , ELR ('o/ — 0/%g, Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing / / Fire wall ��: 00 P : M. / a f � — '2 —c � Fire Sprinkler Fire Alarm ( / o Susp'd Ceiling / r r / i' . .. ii /Ma (/ Roof illo Misc: A! ii . .• A • A • ..1 i . Final /? L ' mi l , •-t st 1f i-t. PASS PART FAIL /` is.., E � �, �C � � /!2 ti--,. 4 c� PLUMBING �/1 / aa--7' � � ,v,, /4,- Y,a, - ;( z� � � L � l t : 2* . Post & Beam Under A. t .� . .. ' I_ *c( —/v /1i. Al Top Out Water Service Ike ()1 D in 4(f �C Cl/ ,1 Sanitary Sewer / Rain Drains i.1 (7 7 /7 V a e 1 Si Final A PASS PART FAIL ('Q cri ; h � ' 7,y) /, , / f (A) /ft— /'S MECHANICAL Post & Beam ��� J i� , __ 10111 -at i Gas Line Rough I��/lCf ,Six, Ad 47 , At /et */'-` Sc J Smal oke Dampers - 7 1 A/' f :k-7svi 5;c.,_ l 'd ie el )1-1 S7 / / 7 PASS PART FAIL c i l CI , )1 Ac , 4Ccii /h St--- / A c i ELECTRICAL Service 1 `t' ' G�)/*p.) -- / S 41 e '� 741 Q O " Rough In l UG /Slab c71O1Od'Dli.� 6 ,.t a/ h y ,, /YJp 0"i co Low Voltage D` Fire Alarm EI,S ) PIC* P(' (..F✓'COrv- T LP PART FAIL SITE Backfill /Grading Mr ' L -_ - )i.+ � ar • A `` � ur .I_!_ .', . Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA / Approach /Sidewalk Date / I '" 7 - o / Inspector 2r1 Ext Other l Q `. Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. tel Gp CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 / BUP / Date Requested / - ZJ AM PM BLD Location /.5 V'(> SC / / Ai( Suite MEC Contact Person a /L 4/1 • N' h (,, Ph .26 — 99a PLM Contractor Ph SWR BUILDING Tenant/Owner ) ELC Retaining Wall ELR p / � U Z 7 Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing _ Firewall ----4111L.4=="14/ Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL 14ital2 PLUMBING Post & Beam Under Slab Top Out c Water Service J `-, Sanitary Sewer Rain Drains /L P / j Co i. /9 Cam HA Final PASS PART FAIL MECHANICAL "P".7.e. Post & Beam Rough In Gas Line ;n / I. ( ' ��YL Smoke Dampers Final PASS PART FAIL _k-ECIROC er■ice Rough In UG /Slab Low {te ire A arm PAR � Backfill /Gradin Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Other Date // A / -- (3/ Inspector . _ ,., .. Ext • Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.