Permit CITY OF TIGARD ELECTRICAL ENER -
RESTRICTED ENERGY
I'I4c DEVELOPMENT SERVICES PERMIT #: ELR2003 -00055
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 2/21/03
SITE ADDRESS: 14945 SW SEQUOIA PKWY 150 PARCEL: 2S112AD -01000
SUBDIVISION: PACIFIC CORP. CENTER ZONING: I -P
BLOCK: LOT: JURISDICTION: TIG
Project Description: I
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 XTREME COMMUNICATIONS, INC..
15350 SW SEQUOIA PKWY #300 -WMI 901 W. COLUMBIS RIVER HWY.
PORTLAND, OR 97224 TROUTDALE, OR 97060
Phone: Phone: 503 618 - 8816
Reg #: ELE 3- 515CEP
LIC 147263
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 2/21/03 $75.00 Elect'I Final
[TAX] 8% State Tax 2/21/03 $6.00
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 n, es adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 -0010 throuc
Iss d b I / Permittee signature
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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 inspection needed the next business day
Fr-lb-20-03 07 :01A BTG P.02
Electrical Permit Application
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City p PeoeeafAtept no.: ; ,.
cityetf 7igrtrd Nadi 13125 SW Hall
Due issued: 1 1,M Receipt no.:
Phone: (503) 639 -4171
Fax (503) 598 -1960 FEB 20 2003 Cue M ono.: Payment type:
Land use approval:
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