Permit . . w
� , CITY OF T ELECTRICAL RESTRICTED ENERGY PERMIT
o DEVELOPMENT SERVICES PERMIT #: E -00136
..� II , OR 97223 503 - 639 -4171 2511 05
005
13125 SW Hall Blvd., T i gard DATE ISSUED: 1/2
PARCEL: 2 S 112 DA -00800
SITE ADDRESS: 15055 SW SEQUOIA PKWY 180 ZONING: I -P
SUBDIVISION: PACIFIC CORP. CENTER LOT: JURISDICTION: TIG
Project Description: Install low voltage for voice /data.
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 STEELHEAD TECHNOLOGIES INC
15350 SW SEQUOIA PKWY #300 -WMI 1520 NW 6TH CT
PORTLAND, OR 97224 GRESHAM, OR 97030
Phone: 503- 624 -6300 Phone: 503- 492 -2119
Reg #: LIC 159346
ELE 26- 1205CLE
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 6/1/2005 $75.00
[TAX] 8% State Surchart 6/1/2005 $6.00
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and
all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not
started • • • - _ a says of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires
you • follow rules as • •ted by the Oregon Utility Notification Center. Those rule are set forth in OAR 952 -001 -0010
th • ugh OAR 952 -001 -■ :0. ' •u may obtain copies of these rules or di r - tea• estions to OUNC - 503'24: 6699.
I .sued By: / / -� i 4 /4 • l Permittee Si , W
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N DATE:
LICENSE NO:
Call 503 -639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
FROM :.STEELHEAD3TECHNOLOGIES FAX NO. :5034926265 Ma 31 2005 07:34AM P1
— ... . •® • a e• r. r r r u a a a oz a a w Y !J .• . 4
Electric ermit A li . _ /
City of Tigard !IIIIITI
B,n
1317.5 Sw Hell Blvd.. Tigard, OR 91 9 f, men nevi .•• 11 O,her lee it:
Phony 303.639.4171 Pas: 303398.196(1 �. \ tl 1 1 , - � _ ^ ' � liarcb 9 t , /! El See Ted
Inspection Line: S03.6311.411$ J i' / t/((I�� L :br
Interne[: www.ci [iQsrdar ui
�� • Notified/Method: • r 5�pplunIt as IniAemato
. lin ew construction A • • ”, . .... � i f I • Picric cheek all that apply -
� Qservice over r.3 . comae) ❑llazatdottl: location
Demohiion ❑ , '; ❑Service over no =pa,
amps - ration Qi3 elkIng over lo,00D s(. R
L _ . caTECOa • • • • coNst'avclE br4 • :.. ••• • . , of 1- End 2- 11intly dwc has5 4 or room new residential
Accessory loading Q System over 600 volts nominal units in Doe mecum 1. and 2-family dwelling Ctmtmetoiallr ill ❑ r ❑Baildcigwer three swiss QFee4et;.4otr amps or iron
0 Multi- faruly 0 Master builder 0 Other: g�I � 00 load over 99 persons DMmmuh,caued*to-eomno co
• Jo • SIB$ U1FORMA norf.4ND LOCATION •• ; •t/, ( DEgtessflighcag plan RN/ park
Job no.: 1
Job site address: X55 S tP S ea t! l d ❑fleatttroareisa7itY Do.
Submit .2,_ seta of pima with any ate above.
City /State /ZIP: r)„ t at- The above moot applicable 90 temporary coltsarelien seroim.
� FEE* .SC>�DIIi.E •
Suite/bldg./apt. no.! S = :..L 0 1hV17 ' _ . , • . Q F+ Terri ••
Cross street/direction.; 10 job site: • A 0 , ___ -4 - New residoasa w tn
t siaglor uniara IS &Veiling nr.
ai
ladodas attached garage.
1 .000 set. It. at less ' 145.15 4 1
Subdivision: I L o.
` t n: EA- edel l 500 sq. Lee partied 33.40 I
Limited enew, rtsiderma, 75.00 ` / 2 1
Tax map/parcel on.: Limited i gy eon�dGel c 75.00 ' 2
DESCRIPiION• OF WORK Each maaufad+med er modular I 1 '
dwelling. service andror Swig: I 90.90. 2
V I Services or [ethersbemuse:en,altS7 iWW
200 stripe or less ` J 80.30 , 2
• p. PROP " Y O WNER 1—, ENANIF 201 amps to 400 arms 10660 I 2
401 an�I,sti 160.60 12
Name . ■ _ -k . C. a .: •i■IV `ems : — 601 amps to 1,000 stays 240.60 r 2
r 0 OAS ssecta ntpsor votts 454.63 2
Address: IS osa- S kit, , S �v O`er` �(y j 156 its z
City /SultcrZ(P: 01%—•" ---I I Temporary services or feeders l asauation. alteration, vnd/ar
rEoo
MUM; (TC�) q` L 'y e;x. Fait: ( ) - I Sm
.V0 reaps or les 1
s _ 66.85 ( 1
. Owner installation: This installation is being made on ploper:y that I o which is not " 301 maps to400 amps ;00.3 f 2
. intended for sale, tease, rent, or exchange, acttordiag to ORS 447, 449, 670, and 701. 401 s to 600 amps 133.75 t 2
Owner signature: Date: I Branch a5rauirs nt:w.elm lilen par payer
❑ APPLICANT COI4TACl• ri soy A. tee for 0= 01 edreatia wtrh i
t h
soma a or feeder each
Business name:. .L IQ L mmm i• l cM r, branch c"""t - 6.65
( 8• Fox for branch eueusts I
Cornet name ; I wit/ma,t oee.•lce oe feeder eel. 4635
Address; C ' + v � � I Each sad 1 branch , &twit 1 L 6 -65 ' - r 2
• y/S ` !`e3 sl► - Q"- 42 T Miscellaneous (eee.eiee or Roder not included)
Phone : (5 Cr+) ctq2— I lk Fax : (S GG d Sigh or outline rightism O A ) 2
i3 i
E•ttlatil: siq ii dr uqs) or limited- •
CONTRACTOR energy poses, alteration. or
extension. Dest:nlbe: Page 2 1 1 2 1
Businta>s name: _ .` J -� M
o v ;
,/ + Each additional over allowable is auy of the above
Address: / /vV • Ferinstaeaioi 6230 I
- 7 0 Investigation per hour (! ht m3q ' , 62 '
City/State/VP: R ` •
I
PM= ( Fax: ( ) I industrial ohm per hctr I i 73.75 t t
/ ` < r , � ELECTRICAL YFR'vr T MN'
' 7 , Electrical Lie -4 %20 Sr! Su mrv• Lie . Sutatanal I 7
Suprv. Electrician signature. required:
Mini aevi� (25% of permit fen) Q tr i
/ / ,,/ i Date: Slit surcharge (PAGE permit fee) ( r` t�
Print name: v ,,mw
/� I TOTAL PEPM1T FEE , E
Authorized s cute: �, pencil application expire a m
ilia days alter h hat harm =tweed m mmpkte
i
I Print •'R . / e irrAraki,Mardli Date: I • Fee ereatooseey set by Tr eiildi3g lndusny Suvtec hears
•• Motor of ism: em par Prop: allo..rd.
inl3c1Wideerreib•ELC4 I ?SO •..�, r ,O•x.COMN•EB
CITY OF TIGARD
BUILDING DIVISION , . #: ELR2005 -00136
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/1 /2005
Phone: (503) 639 -4171 .m1NI llll
Inspection Requests (24 Hrs.): (503) 639 -4175 __..
INSPECTION WORKSHEET FOR DATE: 7/5/2005 TIME: 7:12AM PAGE: 60
SITE ADDRESS: 15055 SW SEQUOIA PKWY 180 CLASS OF WORK:
SUBDIVISION: PACIFIC CORP. CENTER LOT #: TYPE OF USE:
PROJECT NAME: PACIFIC STAR COMMUNICATION S 44 y"
DESCRIPTION: Install low voltage for voice/data. cni. 4 g G
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: 503.624 -6300
CONTRACTOR: STEELHEAD TECHNOLOGIES INC PHONE #: 503-492-2119
Inspection Request Scheduled For: Date: 7/5/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
' Low 4tag= 010693 -01 503-492 -2119 Y
• ections /Comments /I • -- . • s:
— I TM ` Totew 1 1 dzi 0S
b ( c t( v6
c -1.l`)
Nt
PASS. ❑ PARTIAL APPROVAL ❑ CANCEL El NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: N L Date: b Phone #: (503) 718-