Permit (19) CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT l t Permit#: ELC2016-00625
TICJ ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 tr`' Date Issued: 08/10/2016
�:/�3/ /67/3�/' Parcel: 2S112DD01600
Jurisdiction: Tigard
Site address: 15575 SW SEQUOIA PKWY 100
Project: Inspired Results Subdivision: PACIFIC CORPORATE CENTER Lot: 4
Project Description: Low Voltage Data com cabling for SUITE 180 NOT SUITE 160. 8/31/16:REPRINTED permit to show change of
address from suite 160 to suite 100.
Contractor: PACIFIC NETWORKS INC Owner: PACIFIC REALTY ASSOCIATES
16869 SW 65TH AVE, STE 373 ATTN: N PIVEN
LAKE OSWEGO, OR 97035 15350 SW SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-645-4000 PHONE:
FAX: 503-352-0202
FEES
Quantity Description Date Amount
1 ea Signal circuit or Limited 08/10/2016 $75.00
Specifics: Energy Panel
1 ea 12%State Surcharge- 08/10/2016 $9.00
Type of Use: COM Electrical
Class of Work: ALT 45 Misc Administration Fee 08/31/2016 $45.00
Type of Const:
Occupancy Grp:
Total $129.00
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a c•• s or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. �✓
Issued By: Permittee Signature:
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' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
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.