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Permit Support Document (23) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT ' 2: COMMUNITY DEVELOPMENT Permit#: ELR2017-00152 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 I Date Issued: 07/11/2017 Parcel: 2S112DA00800 `. Jurisdiction: Tigard Site address: 15115 SW SEQUOIA PKWY 130 Project: PacStar Low Voltage Cabling Subdivision: PACIFIC CORPORATE CENTER Lot: 2 Project Description: 510636 PM670 PacStar-Install cable to Wireless Access Point/Install cables to(4)production areas Terrance Jorissen is PM. 7/31/2017: REPRINT to correct address from 15055 to 15115,suite 130. Contractor: COCHRAN INC Owner: PACIFIC REALTY ASSOCIATES LP 7550 SW TECH CENTER DR#220 ATTN: N PIVEN TIGARD, OR 97223 15350 SW SEQUOIA PKWY#300 PORTLAND, OR 97224 PHONE: 503-234-6564 PHONE: FAX: 503-238-2098 FEES Description Date Amount Specifics: Restricted Energy Permit 07/11/2017 $75.00 Type of Use: COM 12%State Surcharge-Electrical 07/11/2017 $9.00 Class of Work: ALT Misc Administration Fee 08/01/2017 $45.00 Total Number of Systems: 1 Audio&Stereo: 0 Boiler Controls: 0 CCTV: 0 Clock Systems: 0 Data&Telecommunications: 1 Fire Alarm: 0 HVAC: 0 Instrumentation: 0 Intercom/Paging: 0 Landscape/Irrigation: 0 Landscape Lighting: 0 Medical: 0 Nurse Calls: 0 Protective Signal: 0 Security Alarm: 0 Other: 0 Total $129.00 Other Desc: 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 throu•• e A R 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: Permittee Signature: 1�/1G-/e057.770 f� 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. City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15115 SW SEQUOIA PKWY 130, TIGARD, OR, 97224 Record Type: Record ID: Commercial - Electrical Limited Energy ELR2017-00152 Inspection Type: Inspector: 198 Low voltage final Jeff Grove Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15055 SW SEQUOIA PKWY 100, TIGARD, OR, 97224 Record Type: Record ID: Commercial - Electrical Limited Energy ELR2017-00152 Inspection Type: Inspector: 198 Low voltage final Jeff Grove Result: FA I L Comments: Address incorrect Should read 15115 sequoia 130 Please correct at the city and recall Work inspected and ok Violation Summary: Inspector Contractor