Permit Support Document (20) 'PICITY OF TIGARDELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT .`= Permit#: ELR2019-00115
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718 24391 Date Issued: 06/17/2019
�..__ . Parcel: 2S113AC00101
Jurisdiction: Tigard
Site address: 7245 SW DURHAM RD 180
Project: Pacstar Subdivision:COUNCIL VIEW ACRES(LOTS 21-44) Lot: 37
Project Description: Pacstar Network data cabling. 8/19/2019: REPRINT permit to correct suite from 100 to 180.
Contractor: PACIFIC NETWORKS INC Owner: PACIFIC REALTY ASSOCIATES LP
16869 SW 65TH AVE, STE 373 ATTN: N PIVEN
LAKE OSWEGO, OR 97035 15350 SE SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-645-4000 PHONE:
FAX: 503-352-0202
FEES
Description Date Amount
Specifics: Restricted Energy Permit 06/17/2019 $75.00
12%State Surcharge-Electrical 06/17/2019 $9.00
Type of Use: COM
Class of Work: ALT
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 $84.00
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 through OAR 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.
f) 3P/I- J7- L-T—
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.