Permit V. -.
CITY TIGARD ELECTRICAL PERMIT -
y DEVELOPMENT SERVICES RESTRICTED ENERGY
PERMIT #: ELR2004 -00166
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/18/2004
SITE ADDRESS: 12909 SW 68TH PKWY 400 PARCEL: 2S101AD -03200
W
SUBDIVISION: TIGARD OFFICE BUILDING ZONING: MUE
BLOCK: LOT: JURISDICTION: TIG
Project Description: Low voltage for data telecommunications.
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: Phone: 503 492 - 2119
Reg #: LIC 159346
ELE 26- 1205CLE
FEES Required Inspections
•
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 6/18/2004 $75.00 Elect'I Final
[TAX] 8% State Surchart 6/18/2004 $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 fo - . • opted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010
throug OAR 952 - 001 -c 100.:u may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699. • CiS) ff=;;_s__csoli Issue by ._ : ;� � 1 ' Permittee Signatu
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 an inspection needed the next business day
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CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: 4503) 639 -4175
INSPECTION DIVISION Business Line: 4503) 639 -4171 MST
BUP
Received Date Requested 6 AM PM BUP
Location - (1 Suite WO MEC
Contact Person • ( 77/ ) 9( - Z 1'6 `t PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access:
Ftg Drain EL Q,6 /64.
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
. ) 1
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation / J 1 er f i " F/40
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fi = alarm
. � � Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
�y PART FAIL
s Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line /
ADAoach/Sidewalk Date I nspector kP"`�� Ext
PP
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL