Permit %
r. CITY OF TIGARD ELECTRICAL ENER -
RESTRICTED ENERGY
Ji�� DEVELOPMENT SERVICES PERMIT #: ELR2004 -00195
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/6/2004
SITE ADDRESS: 13221 SW 68TH PKWY 120 PARCEL: 2S101DA -00102
SUBDIVISION: TRIANGLE CORPORATE PARK ZONING: MUE
BLOCK: LOT: 002 JURISDICTION: TIG
Project Description: Data telecommunication install.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPEIIRRIGAT:
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:
TIGARD TRIANGLE I LLC PAVELCOMM INC
4650 SW MACADAM AVE STE 220 1640 NW 14TH AVE
PORTLAND, OR 97201 PORTLAND, OR 97209
Phone: Phone: 503- 223 -5008
Reg #: ELE 26- 559CEP
• LIC 00063963
MET 00003259
•
FEES SUP liaii & d Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 7/6/2004 $75.00 Elect'I Final
[TAX] 8% State Surcharl 7/6/2004 $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 follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 -0010
through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246-6699.
Issued by �� Permittee Signature cze L• � -�,—
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
Jun -28 -2004 06:52am From - PAVELCOMM INC +5032230104 T -700 P.001 /003 F-413
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Received Jun -08 -2004 12:1Tpm Frcm Tee
- fiO35881860 \' '
PA IV�I INC Page 001 , , •
CITY OF TIGARD 24 -Hour
BUILDING Inspection Live;, (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested AM PM BUP
Location 1 3 ZZ ( &erd ?(6.4) Suite / 24) MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access: — o o 1 9'5
Ftg Drain � ELR ZOa y
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation CG& A n0 ran ` FIB
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 —4'
F : larm
in PART FAIL 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
El Please call for reinspection RE: Unable to inspect no access
Fire Supply Line
ADA
Approach/Sidewalk Data 7 2/.. O V Inspector / - /c Ex t
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Lila (503) 639 -4175 MST
INSPECTION DIVISION Business U (503) 639 -4171
BUP
Received 7 hR pate 7 / AM PM BUP
Location _/ / l v =`— ,Q Suite /- MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) ‘-' SWR
BUILDING Tenant/Owner ` RR
,2-oc--9O/ 7
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation D �� l ,1 , er r t �.p P� V - _ c - & f ? 16 —
Drywall Nailing
Firewall Crr J E P
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
P RT FAIL
E RIC
Sery -
-
o gh -In
- - -
CGV9�
ow Volt -•
Fire larm
Fi .4 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
El Please call for reinspection RE: ❑ Unable to inspect – no access
Fire Supply Line
ADA
Approach/Sidewalk Date 7 0( Inspector -)60t. ���1+` Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL