Permit RESTRICTED C ITY OF TIGARD NERD
RESTRICTED ENERGY
DEVELOPMENT H B 1639 -4171 DATE ISSUED: E 90001 -00305
SITE ADDRESS: 15705 SW 72ND AVE PARCEL: 2S112DC -00100
SUBDIVISION: OREGON BUS. PARK III ZONING: I -L
BLOCK: LOT: 002 JURISDICTION: TIG
'Project Description: Data and Telecommunications system.
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:
PACIFIC REALTY ASSOCIATES NETSWORK, INC.
15350 SW SEQUOIA PKWY #300 -WMI 18151 SW BOONES FERRY RD.
PORTLAND, OR 97224
Phone: Phone: 503 - 464 -6600
Reg #: LIC 138239
ELE 34- 513CLE
SUP 2812JLE
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT CTR 11/29/01 $75.00 2720010000 Elect'l Final
5PCT CTR 11/29/01 $6.00 2720010000
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 a set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or dire uesti to OUNC �,t (503)
Issue 246-1987.
/ / .( g
Issued by Permittee Si natur
•
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
_ ..11/ X001 10:44 FAX 5035981960 CITY OF TIGARD 11002
ElectricalPermitApplication A Date received: / / yl di Permit no." ,'gyp, _ !w
_:1i City of Tigard Project/appl. no Bxptre date:
city o Bard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: : g` Receiptno.:
Phone: (503) 639.4171
Fax: (503) 598 - 1960 Case file no.: Payment type:
Land use approval:
•
TYPE OF PERMIT . < _
O 1 & 2 family dwelling or accessory %Commercial/ndusuial 0 Multi - family 0 Tenant improvement
0 New construction ❑ Addition/alteration/replacemcnt 0 Other 0 Partial
JOB SITE INFORNI&TION °
Job address: /5(07 SW 72.14 /)venue '7 Bldg. no.: Suite no.: Tax map/tax lot/account no.:
Lot: Block: Subdivision:
Project name:Got, i/ i Description and location of work on premises:
Estimated date of completion/inspection:
CONTRACTOR APPLICATION FEL SCHEDULE
Job no: o?/ b // ? (v IIIIIIIIIhg Qty IR Told Pa
Business name: /wars w o i K INC.
} Na.te t- aingkortantti -family per
Address: / , l S 1 $I,t) Doane Fern, ' - • dttellogrm itIndadea'astadred®aage:
City: ' , . D IZEMEid ZIP: g 712 Serviaotduderb
Phone: ;03• '13(.. Fax: 503•(0ill•143 E-mail: r)ehto. rkinc.co 1000sq- IL " less • 4
CCB no.: 138 2 t2 Elec_ bus lie. no: J e G each additional 500 .. ft- or portion thereof =I �—
Iim 'tat eaergy,msidendal ___ 2
City/metro lie. i •.: to /35 ,. /0 0/ o 3- Linda:den v .non- residential ___ 2
a''�� r . / Each manufactured home or modular duelling Mil
S .:. • - • iwg electrician OW iced) D ata avian Service and/or feeder 2
Sup. elect. name • 'at): u O /J KA R P License no: L VI a-JL• Services or feeders— Installation,
alteration or relocation:
PROPERT OWNER 200 amp orless
11111 . 2
201 amps to 400 amps MEM 2 .
Name (print): 401 amps to 600 amps ' M__ 2
Mailing address: 601 amps to 1000 amps E_ • 2
City: State: ZIP: Over 1000 amps or volts ___ 2
Phone: Fax: E -mail: Reconnect old l♦(♦!� l •
Owner installation: T h e installation is being made on p r o p e r t y 1 own Temporary services or feeders -- llattl
which is not intended for sale, lease, rent, or exchange according to �aOO'a�'4°"' ortslomtsioa
200 amps orless 2
ORS 447, 455, 479, 670, 701. 201 to 400 amps __ — 2
Owner's signature: Date: 401 to 600 am • MIMI 2
ENGINEER . . Branch *calm -new, alteration,
or ettettslon per panel- -
Name: A. Fee for branch circuits with purchase of
•
Address: service or feeder fee, each branch circuit 2
Cit State: ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit ■ ■ 2
Phone: Fax: E-mail: . Each additional branch circuit ME_
PLAN REVIEW (Please check all that app/ }) Misc. (Service or feeder not included)
O Service over 225amps-commercial 0Health -care facility Bach pump or itigatioacircle ■ � _ 2
O Service over 320 amps -rating of 1&2 0 Hazardous location Each signor outline lighting _ ■ ■ . 2
family dwellings 0 Building over 10.000 square feet four or Signal elrau lt(s) or a limited =tern panel, Ol
0 System over 600 volts nominal more residential units in one structure alteration, 2
0 Building over three stories 0 Feeders. 400 amps or more
0 Occupant load over 99 persons 0 Manufactured structures or RV park
0 Eentallightingptan 0 Other M__
Submit _ sets of plans with any of the above. • Investigation fee •
The above are not applicable to temporary construction service. Other
Na au Jurisdictions accept crest colt, plow call *Make for lone iefonaatio s Notice: This permit application Permit fee $ Z� 0 0
7
. 0 Visa 0 MasterCard expires if a permit is not obtained Plan review (at _ %) $
cted;t card rwtoo - / / . within 180 days after it has been State surcharge (8%) .... $ eo • 00
accepted as complete. TOTAL $ J'/ . 00
- Name el =bolder as shown oa credit card
3 _
Cardholder agleam Amuse 4104615 (600/COM)
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
'/ BUP
Date Requested ! — I `t' AM PM BLD
Location / s 7 7,?-.7,79 Suite MEC
Contact Person 54(6 Ph 8! 6 c/ 6 Lf.1 PLM
Contractor 4,. `{��Q f ` hL
S =Gd„, Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR se/ ad
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: -
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Fire wall '�2
Fire Sprinkler . lt7 Vv C
Fire Alarm
Susp'd Ceiling
Roof
Misc: ✓ '
Final
PASS PART FAIL
PLUMBING
∎
Post &Beam P15/0 ti _ ii,_ I
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In •
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
_ ow Voltaq
t rik: ( 3.
Fire Alarm
Final
PART FAIL
s
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk Date L /
Other /� ' 7 `�� Inspector �Lpy�� Ext
Final (/
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST Mt?
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 = • .#
BUP
Date Requested 1 - AM PM BLD
Location 1 S 70 S 77Z /n,/ /1-1/-e__ Suite MEC
Contact Person Ph bI b y PLM
C/
Contractor Q Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ° ELR .20
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
' Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
ough n
U a.
c�Gi Qolta9e� //
Fire Alarm
Fin
PART FAIL
BackfilllGrading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach/Sidewalk 1 , _1)I>.2I Inspector C'1
Other Date Ins G' Ext
��
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.