Permit CITY OF TIGARD
ELECTRICAL RESTRICTED ENERGY PERMIT
i DEVELOPMENT SERVICES PERMIT #: ELR2006 - 10016
' .. I -- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 3/20/2006
PARCEL: 2S00600
SITE ADDRESS: 16195 SW 72ND AVE BLD.D ZONING: I - L
SUBDIVISION: PACTRUST BUSINESS CENTER LOT: JURISDICTION: TIG
Project Description: Limited energy for voice /data.
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: 503- 624 -6300 Contact #: PRI 503- 492 -2119
FAX 503- 492 -6265
FEES Reg #: ELE 26- 1205CLE
LIC 159346
Description Date Amount
[ELPRMT] ELR Permit 4/4/2006 $75.00
[TAX] 8% State Surcha 4/4/2006 $6.00 REQUIRED ITEMS AND REPORTS
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:
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 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
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.
1912 SW Han Blvd.. Tigard, OR 97223 e
Phone: 503.¢39.4171 Fax: 503.398.1960 `• t v • 1 'j DatdB c5/.16 8 g w1Ct Pars 06 ��14
Inspection Lint: $03.639.4175 -14 - ' ) owe Ready /8¢. �� �� --P-„... � id sea rep 2 for
;;. Internet www.eltigard.or.es Netifedf e li `-"' . ' 1 ,,,,� �9) h s'I sey p!anneal lnronn.tMn
. , 1 'OF WORK" .;i
i i • ' . , ' ' '• .: PLAPI REirlgw ` -
�te construction (� Addition/alteration/replacement - Please check all that apply:
❑ Other: ❑Servies over 225 amps, e2mnm'1 OBarinlous location
❑ Demolition ❑Service over 320 amps - rating OBuildng over 10,000 sq. ft
• ' - : •' . `,• CATEGGOOOP .COK$TRUCTIOON:.' •: ' . • % :: "' :: •' ..... -`T !':, r I of 1 • and 2.13um1y dwell In=s) 4 or more new residential
❑ 1- and 2 -family dwelling , ICJ Lommerda1/bdustrial b Accessory building DSyst over 600 volts nominal mils in one men=
• ❑ Mnhi- family ❑ Master builder ❑Other ❑Building over three stories OPecdess. 400 craps or more
❑Oontpent lead over 99 persons 1✓- orn+flrdvre
d structures or
' "'. =.:JOB'i17'L irrtORMATION A1YA ,LOCATIO:'t ".:, i;' • OEareaslighting plan RV pans
• Job no.: Job site address % (�'y� 5 9 7 , ,(�[ OHeaith•eaeee facility ❑ �
Submit i sea of plans with say of tba above
�iry/$tatefZfP: The above are not applicable to temporary construction service.
LLJ co Flap
� trite/bid /n no : I Project name: G i nweresn•e (e, w. � sac t Teal I
Cross street /directions to job site: • . New resideetial sln� or multi -family dwelling unit.
> o - . ,, Includes attached garage.
I ...mu cv 1,000 sq. A. or 1esa _ 145.11 4
•
C\12 1.1. LeSubdivision' • i Lot no.' Ea. add'1500 sq. ft. or portion 33.40 1
• _ Limited energy, residential 75.00 + 2
'
e= Tax map/panel eo - ' • Limited , non•reekiential 75.00 2
, .- . OESC1UPTI W
Ili - ,-1 :,':'•::' .: •• : > :: „ •,.: :.: ._ dN:'�O$ -: ORK " . •.. • . . Eaclrmenufeowrodormodular
Er r) D �� v u t J �w dwelling, service end/or feeder 90.90 , 2
, �7 Services or feeders Installation, akeratien, and/or relocation
in•°' 200 Amps or less I 80.30 2
•
❑'- PROPERTY O1i'NER' - • ' ❑CANT • .. -.
• • • • - .. ' 201 mum to 400 amps I I 106.85
. 2
• 401 tmtps to 600 amps ^ 160.60 t
Name 601 amps lo 1,000 imps 240.60 2
Address: .. over 1,000 seem or volts 454.15 2
Reconnect only 66.85 2
C1ty/State/ZlP: Temporary services or feeders installation, aheratlon, and/or
relocation
Phone: ( ) 1 Lear ( ) 200 amps or less 66.85 1
Owner i astaltatlon: This installation is being made on property that 1 own which is not ' 201 snips to 400 amps _ 100.30 2
intended for sale, lease, rent. or exchange, according to ORS 447, 449, 670, acrd 701. 401 carps to 600 amps 133.75 _ 2
Owner signature: Date: Branch circuits - eew, stteratl0n, or extension, per panel
• • ..... : i>Pef it l►Nr' ° � • : CoNTAcx• renoN :: :. ; ;' '•• : A. Fee for branch eiradu with
,,� ter ice or feeder rim met
Business =no: Lj , _ e1 �,,p /L V>�v . 1.A ' • branch circuit
6.65 2
a` " � 1 ~ B. Fee for branch circuits
Contact name: /',..,' n,. `�
,. (' . ' .cmjc without service or feeder feet. 46.85 2
• Address: � �.1+ f 1. _ • ( each branch circuit
►' E ach adcfl branch circuit 6.65 2
-
City/StatelZlP: C re_) [ f k s at- q 71)7 U M1,crllaneev (service or feeder met included)
Pump or irrigation circle 53A0 2
Phone: ( cip 4f -all 1 F» : � 4q). -r9 -6 sign or whine lighting 53A0
2
• E-mail: r - Sf'-Lb d " e v ere 7ui• - r.4 • `si cireu it(s) or limits •
•
✓• J = ' = CONTRACTOR•. :: ,.'•, . : •...• • .. :,.:.: panel alteration, or
� , rL . �,,"" extension Page 2 2
. Business mane: s f N I `'•`'/ k L /i#'b f N f /s"• •, �
Address: e - N L.p • Co Pi • Each additteoat Inspection over allowable 1. of the above • Per inspection 6250
e 4 • tlf Pty /State rZ P: 6 r e 5 t eft °( 4U 1 v . i Ion erlpilau per hour (t brine+) 62.50
1 /
� a+ Phoney. ofj
c) ){e,( '2- -1 j 1 1 Fax : '> 1' '1 2 ......... ) f 6 lOJ Idustridplant per hour 73.75
` / / ya , '' '..: ELBCTItf PEEOY[fC''3rELrS`
f Lin.: 6e, 4C I Electrical L�. :� • rv. e. '__„;,`..7.•• Sub, 1 7
S uprv. Electrician sign nire, rdgi�: Pion reVISW (25% of pe rah fee) t
Print name: ...• .5 z Date:3 ` ,� O.- 0 S shae,rarge (Sri efpem,it tee)
TOTAL PERMTT FEE r
• , Authorized alpature: Tut paste appaesrloa molts It a main b not chums 4 within 290
1 7 6 days after k has be accepted n complete •
Print name: • Date: • allowed. t `bdaruy service Hoatd
•• }Nabs of I �io
inactacarferrountAra doprdas met • aco- nsisnitvovtotoW®
•
CITY OFTIGARD
BUILDING DIVISION PERMIT #: ELR2006. 1001 6
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/2O/2006
Phone: (503) 639- 4171wd I � I °
Inspection Requests (24 Hrs.): (503) 639 -4175 1 ..
INSPECTION WORKSHEET FOR DATE: 5/9 /2006 TIME: 7:01AM PAGE: 63
SITE ADDRESS: 16195 SW 72ND AVE BLD,D CLASS OF WORK:
SUBDIVISION: PACTRUST BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: OPTION CARE
DESCRIPTION: Limited energy for voice/data.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: 503.624-6300
CONTRACTOR: S TEELHEAI:? TECHNOLOGIES INC . PHONE #: 503 - 492 - 2119
Inspection Request Scheduled For: Date: 5/9/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 029488.01 503-260-6897 N
Corrections /Comments /Instructions:
•
. G.
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
or: N661-11:11
V Date Q U 6 Phone #: (503) 718 -Z"I V
•
Inspector: � 1 ( )
CITY OFTIGARD
- --
BUILDING DIVISION PERMIT #: ELR 2006.10016
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/20/2006
Phone: (503) 639 -4171 �°y�b�'
Inspection Requests (24 Hrs.): (503) 639 -4175 "! I
INSPECTION WORKSHEET FOR DATE: 4/27/2006 TIME: 7:04AM PAGE: t3'1
SITE ADDRESS: 16195 SW 72ND AVE_ BLD.D CLASS OF WORK:
SUBDIVISION: PACTRUST BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: OPTION CARE
DESCRIPTION: Limited energy for voice /data.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: 503. 624-6300
CONTRACTOR: STEELHEAD TECHNOLOGIES INC PHONE #: 503-492.2'119
Inspection Request Scheduled For: Date: 4/27/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 028822-01 503 - 260.6897 N
Corrections /Comments /Instructions:
01 CA Pt ch,(6. 6 • U
q�
oep 4 (1A AQo o .
ce I Li 0) — )S — a
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
►1 FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED _A
Inspector: V A 2- k6 I) 06 t Date: L 2 06 Phone #: (503) 718 - �.� I/4
CITY OF TIGARD .r{
BUILDING DIVISION ` PERMIT #£L.R20O/)o1 0 01
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 //ouit'll
Inspection Requests (24 Hrs.): (503) 639 -4175 R 'I
INSPECTION WORKSHEET FOR DATE: 4 I /10 6 TIME: PAGE:
SITE ADDRESS: % I 1 9s' lj PW . BI'pG `' CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Li ( , ' Ob Pour Time:
•
Code # Inspection Description Confirm # Contact # Message
13 CC %Lt cA)'<.
Corrections /Comments /Instructions:
O. I C.1
X PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL [g CALL, FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G-A95 1`v "is'-f Date:4 1 dO Phone #: (503) 718 - 'kL
CITY OF TIGARD z --,n
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639- 4171uia
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
/�"' CLASS OF WORK:
SITE ADDRESS: I? co, P rqc
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE(# '3 v 0...(6,g497 CONTRACTOR: ? PHONE 'R-
Inspection Request Scheduled For: Date: Pour T al e:
Code # Inspection Description Confirm # Contact # Message
L,U . (1 Coves.. ,cp •
Corrections /Comments /Instructions: Z� � YS Z
C ocik p ct 11-G a G-c°. �s 3 s
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
.FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 4 Date: —5-- - Phone #: (503) 718-