Permit CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
*4. DEVELOPMENT SERVICES PERMIT #: ELR2004 -00197
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/8/2004
SITE ADDRESS: 16650 SW 72ND AVE B -12 PARCEL: 2S113AD -01800
SUBDIVISION: OREGON BUSINESS PARK I ZONING: I -L
BLOCK: LOT: 011 JURISDICTION: TIG
Proiect Description: Tenant Improvement
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 Ceiling Cover
[ELPRMT] ELR Permit 7/8/2004 $75.00 Wall Cover
Elect'I Final
[TAX] 8% State Surcharl 7/8/2004 $6.00
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and
all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not
started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires
you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 -0010
through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699.
Issued by Permittee Signature Ap
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N DATE:
LICENSE NO:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
FRG ''STEELHEAD4TECANOLOGIES FAX NO. :5034926265 Jul. 08 2004 07:11AM P3
01/U•/JEUU4 14:01 t'Ad bY34104INU0 1.11Y OF 11UAIW Vdluuc
Electrical Permit•A olic f� ►1:()i, It. t >tsi ON! ..%
p r CEIV ..
City of Tigard ?a�tNrI Zoo col q
13125 SW 1411 Blvd., Ttgard, OA 97223 .Q0 a ./ A-
Phony 503.639A171 Pon 503,598.1960 o ' ' { , •• - : Door vomit ,la . d�
Inspection line: 503.639A1 JUL 0 al. • I_ DateDead)d8ir
Leone; www.ddtplyd.oras • _.
ifi - +_V r 7 ��,..�•..'� . . '' 4`f S?C " i, ' '• 'i� 2m t•.-
G ew consnuctian Q A..• = , '.'- .1 z PIO=Cledcon ®st apply:
❑ De�alirinn t?tht r -" I D5ervioe ova 225 mops, mourn Q u location
�L+.��-, r t - l i r Y F ' , ,,, . , :'7,7-' — : - ..� � - DServ►re we 324 amps - l a s i n g i over 10,000 sq. it, •
.,,y? 'aa.- � I^' l .A . . JI .SCI r. ,', . - - r - -,. , . A. of I. and 1y4w III1g,$ 4ar x��new iL9d�.Li2.
p 1. and 2 ->armly dwelling .. • . : Accessory building Do ver 600 volts saal t: ill Otte strut are
❑ Mt,m•ffia7y 0 Messer ❑ Other
bra ❑ luildiny over three envier mFee4 '00 sus o- snore
03 , , > "r - - =::;- _ _ :,:, ,..-t.--:. ..,r: _ : I:: - : ;,;" 4 1; - rrr+n�,,__ V+T.� $OpGiOlif 1..I Cl: 9Q1:CARES Or
; r '� ; i - r A � r i> `' ( r c n L 1 ...i bU RV.patY
I �l . _ tl:�c facility �- 1 Set=h rob efylims with �aedie above.
Qty /Sr iZIP: - o ' ( 6$____ 41- -8--1,/ - Ilse above se rum t�yplieable m tefttponry mnstrocion swiss_
5ultn/b1i3g hdp� n0: Project n ( . - ..c . I . :�:, . a , e, ^•... ":/_ _ ` . • ; •t • ' 1
co 138 iaeevdnt�ns mini) slim ,/ [ . �Il rettadae taehedai f or malirfamity done lt bait
1 1,000 K. A or less 145.15 1 4 1
Subdivision: 1 Lot on Fa. add1500 03 8 Or portion 33.40 1
Limited enWm.residential 75.00 2
Tax map /parcel no.:
'•"'I7: 1 r ; t ; ' ,' _.,.' i= - - ' ; .. .T - :177 - ,7 - -. .,.. •.,� I L�a>edmmgy '3.0 2
I li 1 J 1 a , J' l f', ,..
''li' 1 , 4 :4 .,iz�L �t':- t _ _2-c': `'�_ " ,.':H' 1"Y, , —
l�:h>,eaai8icaued ormtx9,ilet
1
thsellinp, vice rod/or �
ser 90.90 1 2
d Sereeces or;eeears:otla_atios, akeratioe. aoe/er >olonama
200 mom or left 5040 2 i
, :_ I T = r - 7 r, - • �
`1 ' I > r J1 r,�Fj
t7v ipi cc i 271 argil tD 400 �s 106-65 2 1
. '....2.1..,.:.1.7z.._- __._ -3 - r-h. , 'I' ----'^ d � i . ' '' - , ,.4∎ r f b: , Ati`i 401 �to6443t 3 160.60 : 2
N ame: pot- .tad S / r e ,. ` - () r 1 601 eropa to 1,000 ego 240.60 1 2
Address: M •-�- _ • v1 _, n . • 0 . �� 1 Over 1,000 amps or volts 454.65 1 2 •
City /Stara/ZIP: rI l pll � i± ( 1 ` 2 i
. � services or ia:<aDStEOe s�oti. eted/o
robe:Woo -1
• t • / a 204 amps or loos 66.05 1
Owner installation: installation is bed made on property that I own which is not . 201 stops X400 spa 100.30 2 •
intended for sole, lease, rent, or exchange, according to ORS 447, 449, 670, smd 701.
4DtmC00� _ sa s 135.75 2
Owner 8ignatlire _I Hr* b d h re dis- Dew . rori;e, or aodoo, per p� -
, E '.'',; .7 ^ —
c - ---__^r -^ : 7:1 :' —_ : •. 1 TL ,... - 14'0 t circuits ova
or bred tan. coca
Business name Lt I et l t/ breath circuit 6.65 2
B. Fee tier brareh comets
Conrad mamma Q A F lU� s service or feeder ;ea,
d6.3$ 2
a,e S �`,,ej Si— welt b1s[rdtaisuit ctrl m _ I
/� B ub add, brancht ! 6 ! • 2
City /State/Zll►_ 1 J O /� - 4 -Z Z eg
q .,rte ais (service or feeder ootlncbid )
Pitons: �A ) 103 a v - y0 Li 8 F 71gr��f 16 3y - 6 t er "'mp to wertgalion tied* 53.eo 1 s
Simi Or outline ligleing 53.40 , 2
` - mail: � Syipml�rc'ti� a Hairea-
E: '1l r ? '' .,. f ixii. : :' <. ..- - tit L (1 �2' a 4 energ
I I J•e f td r• 4, �'�::� .� Lr i", J � 2";.' n .:�Y� .ar':..t:� v ,. �:� =:;:�iii,•r Q
. , .. ,111 `. E ad diti a oal le m :lion Ov er allowable to � any of the above
�7 Per 62 1
•••• P� ( ! �t // m.�pnlea pc hour (I <o= 62,30
Phone: ( ) . _ i Fax: ( c 2.-- 624 $_ lothmnal ba; - hour - 73.73
/51 3 , Eleeiricel -J ,i *safest Li . ► a ' subtotal riS
5iilnv. Electrician signat,ae, required: X i - of permir
.. ..,„..----t Ylsa swim (2S% aaperient $e)
Dg= X • . `' '
Print D Stitt swi barge (s%, iej ! / %
';ice.' � Date: • � (� � S ors g
ToTALP>ZEtIarvEE t
Aolhatisod6i41l3hiiC: Ilan pen* appl ember Nomura is 'sot etelanse within rap
1 eve ribs a tae Dom acts 4 as toa,pfeQ
Pant name: Date: • roe r eftoenlogi lab, rei•c:ome.ltuddiat tadoortSmice rau,d
" l+araberotrnwesdaaepap000raltowed
tokuid aareentare.>• aaax 12/03 UaJdssit1012/00W4V>g
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: M03) 639 -4175
•
INSPECTION DIVISION Business Line: (503) 639 - 4171 MST
BUP
Received Date Requested AM PM BUP
Location 1 665-C)-- Suite [; -- 12— MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Ft Drain Access:
9 ELR WWI-- OD l9
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall Taa4OM ) fPR�L� _ F
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
Fire Alarm
in 111 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
S PART FAIL
SITE Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line Ext
Date ADA D '7 (�
ae ` `r l
Approach/Sidewalk — Y Inspector 1- (��a -Y
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL