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11354 SW DURHAM ROAD I 1 V V� i�► d S A7 a 1 i 11 354 SW Durham Ild CITY O F T I G A R D — ELECTRICAL PERMIT- / �" RESTRICTED ENERGY DEVELOPMENT SERVICES PERMIT#: ELR2001-00243 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 10/1/01 SITE ADDRESS: 1135,4 SW DURHAM RD WASH, MUTUAL BANK PARCEL: 2S115AB-01800 SUBDIVISION: TIGARD TOWNE SQUARE ZONING: C-G SLOCK: LOT: JURISDICTION: TIG Prosect Drscription: Low voltage for CCTV. (2) systems A. RESIDENTIAL _ B.COMMERCIAL AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM. NURSE CALr-S: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: CCTV X TOTAL#OF SYSTEMS: 2 Owner: Contractor: BIT HOLDINGS LTD PARTNERSHIP ADT SECURITY SERVICES, INC BY FORUM PROPERTIES INC 2815 SW 153RD DR FIVE CENTERPOINTE DR STE 290 BEAVERTON, OR 97006 LAKE OSWEGO, OR 97035 Phone: Phone: 503-469-7244 Reg#: LIC 59944 ELE 26-209CLE _ FEES _ Required Inspections -"Type By _ Date Amount _Receipt Low Voltage Inspection 1 PRMT CTR 10/1/01 $150.00 2720010000 Elect'I Final 5PCT GTR 10/1/01 $12.00 2720010000 Total $162.00 This Permit is issued subject to the regulation, contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done i.i 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 Notificat;an Center. Those rules are set forth in OAR 952-001-001 thr gh LIAR 952 G01 0080. Yrna may obtain copies of these rules or direct questions to OUNC ac (503) 246-1987. Issued by t - _ Pennittee Signature OWNER INSTALLATION ONLY The installation is being made on property I o%--.. which is not intended for sale, lease, or rant. OWNEk'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR ELE01% DATE: LICENSE NO: -- ------- - ----- _ - - - - -- — Call 639-4175 by 7:00 P.M. for an inspection needed the next business day 09/28/2001 14:39 FAX 50341197110 ADT SECURITY a 00) Electrical PerinitApplicai ion Date received: / d Permit no.: City of Tigard ��E(�( Project/�ppL no.: Expiredate: CifyujTigard Address: 13125 SW lull Blvd,Tigari];DR 97ZD patcis.ucd: Ay. Receil no.: Phone: (503) 639-4171 -- - --J� —7� ----- Fax: (503)598-1960 SSE ' ?06; ('ascf0cnu.: I'aymanttype Land use approval: eeMhjHN )l _ e U 1 &2 Family dwelling or accessory &ommercial/in al 0 Multi-f:mtily U Tenant imnio, incur O New construction U Addit' n/altrralio eplacemcur U Other: _. U Vaitial 9 Job address: r pawl Itldy n.. : 1`;uitr ntt.: ITax map/tax lot/account no Lot: Block: Suhdivisnnn - - Prujecl sante: �� rDescriptiun and location of work on premises: CCTV Gslim led date of cnmp etion/inspeclion: L� CONTIM10111 APPLICATION FEE SCHEDULE Job 110: fr Itr MAX Business name: n'• _ lkscription Qtv. (ta.)- 'told no.ins ------- �s-a;;- New vv%ldennal-sIngle ormulti family per Address: _ LJa dwelling will.lnclndesHttuchedgarngc. City: J-- � �1t_7-0 6W:— servicelA"'Oed: Phone: - Fax-Ag-V14) 1',-mail: Itxlosq.ft.orless_ 4 Each additinnd 500 sq.fl.ur purtioiitherrof _CCD no.: tlyyC/ elcc.bus.tic.no:,�c- -- r_ - --��1 LitNtedenergy,roeidential 2 Cit / etro lic.no.: _ t7 Limited energy,non-rosidential I r 2 _i2_7--QL_ Each manufactured home nr modular dwelling ature of%topes v' -in c mr.(Man re uired) hate Service and/or feeder 2 Sup.elect.name(print): (�( License no = " F Services or leaden-hntalbdon, alteration or robutbn: 2t10 amps 0r Ices Name(print): 201 amps to 400 amps _ 2 ---- —-- 401 amps to 60Q amps Mailing address: Y 601 amps to 1000 amps City: A Stale: ZIP_- �— Over 1000 amps or Volta _ 2 - Phone: Fax: I E-mail: Recwutectonly I Owner installation:The installation is being made on property 1 own 'i,wpotatyservices nrfeeden- which is not intended for sale,lease,rent,or exchange according to Instatladlon,alteration,or relocation: ORS 4.47,455,479,670,701. 21x)amps or less 2 201 amps to 400 amps 2 Owner's signature: Date: 401 to 600 ams _ 2 Branch circafls-new,alteration, — -atextensionper panel. - rAddmss: -- - ea -- A fee For branch circuits N4tl1 purchase of service or feeder tee.each branch circuit _ l City: State: ZIP: B. Fee for branch circuits without purchase Photte: Fax: �- E-mail: of service or feeder fee,first branch circuit: 2 'ach additional branch circuit: f\'Ise.(Santee or feeder not Included): O Service over 225 amps-wrnmercia] U I P!alth-cstefscility Et-h pump or irrigation circle_ - V 2 UServiceover120amps-rating oft&2 Ullazardouslocation Es.•hsign orouilineIighti, ng _ 2 family dwellings U Building over 10,001 square feet four or Signd circuit(-)or a limited energy panel, 0 System over 600 valla nondnal more residential units in one structure alteration,or extension" �JV L 2 U Building over three stories U FeWers,4011 amps or more 'Description: _ U O,:cupent load nver"per^.� U MsmifacwrM•nuctures or RV pale Each adtbtbllal Inspection over the allowable N any of the al tie: U Egress/lightingplan U Other _ - _--- Per Inspection Submit_-_sets of plans with any of the shrive. Investigation foe _ 'lire above are tint applicable to temporary constraA ton service. other -- _ — - - Permit fee..................... 54.-- Nd all lurlstlkUons sivept cmiln came,ptr*w call luriraction for ronin itdtxmaoon Notice:This permit application t]Vlss U MAMOCard expires if a permit is not obtained flan review(at —• %) $ credit card number: within 1 r:0 days after it has been Stale surcharge(896) .,.. Name rt cardholder ear own on credit cei� _ n"p fes accepted as complete. TOTAi, .......................$ - _ S __ Cutlhdder dgnanure Amount 4a-"Ii(6W/MM) ��� O� �I +(V;��® ELECTRICAL PERMIT PERMIT#: ELC2001-00490 DEVELOPMENT SERVICES DATE ISSUED: 1013/01 13125 SW Hall Blvd., Tiqarr' OR 97223 (503) 639-4171 PARCEL: 2S115AB-01800 SITE ADDRESS: 11354 SW DURHAM RD WASH. MUTUAL SUBDIVISION: I$IGARD TOWNE SQUARE ZONING: C G BLOCK: LOT : JURISDICTION: TIG Project Description: Install of(3) branch circuits for new ATM installation. Job#JE57277 _RESIDENTIAL UNIT TEMP SRVCIFEEDERS MISCELLANEOUS 1009 Sr' OR LESS: 0 - 200 amp: PUMP/IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: 51GNIOUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: A MANF HMI SVC/ FDR: 601+amps - 1000 volts: MINOORR LABEL ((101: L: 1 SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS-- 0 NSPECTIONS -0 - 200 amp: W/SERVICE CR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 2 IN PLIkNT: 601 - 1000 amu: PLAN REVIEW SECTION 1000+ amp/volt: >=4 RES UNITS: > 600 VOLT NOMINAL: Reconrect only. SVCIFDR >= 225 AM'S__ _ CLAS5 AREA/SPE1_OCC: Owner: Contractor: BIT HOLDINGS LTD PARTNERSHIP VECA ELECTRIC CO INC BY FORUM PROPERTIES INC PO BOX 32.48 FIVE CENTERPOINTE DR STE 290 BELLEVUE, WA 98009 LAKE OSWEGO, OR 97035 Phone: Phc.ne: 800-974-VECA Reg#: LIC 0082974 SUP 3903S ELE 37-919C FEES _ _, Required Inspections— _ Type By Date -- Amount Receipt Waling Corer f'RMT CTR 10/3/01 $60.15 2.720010000( Elect'I Final 5PCT CTR 10/3/01 $4.81 2720010000( Total $64.96 This Permit is issued subject to the regulations contained in the Tigard Municipal Code.State of OR. Specially Codes and all other applicable laws All work will be,done in accordance with approved plans This permit will expire 9 work is not started within 180 days of issuance, or if work is suspended for niore 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 952-001-0080. You may obtain pies of these rules or died ques..,)ns to Permit Signature: Issued By: �,-�1 OWNER INSTALLATION ONLY _ The installation is being niade 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: _ ) ►__, � �1� t Vii=--= --- DATE: LICENSE NO: Call 639-4175 by 7:00pm for an Inspection the next business day OCT-02-2001 TUE 0115 PM FAX NO. P. 02 10/OP/2001 11:54 l"AX $033981960 f.ITS' OF TIG.iRfi QI002/003 Electriad Per App 0caf'on DAtenalve4 ! �. / V City of Tigard l� ECEIVED prAd k Iojectrappl,RD.-, �7777 Clryvr7'rgord Address: 13125 SW Hall BI d,Tijud,OR M23 Dattissucd:P11tmc: (503) 639-4171 200i Fwt: (503)398-1960 Casr file at,.: Ptytnenttypt LaIld use approval: rMMM 1NI DFVELOF`.A1 Cl 1 °.. 'family dwelling nr Ac17es30ry CotnrnercialAndiawlal U Mtiltl-family ❑Tenant.irnpm�c hent U P:ew construction ©Addition/alrarAuon/millaceniont U Orlwr ____ O Partial Job addtLsa; 1 I Gtr kii�i�r'^t� AD i9�ldl.no.: Sultc no.: Tex nUpltm 11ot/accmmt uo.: 1 .. Lot lock- 9UN:6V siun pftaect none: � �l9�lttC3exri on ad location of work onsremises: (�©VOL Patimatai date of completlorJitrspeclinn: O / /N I IRU-9 I MIDI Fs Mai Otir. ('j•) Total w.Im — -- Ntw ar nown strody pr* A4draas: / _7�AAV 1t�ae.Ncleatr+i..rc,ch+atu+aR Clty: �5tAte: Wig 1.116 sw,. rlrMe phoria' .{/ as. OSb E•until: lo(10 q.n nr Inn -- 4 CCB Rol Vle4 hus.llc.uo, Each" utw ty.rt or�nr,l,m,hr.rK,l - tlltdadeorr Irstdeatw T C7 /R► He,n 2 7 (tmyy0w_non,AeldwNal _ _ - 2 Belch atanalmured home or moCulrr dwellins >tl two a , sine olec9iolM( ureg trt11Pole acrvlr.�NeVrK(reior 2 _ — Utaao: meat 11tl' 9v .clot.tarot,(ntinQ: a rthortlan or nluaAiaa: 200 am a•rt im 2 Nalne(print)- P-4.UUAA•t N IL ZQ1 auk )400 Athpe— — 2 Mawli sddtest: 1Z.G _ !C '�1 w600am 1 l�_ � A� i amps w l un4ra 2 elty; Slalo: Z1P: I Q Aver 1000 arn�or vola 2 Pttona$tr., - /- rex: F.-mail: Reeonnv.;onl '�' 1 rYVMFt•in!WIRlinn;Thm il1011adou is 11cinj R+:ult an prnpatr I OWN Teaponryaervicrrear4v.tws- wNch is not+RrN1 PA for Tale,lease,rent,Or exchAnge avconfing 10 60AUX isa,an ilueatfoa4ea rabeerknr 01zs 447,455,479,670,701, 2=10rnl"'s lot arta u 400 na n l.)wnd(a al OUIM: Daus: 1 t.GM aMP6 1 _ �raie�iietYh r•new,arrarwdort, or nttatta leo paY panel• jJurr►. A. Per r,,,I+andh cimulu with pur'ct esu d' 114dertt;: —_� �--. +e..iu orfaederlm,aaeh bntx:F drrt,lt 7 CirY _ 1,:11AGC.. _ �x'1'1.:._.._._ H u forbtmch crtcttia without purchiK -- mail of auvra or ka6+.fee 6rh tech drevic 2 !'hone: FAX: $ tion uddtaorwl t -- -- Miaa.(,Servieauef not U Service over 225 traps-cc n inarci&I La Health rare(aAkey Goch. yvmp or inization tifete 2 G ova.120 Servkz:ov20 ur"tiling of 1&I U HusMow loco(on &ica outline than 2 fntnilydweUlnp ntruildingover 10,000Kux,,tettfvw,t Cltnaleltr.ull(t)nYaIlRlllr mtiYDam, []Sl.Rrmorar6n0voltnrominal rearttetfduttiolunitsinvaciovctutt alteration.ofextondons _7 t]sulldwo-TwUn,naturias QPeadaim400ampsainore •Daern in. t]r)ccstpant load over 99 partoM O M tnufadnrod tQVCNri1 or RV;,vk li6 raYlatd=P wss i=I allows b h YY Ot Itte abo n NteuAiohdoiplen q Otltar Submit__ sets of PUM whb u1 of the abevr. n we �.•.-_—: Tba shave aro not elp"cable to tmpomy towtMetlep rtatrtim r Petrnit fee.....................$ r+«m,t arwk�aa ar 4r —•Flow wl)-w4ittlen ret n m Notice:nix oertnit application vIQ w M �•—� S upira it a Permit is not bW,A Plan tevieW(at %) c_ r ,vuehor �._�!_�..1 �r L. uAu+,n I10 dry,afte,it has been State aumhtrte(11%) 3 .1� TM ncteptW u cetasplNe. TOTAL ........S tod __- _rttrutvrc,_Y — w ,T;.,.r uDaflt(a�'oM: OCT-02-2001 TUE 01 15 PM FAX NO, P. 03 10/02/L'001 11:54 FAX 5038d819d0 CITY OF TIGARD ®001/003 I ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES: Complete Fee Schedule Below` TYPE;o�Qy-Tea, LVED-RESIDENTIAL ONLY N fiber of Ina Rrifn pedlons r nn�e _{tallowRd (►'cJtxALL 3V9TFM3) y- ^• $7S.00 Service inclmded.' Itoms Cost Total Cued;Typo el Werk Involved: Raaldential,Imo'$mit 1000 N' 1-W law $145.16 a Audio enr:Stereo Systame- kach additional boa 9y,n,or purtbn lmermf'4 333,40_ - d U Burglar Alarm Limited Pr"wVy 3>5 on r-;io Mwrufd Moran or Modular LU*Nntl 9r-nnnn or Feeder _ $90.90 2 I Gansue Door Opener' Bervluee hr Faealars r FdeitlnyJ,VmnGlabon and All,Condltdoning Syslorn' InMeemtlnn alturallon,or rtdowbon 200 amps cr lame $80.30 2 201 emps In 400 ernpc $1U5.as- 2 t_..� Viwutn Systema" 401 armp6 to 4300 amps $180.60 __ 2 601 nmps to 1000 amps $240 HO ? 0"r 1000 amps or voile _ 54'34.65 - 2 Rnwnnars only a - 568 86 _ 2 Trmpruary 9arvlcas or Feedwa TYPE OF WORK INVOLVED-COMMERCIAL ONLY Inctalladon,altaratdnn,nr rel whom Fee for each system.. . ............................................... $T$.00 M armpe or Ieaa; Was.. 2 (SCZ OA(:91 ty2t3 260)r 2:1 amps In 400 amps $100,30 2 401 impa to 400 amps _ $133,73_ �� 2 I Chr•*Type of work inec4ved Over(300 aml)a n•1000 volts. see"f+"above. Audto and Surruo tiyslArne Wench Ctrouits I--1 New.amwedan ter e0dendlon pur panel l l Boller Cantrd: o)The lee for trench dreults with Purchase of yery/ce or j Clark"lame Mader he. Fadi branch rarguh _ Sts r!5 I Data Tgl9xmmunlca0rrl itmuliotlon h)Thiii tee toe twnnh chord% . . WllhnrR pu mhaae of tervlere urNear fat:. Mir Alarm l 7lalkttion r'Insl hrnnah circuit ( tas,fsa 44 Pesach edditinnal arsndl GrcWt 39,es»l h4VAG Mlaglitanrlroua 0 (SuMns orlherlornot1ntshxhdl InstrumantttHon Each pump or dirimllun wlibrvle 163.40 Intaimm nrxl paging Systeme Each sign M dytlnn lighting -—� 587.40 Stgnii urwit' nr n Itmlted energy _ _ panel,alterarton cx outunclon 375.00_ L7 L2ndScapa Itllgatlon Contml' MrnO(labahlln) 5125.00 n3rn additlona!Inapeetdon over — �] Medical the allowabI4 In any of the above der Insprr 8qn _ $13100 Numo Calls Nr hran $62.50 _ in want �_ $T9.1td L J Outdoor Landscape Fees., i Protealva s)gnsling Fntsr tetal of above tees S _6D'_I Qtturr 8%?Tito 9urrharge 3 _r .�I � '~ -•— Number of Systeme, 9!14 0I4m nnvhil,res Ser'Plan g"W'secoor on s ' h!o ilia oaf rue MqulrOd 0,nrl. %rn•mgvirecd for ee other inalallerlam "oroppikaQan, -. ._-- �I �y/ Tots!Balance Due Y � I. 'T K' Fees: (infer total of atfeva fx� IJ Trttsl ACC4unt M IPA Alele Surchargn Totrl Balance Due $ <<.tai:'on q.rlr dtt7 w: 06%Olin! CITY OF TIGARD 24-Hour BML DING Irspection Line- (503)639-4175 INSPECTION DIVISION Business Line: (503)639-4171 MST BLIP Receivsd _ _ Date Reted 3 AM __,PM _ BLIP Location _ - 3 S 77aA_-'/' cpm _Suitecl� MEC - Ccntact Person ��n �?`�.,/�.ct Ph L���- `' _ PLM Contractor - - Ph(— I SWR BUILDING Tenant/Owner --_-___(i(J �" �' ( ' _ ELC _ Footing Foundation - ELC Ftg Drain Access: E L R Crawl Drain Slab Inspection Notes: SIT _ Post&Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Drywall ry Insulation Dry wall Nailing -- Firewall VVV Fire Sprinkler --- --- Fire Alarm Susp'd Ceiling - --- — - Roof Other. _ -- -- - Final PASS PART FAIL - - PLUMBIfVGt Post&Beam — Under Slab Hough-In Water Service Sanitary Sewer Rain Drains - - -- - --- Catch Basin/Manhole Storm Drain - - -- - -- Shower Pan Other: -- --- - - - -- Final —�— PASS PART FAIL - MECHANICNL - Post&Beam _ Rough-in Gas Line Smoke Dampers Final PASS PART FAIL - -- -- -- ELECTRICAL Service Rough-In UG/Slab to - �'f - Alarm re 11 AS PART FAIL L .1 WReinspection fee of$__ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. a [] Please call for reinspection RE:__ Unable to inspect-no access Fire Supply Line ADA Q Z Approach/Sidewalk Date _k- in9peato 'v't Other: G Final Ott NOT REMOVE this Inspection rero,I from the J b site. PASS PART FAIL rIGARD BUILDING INSPECTION DIVISION MST inspection Line: 639-4175 Business Line: 639-4171 -- --- BUP _ _Date Requested � L�__AM PM -- ----- B L D Location— L� _' _S �_� GL- �t17 Suite _ MEC i Contact Person �-'�- 11� Ph 0'? o�S-S- oU=�q PLM --� ---- Contractor _— �L Ph SWR BUILDING - Tenant/Owner �G�j� . �1c.1u.� -tt�-t ELC Retaining Wall ELR Footing Access: Foundation FPS Fig Drain Crawl Drain Inspection Notes: SGN Slab SIT Post&Beam —- Ext Sheath/Shear Int Sheath/Shear --- Framing ��� Ik-./ �� C�—� -, ��� —,L S<�L.��r=•----------- Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling _c -ii l Roof T— Misc: r Final PASS PART FAIL -- oel 0v — PLUMBING Post& Beam ------ y,� — Under Slab --- : ► �� �CI?iI� ToY C} r� -lSll� P Out Water Service Sar.:tary Sewer - Rain Drains IL _ Final �' - -- --- PASS PAR7 FAIL MECHANICAL -- Post& Beam Rough In Gas Line Smoke Dampers Final - - PASS PART FAIL ELECTRICAL - -- - Service UG/Slab Low Voltage - — � ---�- ---_- F' lar n A W PART FAIL Backfill/Grading - - — Sanitary Sewer Storm Drain I j Reinspection feu of$ 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 Other Date _ Inspector �C �? _ Fxt Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY 4F T1GARD ELECTRICAL ENER - RESTRICTED ENERGY DEVELOPMENT SERVICES PERMIT#: ELR2003-00328 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 10/22/03 SITE ADDRESS: 11354 SW Dom. ,-1AM RD WASH. MUTUAL BANK PARCEL: 2S115AB-01800 SUBDIVISION: TIGARD TOWNE SQUARE ZONING: C-G BL OCK: LOT: JURISDICTION: TIG Proiect Description. Install voice and data caabling. A. RESIDENTIAL B._COMMERCIAL AUDIO & STEREO: - AUDIO& STEREO: i INTERCOM & PAGING: BURGI-"R 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: I Owner: Contractor: BIT HOLDINGS LTD PARTNERSHIP NETVERSANT CASCADES INC BY FORUM PROPERTIES INC 9020 SW GEMINI DRIVE FIVE CENT ERPOINTE DR STE 290 BEAVERTON, OR 97008 LAKE OSWEGO, OR 97035 Phone: Phone: 503-646-0533 Reg #: ELE 34-589CLE LIC 150328 SUP 2903LEA FEES Required Inspections Description _ Date —~ Amount Low Voltage Inspection I:LPRM"1'J ELR Permi, 10/22/03 $75.00 Elect'I Final I IA X 18%State Tax 10/22/03 $6.00 Total $81.00 �D This Permit is issued subject to the regulations contained in the Tigard Municipal rete, 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 ATTENTIONOregon 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 �� � 1�_ z �, ti,.d>"s ,� _� Permittee Signature OWNER INSTALLATiori ONLY T he 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'NDATE: LICENSE NO Call 639-4175 by 7:00 P.M. for an inspection needed the next business day 10/202003 16:41 FAX 603 641 6619 NetVersant Cascades, Inc 001 r - Electrical PerWt,A►ppUcation City Of Tigard �:^r,nnl,pp,; P>t01lCdicc; co qr,g, d Address:13125 SW Hall Blvd,Ti ate Urate ictued: By: Phone:(703)639-4171 — — -- Fax:(503)Fig-19+10 a Paytncnttype: Land use approval:_ 0 �T ❑1&1 family dwellinit or accomory omen �i�, jf) C,Muhl-famlly O Tenant Improvctneot New enngtnll7Jon Q Other. Q Portia] Job address. t " f3ldit nu Snug m.: lair fnapltl7t IOVaccounr no Block: 3abdivisloo: T�4y�a�IvHE Fi INL- Project name:'W14 P•l to J+41 11 fh:auipum and location of wark on ptomim: WIN 1&014 ( -•} �y C 6atima%ed date of com.Uletion/ill3w.tion Job now: PI '7,w rill 1 p Bttalaesa .tV-- -049. Uevtriatlnn O coral rtv.i-P - wmirY+,tal s�trornu,lli•tamilrprY Adtlrcas: ,S Ntrn `Pi _ dlyelinr{mot.InrJurinalrarhr+r�,ag*. Gi �� Vl State: � Z1P: Rd D� 9�rrie.;nrlea.r4 141one:1A3-U4U-p_y35 I Fax*bgWlr E-trailtwP�sor,Q :0o0aq.h.orlara 4 Gxh adJitiarit 50 7 .fc«« c don rhuro CCR no.: 11111�jJ - �P.lec,Glu.Ile.nu: 5y_�y��_ uC'1.8 umitcdcrerer,rvirlr.�,tlol 2 - Wmltearoerv,twm- rgidenual 2 fachmanufactured Acme nrmaaulerawolure 5 taJE Or SNDrlriyita;c1muit.6n(rc uircti) Daa Vervlce wuVor feeder Z Su olect.uaroe(ptioq ? r/ / 1,iareeno �� SO^"aaorfeeders+testaYlbe, slreration orrclocalie� 7 6 amPa or loge Z Nmne( riot• -- —Y _ _ol-aropaa40uamp, _ _ 1 MtulingH6AracC: — 401 amps to600amps 601 0tnpr w 10001H1pg 2 city: _ State. -- ZIP. nw:rlrinnam"orvoltg 2 Phone: Felt: &snail: xeenaeroN t Owner installati,m:7be installation i9 being made an property I oW11 T•mprmryaerrkatorl w-M which is not Intaudad for sale,loess,rent,or exchange according to taurWlLfiao alfar+tiorr..rr.l�.liens ORS 447.455.479,670,701. 2 r'upa or 1— 2 201 amps to 4W amps 2 owners sl ire' 401 to EOU rm 2 I nntfiUrlLil9 now,alteration. r asfeslrrer rae'a.rah Name' A Fee ferbrnnnh o,nuim with pomhmoof Addnsao: rervim or feeda feq sank bnaah dreu$_ 1 Cltyt SIH[e' 7IP' 0.Cctforhrench c r oils wtthoatparcheec —--- -- of avvloe or fercter fee first hra�nh urcvil 1 M�- Fax: ��� Eunaadldoaalnranchdrealt Mtac.(SrirkenrnederantiactYicdl: � 3cnicr a-Az 2^_4 arapn ....M.111 Q Hearth-Cart:Fkaury Foch pump or Irrierdan cork 7 Q 5ervlrrorer320aom-raun£of 1&2 Q Hayar6milmadonh'%;7Zt .Iiahtinp furtilyd-eilinpa ❑BulldpyovKl0.oatlrglrmeRetlpuror Signal[iwillNerlhtnittdeMrRrpanel, L�ltr �7Cg 2 7 ?nlemovcr600.olteoornurol macralllaerlwriui„nacauucwrc alterotton o►extenaion' _ FN= 'J QHulkingavenhreesories (3Nede.%400amp ornare 'Dwodpdon.. O(7eeapanl load outs X19 Dersnnr U Matal'aett W StrartlKet«R V part rjKh additlewal rarprn"__% MI 44p,arta/e: O Egrms mceumvim U emrr - subinil •cis of plmy Rich m .Ytbr alrorr _^ Inveldladonru --._ I_ The above arenot appllriUle to tram ry uruormctloll rerrlre outer w� no res Judw kdw resscr crsit ceras akne can Imlydlodan tw arae Wartroew. Neuse:7W permit application Plettnit ft .I ❑visa U Muterf'ard expires if a vermis is nn?obtalaerl Pimr review(at %) S LMal cant number— Lwithin 110 dayc after it hu heed State sntcharere(8%)---S U'00 r— accepted aseomplete TOTAL..................--.-a I'r�./eaedM.idw�rescan ea tc�lM ` I — —'1(tMtni ••p-Kis te�orn ctadholdar airHulrQ RECEIVED OCT z 1 2003 GiTY OF TIGARD BUILDING DIVISION I Ui AAI AUUJ 11.00 rZIA 0UJ V4 VVAV t9A b$Allb 1.db%-4AUt9b, Alit. W-1UVA. . j Building Division Applicant Request to Cancel PL-rmSt Crl-V OF TIGARD,BUILDING OFFICTAT, F 13125 SW HallBNd.,Tigard, OR 9'7223 RECEIVED OCT 2 3 2003 Phcn,e: 503.039.4171 Fw 503.598.1960 v� <�kROM: Applicant Name: N e 4 V e- �-�a,-,A T ddd Mailing Addrew: 1,)t{O S� N�'M �/l _ l4M v e— City/state/zap: ���>e/,,�{y e 0 6 g� Phone No.: Fax NO- q Cr(,p13 — PLE ME CANCEL PERMIT APPLICA170N AND R.fiF(JIVD.PERMIT FEES,IF,ANY, . FOR THE FOU. OWING: Permit No.: —00 Typeoi'l'ettmit: lW V G1—�4( �s7C' ,�7/1�L'�,�C? 2_� Site Address: I I�S�r �� r h a �-r,P,�..,✓ S�rbdiviaion: Lnt No.: RX-ulrlNATZON: �i il�L►'SGt��f - 5�g��c (��C. C(1 e G . C � Jon W "' O O!n � o tL �'" `" ¢ C7 > Signature: �~ ^2 Sn _ Date•. ^? u~. C7 Print Name SPU f4 zW0 .- W U 155 m r Route to Admin.: Date: Permit Canwoled: Date- l3 y. Refund Processed: IB3r -- f IEU;�d-_,c�,,a�Regd„cemfl.n�laec 04M „tool ,, aa�'!�a du.jL,la . .. osstpescos zv:► or.:Tt con�.;E ,oT xp� :edA-L :1oafgns :"W11N xv=l :/Iupdtuoz) 0961136SfU; %lapuag nw- $£ 111111 :uc�13[sJtiq 1 aaBed wV i f 1 1. :311111 £0/ZZ/O 6 a�e0 (pOp000011S 3uaA3) suaA3 POA1038N