Permit (102) ELECTRICAL PERMIT -
CITY OF TIGARD RESTRICTED ENERGY
�,t��I DEVELOPMENT H BMEN ) 639 -4171 DATE ISSUED: ED: 5% 03
SITE ADDRESS: 16200 SW PACIFIC HWY "ANK OF T PARCEL: 2S115A6 -01900
SUBDIVISION: WBATItD TOWNE SQUARE — ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
Project Description: Low voltage for door bell.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: DOOR BELL X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
BIT HOLDINGS LTD PARTNERSHIP PRAIRIE ELECTRIC INC
BY FORUM PROPERTIES INC 6000 NE 88TH STREET
FIVE CENTERPOINTE DR STE 290 VANCOUVER, WA 98665
LAKE OSWEGO, OR 97035
Phone: Phone: 360 - 573 - 2750
Reg #: SUP 3562S
LIC 60178
ELE 37-491C
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 5/5/03 $75.00 Elect'I Final
[TAX] 8% State Tax 5/5/03 $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 CV c(12,1014 (rkk1 t il/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
MAY - 02 - 03 15:05 FROM— Prairie Electric 360 - 576 -7422 T -079 P.001 /002 F -769
1
' ElectricalPermitApplication (>t I. ICI., u,S r. 0M-1
1 - Date received: t" -- �,•• • • - ./, _ - -• • I dl
1 -,- ' j City of Tigard 1'ro a cr/hppl. na.: > date: c ,, fTi Address 13125 SW Hall BI vd, 'Tigard Ol[�. 97223 Date issued: ByC.6 Receipt no
Phone: (503) 6394171 m ;'
Fax: (503) 598 - 1960 Case file no.: Payment type:
Land use approval: _ M N r. 0. 7E03
4
'FY'I C 1' 1 . , +111'1 •
Q 1 & 2 family dwelling or accessory ., Commercialfindustriel ❑Multi - family 0 Tenant improvement
❑ 1 construction ❑ • .dition/alterationheplacement ❑ Other: ❑ Paz tial
i ,iolt sun,: 1aNFt)RI11A'1•ION
r , Job address: I , 71 a 5 9 IPL f I c. tiv..P ( Bldg. no.: Suite no,: Tax map/tax lot/account no.:
• tLor.. Block: Subdivision:
;PCOOectname: bar*, ' Description and location of work on premises: )O OOV R.. s
• IEs e•. - . date of completion(uspecdofl
CONTRACTOR APPLICATION t Fr: SC11E1)I;t.F.
:j CONTRACTOR
1 D. Fee Matt
a0 IIOS • � '
1 . 9 tv�E a Dmert d on Qt y. ea. Total tin.
Bus class name; r ABC.- Newreeiden singleormultl- faaaly Per
• Address: .. 04P Q NE I ! St dwemo
ilMNILT Pt}C & State: 1 ZIP: 9 ali rritim Sento:included:
' Phone: 3° 3-771 GIZFIEMM E-mail: 1000 s • ft. or lanes 4
CCU no.: t o • 1 : Elec. bus - iic. no: -?, yet I C, Z,at energy � or !torsion thereof
residential -- 2
Cit /metro lie. no.: 1O 02. — r Limited energy. non-residential 2
• i 1 _ : 2. a 3 Each mmlufaconerl home or modular dwelling
! Signamro of • • - • g electrician (require • t Data Service nattier feeder
Sup,' elect. acme (pant) EA la.- License me 3S Servlesorfeedete ipstallatlon,
alrerationorrdoeation:
PIZQI'I•;R1'1' ()15'Nf•,lt 7.00 Imps or leas 2
• N , � � e (print): 1 VIA, _ ' • ¶ -1-0101C--- 201 amps to 400 ,. • • 2
401 am • m 60D amps 2
Ma ling address: , _r • Pig( 1C, �� 601 am to 1000 amps 2
Wi 1 State: VP: over 1000 amps or volts 2
Phone: R ;:. --Lux Fax.: E -mail: Reconnect o. ■ 1
* Owuer installation: The installation is being made on property I own Ttmtpor'aryservieesor for-Jeri - • .
l which is not intended far sale lease, teat, or exchange according to on,n0o on
` O R$ 447, 455.479, 670, 701. 200 amps or leis 2
q 201 am • s to 400 • 2
Owners signature: Date: 401 to WO • ,, •- 2
L; N t : l j\' 1.:1-'.R Branch dremks -new, alteration,
or etrteteioh per panel:
i A. Fee for branch circuits with purchase of
1 service or feeder fee, each branch circuit 2
i' City; State: ZIP: B. Fee for bnmeh circuia without porch=
of service or feeder fee. Bart breach circuit: 2
,,, Plaine: Fax,: E-Mail: Each additional breach eimdc
HA REVIEW (PIcuse check ;all that APply) Misr. (Service orfeederrotincluded):
O Service Over 225 maps comnutvtal O Hciltheme bonny Each pump or irrigation circle 2 —
n ST/vicc ove 320 ampsrmnug of teat n H location Each sign or outline li8brlarg Z
fem0y dwellings O Building over 10.000 square arc four or Sigad eimui4s) or a limited mar/ pane],
O System once 600 volts nominal mere rasitl�aE to one smlC •"• alrcnrtiw. Or wanton' 2 •
•
4 0 Bitildirm over than stories O Feeders. 400 amps or more -Desert • don:
/ Q Oast fond over 99 persons l] Manufrerwed awcn,ree Or RV park Fat* addldona l Inspection over the unmade inanyof the above: rems c ur ploo O other. - per inspection I I I
Submit _sets of plans with any of the above.
Invented
oa fee
The above are not applicable to temporary construction 5Ca'yice. Other
r . No, an ja irsrasions accept Ueda mods. please all joradioron for more ' ' Nonce: This permit application Permit fee ...... ................ $ , 7S- "°°
i(Vrsa O tutasartc' to expires if a permit is not obtained � review (at _ %) $
car num , ` 22-92— Z (o 010 / / within 180 days am it has been State surcharge (896) --...$ ( Q M
1 c T Fir accepted as complete. TOTAL -- ... ............. -... $ ( -0 0
a ®t W ...WP oa uadie end
Cardhuldet sigmas Amoant 4404467 (emufcoM)
1
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPEC.TION•DIVISION Business Line: (503) 639 - 4171 MST
BUP
Received Date Requested °� AM T PM BUP
Location / ' �� Suite %. ' - MEC
Contact Person .yt Ph ( 360 ) 573 3 - 75b PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access:
Ftg Drain ELR e
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
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
Fire Alarm
PASS PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SI El Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date f 0 . 3 Inspe or l.1il.D y am^ Ext
Other:
Final DO NOT REMOVE this inspection record from th b site.
PASS PART FAIL