Permit (36) : Ni C I TY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
4 z- 4 6.611i 4 DEVELOPMENT SERVICES PERMIT #: ELR2003 -00157
I ! 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/29/03
SITE ADDRESS: 16200 SW PACIFIC HY A PARCEL: 2S115A6 -01900
W
SUBDIVISION: TIGARD TOWNE SQUARE ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
Project Description: Low voltage for HVAC.
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: X PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
BIT HOLDINGS LTD PARTNERSHIP MCKINSTRY CO.
BY FORUM PROPERTIES INC 5400 NE COLUMBIA
FIVE CENTERPOINTE DR STE 290 PORTLAND, OR 97218
LAKE OSWEGO, OR 97035
Phone: Phone: 503 997 - 0234
Reg #: LIC 40981
ELE 26- 1190CLE
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 7/7/03 $75.00 Elect'I Final
[TAX] 8% State Tax 7/7/03 $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 eTh
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
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
p ,/ //// BUP
/
Received / 2 �• 3 5 Date Requested * --1-2 7`AM PM BUP
Location i' 2 OZ) Pe c,ceic..2_, Suite MEC
Contact Person • Ph ( ) 2'5 _/9/4/ PLM
Contractor \` c Ph ( ) SWR - - -- -
BUILDING Tenant/Owner
`rte
Footing !�
Foundation Access: y ~' C-
Ftg Drain -3 / 57 7
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Drywall on C I
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
FAIL
ELECTRICAL
Service.
Rough -In
UG/Slab
ow Voltag 1
arm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
AM) PART FAIL
SITE ❑ Please call for - inspec on RE: Unable to inspect — no access
Fire Supply Line
ADA /
Ext 4I
Approach/Sidewalk Date � 0 Inspector,/ A -4 a / . . /!.1'
Other:
Final DO NOT REMOVE this inspection record rom the job Ite.
PASS PART FAIL