Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
1 111 °
• • I COMMUNITY DEVELOPMENT Permit e: ELR2009 -00267
Date Issued: 08/18/2009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 25110A600100
Jurisdiction: TIGARD
Site address: 14000 SW 112TH AVE 76
Subdivision: PARKWOOD COURT APARTMENTS Lot: 0
Project: Parkwood Court
Project Description: Units 76 -93: Installation of data/telecommunications.
FEES
Owner.
ALRANCO, INC Description Date Amount
BY JOHN R RICHES, 2601 ORCHARD HEIGHTS Restricted Energy Permit 08/18/2009 $75.00
RD NW 12% State Surcharge - Electrical 08/18/2009 $9.00
PHONE:
Contractor:
NORTH SKY COMMUNICATIONS INC
11818 SE MILL PLAIN BLVD, SUITE 410
VANCOUVER, WA 98687
PHONE: 360 - 254 -6920
FAX: 1- 866 - 530 -4325
Type of Use: MF
Class of Work: ALT
Total Number of Systems: 1
•
Audio & Stereo: N Boiler Controls: N
CCTV: N Clock Systems: N
Data & Telecommunications: Y Fire Alarm: N
HVAC: N Instrumentation: N Total $84.00
Intercom/Paging: N Landscape /Irrigation: N
Landscape Lighting: N Medical: N Required items and Reports (Conditions)
Nurse Calls: N Protective Signal: N •
Security Alarm: N Other: N
Other Desc:
This permit is issued subject to the regulations contained In the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 the 180
days. ATTENTION: Oregon law requires you to follow the 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 a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: Permittee Signature: O// A7 ' C(97719/ f
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' Date:
LICENSE NO.
Call 603.639.4176 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 plane are required on the Job site at the time of each Inspection.
, •
RECERIED
1 7 2009
AUG
Electrical Permit Application FOR ;ot� ONLY ; : : : : : = -' RD
City of 'Tigard uarhW sr x/17. Perna r . r 1 '.,r: i ?VG
'I 11135 SW Nall Blvd.. ISp nnl. OR 97221 DatdO : r o Q •;�y �, u A Plan
nte ler:
t 1 '' Rune: 503.6.39.4171 Fax: 503.S9R.1960 Oedow OtherPenni,:
ne
TIGARD lospecliuuLine: 501.630.4175 Dine Readylny, mile ® See ingc:for
Internet: www.tigaN•or.gnv NullrreUlMr.iNd: 776-- I Supplementallnfornmtlun
,.. .. '!'.TYPE A4 WORK : ' :', ... • .. `'' • •,. •• '.'PLAN RfIVICW.' ;! : : : :• '.... .
0 New conslnlcrion 0 Audition /alteration /replacement Plow check all that apply(wamb 1 sett oflxoar ,vlheui checked !etow):
0 Demolition U C Servtcc ar feeder 40a amps us more 0 ffnllainf ueef llmae xlailea.
- mete due available Crop curare. ❑ Marinas and Mulyadi.
t • • • . :. CATE('ORY •OF:CONS') UCTION : • ••
• etc,: Oh IO,kok.mqu at ISO .nheur ❑ H ladny (whist!.
` Ic.% to rowel. Of MCC* N,OW ❑ CMINIMCIA•uro a0dadunrd
❑ I - and 2.1'mnily dwelling ❑ Commercial /industrial ❑ Accessory building amp fur ell enterinnolletienr. buildinss,
151 Multi-family [I Master builder ❑ Oilier: a rile pol ❑ lnnalhaion of 75 KVA u.
r'.. JOB'SITF, •INFORMATION AND LOCATION ': ' OEerr o Y e 7 , , !,aapanmy nil .yaem.
' ... QA.hltllnn of �tedv moms purl nl ❑ " .
", "li'
2 ""I •y"
lob no.: — I Job situaddrere: 14000SWt1 IINHP u..atpaacy.
❑ Six III INN regidential man. o It cemelponaI yell kle puler.
I' City /State/ZIP: TIGARD, OR 97224 2 ❑ Health -ca,e facilities. 0 Su11111p voltage for more lion
O Hazard lacxtiuni. 600 volt. nominal.
Suite /bldg. /apt. no.'6 I Project name: PARKWOOD COURT ❑S ernnooi feeerron0ottlas ur more.
.. ' ... Fre . SC11CDUI,G " :' • '
Cross street /directions to job site: n.reatain
I Oar. I rR. I r „I „I )
New residential single. or ululll•fxmlly dwelling n
luelud attached garage.
Subdivision: I Lot no.: 1,000 so. R. or less 145.)5 _ 4
Tax nulplpareel no.; s��O D�� —, loan All 500 sty. ft. or portion 33.40 I
��fZ�_ Limited energy, resident's! 73.00
•• DESCRIPTION 01” WORT(• (whit:awte sap 0.)
INSTALL FIBER OPTICS FOR VERIZON Lillliicelcrsagy , molri•Inrnily 7500 2 '
rcridcmial fsvhh t.1 ■u N . n.)
-- Services or feeders insla11n11on, iltornllnn. and/or ie1iioillnn
200 amps or Icsi 80.20 2
•'❑ PROPMRTY.'OWNER :'1 :,. • •.• 13'TENA • ' t • • 201 amps lo400mnps 10685 2 '
Name: 401 maps in 600 amps 160.60 2
— (,0l amps to 1,0)0 amps _ 240.60 _ 2
Address: Over 1,000 amps or MIN 454.65 _ 2
City/State/ZIP: Temporary services or feeders Inslallatiun, alteration, and/or
relocation
Phone: ( ) Fox: ( ) 200 amps or less 66.R5 I
Owner Inshdlnlion: This insmlintion is being mule on property that 1 own which is not 201 amps to 400 amps 100.30 2
intended for sole, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Hr
Owner signature: ___, -. _ Date: _ unch eb culls - reds, hher or extension, per panel
A. Fee for branch circuits With
•.' :' .... ' . ❑ APPLICANT . 7 - .7 7 :1 ' •'•• - CONTACT PERSON' • .. above set vire or feeder re% 6.65 2
each brunch cirenil
Rusincs5 NORTH SKY COMMUNICATIONS, INC. R. Fee for tunnel) cinrnil. _
Contact name: ERIK SCHENCK u'idrour scrviwa feeder fee, 4685 2
linl branch cilcuil ----6-- A -5-
Address: 11818 SE MILL PLAIN BLVD STE. 410 Iiachadd'Ibrllnchcilctult _ —
bliseellancous (service or feeder nut included)
City /Store/ZIP; VANCOUVER. WA 98684 Each lnunnf: :eared or nodular I 90.90
Phase: (503 ) 969 -7729 Fax:: ( 866) Rc c ot utxc, service marl /or feeder
452 -4853 Reeantea only 66.85 2
E -mail: mduorlonortbskycomm.com Pmnpor irrigation circle 33,40 2
CON'1'RAC(OR •• • • Sign or outline lighting 53.40 2
Business eamc: NORTH SKY COMMUNICATIONS, INC. e rcuir(s
energy plod :thermion. or
Address: 11818 SE MILL PLAIN BLVD. STE 410 extension. Describe: 1 Paget $75.00 2
City /State/ZIP: VANCOUVER, WA 98684 Each additional Inspection over alImrnbla In an of the above •
Pct inspection _ 62.50
Phone: ( 360) 254 -6920 I Fnx: ( ) 1 -866- 530 -4325
Invest leaden Ier hour (l I:r man 6350
CCe Lie.: 14117 I Electrical Lic.17 -154CL Supt. Lie.: 173LEB Industrial plant per hour 73.7$
'.•: • PERMIT FEES . • 7 .•' . ' •
Suprv. Electrician signature, required: Smbmhrl: $75.00
Prins !mow: JACK CAGLE Date: 8/17/09 Plan review (25%ofpermit fee):
gime surcharge OM of pet feu): $9.00
Authorized signature: 4. 4 -- TOTAL PfiRhli'r Flit :: 84.00
Print ttnnsCl
E A, DOLPH I Dale: 8/17/09 ' 1' 116 poelmltnpplh• otlunu:: pins Ira wadi Is no! ObinlnedtdthtuIOU
Joys after II bas beta netcpled ay eumplelt•,
. Nu aIn∎ptcilunt ulluwed ter peunll.
In vfloin ,po.n4d1:l.C•Ilmni.tpp.ane QW.VOc Nn «dala11 /n.Vcosuw,O
Y4P,F.S �a.az�
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