Permit I - I
•
. n CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
I I I ° COMMUNITY DEVELOPMENT Permit0: ELR2009 -00268
Date Issued: /20
08/1809
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 parcel: 08 00100
Jurisdiction: TIGARD
Site address: 14010 SW 112TH AVE 60
Subdivision: PARKWOOD COURT APARTMENTS Lot: 0
Project: Parkwood Court
Project Description: Units 60-75: Installation of data/telecommunications.
FEES
Owner.
Description Date Amount
Restricted Energy Permit 08/18/2009 $75.00
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 Required Items and Reports (Conditions)
Landscape Lighting: N Medical: N
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 throug R 2- 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: C� Permittee Signature: , " .6 " ,,
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 603.839.4176 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 plans are required on the Job site at the time of each Inspection.
E C PEO I VE0 D
AUG 1 7 2009
CITY o TIGARD
Electrical Permit Apoicalllon BRING
City of Tigard RerehW ~ ~
Dam/0 : Penr,l Na
r 13125 SW Nall Blvd, Tigard. OR 97223 F6v1 Review
Pllou: 503.639.4171 tax: 503.598.11960 Downy, OlImpemdl4
Inslmctiou Ulm 503.639,4175 O:ne Rody/ny: hnhi 0 see IMgc 2 for
Irucrncl: w%vivAgmtl-or.gnv NulificrUMnhlu); Su0 dcmcnlnI Inrelmin loa
.TYr-F, O WORK PLAN RIiV.ICN.''
0 New vooNMiction ' Additibit/allcraliollrrei)InCCincitt Plcrosc crAckalI llitopply(subuli43ace m bans wlucu,s 0-kcil
ce!wv):
❑ Seivlce or rcedtr 400 amps or nsvc ❑ nnihhny liver flime stoics,
❑ Demolition 0 Other; whew 4116.svallahle 44411 emronl ❑ Mnnnw.end howywdr•
Cscccds IO,WG rnyu :d I Sn rote ur ❑ rluatny builJinpJ.
CA'fECURY Uf L'ONtI'ttUL'1'tUN. ;
ksc to geoviA or uxcccdv W,Ofq Q Cuotowchl•uro agdcldwral
❑I•and2-I'ninilydwcllino 0Commercialrintlustried ❑Accessorybuilding clopsI'urallottltrInsidlmious. buildings.
0 Muhi-family 0 Masse' builder 0 Oilim ❑ litre leafy,. Q taq;dlndOn of 7S KVA or
❑ Cnlcrbu•c alon,. la r Kparaicl 1 IvrJ r r
JOB S{TF. INFORMATION AND LOCATION ' Addilinn fnewmornrluadnr C] ~,'f'' •q. Y ~a•• men,.
Job no.: Job site address: 14010 SW 112TH AVE 11)O)iP am„lie. uccupanc y.
OR []Six or more rClaltnliul nail C, ❑ RCC-lili 111.4 101MC J"fily.
city/sltne/ZtP: TIGARD, OR 9]224 L7Ncatth•carcracifitics. ❑Supp)yvolwcorm•nroreMan
❑ Nxznnimmluculiunt 4n0 mina rwu,hvq.
Suilc161dg.Mpt. no6o -~S Frojccl mono: PARKWOOD COURTr ❑.Smicomrrecdcr600uupuurnwre.
'
Cross xifeCthtircctions to job rile: 77777777 '..Frre•SC1IEDULB uacn uinn r«. riA61
New msidt•ntlut single• or multlAntily divelllag wilt.
Includus olinched ga4a90. _
Subdivision: Lo(ito.: Id)00sq.11.of less 145.15 4
La. ad(I'I 50U srf. Ii. or portion 33.40 _ I
Tnx map/parcel ao.: Limited tangy, icsidomill
DC3CRIf" r1ON OF WOrtK 75.00 2
(u•itlr :dAlsx .cr . li.
INSTALL FIBER OPTICS FOR VERIZON Li)„il4tlcnorgy,lnulil•I'tlinily 7500 2
tesidcm ial (vi4h t,talvc ,X j. 0.)
Services or feeders inillAntion ulterntlon m,d/rrMucullon
200 alops or Icss 80.70 2
❑ PROPPRTY OWNER '.D'TF,NAN'f ?01 auryrxu,400amps 106.85 2
Name:: 401 naps to 600 it'' 160b0 2
601 an,t>a to 1,000;uups 240.60 _ 2
Address: Over 1,000 amps or volts 454.65 2
City/Since/7.IP: 'fomporrry services or feeders Instullatlun, uitvrutton, and/or
relocation
Phone: ( ) Fax: ( ) 200 amps or le.s 66.65 I
Owner Installation: This instnllntion is being made on properly that. I own 1, i is nut 201 ,nips to 400 amps 11X1.3(1 2
hunded for tiult:, Ime, rent, or exchuogc, at:cording to ORS 447, 449, 670• find 701. 401 !Pn Jx10.599 amps 133.75 2
Rraaeh clrcldlx - IJew, «iterudou or exteus on
signaturc: , er and
pwncr ...Dort:
A.1'cc for brooch circuil5 miJp
❑ APPLICANT •CUN'fACr MASON above service or feeder Ito, 6.65 2
each bnuich circuit
Rusinnss nowt : NORTH SKY COMMUNICATIONS, INC. n. Fee fnrbnulcb circuit.,
ConlaC[unnle) ERIK SCHENCK wliriont,cryieourfeeder Ice, 4665 2
Address: first branch circuit _
finch add'I brooch circuit 6,65 ?
11818 SE MILL PLAIN BLVD STE. 410
tviiscelfmreous service or feeder nut included
City"Stott/ZIP; VANCOUVER, WA 98684 Full inunnlAcuucd or modu or
Phone: (503 ) 969-7729 Fax:: (866) d,valinn, service and/or fr"edc' 90'9D oY
452-4853 Rcconncotoil ly 66.85 2
Entail: ~5.kycommmm Pump or inigativucircle 53.40 2
CONTRACTOR ' ' Sign or uullino lighling 53.40 2
Business name: NORTH SKY COMMUNICATIONS INC. Siguulcircuit(s)or li4uitcd-
cacrgy P:ntcl, Acwliun, or
AddrexA': 11818 SE MILL PLAIN BLVD, STE 410 extension. Describe: 1 Page'2 $75.00 2
city/StalerzlP: VANCOUVER WA 98684 Cncltuddltfonxllur ecfionoveralinlvnblohton ofll,e;%bove
Per (360, 254-692a Fnx: ( ) 1-866-530-4325 )n spOC(ion 6215)
hwcsiigallrnl>erhour(lhrn,tnt 621St)
CCi3 Lie.: 14117 Plectrical Lic.17-154CL Suprv. Lie.: 173LEB Indtimli:ell,lamperhoor 73.75
, ntRCTKICA1, PERMIT FF.h^S
Stipm Gtcctricinn signature, rt:gnii'cd; A4AK Subtuhd:
Print nnmc: JACK CAGLE Datc: 8/17/09 Vivo raview (25% of permil roe):
Sane flirchargC (1242 or ponnii feu): 00
Authorimd signalum: _ 1 OTAL P[iRh11'r 1'liti: 840
Thk pormit uppltrnavn uxpirv, If ;r Poirot is not owahi 61 -110
0
Print made: E-T-HAN A. DOLP Date: 8/17/09 days after it sills brrnucreptcdArtully1ty.
Number ul'lmspecduo, olluwed,wr pennlr.
I?0rdhrynevcln,a diil,(:. r:o,i~dpP.,l^r OSl?,vp6 JR) 461sill 110YCO\V,V0I