Permit 11 q
CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
° COMMUNITY DEVELOPMENT Permit #: ELR2009 -00273
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/18/2009
Parcel: 2S110AB00100
Jurisdiction: TIGARD
Site address: 14060 SW 112TH AVE 18
Subdivision: PARKWOOD COURT APARTMENTS Lot: 0
Project: Parkwood Court
Project Description: Units 18 -25: Installation of data/telecommunications.
Owner. FEES
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 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 through OAR 952-001-0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.248.6699 or 1.800.332.2344. /
Issued By: C Permittee Signature: OA/ 4 1 / 7 /"?../ e.9-77,10-\/
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 plans are required on the Job site at the time of each inspection.
t .
RECEIVED
AUG 1 7 2009
Electrical Permit Application .. .. , ; FOX (MELEE USCONLY,; : _ ..`., :.
City W ill 1 ne . : , %. -
111111 a ,
4 13125 SW Hall Blvd., Tigard. OR 97223 �. i °.�. •• .. , • ..,• � .
Phone: 503.639.4171 Pax: 503.598.19611 OtlrerI'ciddl:
TIGARD Inspection Lure: 503.639.4175 DateReadyray: El See PagoZ
Internet: www.dgunlor.gov Notified/Method: Mili SupplementalInformallon
. ..TYPE OP WORK 'Y::1• ` : ••..lo • •••• •• PLAN REVIEW't;t;' -.... .
❑ New uousuueiion O Addldanlnlieraionrrepincement Plow dicok al! lhit apply 0uhii 2um (Winos Whams sInakcd :loluw):
CI DCth0Efi011 ❑ Other; Qservleo or Rcdcr 400 amps or Mae 0 Onlldingo 01110w00 (00.
whe re the nvsilahle 1000 curiae 0 Mnrimu and May. nls.
:. CATEGORY 4.31i':CONS1'1 {UCI'ION exceeds 10000 amps Id ISO MIK1lr 0 Mating buildings.
❑ I• and 2.littnilydwetlin ksctoaround•orexceed,/ 14.000 0 Cmnnterclal•erso aarleulurrat
g ❑ Commercial /industrial ❑ Accessory building mops for all (mar liniallution. 050410gr.
12 Multifamily ❑ Master builder ❑ Olber: ❑ Nis pump. 0 Installation of 75 KVA or
. ' • JOB SITE- INRORMATION AND LOCATION '1'.' QBnwrgerrey ayxterrt. larger Malady derf.ed apical.
8A load of ❑ "A ", "I' " "Id " "1.3 ".
Job no.: Job site address: 14060 SW 112TH AVE WNW or o se rcx uoaopaacy.
❑ Six at tlture fceHkntial Intim Q Reerenlinnal vehicle paw.
City/State/ZIP: TIGARD, OR 97224 I) 9w/ ❑ Hcalih•cereracahica. 0 Supply vollag) (Or ulorcthan
r' ❑ Ha ?edam Wiliam 600 wan rnsnurwl.
Suite /bldg,/npt. no. �d , �5 Project name: PARKWOOD COURT �_ 0 Snvtoo or tccdcr600 nips or mire,
Cross street/directions (0 job site: _ ucutlairm 3 oty. 3 PK. I nat.' I •
- New residential %Ingle. or multl•fnmlly dwelling mutt,
fncladus attached garage.
Subdivision: Lot no.: 1.000 sq. 0. or Into 145.1$ T 4
Ea. ;Ail 500 sq. II. or 1loninn 33.40 I
Tax imp/parcel no.: limited energy, residential
DESCRlrrloN Or WORK • (with above eq. a.) 75.00 2
INSTALL FIBER OPTICS FOR VERIZON L "nitetlenergy, n,alcl- ° "nily
75.00 2 •
reolunllal (wills rdmw sec. n.)
Services or feeders InefallntIon and/nr r let:Minn
200 slops or lcsx 1 80.30 2
..❑ PROPER'L'Y OWNER " "'I :,• '• • •.• la •' ' :1 201 amps m400maps I 106.85 2
Name: 401 maps to 600 naps 160.60 2.
•- 601 amps to 1,000 aumps + 240.60 2
Address: Over 1,000 amps or wills l 454.63 2
City /Stnte/ZIP: ' Temporary services or feeders Installation, alteration, and /or
relocation
Phone: ( ) I Fox: ( ) 200 snips or lees 66.85 I
' Owner Installation: 'This installation is being made on properly ththal I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, end 701. 401 amps to 599 limps 133.75 2
Owner slgnnhrre: Date: Ifro circuits - new, niter:Mon or extension, per panel
A. Ice for branch circuits with
' ❑ APPLICANT • . • ' : : ' • '.• O CONTACT PERSON ' ubove service or feeder fee, 6.65 2
Runtiness name: each brunch circuit
NORTH SKY COMMUNICATIONS, INC. a. Pee for branch circuits
Contact name: ERIK SCHENCK withohr service or feeder feu, 4685 2
lirsl brtnch circuit
Address: 11818 SE MILL PLAIN BLVD STE. 410 Hach edd'Ibnmchcircuk I ._ 6.65
Miscellaneous (service or feeder riot included)
City/State/ZIP; VANCOUVER, WA 98684 Each inunufaclured or 'nodular
Jatlllinn„ service eta /or feeder
2
Pltolla: (503 )969 7729 I Fax: : ( 866 > 452 -4853 Reconnect only 6645 2
Entail; mduort northskycomm.com Pump orinigatiencircle 53.40 2 '
" CON'fRACfOR Sign or vanilla Ili/Ming 53.40 • '
Buttinoaa NORTH SKY COMMUNICATIONS, INC. sigoni circuit(c)orlimited-
energy panel, alteralium or
Address: 11818 SE MILL PLAIN BLVD. STE 410 extension. Describe: 1 Paget $75.00 2
City /Stnte/ZIP: VANCOUVER, WA 98684 Each additional Inspection over allowable In any of the above
Phone: ( 360) 254 -6920 [Fax: ( ) 1 -866- 530 -4325 I h n v inspection 62.50
rvcsligudarpluhour(I 62.513
CCR Lie.: 14117 I Electrical L -164CL Suprv. Lic.: 173LEB Indusaiai plant per hour 73.75
,�J • 'ELECTRICAL PERMIT - .
Suprv. Clcctrici0l slgnnturc, requited: J Subtulxi: l: $75
Print 11000: JACK CAGLE Date: 8/17/09 Plan review (2591, of permit fee):
,f - Sure n (12% of permit NO $9,00
Authorized signature: �`'l . TOTAL PERMIT PEE: $84.00
Print clone: ✓ Yr � I DaIc: 8 /17 /09
'rids pm:nt(t eppl tendon a %plrs If n permit Is not obtained 1Hthht 180
ETHAN A. DOLPH days after 11 hoc been omitted as complete.
• Number of tarpeolune allowed per poem.
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