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Permit i t . ELECTRICAL RESTRICTED ENERGY PERMIT q a s COMMUNITY DEVELOPMENT Permit #: ELR2009 -00309 A 1 3125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/02/2009 T;E GAR Parcel: 1S 134BC00403 Jurisdiction: Tigard Site address: 12505 SW NORTH DAKOTA ST 901 Subdivision: Lot: 0 Project: Meadow Creek Project Description: Install fiber optics for Verizon. FEES Owner: BEL -EQR III LIMITED PARTNERSHIP Description Date Amount BY EQR -REAL ESTATE DEPT, PO BOX 87407 Restricted Energy Permit 10/02/2009 $67.84 CHICAGO, IL 60680 12% State Surcharge - Electrical 10/02/2009 $8.14 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 $75.98 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 503.246 or 1.800.332.2344. Issued By: Permittee Signature: 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 503.639.4175 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. Electrical Permit A pplicati RE CEIVED .. . .... = :: FO.4 i15E ONLY: t:.::.:.;: , . `... -;?::.': City of'rigard O Received t, 1 T O 1 to ('! Date /Ily: 1 A Penn ho.; R Z q d G 3 c 131 25 SW Hall Blvd., Tiourd, OR 17- Plan Review I v I'' none: 503.6.39,4)71 Fix: SA544,1960 Datritiy: Odom Permit: fl GARD (nspectioo l..lna 503.619 OF T /� U;uc Reatlylny; lw� 1 B1 5 e Page b ror /fire v !'� RD Nulifrcd MCthuA: k tc i Supp(en cionl fo oi•mntlun . , . . TYPE OF WORK . . . . PLAN REVIEW V.''.':':' ' ❑ New eonsttucliof 0 Addition /alteration /replaceman Plcncc arca: Al Ihat apply (submit 2 sets of ,Iona w iitcuts chcckcd:melaw): CI Demolition 0 Other: O SC,VICC or Cock( 400 :nape ur 0x ❑ !Wilding over then cto ies. whore the 5vailahlc Ii,u11310341 Q Mannar and homyanls. ... CATEGORY or CONSTR UC'I'ION :.:.'•. .. '- ,;:'.... 1)5334310,000 al 150,1, 113 to 0 Fipa+ing 6uildingi. Ica: to gn er 3033341 14.060 ❑ CooulorcL:11•uso agdeulutrre ❑ 1 - and 2- ihmily dwelling ❑ ComnlcrcinI /industrinl ❑ Accessory building Amps fornU oilicr tastuukliuls. buildings. Q lvtolti- family ❑ Master builder ❑ Other: ❑ rite pay p f. 3(tlwwu of 55 KVA o, • . -JOE SITE • INCORNIATION AND LOCATION ' ❑8nmcrgencysyatom• Iarguscpa,ulciy4crivcdsytlmo. • . ❑A",,',2 of ncwmnlm Iona nl l7 "A" , T;. , "1.2" "1•) Job no.: Job site address: 12505 SW NORTH DAKOTA 100 HP or uxut. occupancy. Six or Mole residential nal. © Ramaliunal vehicle orkv City /State/ZIP: TIGARD, OR 97223 0 Hcn11h•auc faci0iics. C3 Snpply vnl,ago for nlorc than 143,1,4 013 1 03 3110 00. 63x1 votes nominal. Salle /bldg. /apt. no, 901 -916 1 Project name: MEADOW CREEK M 0 Scrvico et feeder 400 tulips ormom • Cross skeet/directions t0 job site: FI f3'SC(ICDUI _ imElaritimuormstmlizat New residential single. or nlultl•famlty dwelling suit. lacfndue attached garage, Subdivision: Lot no.: 1,000 so. 0. or less — 145.15 4 Tax ant / parcel n0.1 l a. 144'1 SOU sq. F. or portion 37.40 t P PI Limited energy. residential DESCRIPTION Of WORK ' (with ebose 31 . o. 75.00 2 INSTALL FIBER OPTICS FOR VERIZON Lllnit3tl3netgy, multi- Family 75.00 2 ' rceiticnlial (with ntrne ml, tl.) Scrvlees or feeders installation alteration and/or relocation r. 200 80.30 lo less 06.3 � ❑ pROPER'I'Y OWNF,R TENANT ' ` 201 1 amps l0 les amps 106.85 Name: 401 naps to 600 amps 1 (60.(30 601 mow: to 1,000 amps 240.40 _ lel Address' Over 1,000 amps or volts ~ 454.65 2 City /State /ZIP: Temporary services nr feeders Installation, alterallon,and /or relocation Phone: ( ) Fox: ( ) 200 amps or less 66.85 I Owner installation: This installation is being made on propeliy that ( own which is not 2 201 3mps 10 41)0 i 1no 100.30 t imendetl for sate, tense, rem, or owlmnge, according to ORS 447, 449, 670. anti 701. 401 tunes to 599 amps 133.75 f 2 Owner signature,. .Date: Brunch circuits» nets, ultrratton, or extension er nncl --- - --- A. Pco for blanch 31331,115 midi 0 APPLICANT' . ' :.1 • `'0'CONTACf PERSON' . above service or feeder lbe, • each brooch circuit 665 Business name: NORTH SKY COMMUNICATIONS, INC, (3. FccIorbranchcircuis Contact 110111e ERIK SCHENCK w m0AOpr service or feeder fee, 4685 _ __._, first branch circuit Address: 11818 SE MILL PLAIN BLVD STE. 410 Each add'I branch circuit — 6.65 Miscellaneous (service or feeder nut included City /State /ZIP: VANCOUVER, WA 98684 Each inununtctnnod or modular dwollio 90'90 II Phone: (503 ) 969 -7729 1 Fnx :: ( 866 ).452-4853 Reconnect only 1111 66.85 _ G -mail: and ioraenorthskycomm.com Pomp orit Option circle 53.40 2 CON'i'RA(TOR • Siga0routihlo 5140 2 , N ORTH SKY COMMUNICATIONS INC e Business name: cucr pauci, ahcr4ion, or Address: 11818 SE MILL PLAIN BLVD. STE 410 exle,i$ion, Miner +be: 1 Pn 2 $75.00 2 City /State/ZIP: VANCOUVER WA 98684 1((0311 additional Inspection over allowable In any of the above n e3tron G2•s Phone: ( 360) 254 -6920 Fax:( ) 1- 866 -530 -4325 i nvestigeslignlimlper h m /tour IN CCB Lie.: 14117 Electrical Lic.:17 -154CL Sul ". Lic.: 173LEB llldtlstliatplau per hour 73,75 • • I, • 'ELECTRICAL PERMIT PEPS ' 1 Suprv. Electrician signature, required: Subtotal: (07 `� • Prim none: JACK CAGLE Dates 10/01/09 Plan review(259P too): I TOTAL State surcharge TAL l I'Ist�. , j : . c): ', l Authorized signnuac: ' 1 PERMIT Date: 10/01 /09 Tilts porm11 uppltrnlioa expires Ira punnit Is not o0rnhm4 134106 n 1 Itlo J• 'T B Print mune: ETHAN A. DOLPI -I day.. Ow It has bee„ nacpled AO tw 6 140/1103/ ut'lutpccilunx ttllowett (1001)01111, Is enndtnyw0 .r,utt(3l,C•v.•rnu.spp.onr 03,5.00!, 4411 4015101 Im icostm0I(