Loading...
Permit *Thi 4r. CITY OF YIGAR® ELECTRICAL RESTRICTED ENERGY PERMIT t fi � . y . COMMUNITY DEVELOPMENT Permit #: ELR2009 00318 ' Date Issued: 10/02/2009 ` TiGARLt1 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 1S134BC00403 Jurisdiction: Tigard Site address: 12505 SW NORTH DAKOTA ST 1801 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 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 503.246.66699 or 1.800.332.2344. Issued By: wN Permittee Signature: I _.5L v \ 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. • RECEIVED Electrical Permit Application .. ::: FOR OI FLChUSEONLY.::.:•::'. :;•:• :::.; 312 of'!i ilyd li .i C %� � � Pcr IM E1Y�Z� -lie 1ti Y �' . No.: i + ' 3125 SW Nall Blvd., Ti'•urd, OR 97223 Phone: 503.639.4171 ' � "f1GARD Emile e TIGARD inspection Line: 50 ING D U:mo RcaJy /11y: Ed Sec 1'nge t for interact: wtwv.tigat thAfcamedmd: Supplema,tnllnfnrmn0on Tvrr, �h WORK ...:..... : •:. :..;. PhAN RRV.ILtW.';::':;'' ❑ New c0n0ltlleliOn 0 Addition/alteration/replacement Plc:ue check: dl lha( npp1y (mh11I 2 set Arpl011 ,v/ii con chce0cd be)ow): 0 service or feeder 40a amps or anus 011111101 averoncc storks. 9 Demolition 0 Other: where do available twit meet 0 Monnus and baaryards. • . : ::s `• CATEGORY -OF CONSTRUCTION `.i'::. .::. exceeds 10,000 amps ,iso wets or D f7atlnybuildiogs. I lm lo grouts. or cxcuoJo 14,11(10 0 Canorcl agricutuotl ❑ 1- and 2.1'alnily dwelling ❑ Commercial/industrial ❑ Accessory building coops for All othtc inswilltoiims. bmnding4. E] Multi- family 0 Master builder ❑ Other; ON., wen ❑ (n.cdlnGOn of 70 KVA ur Q t ergaroy s tar cr sc t, del AdrlveJ c tau. SITE AND LOCATION $ y y' ... .. JOB SIT - . ` ... • '.' ..'... (] A,klilinn n l alto molar load of [l " A" "! ?.• "I.2 "I.3", Job no.: 7 Job site address: 12505 SW NORTH DAKOTA n)otia or mxe_ eseopam y ❑ Six or more resktoai:d u 0 Rem:Model vehicle oak, Clty/State/ZI P: TIGARD, OR 97223 0 hvalth•c:no 1 viiic,. 0 supply volloec r more dim, 0 Ha'tan4)m, lucatieni• 000 'MN nominal. Snits /bldg. /apt. no. 1801 -1816 J Project Warne: MEADOW CREEK O Service nr feeder 600 ao,pcon FRE Cross street/directions to job site: •SCIIEDULE ": J uc,enptlfin 1 Div, I l'ec. I •t'idnl 1' New residential single - or nudtl•fandiy (Evening milt. Includes attached ga - agc. Subdivision: Lot no.: 1,000 se. 6. or less I 145.15 I'___.. l f 4 - 1 1 L;t, add 500 nq. 11. o (1 0111114 33.40 I Tan map /parcel 110.1 _ - __.._� - --- - - -_... --- - -- -._ ._- • Limited energy, residential 75.00 2 DESCRIPTION OF WORI(' (withalxroe sq. II.) INSTALL FIBER OPTICS FOR VERIZON L1,nite<I energy, n)u111- 1it11111y 75.00 2 . resietcntinl (wiu, niatts: a 0.1 _ Services or (cotters installation, alteration, andiar relocation 200atn» or less 80.30 2 • • '© PROPRR'!•Y OWNER • • • . .0: TENANT ' ' 201 emits to 400 crops 106.85 2 • Name: 40Iampst u600env; I 160.60 2 601 ;animus 1,000 amps 1 240.40 2 Address: M Over 1,000 amps or volts 454.65 �� 2 City /Stine /ZIP: Temporary services or (ceders Installation, :titerattou, atW /or relocation Phone: ( ) For: ( ) 200 Amps o,' Less 66.85 1 Owner installation: This installation is being nude on property that 1 own which is not ' 201 m :fps 10400 nmps 100.30 2 intended for sate, tense, real, or exchange, according to ORS 447, 449, 670, and 701. 401 tamps to 599 amps I 113.75 1 2 Owner signature: ... - -. _ Date: (hunch circuits new, nitcratio', or extension, Leer panel A. l'ec for broach 0410 11,0 with '• 0 APPLICANT • r :. • • • : '• � i[ ' • O ' CONTACT PERSON ' ubovc service or [ceder (co, 6.65 2 each branch circuit nosiness NORTH SKY COMMUNICATIONS, 0. Fee for brooch circuits - witltow service or feeler fee, Contact strum: ERIK SCHENCK 46.85 2 „ - lust branch circuit _ Address: 11818 SE MILL PLAIN BLVD STE. 410 Each :t d d'l brands cite1>it 6.65 _ Miscellaneous (service or [ceder not included) City /State /ZIP: VANCOUVER, WA 98684 Each tnunutltcturcd or nwdulur 90.90 - dwctlin urviec and /or fcerla• Phone: (503 ) 969 -7729 I Fax; ; ( 866 ) 452 -4853 Rccomlcc1 only 66.85 2 £ -mail: mduooOnorthskycomm.com Primp or irrigation circle 53.40 2 CUN'CRACTOR Sign or 0(nlhro lighting 53.40 2 NORTH SKY COMMUNICATIONS INC. Business 117100: Signal ooi,( or limited- cucrgy pool, altordi0u. or Address: 11818 SE MILL PLAIN BLVD. STE 410 extension. Describe: 1 Pa $75.00 2 City/St"/ZIP: VANCOUVER, WA 98684 Ends nddltionausp lleotion oyes allow ablobt any o f the above Per inspection 62,50 Phone: ( 360) 254 -6920 Fox: ( ) 1- 866 - 530 - 432_5 hwcsligntion nor 110111 0 br mina 62su CCS Lie.: 14117 Electrical Lic. 154CL Suply Lie.: 173LE6 Industrial phial der hour 73.7 /' i' • `'.'•ELECTRICAL PERMIT PETS • -• •••- Suprv, E)cclricinn signature, rtqu1r011 Subtotal: 37.61z (0 _ 94 Aimiroly Print rmmo: JACK CAGLE Date: 10/01/09 Plan review (2544, of permit sec): - Stale surcharge (12% of permit fee): $8:06 e . 14 Authorized signature: �/! , TOTAL Pf;RMIT MG.; S 11 7 'fats In upp11cn8uu ospin ra vomit Is not obtnlucd nithtn ISO ! 5 _ 98 Prim nu)1c: ETHAN A. DOLPH Dale: 10/01/09 dnrcote ,•Irh.beenneecp(e.1nreuatplety, laennnin N'NUdn \Ii1,C•Vorn,�•t, In: OS/3L00 . Num6o, OrhntpoeIuor ollu>vd perpe(4111. b (p' 4.Ib 40151'1 Inl.000\tAViill