Loading...
Permit • CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT Permit #: ELR2009 -00319 Date Issued: 10/02/2009 1Ti 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 1S 1346C00403 Jurisdiction: Tigard Site address: 12505 SW NORTH DAKOTA ST 1901 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 503.246.6699 or 1.800.332.2344. Issued By: r ,� `1 Permittee Signature: P 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 App , ri (FIVER ... • _ i�ox;air><e> usivoiv0Y ,;- ... Cit oF'Ti Tigard ttaehw Al1 ? t�.Z40g '06 ( Y S actelvy: Permit Stu.: 11125 Su/ HMI Blvd., Tigard, ( 1721 r n Pim R ,v cvic • ' 1 503.639.4171 lax: SO Sc8.1 1 / L. Uandhy: Other Permit: fnspcction Linc: 507.639.4175 Data Read 10 in n:,: TIGARD Y Y: 6d Ste L'acct Internet: wwtv.tigat<I -or. iJ ITY OF TIGARD NutlfCdIMchud: r Supplemental lnfnrnietloo ,:.• : B INGIOWISION :: :: •:: PLAN R VI W. '; : ' :'.: • Q NeweOrlslnletion GI Addition /alteration/replacement PIc: caxckalltha t en pty(suhmii2scuol 'el:ms /itanrchcckcd1410w): 0 Se+vke or fetter on ninpi of utum ❑ ntdl"it+y .va• rhn:< (1odax. 0 DamOli(i011 []Other: whit ro (Ito :vailahIC 6uliClacnl ❑ Miirinus and Msdyurds, .. • CATEGC)i(Y , OF . CONSTIRUC'1'ION - .. exao1ds 10,W0:unp1 n 1201 Of Q gloating iwitdings. • - 1c:c co groins(. or cxeccds 14,0119 0 Cunln,orcl:n•uso agrtculittnd O 1 - and 2- fnrnily dwelling ❑ Conuttcrcint /in((nstrint 0 Accessory building OWN Fur n11 office iuxinhmiuus, Wilding. cj Multi•fumily 0 Master builder ❑ Other: ❑ C0c!mune. 0 fng ■111ufiun of 7.0 KVA or .. Cm,ergeocy swam. larger >c thin( slctivcd stem, ...' :.:`' '. . -JOB SITE.•INIgORMATION AND LOCATION " Q Addition ni nmv minor toad nt ❑ "t "1.3", ',m em. 1 lob sitendth'ess: 12505 SW NORTH DAKOTA MOW or " "' nu uil o , ❑ Six ur more residential unite, ❑ R ecmollmtat vchide park% City/State/ZIP: TI GARD, OR 97223 ❑ HCahh•carc rncuiti1 . 0 supply volIiic rnr 1,111 that1 D Hsraninms locutions. 600 vnnt na0i0I. Suite /bldg. /apt. no. 1901 -1916 Project name: MEADOW CREEK I' Service Of neat/ MO a+q,s. "lore. _ _---.. _ FP,6 SCffGDUT,Ii .... Cross street /directions to job site: M nraarlpnnn J 011. 1 Av. 1 1 i . New residential single. or multi - family dwelling unit. Includes Mulched garage, Subdivision: - 1 Lot no.: 1.000 so. 0. or loss - 1 45.1 5 _ -_. o - -1 La. add') 500 sr. U. or ioninn 11111 33.40 fl Tax nuhp /paleel Ito.( Limited cucrgy, residcnlial DI?SCRIPTION 01' WORD( (wilt, ss . fr.) 1111 75.00 INSTALL FIBER OPTICS FOR VERIZON Limited energy, multi - Wilily IN 7s MO • residunial (with mboty, st. 0.) Services or feeders insinllotlon, ulterall0n,mtd/or rCIIodlnn 200 amps co less 80.30 . •' © PROP88 )'Y 'OWNER .'' . 0' TRNA NT 201 amps to 400 ,mops 106.85 2 Name: 401 amps to 600 maps 160.60 2 " 601 anq>.s to 1 ,000 aims i 240.60 2 Address: Over 1,000 a 0r volts 454.65 �+ 2 City /St ate /ZIP: 'fampurnry ser vices or ( Installation, :titer (100, auti/oc relocation Phone: ( ) Fox: ( ) 200 amps or la -vs 1111 66.85 al 1 Owner installation: This inslnllntion is being made on properly that 1 own which is not 201 amps to 400 iunps 100.30 2 intended for sale, sense, rent, or exchungo, according to ORS 447, 449, 670, and 701. 401 am is to 599 unto IIIIIIIIMEIIIIIIIII 2 Date: _ (Tench circuits - new, aeration, or extension, per Panel �.� _ Owner sign allH'C :............. _.__-_.._ __ -- -- -___ ----•- A. Pee for branch circuis ndUi • 0 APPLICANT ' .:::I • '.. In CONTACT PEnSON ' abovc .selvicu or (ceder rco, 6.65 2 each branch circuit Businessna0)0: NORTH SKY COMMUNICATIONS, INC. 3. Fee for branch circuits - ' ' Contact 000(0 ERIK SCHENCK uir7lour service or feeder fec 4685 3 lust branch circuit , Address: 11818 SE MILL PLAIN BLVD STE. 410 Fochadd'l branch cheuit 67(15 2 Miscellaneous (service or feeder not iteluded . City /Salle /ZIP: VANCOUVER, WA 98684 Each inunu(tc(tired or modular 9(1.90 Phone: (503 ) 969 -7729 - I Fax:: ( 866 ) 452 -4853 dw0(lin8, .i.1 attunr /cheer AcconuccI O o 66.85 2 aI„ai): -mdu zcanorthskys G� Pinup or is 01;11 53.40 - 2 CON'CRA(1T(IR Sign or 00(1100 lighting 53.40 2 NORTH SKY COMMUNICATIONS, INC. energy an (a) o • Eiusincss nano;: , IN energy panel, alteration. or Address: 11818 SE MILL PLAIN BLVD. STE 410 00101Sion, Describe: 1 Paso 2 $75.00 2 City/State/ZIP: VANCOUVER, WA 98684 Each additional luepedion over Afoul bto In any of the above Phone: ( 360) 254 -6920 1 Fax:( ) 1 -866- 530 -4325 _ Pct inspection 62.50 bngcsfiptnioa per hour ( larmi,u 62.50 CCa Lie.: 14117 1 Electrical Lie.17-154CL Suprv, Lie.: 173LEB huh1stial plant per hour 73.75 • 1(A?(:TRICAI, PERMIT FEES . Suprv.EtcclricinnSignnturc,required: ✓ - Subtotal: i 7, 8/4 Print 110(11 JACK CAGLE Datc: /01 /09 Phut raviow (25go of Nola( fee): QQ State surcharge (1290 of permit fee): U- ( a Autho ixcd Signnturc: !A .01 TOTAL PERMIT Mt:: o 'l'hts p ormlt uppllrn(lo,, ospin:1 if a pond( Is not obidncd uiI16n 180 �� • 8 Print "0.. ETHAN A. DOLPH Date: 10 /01/09 any An, it lid. hrcn necoted e, ...Oct, Numlxr urinopcatoita allutveu per p11161. lACIoNingv'o , ll.0il,C'l' 0, .y,p.ane 01/3(,06 440 461Y19/ s /11.VCUa1AYl ;11