Permit . },
IN CITY OF TI G RD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00136
GARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/11/2007
TI
" PARCEL: 1 S 135DA -02402
SITE ADDRESS: 11155 SW HALL BLVD 105 -108 ZONING: R -12
SUBDIVISION: ST. JAMES APARTMENTS LOT: 010 JURISDICTION: TIG
PROJECT: ST. JAMES APTS
Project Description: Installation of fiber optic for Verizon.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS:
Owner: Contractor:
JOHNSON, LYNNE AND R BLAKE NORTH SKY COMMUNICATIONS INC
TRUSTEES PO BOX 87550
2445 -A MAKIKI HEIGHTS DR VANCOUVER, WA 98687
HONOLULU, HI 96822
Phone: Contact #: PRI 503- 209 -7521
FAX 866 - 743 -3974
FEES Reg #: ELE 17- 154CLE
LIC 141171
Description Date Amount
[ELPRMT] ELR Permit 5/11/2007 $75.00
[TAX] 8% State Surcha 5/11/2007 $6.00 REQUIRED ITEMS AND REPORTS
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow 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 copies of these
rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued B „/ _ ` 1 /// Permittee Signature: A 1 j etc lirni , re
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'N: 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.
MAY-11 -0T: 10:23AM FROM -North Sky Communication 3602545097 T - 371 P.0151017
/ F -330
�, �� ,a F o t c• ol b
Electrical Permit Applic \N asen «:qrn n mod : - .
,
}` , City of 7Cigard "°- n ettvaa 5 (1 ,L,011 ,L,011 PemtitNo : --1C . •• 3(
Ml . a " 13125 SW Hall Blvd, Tigard, Ok 97223 "i ' 001 Plan Review Other permit: E BO 23
it . t _� Phone; 503.639.4171 Fax: 50.J.54.1460 0 Date/B
^+ D Ins Lin
C- 503.639.4175 c ry �` I iG a�D No te ed /Me BY rmh' El for
AT [GAR L 1 Notified/Me l 4 } Supplemental Information
{,war se. Internet: www.tigatd-or.gov _ • \11 S10 ' �
1 l a T Y T r• T r T 1 L.".' T l e t ti I 77,r i
�.'s, .., , �.'1,. f T { 2 . , �. ��'. 1 } r , 71, 'I; ('1a i ',`,'?' PN I 1 li C X 1 7. , ..., 4, 7, K.715•4K LI: E' r ,: Jt'',, A tr�..k�r.
7�rf� k Y. iiA 71� f .,.'.'l-,'1 , Ir�(t l t ' v I t 1
' 1' } 7 { ^ r. \'} J 1 .4 *111 l "}l:f u vi iY�''. �d i i',G .4 N °. i, %a:.:E53 �d 1t2rL;L„`n `!` ,, ; .,( r... .4.,7: . wl L � TL�'7
u: tut /' 4.1)1 ° �' �a G xi a ,.y, •�' - .i,r�. �,1.,,f .. . .,i )rr .s�atf �1s1, i 1 • ' + " L Piton check all that apply (submit 2 sets of eked below
..d -�?S t uu>u- - pp plans w /iteau checked ):
❑ New construction Addition ! altiltlon /iepltlCemcnt ❑ Service or feeder 400 amps or more 0 Building over three stories.
❑ Demolition ❑ Other where the available fault current ❑ Marinas and boatyards.
s T r i * i , �, , w A ga i > ^ r i ^ , *'�), ,1 y rl � exceeds 10,000 amps at 150 volts or ❑ Floating buildings
�l :,� rid, } +�i A,n f } . � } �. �v6t'� a�31d " 1 + = lt; {F , " gt1,i (i j u � ' i .t ',.;
4 z 4 0'`....,, y.- less to ground, or exceeds 14.000 ❑ C ommelt iai.use agricultural
❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all otter installations. buildings.
■ [] Master b ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
' Multi famil y 0 Emergency system largo m separately derived sy.rL
ri- r fi ' S a r t ,q iiir , ids ! Cut t a ` i" � n � a 3' 0. *i �.i i'..'rj,:,1, : I,; F i ,;, 0 A td of new motor load of 0 "A". "E", "1-2", . -3
i..kf,r'rM` t11:!C'l•Mii i.l ^ z Nmi :f 0.• t A —1 .1 ..:. - 1J }c R. a,"
t ' 1001-1P or snore. occupancy.
Job no.: Job site address: 1 i � J ❑ Six or more residential unit. ❑ Recreatiorit vehicle park:.
❑ Haza rd cute facilities. 0 Supply voltage for more than
6
City/State/ZIP: `� / ( , `DI:- ❑Hazardous h> 00 volts nominal.
Project 112IT1c: t. `. J , L I f �� I 1 6 °Service or feeder 600 amps or more.
Suitc/bldgJapt, no.: {
, ) ,. r 61 a y� � a � y • y s „
, ��:td5'. SZ'S.!�i�4L.t'L�''�N.. } ; 1� �l� ��17 _�!.j i sF".�
Cross strect/directions to job site: Dccriptioa - Ors Foe. Total •
Now residential single- or multi- family dwelling unit.
A ow
i11 1 I. Includes attached garage. -
Lot no.:
1,000 sq. A. or less 145.15 ( j 4
.
Subdivision: Ea, add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no Limited energy, residential 75.00 2
•r + • . { i t ht 1 . i1�' " ,45} 'W5, vra Nt1 (wilt above :
i :. l r��' 27Pr;�r rT�'�j':,2 *P.41 �A 1 0 1 1 , 4 , ,, tt ,., , },y,, � a . k,.- _' Limited energy, multi family 2
`� / residential (with above aq. 75.00
J �!� - 'i`l� . �` 1 ' Services or feeders installation and/or relocation
200 amps or less 8030 2
7 �I z5 �3� a 5 rn. it ? � J� . r w, „a'7' t` 4V ° t :7- F { rf� ,Y rrt l amps 2
Y ?7, 4 0 P l.'"- 'fib.^.. rci4'.11 41 i i t IP-5, l lW' . ti orp.1 h} lCe,.�, !4 1 I �'� VA 201 to 400 steps 106.85
r 5 aj r t .. 401 amps to 600 amps 160.60 2
Malec: 601 amps Lo 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2 •
Temporary services or feeders Installation, :alteration, and /or
City /State/ZIP: 'relocation
Phone: ( ) Fax ( ) 200 amps or leas 66.85 1 1 -
201 amps to 400 amps 100.30 2
Owner installation: This installation is b,: ing made on property that I own which is not 401 amps to 599 amps 133.75 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits - new, alteration, or extension, per panel
Owner signature. Date: A. Fcc for branch circuits with
Mi'T , �'A, i tC ^Cum q�/ �” t, yr q �,, � r t„ 5 """"t—' et 7- ; 11'*,'•' above service or feeder fee,
,� 1c l H'', `� `c rti h 1t ..• t - , �. U�SLLad; q y j �S ct " ' i, s � l4 v lx �.r 6.65 2
t.�u�_ Il�..us..a, v Y �f e, „e..:;.. Z.!! ., r e:v.sgF,u. a t.J.' acs each branch circuit
Business name: Nut/41 A 1 B. Fcc for branch circuits
without service or feeder fee, 46.85 2
Contact name: rM fast branch circuit ,
11 _ ` /� • /� r Each add'l blanch circuit 6.65 j 2
Address: 1 ► , l� { (A/� l ! �j �
' M3sceliancous (service or feeder not included)
City /State/ZIP: y W 1 4k •/ S1 Each manufactured or modular 90.90 2
} 1 dwclliN, service and /or feeder
Phone (6 03) 1,19g 1 f2 Fax: : ( i $DfI }' Reconnect only 66.85 2
n ��'s e d � ' 0 / A h, 1 Cb' m pump gr irrigation circle 53.40 2
r f214 f r { tir r L i , 'iy7 , l� �l,,i C , � w 1 is'. T i f ' Sign or outline lighting _ 2
., .v1MJY'YLYJiL., y , ( ,�{..)rl +' R. 1,1Yl,i\.C.1lu, flu Q u✓} • ^ l.. ]:Jy..�1 '...`v_ 1..�! -:. 1!1
Signal circuit(s) or limited -
Business name: / eL .- • •v.Q, energy panel, alreration, or
extension. Describe: 1 Page2 1G 2
Address:
City/State/ZIP: Each additional inspection over allowable in any of the above
per inspection 62.50
Phone: ( ) Fax: ( ) Investigation per hour (1 hr min) 62.50 ,
Electrical Lie.: l - Suprv. Lic.: Industrial plant per hour 73.75
CCB Lic.: I y , �, „ ti •� M� , a N t� , ; �' r �1 V t t jL
�1'T e.a...10/..k... r 1 t
':,i�♦q'. rt -ad \ 5� i∎ f h � ,
Suprv. Electrician signature, required: Subtotal:
D Plan review (25% of permit fee):
Date: Print name: State surcharge (8% of permit fee): to W
�Rf�s>_ �_. � TOTAL PER FEE: 0
Authorized sib
This permit application expires If n pen it Is net obta within 160
Print name: <' 1 ■ . i L , , •1 • Date: /. 10 ..iv
days allot It has been accepted as complete.
• Number of inspections allowed per permit.
I NanidmgTamils\ELC-Permanpy.dac 05/23,06 440-4615T(t I /OS /COMIW2B
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007 -0013G
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/11/0007
Phone: (503) 639 -4171 ",.y�6���
Inspection Requests (24 Hrs.): (503) 639 -4175 s
INSPECTION WORKSHEET FOR DATE: 5/21/2007 TIME: 7:02AM PAGE: aft
SITE ADDRESS: 11155 S.W HALL BLVD 105 - 108 CLASS OF WORK:
SUBDIVISION: ST, JAMES APARTMENTS LOT #: 010 TYPE OF USE:
PROJECT NAME: ST. JAMES APTS
DESCRIPTION: InG.tallation of fiber optic for Verizon.
OWNER: JOHNSON, LYNNE AND R BLAKE, PHONE #:
CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 503 - 209 -7521
Inspection Request Scheduled For: Date: 5/21/2007 Pour Time:
Code # Inspection Description I, Confirm # Contact # Message
199 Electrical final 04B691 -04 503- 849.5198 Y
Corrections /Comments / Instructions:
PASS n PARTIAL APPROVAL I I CANCEL NO ACCESS
I I FAIL I I CALL FOR INSPECTION Il ADDITIONAL FEES ASSESSED
Inspector: �� 1 O �� Date: O I. Phone #: (503) 718 -M