Permit III CITY OF 1 I GA R D ELECTRICAL RESTRICTED ENERGY PERMIT
a=° '" COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00128
'''- DATE ISSUED: 5/11/2007
TIGARD. 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
'= PARCEL: 1S135DA -02402
SITE ADDRESS: 11155 SW HALL BLVD 41 - 48 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.
S. Issued BEAM, d /yhm Jv ' Permittee Signature: A l l ply Qli
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 10:20AM FROM -North Sky Communication 3602545097 T -371 P.007 /017 F -380
ctric
Eleal Permit Applicatio w .° g i' - , ,I_t , " _y.�} ` / � 7
r City Of Tigard , ` r.:1 i , � D 'Received I
�I y 6 o - • Permit No.: - !t - W ( 4
13125 SWHalIBlvd.,Tigard,OR 97223 PlanRevietiv ' Phone: 503.639.4I71 Fax: 503.593 r f j •+ nn Dare/By:
Other Permit: 'Z(,�� �( 2:3, i1 Inspection Line: 503.639.417 i iJ o l Date Ready/By: 1 - el Sec Page Z for
TLG ' FIG Notified/Method: 1 (1' SupplcmentalInformation
Fix t Internet www.tigard- or.goV C i T Y OF
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,. . �fi� ,..,.,1. i � ti .1'N' �: til. rpt IA . -i j a ik !1' M�, i kce 1. lM� < }'!Y ,v.' a
ii,... f Fi ,,,,V,9l� 5 �'L L 1 7: v ,���. • .,., _?a :4;ill. .:,.;I.Jne.....ur? 0 ..tu .1n1..1..u.a- ea,.IctrL.,..IN_ .,L .Y r
1...,rt.4: .,,;.,,e.,n !' r-
:�- :..,.1 ax r 1+N9. w:IC
ion g�{ AA dditiot ialteration/replacement
Please cheek all that apply (submit 2 seta of Plans Vila= checked below):
❑ New construct
J 0 Service or feeder 400 amps or mom ❑ Budding over three stories.
❑ Demolition ❑ .t Other, where the available fault current ❑ Marinas and boatyards.
d ' 7 E dM { ✓»I,I1 Q l c v�i y � :3,fi 4 1 . + 4 _ ,i4 ,"- -. - ,ktigigc.. 3�� s na ,NoL ap p e j r 4, i, at exceeds 10,000 amps 150 volts or ❑ Floating buildings,
il
• less to grouted, or exceeds 14.000 O Commeteial -use agricultural
❑ I and 2 family dwelling ❑ Ctnnmcrcialindustrial ❑ Accessory building amps for all other installations. buildings.
►,� Multi-family 0 Master buildex _
❑ Other: ❑ Fire pwop. ❑ Installation of 75 KVA or
-,.. 7-r 1771 ' 6 7 ❑ Emergency syStMn. larger separately derived system
77t " r}'l ' ((, �, ' 4 ,, >,.�y;n t o . 1 o a19: �If * 0 0, A V e i ,. 4li lr�.�_ Addition of new motor Toad of C3 ..A., "En, "1-2", "1 -3..
4 , �, 100 or or mots. occupancy. p
Job no,: lob site address ❑ 10 more residential units. ❑ Recreational vehicle arks.
City/State/ZIP: 1,, / ( / g'(' ❑ Health - care facilities. 0 Supply voltage for more than • L ❑ Iiarardous bcations. 600 volts nominal.
Suite/bidg_/apt no.: $ Projcct name: A i i .. . r ki ' r u i En Scn c or feeder 000 amps or more.
,, `' ";, �p ':-..',74P ':-..',74P 'lariat_ ME UXE WR.. ,. ;,, t
Cross street/directions to job site: n . . • don CLVIIII7d1111 i111a
New residential single or multi family dwelling unit.
f Includes attached garage.
Subdivisi I L ot no.: 1,000 sq. ft. or less 145.15 4
1 add'l 500 sq. ft. or portion 33.40 I
Tax map /parcel no Limited energy, residential 75.00 2
�k ?� {rl� ' 1 iSZMP
ir6)t I(r '�' 4 iy {i��f{ 13* 0 .1 1 A � a "', ' 'r -, $ tan itit;t'..o (wiW abovesq. ft)
r N,t.{r.1.,' ''a. "..,,.t t
l, ,4.L.J. .c.t.b.:i. ,,4t,,Ssanr' , i .5 , y y. - ".A 1�V 'i�.�5.
J1 1 I t��# ,� I I l u r e sidcn d energy, (with above sq . ft ) 75,00 2
residential (wirlt shoe eq. ft
Services or feeders installation, alteration. and/or relocation
9s y ys 200 amps or less $0.30 2
CS � l��r�? � . i 1 745 ? t "t�'ah ;i t lriT •..: ` a .. a r°°'►'•I,�" gA ' 4. 201 amps to 400 amps 106.85 2
Name: _ 401 amps to 600 amps 160.60 2
— — 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
• Temporary services or feeders insta alteration, and /or
City /Statc/ZIP: ' 'relocation
Phone: ( ) I Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is bs:ing made on property that I own which is not 201 amps to 400 amps 10030 2 __
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 40I_ amps to 599 amps 133.75_ 2
Branch circuits - new alterutio or extension . cr • and
Owner si a te ; _ Date: A. Fee for branch chewier with
o rrr- L ?t T C +Z'=P `- w r'1 �� l i w ' R r1t i �J'� r. + ' 4# h' 4 aove servce or eer ,
";� w 4{ " s' itt i 1`i v'L Fit° t " :rl i { : `i, t5._ "i.si F!i h-- . 1�_s.. �', � le Q n?(p; •:ll!` b i fde fee 6,65 2
r ,.,.t 1 Jw : each branch circuit
1) • t t B. Fee for branch circuits
without service or feeder fec, 46.85 2
Contact name A % J ' f ast b ranch circuit
Address: (
s t i Each add'l branch circuit 6.65 - 2
• 1 1 t 1 t•
hEsccllancous (service or feeder not Included)
City /State/ZIP: kh k A,14.&.' Y V . 1 to 11 Each manufactured or modular 90.90 2
( 665) 9 ' ��f ` Fa 6;1.'0_1 4 i `7� L{+ Reconnect n service and/or feeder
Phones Rtxonaect o 66.85 2
WM ' _ , s ;� re N0 C)' 0 t1 1 C 1'f Pump or irrigation ci rcle 53.40 2
'ma y, 3 a_. (ti:, ry v, 4 r. ,F + �f ✓ .SI OT outline 11 .40 2
_
z z x Fi t' 7 Pf-w.giWo z •'..° Nt0L -Alt :r M ' :+L t' !1 k l" g lighting 53
13 usiness name: •v.e Signal circuits) or limited-
/ energy panel, alteration, or
Address: a tension. Describe: 1 Page 2 16 2
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
CCI3 Lie.: \ ' Electrical Lc.: 11 - 154 ca, Suprv. Lic.: Industrial plantperhour 73.75 p �
- ;,l , 01 4 .„..„44.„„„,...i,„ f
oft i f• A.,..90:411', FS $4' t (vl
qlr tdi;ni _. �ilzJi2 � j �: u y; + St t . �.
Suprv. Electrician signature, required: Subtotal:
Date: Plan review (25% of petmit fee):
Print name: State surcharge (8% of permit fee); Ip
-
Authorized s1 TOTAL PERMIT FEE: 'i
r This permit applicadon expires if a permit Is not obtained within 180
Print name: -.1 i � . k i 1 r � Date: h \ i ...1:;(1 days after it has been accepted ns complete_
• Number of inspections allowed per permit_
L• tBoedmewnnalunELC.Pesmitnpp.doe =Yon 440461ST(I U05 /CURB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: El .R2007-00128
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/11/2007
Phone: (503) 639 - 4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 5/15/2007 TIME: 7:OOAM PAGE: 81
SITE ADDRESS: 11155 SW HALL BLVD 41 - CLASS OF WORK:
SUBDIVISION: Si'. JAMES APARTMENTS LOT #: 010 TYPE OF USE:
PROJECT NAME: ST . JAMES APTS
DESCRIPTION: Installation 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: 5/15/2007 Pour Time:
Code # Inspection Description .Confirm # _ Contact # Message
199 Electrical final 048273.01 503. 849.5198 N
Corrections /Comments/ Instructions:
4
fict'S I 1 PARTIAL APPROVAL CANCEL NO ACCESS
1 1 FAIL n CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: . lv 1e) Date: — 11—tri Phone #: (503) 718- 2.'Nb