Permit ri ,V CITY OF T I GA R D ELECTRICAL RESTRICTED ENERGY PERMIT
t ° ,: '- COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00132
**-^* DATE ISSUED: 5/11/2007
ZG4RD 13125 SW H Bl Tigard, OR 97223 503.639.4171
rr,;:�.,6 PARCEL: 1S135DA -02402
SITE ADDRESS: 11155 SW HALL BLVD 73 - 80 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 By: /i • � '/ / Permittee /4140//eAfti4I)
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 -07 10:22AM FROM- Nort " �ki. ` 3602545097 T-371 P.011/017 F-380
' '�' FOR OFF1 1 . )
Electrical Permit Ap>p a�. 4 a
����- 7�' si-, w: �L°.' t'E'L'4S�'4�rRc•�nti rr. - 4W1‘"
City of Tigard f t. , 1_ 2007 � 5 it 0, _ Permit No.: E,'�.-1
1 ' DDI - 52
' t 13125 SW Hall Blvd., Ti O -. 97223 plan Review
$ r - t t I Other Permit: as? • • q — dye 1
% I . Phone: 503.639 -4171 Fax: 50'5.5 §IIiti O r t t G AR D >� =
Date Ready/By: @I See Page 2 for
Ia n-,'. AKD Inspection Line: 503.639.4175 BUILDING DIVISION Supplemental e 2 Information
ti ardor. Notified/Method
ft •h �c�x ltlterttet: WWW- g 8 °Y - i {
:r .; wtk'T•." 5" ij .'"T 4 r ?:11 t� LF j,�� �'.'�. r', t j� 1��aS �r'�r � C y' �i/ c p✓ i�d���'r��'��'y��S1�
':yr ;Y.,t. 141,tt ,U" ya#∎ii"?"-q` -ni q, >., . 3 ,� }ct:�t~. Pi ,�i l tv ., F ��.y • 7. ,r; ',FileS„ '91 1,1t f a,�.
r- •H!1.10 L �'{I^ , , / � y l b : a 1. '' r :tt ■ t} , .Ir - 7 --,,- '' f } .s, ,- , . -,, -ro .., Jn' 4 1 . , •".'.� r , . , } y' r rf l :, v: sr?a.(r � t n:A.l ut
' ;� �� { , • i+it x,1li u.vJl h "� ,tetcW l' a ` " ' " Please check all t hat apply (submit 2 sets of
plans f,•.rh.ttt7 4 pP Y lens w /items checked below): P
❑ New construction t • ddidonlalteration/replaccment
❑ Service Or feeder 400 amps or more 0 Building over tierce stories.
0 Demolition ❑ Other where the available fault current ❑ Marinas and boatyards.
r � , �� a +� , , ry • , c ' ` ;•, `{TFy` :,1 51,x41717 !`' �s�, " ,"� � < a t ' i;1 exceeds 10.000 amps at 150 volts or ❑ Floating buildings.
t,I l : I tl ,� , , },}rF,. tr.l , ar ` • " �4. ✓ � a ,� R i' 4'" y it'i , 'A l' N 15 : tt1 } �Z t1,bn lb }t: Lk{ yl;' • 1 �V, r,. y ; , ; ,f�,� '� i,�",.y ,' °�1 , ,I r Ices to groue.l or exceeds 14,000 0 Commercial-use agricultural
❑ 1- and 2- fttnily dwelling ❑ Commerdalindnst ial ❑ Accessory building amps for all other installations. building
■' Multi -family ❑ Master builder ❑ Other. 0 rise pump. 1:1 Installation of 75 KVA lir
y CI Emergency system. larger separately derived syStcm.
,'� tlt n, (re � : n U . . r , r 'r, ( 'G t i . , . '1 2r „ t -3°
„ k i > T t f„, L o t n y , t o s �t a N {O3 d 4t , ;t,s� .�(i � 9 ❑ A ddit ion of new motor load of ❑ "A E , 1.
stt,Uui,rtLfar.,4.. yiltiu��a , occvpanry-
_ f Si or or mote.
Job no.: Job site address: Y 0 or mars r�idcntial units. ❑Recreational vehicle par} .
❑ Health -care facilities. ❑ Supply voltage for,nore than
City /State/ZIP: , / { ' '1. F � ❑ Hazardous locations. 600 volts nominal.
`` � / i• ❑ Service or feeder 600 amps or more.
ite/bldg. /apt no.: Project ,tame: JFi . � A g �, �.l �� ! r L' 3, ir , i r tl' �lr ii 4 . 4il,' 3g Te
Cross street/directions to job site: nere
Su ,
wow �� a 1 a � . .�� � ., To tal . c
rr tion t}• —
New residential single- or multi- family dwelling unit
r - r7 _ I + Includes attached garage. _
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
!
Fa: add') 500 sq. ft. or portion 33.40 1
Tax snap /parcel no.: - .. Limited energy, residential 75.00 2
!F"'•-t't7h: at,ti , ', "r V;I" ,- ' , .' o p kJ f r' R" S J (' )v (with above se• R) 00
r i t'� 1 ti � }`L�}µi { rt�IrI . c;' . >,t41 �b1h s Y' '' -" s L imit cden Y
!, .� •, J ,.t S r,u r5i'�' .r • . orgy, mulY►•farail
11 _- ► � ^ r esidential (with above s q • ft.
L 75 -00 2
J l +� � � f i /* . o
Services or feeders installation, alterat an relocation
200 amps or less 80.30 2
Y�'i 1 .rfr ,. �tl i P i , fifl: d.,a M �' +e2 i t iter n�" RC''Q `i F } 5� 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: 601 amps to 1,000 amps 240,60 2
Address: Over 1,000 amps or volts 454.65 2
Temporary services or feeders •astaJlation, alteration, and/or
City /Sta1e!ZIP: — 'relocation
Phone; ( )
Fax: ( ) 200 amps or less 66.85 I _
201 amps to 400 amps 100 - 30 2
Owner installation: This installation is being made on property that I own which is not 599 amps 133.75 2
Branch circ
intended for sale, lease, rent, or exchange, according to OILS 447, 449, 670, and 701. 401 amps to it6 - new, alteration or extension, per_panel
Owner signature: Date: A, Fee for branch circuits with
it r:^*r r {p a y r I r n lx,, j r .. -'• , �'° A° e ' fit-' y^4 fi r o above service or feeder fee,
i ; r, i tt },J i i i i r p a t? �, ,,,, ,,e.,• ..'t .a i..,:,t 6.65 2
} }i .. ;,. r �4 =sL, s 4,� r W ;1,rr..w r �. .y„ each blanch circuit
u.. Jan y. L`ra�nrAfs - :
Business name: li lhf�r 1 ! ° ( B. Fee for branch circuits
without service or feeder fee, 46.85 2
Contact name: L k . %� first branch circuit
i /� t Each add:] branch carrot 6.65 2
Address: I ti .. wit .1� { � t k 3�1 brsecllaneous (service or feeder not included)
City/State/Z `J _ w, t /
LT Each manufactured or modular 90,90 2
2 dwelling, service and/or feeder
Phone: (561,)1,0q r 1 ` Fax : ( r �7 i 4- Reconnect only 66.85 2 _
2
'
', ► . O & 1 b m Pump or irrigation critic 53.40
E-mail: V 01,,M174111=
r :� ,f " - iz • i, 4x4 6 1 1 i' p•'y:,,r�,,C Sign or outline lighting 53.40 2
:�ll { �, +� y I1 ! vk�� � krj'i,i:i �� a �, • a �� ��, � a'�:��..t�iti7eL� t'w <�L :Ify4i i�U.ih�t': '�
I.,a; U t�� -tit, 2wr k, ,t Signal circuit(s) or limited -
Business name: S arIr n- CL-Szt r 9 V energy panel, alteration, or
extension. Describe: l Page 2 , 16 2
Address:
City /State/ZIP: Bach additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) Fes- ( ) Investigation per hour (1 he min) 6250
Industrial plant per hour 73.75
y'� 1'� I Electric ill Lt c. I } - I59 S I.ic.: )gin
CCB L1c.. _ :�:,�l, :t „ -� , 7 u� V3y .11ET - . s
Suprv. Electrician signature, required: Subtotal:
Plan review (25% of permit fee):
Print name: Date:
State surcharge (8% of permit fcc): (p QO
Authorized s1 1` TOTAL PERMIT FEE: `
^ This pavan application expires if a permit is not obtained within ego
Print name: �(• l i . 1 L (,(,C ►1✓ D r.
Date: , `9 411 days after It has been accepted a: complete.
— 1 * Number of inspections allowed per permit
kus ellUingTermitaNBLC- PetroirApp.doc 05/23/06 440- 4615T(1)/QS'COM/W
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007-00132
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/11/2007
Phone: (503) 639- 4171olk
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 5/15/2007 TIME: 7:OOAM PAGE: 79
SITE ADDRESS: 11155 SW HALL BLVD 73 CLASS OF WORK:
SUBDIVISION: ST. 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 -03 503-849-5198 N
Corrections /Comments /Instructions:
;?-P"s U PARTIAL APPROVAL N CANCEL n NO ACCESS
1 1 FAIL n CALL FOR INSPECTION 1 1 ADDITIONAL FEES ASSESSED
Inspector: G -1-11 Date: 51 1510 Phone #: (503) 718- .2.114)