Permit 4, '._ • CITY OF TIGARD
ELECTRICAL RESTRICTED ENERGY PERMIT
,�',. COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00133
'T ^ , 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/11/2007
PARCEL: 1 S 135 DA -02402
SITE ADDRESS: 11155 SW HALL BLVD 81 -88 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 By4;111 / 11 ] , . // Permittee Signature: <d^"' T T ppII ru C
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.
MAC'- 11 -07, 10:22AM FROM -North Sky Communication 3602545097 T -371 P.012/017 F-380
EJetc rie:Permit Application ..0 _ qv--.,,,-,,,,- �� ` ti A - .NA r "
- :e N'' 1 City of Tigard '"`d ►S •� Permit No.: '
r: fee ,-i 3`
'
u 13125 SW Hall Blvd., Tigard, OR 972231 Plan Review Other Permit
7001 �►•> __pa ?3
k Phone: 503.639.4171 Fax: 50.x- 598.1960 nare/B • r 0 See Page 2 for
' , � _ '+iiw�,.. a Insp Line: 503.639.4175 1, i C Y GE i I rG r� RD Date Ready/By: �`
7I G ti and -0r. ov Method: 1 I � Supplemental Information
• ARI2 S g Notified/
cK Intrntet: www- S I J (C DIN(' IV C' 1 1 1 t . :,
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Please check all that apply (submit 2 sera of plans wheats checked below):
❑ New construction Z1 ddition /alteration/replaccment 0 service or feeder 400 amps or more ❑ Building over titres stone::.
❑ Demolition ❑ Other. where the available fault current O Marinas and boatyards.
-, F. r 7, n {p : Z n r! A
• F' ' 1 ' i r "r i 1p f , , 'i l t w' '))t Jb :1Y �i ? exceeds 10.000 amps at 150 volts or 1] Floating buildings,
l" Ill (i i' t i r ill lr n L,1. ,I h,v.I @ .a ,v 4. .&,Lt.. f $.n .211 l: 221 i IAiLro' cot,
tr,.>;fifa�. iu • � »�x4�s1u � �� },� + ,�� + S v l - � „ , , ,, r + f #:*'� � +r. ,,. �� ,� less to 1:rounds or exceeds 14,000 ❑ Commercial-use agricultural
❑ 1- and 2- family dwelling El Commercial /industrial ❑ Accessory building amps for all other installations. buildings,
►:d. Multi -family ❑Master builder ❑ other:
0 Fite pump. ❑ installation of75 KVA or
cam, r t r y%T, { *'- � i> "� r ay i 7 q�iTe. �'wr�{.j c"{^^ ^0 El Emergency system- larger separately derived system.
' L' ' k g ti 1 I e 1 0 Y'b , 0 6 : , ' y L. / lu 1 h o : ;r b, 3.4.1 ❑ motor load of ❑ "A". "E" .. 1 -2" ` -3°
i. 1' ' � � � t. r� 11 SI jC'" � �, �; " rp,`ra d �!�-) . 4 �; - ' r'- . � • . d''/w �'�;.h,.1. ;� Addition anew u:f1�3�'t:f'�- 1.>'s�:iL..i.�i, •:.rICS/ �Y.11¢
1 Six or or mote. occupancy_
lob no.: Job site address { • ■ ❑ Six or more residential units_ O Recreational vehicle parks.
City/State/ZIP: /State/ZIP: \ / f 1:1 0 Wraith-core f ciitls_ ❑ Supply voltage for more then ry 1 ' ❑ Hazardous locations. 600 volts nominaL
Suite/b1dg. /apt_ no.: , a Project itame: 41.41 / 0 Service or feeder 600 amps or morn
Ai
Cross stt'eet/directions to job site: lrcr 4ry- Foe. TO9n -
New residential single- or multi - family dwelling unit.
r Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft- or less - 145,15 4
Ea. add'l 500 sq. ft or portion 33.40 1
Tax map /parcel no.; Limited encrpy, residential above aq. tt. 75.00 2
774:,4 1777 4'��� rl 'r' r ` 1 I ;wig g, r., +S a M� o t + "' . v r „'yfy,,t;r .'�+ra - i 1, i �`� (with it.)___ 2
_ t;:nll.:t.,tu..'LaltZ iai �L4.t tle r.. 4; . 'Y..;- • L�:.• T 'y irh. i eL itM�ew» 4/i� d,trl. ,h . :.
Limited energy, multi- family 75.00
�� I i�l� / to , residential (with above e�R)
- r '' Services or feeders installation, alteration, and/or relocation
200 rags or less . 80.30 2
-�r i•L .� T' v Y , �; iP 1 n 1 ,�N +'f r 5� ..w� 0. �L x 4 t r i*7r5`
i"- ;•�': ,i F - i'y r 1i'a , , r � r �1'br � J f a 1, 4J• . , ; +� f , o �k•i•' 201 amps to amps 106.85 2
is i'�,10.1.:; b,43 � ^ l� vi R . - . 1 h` `;y, `'...51 ,.^ entri.t i,.^1. 1 ."_l rL r' :A4A1r. ,6w+ p
Name: 401 amps to G00 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 installation, alteration, and /or
City/StatdZlP: _ - 'relocation
Phone: ( ) T Fax: ( ) 200 amps or less 66.85 1 1
Owner Installation; This installation is being 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. 401 amps to 599 amps 133.75 2
Branch circuit alterat or extension er anel
Owner signature _ Date Fee for branch circuits with
;A" ' r3� ,, f t� r� �, a s a r .. .. ,t , u' ari ' , ' e 'S, ' t" /, a " r ,ire x � ' , . . y .. A above service or f eeder fee,
...,1y4 a, rF :, k am .+ ,. �r b t m 'r'vl,;r". r'y . , yy x • r �i i + branch 6.65 2
�.sr ,.u. r i_,. t e.�ai�r„ _ 1 ,.4,, r- �t.x,rr�r. �.L i f! each rant circuit
Business name: 149 4,'y :O vyk - rYYL B. Fee for branch circuits -
without service or feeder fee, 46.85 2
Contact name: /� ,r� Fustbranchcirruit .__.
Address: 1' t . 6 ' 1 1 6 V1lt ti. 1 t ki 1 - Each add'1 branch circuit i 6.65 2
Q Misoellarteous5Service or feeder not included)
Ciry }a
/Statc/ZIP: , k 1�� j / W, t b ki'f b 1 Each manufactured or modular 90.90 2
Phone: ( 665) 'L�1 `b �� � Pax:: { tp jj L i J� 14. d e cline • Reconnect on l servy a an&or feeder _
66.85 2 _
E v ss �`L 0 Al 1 C b'ft/1
Pump or irrigation circle 53.40 2
j ,�� }t,, ,r M "mo 7 '.rr' r'`;• ; •pY„ ,� r' '3 -m Si or outline ligh 53.40 2
-
�Oi1����T1ig,'''< lrs'She � }' ,����f r �i ��'`P . � e"1 a _ "_ho).^r`.i..i�Lr3L'N."S: l' L.n,wf �,t «'r�,�P -,1•„3 :.tip � � tin b� g
"l a u 1 n Signal circuit(s) or limited -
Business name: Ili; 1 • f •VL energy panel, alteration, or
Address: extension Describe: Page 2 16 2
Ciry/State/ZIP: - each additional inspection ov allowable in any of the above
Per inspection 62.50
Phone: ( ) I Fax: ( ) Investigation per hour (l hr min) 62.50
CC]3 Lic.: 14 1 Electrical Li I plant per hour 73.75
c H. �,�j r ' 1 Suprv. L
Y Lk.: v2
I (' I sl cif r . ,� '3 72:41.�i S ci t C �'� 6,1 0" �J1"!C • Vyt" ""fit uit .
Suprv. Electrician signature, required: Subtotal -
Date: Plan review (25% of permit fee):
Print name: State surcharge (8% of permit fee): IO
Authorized s1 n . - --..� = '` ' ",- 0 _ TOTAL PERMIT FEE: 1
-
/ This permit application expires if a permit is not obtained within 180
u
Print name: , - / 1 u ,�/1 �j D DEC �/C) / , days after it has been accepted complete
• Number of inspections allowed per pertnit
1.113uildm8 aO ' PermitApp,doc 0523/X8 44O.4L I$T(I1/05 /COM/tVEB
- CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007- 00133
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: 5115/2007 TIME: 7: 00AM PAGE: 80
SITE ADDRESS: 11156 SW HALL BLVD 81 - CLASS OF WORK:
SUBDIVISION: ST. JAMES APARTMENTS LOT #: 010 TYPE OF USE:
PROJECT NAME: sr. 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: 5/1512007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 048273-02 503 -849 -5198 N
Corrections /Comments /Instru tions:
A P "S I PARTIAL APPROVAL CANCEL I I NO ACCESS
I I FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: v tJ58L
Date: S 1 09 Phone #: (503) 718 - ALIL164