Permit _- \„ CITY ‘• TIGARD
ELECTRICAL RESTRICTED ENERGY PERMIT
II
' COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00131
' DATE ISSUED: 5/11/2007
'T,, IG 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S135DA-02402
SITE ADDRESS: 11155 SW HALL BLVD 65 - 72 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- I54CLE
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: ji /%jI ` /. / Permittee Signature: $_e.4' p p() ii o ,h on
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.
MY 11 - 07, 10:22AM FROM -North Sky_Commllnl op
„cat•. 3602545097 T-371 P 010 /017 F-380
E1dctri Permit A Uphcaiio - ' .� � - . ` ` rOlz ; , , 1,, p ,
-
Received sl i I f oj- 51 Permit No.: - - 00131 .
��... Ci ty of Tigard � ,
9 13125 SW Ha Blvd., Tigard, OR 97223 !'' :, 11 J . !. 200 P1anR Other Permit: �l..�,Zt� - alas f, t Phone: 503.639.4171 Fax: 503.598.1960 DoteiBr
L • i t . = .•�. hispection Line: 503.639.4175 V 1 I, Y U r f I G r� N D Date Ready/By „_ Supplemental O Sec Page Z for
T1GA mvi Inc g BUILDING DIVISION Notified/Method. • 7 1 mental Information
1,�,�- -��:,� Internet: www a nrd -0r. ov
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- ,� h . i • .. t - .t;,,l� "x "1 .'1 `a `°"� Please cheek all that apply (submit 2 sets of plans w/itcros checked below):
❑ New construction Addition /altcrationkcplacement
❑ Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition ❑ Other where the available fault current ❑ Marinas and boatyards.
1`i 1 /Riilrii t Jlt”' 1') yT'� ' c s e '��IRI 1 e „. pVi �� 7 ' "+�# '
' a exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
it. ii ill cs . trail:,,• }r ./4 .. p , -- lx rd:x. -. ���'1 +, J- „ ��tE , .u.. � ' . ut-. ; , less to ground, or exceeds 14.000 Q Commercial -use agrieulmral
❑ 1- and 2- family dwelling ❑ Commel cial/industrial ❑ Accessory building amps for all other in- tallatiocs. buildings.
0 or Multi- family ❑ Master builder ID Other. Q Fire pomp. El Iostalladon of 75 KVA or
�. {dry Fri , , r ' f � . ,y FVr g r- I ;ri ,LX ❑ Emergency system. larger sepantely derived system,
■ f ' r h 7 ,Fi y !� I.1 r�i t e i54 ' 1 C � � Vi i• , a ' • , i 4''•V-i.. Q k ❑ Addition or new motor load of p ., ,,E., 1-2 ..1 -3
��' a f J.� 100 ormore, occupancy.
Job no - Job site address: Q Six er mono residential units. ❑ Recreational vehicle parks.
Cl /5rate'ZIP; j / gel' �/ ❑ Health-earn fscilitics. ❑ Supply voltage for more than
ty , �t ❑ Hazardous locrtioas. G00 volts nominal,
Suite/bldg. /apt. no.: ` ❑ Service or feeder 600 amps or more.
PIOICCt name . f� L �� ,,- ` F:��{,aRl tam a r , er a w ”i a
Cross street/directions to job site: ihseription T Qty. I Few J Total I •
New residential single or multi- family dwelling unit.
Il■ tM - _ Includes attached garage -
Lot no.: 1,000 sq. ft• or less 145.15 4
Subdivision; Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no Limited energy, residential
CT ,r , +t + r,'>"F� ai+r tii ,-•, . ?j”! s" 9�, :rn' ' +`f with above as a . R) 75.00 2
!'l gif l 74 �4 h t ltit ^ 't,��:� ", r '�� t, 1 ". `N,'t� . '' j . , ' ii w.'tu : i •7 -2'' �', r_ 1i: if'$7:'Zk'i�.a? ] 9 _
' , Limited energy, ffirlti- family 75.00 2
..�',.
i�li / 0 • ' , ' , residential (with above sq. 0.)
Services or feeders instauation, alteration , and/or rclocatiot _
200 amps or less 80.30 2 .
s�,iir� . v gg tr i •fists . F7 S ,),..
r ; : ,,n n t} r i, 1 7 1 1 , 5 4M o e g . ? 4 �; 4::: . , E8t1 � a o ' ;r ,c;; i ulu 5 ,4 i ' $:41 1t r' : 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
Cily /Statc/ZIP: Temp ra Services or feeders installation, alre1•ation, and/or
— Phone: ( ) Fax: ( ) 200 amps or less 66 -85 1
Owner installation: This installation is b.ing made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for ;tale, lease, rent, or exchange. according to ORS 447, 449, 670, and 701. 401 amps to 599 amps - 133.75 2
Branch circuits -- new, alteration, or extension, per panel
Owner si :.attire; Dale: _ A. Fcc for branch circuits with
d s t i ` > ;3 ? r j t'li`G :ro gy Ir ' T above service or feeder fee, 6.65 2
r; ,.. th. %r�, o' jto, 4i , _.,,,,-;,--.41:A24,2!.., �`. a - . 1� 1E 1:6 ' t s 6s ; . ,,, .air...' rid
ay l to ' �1A� �t each branch circuit
N
Business name_ J Yr t, _ V i ` B. Fee for branch circuits
w irhout service or feeder foe, 46.85 2
Contact name:
` S �Q� 8 tstbranch cit�uit
branch cirauit 6.65 2
s 1• 'I
Address: i . 1 . • 1 \ i �31� err Each add
Miscellaneous (service or feeder not included)
E ach manufactured or modular
City/5tate/ZIP i : \� f d dl
90 -90 2
'1,l') ( t - 1 i tri - 2 2 R
j, dwelli , service and/or feeder
Phone: (6' ')
g � j ' � � �� j � Fax i "T � • 'l Reconnect aril 66.85 2
E-mail; ii ' /i A r ' r A 1 Gb
Pump or irrigation circle 53.40 2
R a'Eyl,P' ; 7` ^, j l'i J_ t j ryrr h11 i> i 1W�' ij. o I': ' '
„ e ' 1 1 Z al, ;'NTRI A il r . Sign outline lighting 53.40 2
ti,
p � r rx .., ft ..,. J:7kA : :l�.S�4lr.� - .i.. �� f. V.,_tiiJ w� ��"£A. L L��ii & �e �
S Signal circuit(s) or limited -
Business name: (7 u•_ et- S) 0 eV L energy panel, alteration, or
Address: extension. Dcscn'be: t Page 2 '( 2
City /State/ZIP: Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) J Fa ( ) Invptigadon per hour (1 hr min) 62.50
CCB Lic.: k 41 \'I 1 Electrical Lic.: ti - 154 (tE Suprv. Lic.; Industrial plant per hour 73.75
Suprv. Electrician signature, required: Subtotal:
Date: Plan review (25% of permit fce):
Print name: ^� State surcharge (8% of permit fce): (p a
Authorized st li : - ='"' TOTAL PERMIT FEE:
/ �� This p ermit appGcadoo expires it4 permit is not obtained within 180
Print name: f ' i , , . 1 1 , )(/ p Date: . 1 days alter it has been accepted as complete.
s Number of inspections allowed per pcnnit
I:ta ritai ewer >QtC- R:mitAppdoc 0523/16 440 4e15T(r r/OSICCMnt/FB
CITY OF TIGARD z -
BUILDING DIVISION PERMIT #: ELR2007 -00131
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: 6/16/2007 TIME: 7:OOAM PAGE: 5t3
SITE ADDRESS: 11155.SW HALL BLVD 66-72 CLASS OF WORK:
SUBDIVISION: ST. JAMES APARTMENTS LOT #: 010 TYPE OF USE:
PROJECT NAME: Si JAMES APTS
DESCRIPTION: In.: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: 5/16/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final • 048363 -02 > 503. 848.5188 N
Corrections /Comments /Instructions:
PASS n PARTIAL APPROVAL ❑ CANCEL NO ACCESS
n FAIL CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: ` 1.1 0€ Date: 511 6( 01 Phone #: (503) 718 Viii(