Permit • 'I
ti4
CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
111 1: COMMUNITY DEVELOPMENT Permit *: ELR2009 -00272
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/18/2009
Parcel: 2S110AB00100
Jurisdiction: TIGARD
Site address: 14050 SW 112TH AVE 26
Subdivision: PARKWOOD COURT APARTMENTS Lot: 0
Project: Parkwood Court
Project Description: Units 26 -33: Installation of data /telecommunications.
Owner. FEES
ALRANCO, INC Description Date Amount
BY JOHN R RICHES, 2601 ORCHARD HEIGHTS Restricted Energy Permit 08/18/2009 $75.00
RD NW 12% State Surcharge - Electrical 08/18/2009 $9.00
PHONE:
Contractor:
NORTH SKY COMMUNICATIONS INC
11818 SE MILL PLAIN BLVD, SUITE 410
VANCOUVER, WA 98687
PHONE: 360 - 254 -6920
FAX: 1- 866 - 530 -4325
Type of Use: MF
Class of Work: ALT
Total Number of Systems: 1
Audio & Stereo: 14 Boiler Controls: N
CCTV: N Clock Systems: N
Data & Telecommunications: Y Fire Alarm: N
HVAC: N Instrumentation: N Total $84.00
Intercom /Paging: N Landscape /Irrigation: N Required Items and Reports (Conditions)
Landscape Lighting: N Medical: N
Nurse Calls: N Protective Signal: N
Security Alarm: N Other: N
Other Desc:
This permit is issued subject to the regulations contained In the Tigard' Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 the 180
days. ATTENTION: Oregon law requires you to follow the 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 a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. /
Issued By: rm
Peittee Signature: 0/1/ �/�U��N
77O
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' Date:
LICENSE NO.
Call 603.639.4176 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.
•
.4 Mlles- UtiVtU
• AUG 1 7 2009
CITY OF TIGARD
PLANNING /ENGINEERING
Electrical Permit Application `: :.: Fo>ES, OFFICE IJSEONLY. :. ;.: ;.`.`:' <:`
( t ffi City Of Tigard i :.i I Pcnrit N;E n, . •O/Q'OO- 702•
4 13125 SW Nall Dlvcl., Tigard, OR 47 223
. ' Plume: 503.639.4171 l'oE 503.598.1960 Ffflial.111111111111111 Oihrr VaaJt:
'rIGARD Inspection Line: 501.63 4175 Dar: Ruatlynty: Id Ste Pnge 2 for
fntcmet: www.tig,I J•or.;nv NmlrcdlMulmrt, lign Supplresentnl ln(oresMlun
• :..,. :..: TYPE OF WORK ":;:::.. ..:,• ;.::.':; ::;:• ': PLAN nrv.IBW';:::'•::: • '. .
❑ New conshuelion El Addition/alteration/replacement Hove cbccOall dot apply ( luMt it J sett er plans wlitetrdacccdaoluwk
0 snotty or Node, On amp us nave El nailing owe glum glum uror!ct.
❑Uem01i1i011 ❑Ulher:
uirero Ms waB.hla sell mows es 0 Marina and bmny:udt.
CATEGORY •UF :CONSI'ttUC'1'ION . ...., co eerls IO,WO :rnqurI ISO ,vdt. O MAN; building.
lac ur ground. oreuscJ, 14,0111 ❑ Cauueerrlalaao sgdenhural
0 I - and 2- Inmilydwelling ❑Conmtercinl /inthistrinl ❑ Accessory building amps lur nllouterInuoiluIiom. buildings.
0Mutti- in mil y ❑ Mosier builder ❑ Other: ❑ Fitt ptnp. ❑h
_ . JOB SITF.•INFORMATION AND LOCATION `' ? ' ❑Cn,a m,4 laryusepuategden
.....7 ❑A,hlilinn of new mnrer bud at ❑ "A" "1• ^ '•t.T "1•] ", vca •ys
Job no.: - I lob situ nddre.ss: 14050 SW n 2TH AVE 111010 ur 16x6'`. t`mtit :0er'
0 Si%or more reMleudd unir. 0 Rt.:motional whirl* parks.
eity/slnie/ZlP: TIGARD, OR 97224
I .• 16� ❑Health <aofscihnies, �Suppiywda,6o
❑ Hsr udnm trnotiuos, 6110 Ner1 ratnur11l.
Suite /bldg./apt. no. g4i33 I Project name: PARKWOOD COURT ❑servivo feeder 6OOumpsetomit.
. '..FPE'SCIIBDUI.E ' ' •
Cross sired /direction.s to job site: unery:r:,n 1 Ov f rev. I 'roost I •
-- New ronitlrntlnl:Ingle• or nadtl•fnmlly dwelling 111111.
_ Includes nllnclied garage.
Subdi vision: I Lot no.: 1.000 xn. R. or lose 145.15 4
- -y La. adsi'1500 sq. li. or portion 33.40 I
Too ntup /parcel 110.: L imited energy. residential
75,00 ?
DESCRIPTION OF WORK' (web shins mt. n.)
INSTALL Lint)ndenolly,mubl•Gsmily 7500 ,
NSTALL FIBER OPTICS FOR VERIZON
residurlial (wkh tow.; rt. a.1
. Services or feeders insinlln(Ion and/or trim:Minn
ZOO amps or Icon 80.30 2
.. "0 PROPFR•I'Y.OWNER •• ••I :... :. .. , Cr TENANT •. • : 201 amps lo 400amps 106.85 2 •
Name: 401 amps io600 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 Harps or volts 454.65 - -- 2
City/State/ZIP: Temporary sec vices or feeders Installation, alter:Moo, and/or
relocation
Phone: ( ) Fort: ( ) 200 amps or less 66.85 I
Owner lnstnllnllon: This insmlIntion is being mall` on properly that I own which is nut 201 imps to 400 amps 100.30 2 .
intended for sale, lense, rent, or exchange, according l0 ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75
Owner signature: _. _ _Date: _ - breneh circuits - new, niter:Won, or extension, per panel
A. Fee for branch circuits wilt
❑ APPLICANT ' • • • •' : :1 ' ' "0 CONTACT PERSON ' above so viet er ikcoer rco,
6.65 2 •
each humid) circuit
Businessnaoto: NORTH SKY COMMUNICATIONS, INC, n` t•ne roc benneheharir,
Conmuumno: ERIK SCHENCK I7l/lora service afccderIce• 46.85 2
- _._ lirxt branch circuit
Address: 11818 SE MILL PLAIN BLVD STE. 410 Each ;tdd'I brunch eilettit - - 6.65 - 2
Miscellaneous service or feeder ell' cluded
City /Slme /ZIP; VANCOUVER, WA 98684 Ouch monuiaeh red or modular ) + -,_.
dwelling, service mul /or feeds
90.90 2
Phone: (503 ) 969 -7729 I Fax: : ( 866 ) 452-4853 Reean „cc, only 66.85 2
• E'l tail: mduorle7i northskycomm.com PtnnporitdgatiutteiuvIC 53.40 2
CUN'1'RA - roR . Sign orutelirolighting 53.40 2
Business pant`: Sigoul circuit(%) or limited -
NORTH SKY COMMU NICATIONS , I NC. energy panel, alteration.ur
Address: 11818 SE MILL PLAIN BLVD. STE 410 exlenrion. 1 Paget $75.00 3
City /SIRicrZJP: VANCOUVER. WA 98684 Each dddltional Inspection over Alle mhie In onto( the above •
Phone: ( 360) 254 -6920 J Fee: ( ) 1- 866 - 530 -4325 Per in ' iott _ 61.50
-, hrvcsipntlnu per hour 17 Mill) 6350 -
CCRtic.: 14117 I ElectricalLio.17- 154CL= sopnv.Lic.: 173LEB Industrial plum pe,• hotr 73.75 _
• • • ' •• .ELECTRICAL PERMIT FEES •••
Sunni. Electrician sig"""n`, required: �. . Subiutul: $75.0D
Print mune: JACK CAGLE Date: 8/17/09 Phut review (7596 of permit (cc):
-_. State surcharge (1356 of permit feu): $8
Authorized signalurc:
TOTAL P(i0b(I'P
1. $84.00
8/ 1 7/ 09 The, pormh oppnrnuue oxphet If a permit h not omm11m utddu 180
Print mane: ETHAN A. DOLPH Dole: dogs Ow II low bmt" t'ap'ed nit wrolder.
• Kuulb r Cl In.pc :duns WI...Cd,ac penell.
I:'8.11,11 eetoo11,r:I,C. : aep • ,tnr 0u7L0i HW15I ltl,a!bYWNYYII