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Permit a CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT o COMMUNITY DEVELOPMENT Permit *: ELR2009 -00274 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/18/2009 Parcel: 2S110AB00100 Jurisdiction: TIGARD Site address: 14070 SW 112TH AVE 1 Subdivision: PARKWOOD COURT APARTMENTS Lot: 0 Project: Parkwood Court Project Description: Units 1 -17: 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: N 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: Permittee Signature: (J tn/ ("t/ /O/./ 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. • • 7,7 AECE •• AUG 1 7 2009 Electrical Per mit Application . '.:. FOROFFICEIISC :_•.'.:: City of Tigard Rccelred t.tA. �ll iz• i'1m:IN,t,:E or sr, , _ 7 f�'/ 9 13125 SW Hall Blvd., Tigard, OR 97223 P R : , / i / I I R ' Phone: 503.639.4171 Far: 503.590.1960 Plan Revs WtclOg Other Penult: 'I I G ARD Inspection Lisle: 503.639.4175 Daso Ready /ny: lIs - @I See Page 2 for Internee www.dgnrd•or. ;nv Nwifsed/Muhrwl: / ` Supplemental !demotion .•. TYPE OF WORK `:: •:.::::•:::....:' ''''•': >•• • ;'';.'. ':•:.i • ': PLAN REVIEW. at::: ❑ New eonsuuelion E] Addilion /nllerolion/replacement Please check all that apply (submit 2 sets of plus wrreols tic ell :Om): ❑ Demolition ❑ O111Cf, ❑ Service or (=Jcr Con amps or more 0 Willing over lino stake. where the available Was moot ❑ Murilen aro) hnmy.irds. • ';'•:- v. . CATEGORY (Jr • CONS'TRUCT'ION c en rIo IOW Amps ;it ISO sa,lts or ❑ Flaminahutldinys. ❑ - 2•famll dwelling kutogruurtd.or execute14,000 ❑Cdnurrerclal•usoagderdntr.al I Y g ❑ Conmrercinl /industrial ❑ Accessory building who for rlt outeriuxioilmiuut. buildings, 0 Multi - family ❑ Master builder ❑ Other: CI Nit pony,. ❑ Ina ;dbnun 0(75 KVA or "' '• JOB SITE .INFORMATION AND LOCATION `: ,. ❑ Omer im suved aysren,. • � ❑AddlOnnoi newmronrluvlM ❑ "A" "1•, ",'I•:! " •'I•] Job no.: -I Job site address: 14070 SW 112TH AVE lUGHP to :nom aampaoey. ❑Six or mdse rcritknliul unite, ❑ Reereutloplat vehlek park, City/State/ZIP: TIGARD, OR 97224 ii a, " ❑ Hcnith•carc facilities. ❑ Supply votogo for num Ilan 0 Huanhmc lueo%ium, 6110 voila nomiiwt. Suite /bldg. /apt. no.til I Project name: PARKWOOD COURT ❑ Servico feeder 600 imps ornxuo. :::,.,,,. .... : : Bre'SCHICDULE ••, Cross street /(tircetions to job site: nomanrm ) 0w. I Pre. I 'n l New residential single. or i nd11•famlly dwetlhtg unit. Includes munched garage. Subdivision: I Lot Ito.: 1.010 sq. O. ur less 145.15 _ 4 Ton dutp /parr no.: --- E i. aJ(I'I 500 sq. II. or portion 33.40 I Limited energy. residential 75.00 2 DESCRIPTION OP WORK ' (with :Mom sq. 0.1 INSTALL FIBER OPTICS FOR VERIZON Lln sid e n t or l(vuut sw el1� n a 7s.0o 2 Services or feeders lnstnllnllon, alteration, and/or relocation 200 mulls m less 80.30 2 ..'❑ PROPERTY OWNER .' .I .. .. '•0" TI7,NAN'I' • 201 nrnpc to 400 amps _ 106.85 2 Name: 401ampsto600imps 160.60 2. 601 amps to 1,000 amps 240.60 2 Addrasx: Over 100 am _ fillips or volts - 454.65 2 City /Stare /ZIP: 'fwnpornry services or feeders Inslnllatlon, alteration, and/or relocation Phone: ( ) I Fax: ( ) 200 amps or less 66.85 1 Owner Installation: This inslnllntion Is being made on properly 1haat I own which is not 201 amps 10400 amps 100.30 2 intended for sale, lease, fen), or exclutnge, according to ORS 447, 449, 670. and 701. 401 aims to 599 amps 133.75 I 2 Owner signature: _ -. .___. Date: _ Branch circuits -new, ntlerallou� or extension, per panel A. Fee for brooch circuits with © APPLICANT • • :111 . • '.• 0 - CONTACT PERSON' above gel vice orrcedcr 6.65 2 each brunch circuit lllsiness name: NORTH SKY COMMUNICATIONS, INC. n. Fee for brunch circuit ' Conlnctname: ERIK SCHENCK mil/sonl scrvieeorfecdcrfee. 46.85 2 lint branch circuit Address: 11818 SE MILL PLAIN BLVD STE. 410 Each 'WWI blench circuit 6.65 tvlisecllaiteous (service or feeder not included) City /Stnle/ZIP: VANCOUVER, WA 98684 Each munhfaclurcd or modular dwelling. service molter feeder 90'90 2 Phone: (503) 969 - 7729 I Fax:: ( 866 ) 452 - 4853 Reco only 66.85 2 entail: mduorenorthskycomm.cofn Pump orinigatiuncircle 53.40 2 • CON'fRAI`IOR - Sign or outline lighting 53.40 2 Buxinoxs name: NORTH SKY COMMUNICATIONS, energy INC. Signal ireelKs) arlimhcd- panel, :thermion. or Address: 11818 SE MILL PLAIN BLVD. STE 4 exleasion. Describe: 1 Paget $75.00 2 eity/stalcizIP: VANCOUVER. WA 98684 Csnch addhional Inspection over Allowable In an of the above ' Phone: ( 360) 254 -6920 I Fox: ( ) 1- 866.530 -4325 inv i g ut i o otl 62.50 nvemstlgndnn per hour(/ Errata/ 62.50 CCB Lie.: 14117 Electrical Lie.17 -154CL Strprv, Lic.: 173LEB lusdttrllialptnntperttotrr 73.75 ..... • ••Ef.UC1YtiCAL PERMIT PEERS '... •..'... Su prv. Elcclricinn sign more, required: Subwlmh $75.00 Priln mime: JACK CAGLE Date: 8/17/09 Phlrt review (25%ofponmit fee): State surcharge (I2 %ofpermit fee): $9,00 Authorized signature: i TOTAL PIiRIvI(T PEE: 84 00 Prin nk tnne: ETHAN A. DOLPH Dam: 8/17/09 'rIlla porn11 uppgrun mks days alter II has been neeeplcd ar complete, • Number ul' Impoctlunt nlluwed l.,r ftetoill. Ind•Ihdny ell, m,C•t'.•nnldpp,lnr 044U06 44l,-441$1'(1 I41.VCOaVw1a1