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Permit
C ITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT • COMMUNITY DEVELOPMENT PERMIT #: ELR2009 - 00012 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/5/2009 PARCEL: 2S 102AC -00201 SITE ADDRESS: 09325 SW MAPLEWOOD DR L ZONING: CBD SUBDIVISION: MAIN STREET VILLAGE APARTMENTS LOT: JURISDICTION: TIG PROJECT: MAIN STREET VILLAGE Project Description: Install fiber optics 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: CASA LA VETA ASSOCIATES + NORTH SKY COMMUNICATIONS INC HIGHLANDS ASSOCIATES ET AL 11818 SE MILL PLAIN BLVD BY GUARDIAN MGMT ATTN: BARRY B SUITE 410 PORTLAND, OR 97228 VANCOUVER, WA 98687 Phone: Contact #: PRI 360- 254 -6920 FAX 1- 866 -530 -4325 FEES Reg #: ELE 17- 154CLE LIC 14117 Description Date Amount [ELPRMT] ELR Permit 1/5/2009 $75.00 [TAX] 12% State Surch 1/5/2009 $9.00 REQUIRED ITEMS AND REPORTS Total $84.00 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 riot 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: ' .9 Permittee Signature: p \ k O"`-'" `01 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. r eCEIVED Electrical Permit Application 0 5 2009 ro>iso>FrnLC>Jus>uolvly City of Tigard Received 13123 SW Hall Blvtl., Tiourd, OR r 3 ©F TIGARD Datc /B •: • •O , ► �_ el�� •r o Plan Review rUI Phone: 503.639.4171 Fax: 51 ) Uate /0y: Other Permit: TIGARD Inspection Line: 503.639.4175 ING DIVISI® Date Ready /By: )nris: fifl Sec Page 2 ror Internet: www.tigard- or.gov Notified/Method: 'r t ^ Supplemental Information TYPE OF WORK • • ' • .. PLAN REVIEW .. ' ❑ New construction !7l Addition /alteration /replacement Please cheek all that apply (submit 2 sots of plans w /iteau cheeked Isek w): ❑ Service or feeder 400 amps or more ❑ Bldldin over three stories. ❑ Demolition ❑ Other: when) the c vniluble fault Cunem ❑ Mnrinax and bo, iynrdr. . CATEGORY OF CONSTRUCTION : exceeds 10,000 amps to 150 wilts or ❑ Roaring buildings. less to ground. or exceeds 14,000 ❑ Cunmrereial "use ayricuhural ❑ I - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other insltdlations. buildings. Q Multi -famil y ❑ Master builder ❑ Other: ❑ Fite pump. ❑ Installation of 75 KVA ur • JOB SITE INFORMATION AND LOCATION ❑ Emergency system,. larger YCpa,;,lcly derived system. ❑ Addition of new nxmnr load of ❑ "A'' '•(o' "1.2" "1 . - - - - -- Job no.: Job site add ress: 9325 SW MAPLEWOOD DR. uIOHPormara. ncnnPancy. ❑ Six or m ore rcsklcmial mots. ❑ Kec,catiunal echicic parks. City /State /ZIP: TIGARD, OR 97223 ❑ Heahh.cmo facilities. ❑ Supply voltage for inure than ❑ Hazardous locations. 600 volts nnn,in :d. Suite/bldg. /apt. no.: L 126 -1371 Project name: MAIN STREET VILLAGE 0 Service or feeder 600 amps ormore. FEE SCHEDULE Cross street /directions to job site: nrscdpdon I Qtv. I Fee. I Total l • New residential single- or multi- family dwelling mill. Includes attached garage. Subdivision: Lot no.: 1.000 sq. I'm. or less 145.15 4 Tax map /parcel no.: Ea. ndd'I 500 sq. fl. or portion 33.40 1 Limited energy, residential 75.00 2 DESCRIPTION OF WORK (with above st1. li.) Limited energy, multi - family INSTALL FIBER OPTICS FOR VERIZON residential (with ahtwesn.n.) 75.00 2 Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 0 PROPERTY 'OWNER • I .. • 0 TENANT 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 Name: I I 601 amps to 1,000 amps 240.60 2 — Address: Over 1,000 amps or volts 454.65 I 2 City /State /ZIP: Temporary services or feeders installation, alteration, and /or relocation Phone: ( ) Fax: ( ) 200 amps or less 66.85 1 Owner installation: '/'his installation is being made on property that I own which is not 201 amps 10 400 r 100.3(1 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 circuits - new, alteration, or extension, per panel Owner signature: — ______ Date: _____._,__ A. Fee for branch circuits with ❑ APPLICANT :I : Q CONTACT PERSON above service or feeder fcc, 6.65 2 each branch circuit Business name: NORTH SKY COMMUNICATIONS, INC. B. Fee for branch circuits RY AN ROBERTS without rn nervier or (ceder fee, Contact name: lust st brunch circuit 46.85 2 Address: 11818 SE MILL PLAIN BLVD STE. 410 Each add'l branch circuit 6.65 2 Miscellaneous (service or feeder not included) City /State/ZIP: VANCOUVER, WA 98684 Each manufactured or modular 90.90 2 dwelline, service and /or feeder Phone: (503 ) 519 -5264 Fax: : ( )1- 866 - 905 -4907 Recot,necleul 66.85 2 E-mail: mduor(a)northskvcomm.com Pump or irrigation Circle 53.40 2 CONTRACTOR Sign or outline lighting 53.40 2 Signal citruit(s) or limited- Business name: NORTH SKY COMMUNICATIONS, INC. energy panel. alteration, or Address: 11818 SE MILL PLAIN BLVD, STE 410 extension. Describe: 1 Paget $75.00 2 City /State/ZIP: VANCOUVER, WA 98684 Each additional inspection over allowable in any of the above Per inspection 62.50 Phone: (360) 254 -6920 Fax: ( ) 1- 866 - 530 -4325 Investigation per hour (1 hr mini - -� 62.50 CCB Lie.: 14117 Electrical Lic.17 -154CL Suprv. Lic.: 173LEB industrial plant per hour 73.75 ' ELECfRICA1. PERMIT FEES Suprv. Electrician signature, required: Subtotal: $75.00 Print name: JACK CAGLE Date: Plan review (25% of permit fee): 1 -5 -09 Stale surcharge (12% of permit fee): $9_00 Authorized signature: � - ✓ y � ` TOTAL PERMIT FEE: $84 — This permit upplcaliun oaptres if a permit is not obtained within ISO Print name: ETHON A. A, D OLPH Date: 1 -5 -09 days after It has been accepted as commode. Number of inspections allowed per permit. : lloitdingNcrmh .Nil.0 "14rmdApp.dno 05/2546 d40- 4615'I( I 1m5/CoWW81) CITY OF TIGARD BUILDING DIVISION PERMIT #: EI.R2009-00012 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: •itsn009 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 1/20/2009 TIME: 7 PAGE: 49 SITE ADDRESS: 09325 SW MAPLEWOOD DR L CLASS OF WORK: SUBDIVISION: MAIN STREET VILLAGE APARTMENTS LOT #: TYPE OF USE: PROJECT NAME: MAIN STREET VILLAGE DESCRIPTION: Install fiber optics for Verizon OWNER: CASA LA VETA ASSOCIATES 4., PHONE #: CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 360-2544;920 Inspection Request Scheduled For: Date: 1/20/2009 Pour Time: Code # Inspection Description Confirm # Contact # Message 135 Low voltage 079808-01 503 Y Corrections/Comments/ Instructions: PASS LI PARTIAL APPROVAL CANCEL fl NO ACCESS n FAIL 0 CALL FOR INSPECTION ADDITIONAL FEES ASSESSED Inspector: G OU - Date: V 2° Phone #: (503) 718- 1.4440