Permit •
C ITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2009 -00017
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/5/2009
PARCEL: 2S 102AC -00201
SITE ADDRESS: 09384 SW MAPLEWOOD DR H 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 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.
4 11041\11 Issued By: ` 1Q Permittee Signature: � _ ^ � � OOV\
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.
4,. -
RECEIVED •
Electrical Permit Application F oFFIcE USONLY °`
IV ti 6 2009 -
City of Tigard Received
Y ease /11 i • S • p p�m,il NO 1.12zoc�} • 000 17_,
'e Phone: SW Bull ,4 Tigard, OR 9 Y/ OF TI GARD plan Rev
Phone: 503.63).4171 lax: 503.59 I I�I� /By: Oder PCfr111C
TIGARD Inspection Line: 503.63 9.4175 BUILDING D ue Ready /ny` hvie to Sec page 2 for
Internet: www.lignrd or.gov Notified /Method: _ el l C� _ Supplemental Information
U
-- - • TYPE OF WORK _' 'PLAN REVIEW ... • •
❑ New construction of Addition/alteration/replacement Please check a n that apply (submit 2 sets nr plans W /stelae checked below):
❑ Service or (ceder 400 amps or more ❑ Building over duce stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and hnaiyardr.
• CATEGORY OF CONSTRUCTION exceeds 10,000 amps at ISO volts or ❑ Floating buildings. •
less to Mound. or exceeds 14.000 ❑ Commercial-use agricultural
❑ I - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building temps for all other installations. buildings.
o Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ installation or 75 KvA of
JOB SITE. INFORMATION AND LOCATION .. ❑ 8nergcncy system. bar er separately derived system.
• ❑ Addition of new motor load or ❑ "A" '•p" "t - -1-3".
Job no.: Job site address: 9384 SW MAPLEWOOD DR. 100HPor occupancy.
❑ Six or more residential units. ❑ Itecteutimnnl vehicle parks.
City /State/ZIP: TIGARD, OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 vole nominal.
Suite /bldg./apt. no.: H 79 -90 I Project name: MAIN STREET VILLAGE ❑ Service or feeder 600 amps or Mtn.
Cross street/directions to job site: FEE SCHEDULE •
1 71mo -h tivu I Qty. leer
I I 'Tagil _I._•_
New residential single- or uhultl- family dwelling unit.
Includes attached gantge.
Subdivision: Lot no.: 1,000 sq_ 11. or less ___ 145.15 4
Ea. ndd'I 500 sq. ft. or portion 33.40 I
Tax map/parcel no.:
Limited etcrgy, residential -
DESCRIPTION OF WORK (with 75.00 2
INSTALL FIBER OPTICS FOR VERIZON Lin,itert energy, l "ulli- fen,ily
75.00
residential (with :dove sq, ti.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER • ❑ TENANT 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 lumps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City /State/ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 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 . ., O CONTACT PERSON • above service or feeder fee, 6.65 2
each branch circuit
Business name: NORTH SKY COMMUNICATIONS, INC. B. Fcc for branch circuits
without service or feeder ice,
Contact name: RYAN ROBERTS 46.85 2
lust brunch circuit
Address: 11818 SE MILL PLAIN BLVD STE. 410 Each ndd'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/Stale/ZIP: VANCOUVER, WA 98684 Etch niiiuultcturcd Cl modular
dwelling, service and /or feeder 90.90 2
Phone: (503 ) 519 -5264 I Fax: : • )1- 866 - 905 -4907 Reconnect only 66.85 2
_
E-mail: mduorla'�.northskvcomm.com Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Business name: NORTH SKY COMMUNICATIONS, INC.
Signal
circuit(s)or
t e enemy panel, alteration. or
Address: 11818 SE MILL PLAIN BLVD_ STE 410 extension. Describe: 1 Page2 $75.001 2
City/State /ZIP: VANCOUVER, WA 98684 Each additional inspection over allowable in any of the above
Fax: ( ) 1- 86 6 - 530 -432 Per s 62.50
Phone: (360)
360) 254 -6920 lm•esbig:ttinper hour (I hrmin) 62.50
CCB Lie.: 14117 I Electrical Lic.17 -154CL = Suprv. Lic.: 173 LEB Industrial plant per hour 73.75
i ELECTRICAL PERMIT FEES
Suprv. Electrician signature, requited: ' Subtotal: $75.0Q__
Plan review (25% of permit fee):
Print It(ttnc: JACK EAGLE °a1e: 1 -5 -09
State surcharge (1 2% of permit fee): $9.00
Authorized signature: 0, TOTAL PERMIT PEE; $84.00
This permit application expires if a permit is not obtained within ISO
Print name: ETHON A. DOLPH Date: 1 -5 -09 days liner It hoc been accepted ns campletr.
a Number of inspections allowed per permit.
r: merldingu •en»i„uut.arerm+aApp.dne 0512.1110 •141.4515 1/0i /COMPWIln
Electrical Permit Application FOR OFFICE USE ONLY
Cl`J of Tigard Received PermitNo.: / *7
~j•i-2 ~l~'_~1/
r~ 13125 SW Hall Blvd., Tigard, OR 7 E., 0,71VED Date/By Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 DateBy: Other Permit:
• . Inspection Line: 503.639.4175 JAN 2.7 2010 DateReadyBy: Juris: Q SeePage 2for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF K PLAN REVIEW
❑ New construction ® Addltion/al Please check all that apply (submit 2 sets of plans w/items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 El Commercial-use agricultural
F-1 1-and 2-family dwelling ®Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi-family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
❑ Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A", "I-", "1-2", "1-3",
Job no.: 998 I Job site address: 10330 SW Greenburg Road 100HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: Portland, OR ❑ Health-care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg./apt. no.: 570/590 Project name: ID Experts ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Lincoln 1 Description Fee. Total
New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'1 500 sq. ft. or portion 33.40 1
Tax map/parcel no.: Limited energy, residential 75.00 2
DESCRIPTION CRIPTION OF WORK with above sq. ft.
Limited energy, multi-family
Install Fire Alarm Strobes For Tenant Improvement residential (with above sq. ft.) 75.00 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 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, er panel
Owner signature: Date: A. Fee for branch circuits with
® APPLICANT ❑ CONTACT .PERSON above service or feeder fee,
each branch circuit 6.65 2
Business name: Safe Technology Group Inc B. Fee for branch circuits
without service or feeder fee, 46.85 2
Contact name: Jason Sweet first branch circuit
Address: 6400 NE Hwy 99 Suite G375 Each add'1 branch circuit 6.65 2.
Miscellaneous service or feeder not included
City/State/ZIP: Vancouver WA 98665 Each manufactured or modular 90.90 2
dwelling, service and/or feeder
Phone: (360) 699-2130 I Fax:: (360) 719-1527 Reconnect only 66.85 2
E-mail: sales@safetechnology. net Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Business name: Safe Technology Group Inc. Signal circuit(s) or limited-
energy panel, alteration, or
Address: 6400 NE Hwy 99 Suite G375 extension. Describe: 1 Page 2 75.00 2
City/State/ZIP: Vancouver WA 98665 Each additional inspection over allowable in anof the above
Per inspection 62.50
Phone: (360) 699-2130 1 Fax: (360) 719-1527 Investigation per hour (I hr min) 62.50
CCB Lie.: 173731 Electrical Lie.: CLE79 Suprv. Lie.: 4272LEA Industrial plant per hour 73.75
0,1tyk-1- ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: 75.00
Print name: Jason Sweet Date: 1-25-10 Plan review (25% of permit fee):
State surcharge (12% of permit fee): 9.00
Authorized signature: i. TOTAL PERMIT FEE: 84.00
This permit application expires if a permit is not obtained within 180
Print name: Jason Sweet Date: 1-25-10 days after it has been accepted as complete.
* Number of inspections allowed per permit.
1:\Building\Permits\ELC-PemitApp.doc 05/23/06 440-4615T(11/05/CO\4/WEB
- -
CITY OF TIGARD
BUILDING DIVISION PERMIT #: F L1'000940017
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1P,V2009
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 JAJ IL.
INSPECTION WORKSHEET FOR DATE: .1/20/2009 TIME: 7 PAGE: 6
SITE ADDRESS: 09384 SW MAPLEWOOD DR H 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 +, PHONE #:
CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 360-2EA-6920
•
Inspection Request Scheduled For: Date: 1/20/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 07984t302 503.849-2025
Corrections/Comments/ Instructions:
N
41 /
1Y 1/4 , PASS El PARTIAL APPROVAL El CANCEL NO ACCESS
FAIL El CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: (1.--1 6 ■CG3 1 .‘ Date: ' Phone #: (503) 718- -3144b