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Permit
CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT PERMIT #: ELR2009 - 00018 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/5/2009 PARCEL: 2S102AC - 00201 SITE ADDRESS: 09385 SW MAPLEWOOD DR 0 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 que tions to OUNC at 503.246.6699 or 1.800.332.2344. Issued By: � jJ J j J Permittee Signature: ? .% \ 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. - €CE %VED Electrical Permit Application FORO ' City f Tigard JAN u 6 2009 iteeeha - . y S ate /l3 ,: . . :. ' oci __ Pcnnil No.: �12 /a, ^J " 13125 SW Hall Dlvd., Tigard, OR 97223 (.•LJL 0 M ill O I I r u Review Plume: 503.639.4171 Fax: 503.59R.It I liit/� J y . Oilier Permit: Inspection Line; 503.639.4175 3UILDING ©lVI cad /0 TIGARD IV{ 1 Y Y ' /) Supplemental Information ® Sec Page 2for I ntemci: www.ligard ur.gov I dlMcthnd: , l TYPE OF WORK PLAN REVIEW ❑ New construction 01 Addition/alteration/replacement Vieazo check all that apply (submit 2 sets of pleas w /item, checked below): 0 Service or feeder 400 amps or more ❑ Building over thine stories. ❑ Demolition ❑ Other: where the evailahle O current ❑ Irrinas soil hnnlyards. ... - • . . CATEGORY OF CONSTRUCTION • • ' . exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑Couunercial -use agricultural ❑ I - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other instill Intions. buildings. 17 Multi - family ❑ Master huilder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA m JOB SITE INFORMATION AND LOCATION . ❑ Emergency syslcm. larger SCparulCly derived system. • ❑ Addition or new motor Mad of Job no.: Job site address: 9385 SW MAPLEWOOD DR. 100HPor more R 1 0Cy " ❑Six or more residential units. ❑ Recrcmionnl vehicle p:oka. City /State/ZIP: TIGARD, OR 97223 ❑ Henith•care facilities. ❑ Supply voltage for more than 0 Hazardous location. 500 volts nominal. Suite /bldg, /apt. no.: 0162 -173 Project name: MAIN STREET VILLAGE ❑ Service or feeder GOO amps or MOM. Croas street /dirCClipns to job site: FEE SCHEDULE J nnrrlptlon I Qty. I Kr. I - total I New residential single- or multi- family dwelling unit. Includes attached garage, Subdivision: Lot no.: 1.000 sq. ft. or less 145.15 _ 4 Ea. ndd'I 500 sq. ft. or portion 33.40 I Tax map/parcel no.: Limited energy. residential 75.00 2 DESCRIPTION 01? WORK (with above sq. it.) INSTALL FIBER OPTICS FOR VERIZON Limite<lenergy. mulli•ftunily 75.00 -, rcsidcnlial (with atxwe s ti.) Services or feeders installation, alteration. and/or relocation 200 amps or less 80.10 2 ❑ PROPERTY - I . • ' ❑ TENANT • 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 Name: I 1 ' 601 l to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 2 City /Slate /ZIP: Temporary services or feeders installation, alteration, and/or relocation Phone: ( ) Fax: ( ) 200 slops 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. Fce for branch circuits with ❑ APPLICANT ' ' -'I EU CONTACT PERSON above service or feeder fee, 6.65 each branch circuit Business name: NORTH SKY COMMUNICATIONS, INC. B. Fee for branch circuits Contact name: RYAN ROBERTS without service ui feeder fee, st bt rust citwil 46.85 2 Address: 11818 SE MILL PLAIN BLVD STE. 410 I:achtrdd'l circuit 6.65 - 2 Miscellaneous (service or feeder not included) City /State/ZIP: VANCOUVER, WA 98684 Etch manufactured or modular 90.90 2 - - Y` - - -- dwelling, service. and /or feeder Phone: (503 ) 519 -5264 Fax: : ( )1 -866- 905 -4907 Reconnect only 66.85 2 E-mail: mduor(Cnorthskvcomm.com Pump or inigation circle 53,40 2 CONTRACTOR • • Sign or outline lighting 53.40 2 Business name: NORTH SKY COMMUNICATIONS INC. energy p alter limited- > encrgY Panel, alteration, or Address: 11818 SE MILL PLAIN BLVD. STE 410 extension. Describe: 1 Page 2 $75.00 2 City /State/ZIP: VANCOUVER, WA 98684 Each additional inspection over allowable in any of the above Phone: (360) 254 -6920 Fax: ( ) 1 -866- 530 -4325 investigation csl inspection ' 62.50 iignvation per hour U hr min) 62.50 CCs Lie.: 14117 Electrical Lic.17- 154CL Suprv. Lic.: 173LEB Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES • ' Suprv. Electrician signature, required: /_ .. Subtotal: $75,00 -_, Print name: JACK CAGLE Date: 1 -5 -09 Platt review (25% of permit fee): ��l Slate surcharge (12% of permit fee): $9 �+ Authorized signature: ' ,, TOTAL PERM I'l Eli: $84.00 This permit application expires if n permil is 1101 obtained within 180 Print name: ETHON A. DOLPH Date: 1 -5 -09 (lays alert! hosheen accepted nacomplete. " Number of inspections allowed per permit. 1: ulsildingii 'erommiLC•PCn 031Dda16 440-16 I Yr( I I /05/COMAVIin . JAN-28-2010 THU 09:55 AM CHRISTENSON ELECTRIC,INC FAX NO, 95034193695 P, 01 Electrical Permit AppYic~iil~ri City of Tigard ~EIV ED D"`iv`d Pet,,,uxo. Dstelii 701 d n 13125 SW Hall Blvd., Tigard, ORR7 23 p Plan Review Phone: 503.639.4171 Fax: 50 91% O 2 010 D,,kf$: Other Permit: R,7 en q - A Inspection Line: 503,639.4175 Date Ready/ay: 1ud,;' RI Set page 2 for Internet: vnxw.6gard-ar,govCITY OF TIG Notified/MCthod. Supplemental Informutton r-~ '~l `I~ P✓titipY, yyipy ~j~,~ ~~yy~ fl (ij.)«lr. y ~q P 7 ;r,...,.h ',1• ~ ~"~I,«r~ „ll..t„u~;lP a+-~Hr'tvr1'f~`~ff'+~ few construction Addition/alteration/replacement please check all that apply (submitI sets of plans'wlitems checked below): ❑ Service or feeder 400 amps or more 0 Building over throe stories. Demolition tiler: where the available fault current ❑ Marinas and boatyanls. r,.r("k.,'.q"'7t; ~iY ti"(;;~~:'J+•r:n~~1'~'I "''i'dr.e,,_, -..~,,.y. pitl'L':"l~. KF,.y:.'• .''p; ':'~"'•N!. 1 exceeds O.OOp amps at 150 volts of (3 Floating buildin!;s. ,t fir?„.1u.5;f3.1 ~^'~,,,~1~'~:+t;• ,•,R`~f;.9,.Qfs' ((~~;nS,.. ~r, ,.~~{:J;~l;a. tii., :.i:+,;. Y. L; l;.+.R,t, rkrl o aL_,^T... . cifi,. ra,";...:rr'.'.^.lfa.q,::)a i»el,.i';er. less to ground, or exceeds 14,000 Commercial use agricultural 1- and 2-family dwelling Commerciallindustrial [ Accessory building amps for all other installations. buildings. E] Multi-family 0 Master builder ❑ Other: 17 fire pump. ❑ installation of75 KVA or ❑Emmgeney system, larger separately derived system. ❑Additionofnewmotorloadof D"A" "E. "1-2,, Job no.: Job site address: ~SW ih I OOFtp or more, occupancy. F'J Six or more Tcsidcntial units. ❑ Recreational vehicle parks. City/state/ZIP: Health-care farilitics. ❑ Supply voltage for more than ❑ H4.^2rdom locations. 600 vole norrdnal, Suite/bldg./apt. no.: O Project name ` ❑ Service orfccder 600 amcppg or more. n~ ~ T .'7~4!:!~':~:~k'ri ~Jf•'n,t5,,'9'101?~'F~~~JCi~1 Cross strect/directions to job site: n,r- Pacrl1clan F■a 'for■1 (3~ -7 32 New residential s[n;Ie- or multi-rami)y dwelling unit, Includes attached garage. Subdivision: Lot no,: 1,000 sq. R, or less !45-15 4 Tax map/parcel no.: Ea. add') 500 5q. ft, or portion 33.40 1 Limited aergy, residential 75,00 , 1`'. ,a " ' ',::•4n:..~{,;' "'1''~.: •.".A.#aJi7 / '`7 I .,rr:k'&at~~°; PJt';: :%P;,i'i,.l • ~ "`i rr pl~$e!i ;?x!;1.01'?: Qp.1?y0'1LK. 'r;,.1 :r.c (witl) above sq. ft,) \i .04!~IAAQ Limited energy, multi-family 75.00 2 residential with above !9. ft Services or feeders Installation alteration, and/or relocation 200 amps or less 80.30 2 201 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 r" /State/ZIP: Temporary services or feeders installation, alteration, and/or relocatiotf r ...me: ( ) Fax: ( ) 200 amps or less 66.85 t Owner install2tion: This installation is being made on property that I own which is not 201 amps to 400 am S )00.30 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 elrcultg- now alteration, or extension, er anel Owner signature: Date: A. Fee for branch circuits with abeveserv icoarfeederfee, 1;•..6.,,,,y:.y:7.,• . ..:colic ,,.wn.7.n C. ....,-i4,,: u. R.l;!,, 4+Y. ,iry each branch circuit 6 65 2 Business name: 13. Fee for branch circuits without service or feeder feel Contact name: first branch circuit 46.65 2 Address: Each add') branch circuit 6,65 2 Mlseellaneous service or feeder not Ittcluded City/State/ZIP: Each manufactured or modular dwelling, service and/or feeder 90.90 2 Phone: ( } Fax:: ( ) Reconnect only 66.55 2 E-mail: Pump or irrigation circle 53.40 2 Sign or outline lighting 53.40 2 Business name: Christensen Electric, Inc, Signal circuit(s) or limited panel, panel, alteration, or Address: 111 SW Columbia, Suite 480 extension, Describe: Page 2 2 City/State/ZIP: Portland, OR 97201 Each additional ins ectlon over allowable In as of the above Per inspection 62,50 Phone: (503) 419-3300: ax: (503) Investigation per hour (I hr min) 62-50 CCB Lie.: 458 Electrical ic,- 6-34C Suprv. Lic.; Industrial plant per hour 73.75 CTR Su rv. Electri 1~11G I~~7x`;1'i11tMT''Si;i p cian signature, required: Subtotal: Print name: Robert, 6me, vl_ pate; Plan review (25% of permit fee): State surcharge (12% of permit fee): i ,iorizcd signature: TOTAL PERMIT FEE: This permit application expires if sperm-it is not ndlalned m ISO Print name: Date: day, alter it has berm accepted as complete, ` Numberofinspection If d per permit. __7 1:1AullAing(Fermili~F;t.GPcm,i[App.doe o$>z3ftlo J40~61~TtlllOSrCOMlWEB CITY OF TIGARD BUILDING DIVISION PERMIT #: ICI R2nCi�: f?t10"1t3 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: -1/5/200 Phone: (503) 639- 4171 °w�; I�)�i Inspection Requests (24 Hrs.): (503) 639 - 4175':_ INSPECTION WORKSHEET FOR DATE: 1/15/2009 TIME: 7:02AM PAGE: 15 SITE ADDRESS: t193t#ti SW MAPLEWOOD DR 00 CLASS OF WORK: SUBDIVISION: MAIN STREET VILLAGE APARTMENTS LOT #: TYPE OF USE: PROJECT NAME: MAIN STREET VILLAGE DESCRIPTION: Install fiber optics for Veriron. OWNER: CASA LA VE FA AS aOCIA1 ES +, PHONE #: CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 360-2&i .6920 Inspection Request Scheduled For: Date: //152009 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 079724 -02 503 - 949 -2025 N Corrections /Comments / Instructions: • PASS 0 PARTIAL APPROVAL 0 CANCEL 0 NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION _ ADDITIONAL FEES ASSESSED Inspector: W6e IA Date: 1 • 1 L O • I Phone #: (503) 718- WA i