Permit ill . .. CITY OF TIGARD
ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00342
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/18/2008
PARCEL: 1 S 135CD -00900
SITE ADDRESS: 11475 SW 98TH AVE ZONING: R -
SUBDIVISION: GLACIER LILY APARTMENTS LOT: JURISDICTION: TIG
PROJECT: GLACIER LILLY APARTMENTS
Project Description: Install fiber optics for Verizon. This is for units: 11471, 11473 & 11475.
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: 1
Owner: Contractor:
SHARON DEVELOPMENT CO, LLC NORTH SKY COMMUNICATIONS INC
5795 SW CRANBERRY CT 11818 SE MILL PLAIN BLVD
BEAVERTON, OR 97007 SUITE 410
VANCOUVER, WA 98687
Phone: Contact #: PRI 360 - 254 -6920
FAX 1- 866 -530 -4325
FEES Reg #: ELE I7- 154CLE
LIC 14117
Description Date Amount
[ELPRMT] ELR Permit 12/18/200E $75.00
[TAX] 12% State Surch 12/18/200f $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.
Issued By: 4jr\OVN 0, 1WA. Permittee Signature: .e- 10 Ut�Aioym
1
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 O
Electrical Permit Application : :<FO)lt OEFICE.0 EoNLY
City of Tigard
*
Q �` , ®dg Al. Permit i o . d 1'0 Xi E
N.,_. 13125 SW Hall Blvd., Tigard. OR 97 3 K �T
Phone: 503.639.4171 Fax: 503 598.1960 ® . , L Other Permit:
r a r. AR r) Inspection Line: 503.639,4175 Q1` t ,..\' y /qr �� El See Page 2 for
Internet: www.tigard- or.gov ��J °`` O`' 1 Ied/Mcthme Supplemental Information
TYPE OF WORK a tVw . • .• . . • • . PLAN REVIEW
0 New construction 01 Addition /alteration TlTC Please check all that apply (subinil l sets of plans wfnems checked below):
❑ Service or feeder 400 amps or inure C) Building over three stories.
0 Demolition ❑ Other:
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION . exceeds 1 0,000 amps is 150 volts or ❑ Floating buildings.
loss to ground, or exceeds 14,000 ❑ Commcrcial•uso agricuhu,al
❑ 1 - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps fin all onto iasmllntiona, buildings.
o Multi - family ❑ Master builder ❑ Other: CI Fite pump. ❑ Installation or 75 KVA or
JOB SITE INFORMATION AND LOCATION (3 E morgeocy system. larger separately derived sysicm.
O Addition of new motor load of ❑ "R" "F "'1.2" "1.3'
Job no.; Job site address: SW 98TH AVE. 100HP or mom. occupancy. Six or mote rcs <ientiul units. ❑ Itcueetiunal vehicle parks.
City /State /ZiP: TIGARD, OR 97223 ❑ Health•carc facilities. ❑ Supply vol wee for more than
I Q Hazaudno% localism. 600 volts nt tslnnl.
Suite /bldg. /apt.no.: 11471.11473.114niu 1 Project GLAC i ER LILY ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street /directions to job site: Dcsednna, I O=y. i Fee. I •I', I J •
l� -� New residential single- or multi-family dwelling unit.
)
// t 71, 1 I L / i l y 4-7 S- includes attached garage.
Subdivision: Lot no,: 1,000 sq, ft. or less 145.15 4
• Ea. uckl'l 500 sq, ft. or portion 33.40 1
Tax Wrap /parcel no.: Limited energy, residential
DESCRIPTION OP WORK ' (with atovc Si. 0.) 75,00 2
INSTALL FIBER OPTICS FOR VERIZON Lit r e side porgy, multi-family (with °Ili -f ° ° (I 7500 ' 2 '
reside aloes sal. n.)
Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER ' I .. 0 TENANT 201 amps to 400 a mps 106.85 2
Name: . 401 amps to 600 amps 160.60 2
601 a ripe to 1,000 amps 240.60 2
Address: Over 1,000 ups 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, rem, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Owner signature: _— D ate: Branch circuits - new, alteration, or extension, per panel
A. Fce for branch circuits with
0 APPLICANT l 1 O • PERSON above service or feeder fee, 6.65 2 •
each branch circuit
Business name: NORTH SKY COMMUNICATIONS, INC. B. Fee for branch circuits .
Contact name: RYAN ROBERTS without service or feeder fee, 46.85 2
first brunch circuit
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
dwelling, service and /or feeder 90.90
Phone: (503 ) 519 -5264 Fax: : ( )1 -866- 905 -4907 Reconnect only 66.85 2
E -mail: mduore.northskvcomm.corn Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Business name: NORTH SKY COMMUNICATIONS, INC. nerglcireuit(s)orlimited-
r e energy panel, alteration, or
Address: 11818 SE MILL PLAIN BLVD. STE 410 extension. Describe: 1 Page2 $75.00 2
City /State/7IP: VANCOUVER, WA 98684 Each additional inspection over allowable in any of the above
Per F ax: ( ) 1 -866- 530 -4325 Investigation Phone: (360) 254-6920 lnvc per hour (1 hr min) 62.50
CCB Lie.: 14117 Electrical Lic,.7 - 154CL Suprv. Lic.: 173LEB Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES •
Suprv. Electrician signature, required:
Subtotal: $75.00
Print
mime: JACK CAGLE Date: Plan review (25% or permit fee):
12 -16 -08 Slate surcharge (12% of permit fee): $9.00
Authorized signature: /. f0 TOTAL PERMIT l'EE: $84.00
Print name: ETHON A. DOLPH '• Date: 12 -16 -08 This permit application es if n permit is not obtained within 180
days after (1 t has fins been aecepled nu complete.
" Number of inspections allowed per permit.
I :nlnadiagil'euuits iil.C•I'drntimpp4tx O92.VOG 4411 46151 I/(S/COMAVrn
CITY OF TIGARD
BLiLli DIVISION PERMIT #: ELR2008.00342
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1211012008
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 1/6/2009 TIME: 7 PAGE: 26
SITE ADDRESS: 11475 SW 98TH AVE CLASS OF WORK:
SUBDIVISION: GLACIER LILY APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: GLACIER LILLY APARTMENTS
DESCRIPTION: Install fiber optics for Verizon. This is for units: :17471. ---- - - •, - r :"." ?
OWNER: SHARON DEVELOPMENT CO, LLC, PHONE #:
CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 360
Inspection Request Scheduled For: Date: •/612009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 079407-03 503-563-4082 N
Corrections/Comments/Instructions:
'
1
I
I
g PASS PARTIAL APPROVAL 0 CANCEL 0 NO ACCESS
_
0 FAIL 1 I CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: N06 W Date: 1- 44 )
Phone #: (503) 718- 1414k) ,
i
1
CorrbFTIGARD
SI1LEfiNG DIVISION • PERMIT #: ELR200B.00342
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/18/2008
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175 4 'fl
INSPECTION WORKSHEET FOR DATE: 1 2.1 19/2008 TIME: 7:00AM PAGE: 13
SITE ADDRESS: 11475 SW 98TH AVE CLASS OF WORK:
SUBDIVISION: GLACIER LILY APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: GLACIER LILLY APARTMENTS
DESCRIPTION: Install fiber optics for Verizon. This is for units: 11471, 11473 & 11475.
OWNER: SHARON DEVELOPMENT CO, LLC, PHONE #:
CONTRACTOR: NORTH SKY COMMUNICATIONS INC • PHONE #: 360 -264 -6920
Inspection Request Scheduled For: Date: 12/19/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
136 Low voltage 079154 -03 503-209-7014 N
Corrections /Comments /Instructions: •
•
witimrs mow.
❑ PASS ❑ PARTIAL APPROVAL CANCEL ❑ NO ACCESS
n FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
40
Inspector: -- Date: Phone #: (503) 718-