Permit - � CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2008 -00343
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/18/2008
PARCEL: 1 S135CD -00900
SITE ADDRESS: 11479 SW 98TH AVE ZONING: R -12
SUBDIVISION: GLACIER LILY APARTMENTS LOT: JURISDICTION: TIG
PROJECT: GLACIER LILLY APARTMENTS
Project Description: Install fiber optics for Verizon. This is for units: 11477 & 11479.
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 17- 154CLE
LIC 14117
Description Date Amount
[ELPRMT] ELR Permit 12/18/200E $75.00
[TAX] 12% State Surch 12/18/200E $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: VC41 Permittee Signature: ,Q� � � pp U. ,(
OWNER INSTALLATION ONL Y
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.
Electrical Permit Application � FOR OFFICE USE ONLY
City of Tigard `� Received Permit No.: . , a-pd
n 13125 SW Hall Blvd., Tigard, OR ' 2/ G � n Rev w �G � g O 3 3
a ' Phone: 503.639.4171 Fax: 503.59; t `% \ \ Plates Review Other Penult:
D eiBy:
1 t (JAI( U inspection Line: 503.639.4175 il t (a �[i • cady /ny: hate Sec Pop c 2 for
Internet: www.tigard•or.gov mhtxl: %((mot Supptumenlal Info oration
• TYPE OF WORK . . •PLAN REVIEW ..
b
❑ New construction 5' Addition /alteration/ , 0 Please cheek an that apply (subunit / sets of plans whims checked below):
t21 Demolition ❑ Other: ` ❑ Service or feeder 400 amps or more ❑ milting MX throe aerie
whoa: to available limit current Q Marinas and boatyards.
. CAT EGORY OF CONSTRUCTION . • 1 0 Floating buildings.
.. . czc IU, 000amt s :x ISO volts g � s.
less to ground, or exceeds 1000 ❑ Commercial-use agricultural
❑ I - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building mops for all utter in stulbn ions. buildings.
o Multi - family ❑ Master builder ❑ Other: ❑ elre pump. 0 tnstall:diun or 75 KVA or
JOB SITE. INFORMATION AND LOCATION O Emergency sysicm. larger separately derived system. • CI Addition of sew motor load of ❑ "A" "G' 1.3 - 1 - 3".
Job no.: , Job site address: 11511 SW 98TH AVE. n ix at MO !km :rpaton.
0 ,x nwrC rcsidmnial units. ❑ accrcatinnnl vehicle parks.
city /State/ZIP: TIGARD, OR 97223 0 Hexlth•carefacilities, ❑ Snppty,rolIago for MOM than
❑ Hazardous locations, 600 volts nominal.
Suite/bldg. /apt.no.:11477,11479 Project name: GLACIER LILY ❑Service orfcedcr600 amps or more
FEE SCHEDULE
Cross street /directions to job site: orscoutea 1 Qty, i Pee. 1 'total I •
!/
j) New residential single- or multi- family dwelling unit.
i 7741/±1_71 Includes attached garage. —_
Subdivision: Lot no.: 1.000 sq. rt. or less 145.15 4
Ga. add'I 300 sq. ft. or portion 33.40 I
Tax map/parcel no.: limited energy, residential
DESCRIPTION OF WORK 75.00 2
(with adore sq. n.)
VERIZON lrntitedenergy,multi•I "n,ily 7500
INSTALL FIBER OPTICS FOR V s.
residential (with Access. a.)
Services or feeders Installation, alteration, and/or relocation_
200 amps or less 8030 2
❑ PROPERTY OWNER • ❑ TENANT 201 amps to400amps 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: ( ) f Fax: ( ) 200 amps or less 66.85 I
Owner installation: This installation is being made on properly 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: - - Da — A. Fee for branch circuits with
❑ APPLICANT - .j is 'CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: NORTH SKY COMMUNICATIONS, INC. B. Fee for branch circuits
without service or feeder fee. 46.85 2
R YAN R OBERTS
Contact name: fast branch circuit
Address: 11818 SE MILL PLAIN BLVD STE. 410 Each add'I branch circuit 6.65 r -
Miscellaneous (service or feeder not included) ,
City/Slate/ZIP: VANCOUVER, WA 98684 Each manufactured or modular 90,90 2
Phone: (503) 519 -5264 Fax: : ( )1- 866 -905 -4907 Reconnec onlye and/or feeder 66.85 2
E -mail: mduorta' )northskvcomm.com Pump Or irrigation circle 53:10 2
CONTRACTOR Sign nroutline lighting 53.40 2
Business name: NORTH SKY COMMUNINC. energy p a n l , (s)ortimited-
1 1818 SE MILL PLAIN BLVD. STE 410 CATIONS, ' er
exten e
p alteration, or
.
Address: extension. Describe: 1 Page 2 $75.00 2
City /State/ZIP: VANCOUVER, WA 98684 Each additional inspection over allowable in any of the above
Phonc: ( 360) 254 -6920 Fnx: ( ) 1- 866 - 530 -4325 Per inspection - ___ 62.50
Investigation per hour (! hr min) 62.50
CCR Lit:.: 14117 Electrical Lie.1 -154CL Suprv. Lie.: 173LEB Industrial plant t>Pa hour 73,75
,, ELECTRICAL PERMIT FEES •
Suprv. Electrician signature, required: fl'ai Subtotal: $75.00
Print name: JACK CAGLE Date: 12 -16 -08 flan review (zs56orpermit fee):
St:ue surcharge (12% of pet•tnit fee): $9.00
Authorized signature:
/,".) TOTAL PERMIT PEE: $84
ills permit application expires if a permit is not obtained within ISO
Print name: ETHON A. DOLPH Date: 12 -16 -08 days after it has been accepted as complete"
* Number al inspections allowed per permit.
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BUILDING ��K��U��U��N� PERMIT ~~"°"~°"~°"~ E
13125SVV Hall B�d.. Tigard, ORQ7223 D ATE|SSUED: 13/lE1/2008
Phone: (503) 639-4171
)nope�ionRequests (24Hmj:(6U3)G3Q'417G �� °���
INSPECTION WORKSHEET FOR DATE: 116/2009 TIME: 7:0OAk4 PAGE: 26
SITE ADDRESS: CLAGSOFVVORN�
� |1478SVV9{THAVE �
SUBDIVISION: LOT TYPE � {3LA(�|E�RLILY APAF�TkHENT�� #: �
PROJECT NAME: GI. &ClER LILLY APARTMENTS
DESCRIPTION: Install fiber optics for Verizon. This is for units:
OWNER: SHARON DEVELOPMENT CO, LLC, PHONE # :
CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 300'2546970
Inspection Request Scheduled For: [)atg: 1/6/20O9 Pour Time:
Code # Inspection Description Confirm # Contact # Message
136 Low voltage 07,L)10704 603-603-4O02 N
Corrections/Comments/Instructions:
.
\
�m�
�0
r��PASS ��RARTALAPPRC�AL El �� NO ACCESS
�e� �� PARTIAL �� ��
n FAIL 0 CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
~_ ���� � � a�~ � � �� ��L� |
Inspector: r ^ v~�&�� �«� Date: �^ ��' � Phone #: (503) 718- ��
'
CITY0OF TIGARD
BUILDING DIVISION
A PERMIT #: ELR2008-00343
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12118/2008
Phone:,(503) 639-4171 ::441119tilit'
Inspection Requests (24 Hrs.): (503) 639-4175 ...„. —... *
INSPECTION WORKSHEET FOR DATE: 12/19/2008 TIME: 7 PAGE: 12
SITE ADDRESS: 11479 SW 98M 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: 11477 & 11479.
OWNER: SHARON DEVELOPMENT CO, LLC, PHONE #:
CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 360-2546920
Inspection Request Scheduled For: Date: 12/19/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
13E, Low voltage 079154-04 503-209 N
Corrections/Comments/Instructions:
......„
0 PASS 0 PARTIAL APPROVAL E ANCEL NO ACCESS
_
fl FAIL 0 CALL FOR INSPECTION 0 ADD ITIONAL F ES ASSESSED
• ... , i tl.
op
Inspector: . Date: 4 "' Phone #: (503) 718-
: , .