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Permit
�«. N CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00142 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/6/2008 PARCEL: 1 S 135CD -03900 SITE ADDRESS: 11909 SW 95TH AVE 1 ZONING: R SUBDIVISION: DOVE COURT APARTMENTS LOT: 008 JURISDICTION: TIG PROJECT: DOVE COURT APARTMENTS Project Description: Units: 1 -3. Installing 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: 1 Owner: Contractor: HOUSING AUTHORITY OF NORTH SKY COMMUNICATIONS INC WASHINGTON COUNTY 11818 SE MILL PLAIN BLVD STE 4 111 NE LINCOLN ST #200 -L VANCOUVER, WA 98687 HILLSBORO, OR 97124 Phone: Contact #: PRI 360 - 254 - 6920 FAX 1- 866 -530 -4325 Reg #: ELE 17- 154CLE FEES LIC 14117 Description Date Amount [ELPRMT] ELR Permit 6/6/2008 $75.00 [TAX] 12% State Surch 6/6/2008 $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: _ Permittee Signature: ,� I�/ �x 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. .JUN 05 2008 11:50 PM FR TO 5035981960 P.03 RECEIVED Electrical Permit A>�plic Lion ra or>i x u r ONLY City fTigard JUN 0 5 2008 . `rw lrI <-• w 13125 SW Hall Blvd.. Tigvrd., OR 97223 oh. Pcnuii: x phone: 503.639.4171 lax: 503.598.1961) a.1� ! IUAh L, ISM11.1111111 TIGARD rnspection um:: 503.639.4175 ` r ?‘ i R q t ° I f }: 0414:. W Y: ® See No 2 ror Internet: www.tioard- or.gov Notified /Method: M Supplemental Information TYPE .O1 WORK >., PLAN RrviEW `; [] Now construction E { Aciditionfalterationlrcplact treat Please cheek all that apply (sutmtit a sew or )suit's Wrnomx checked ho.,,„ © ScrvKC or feeder 400 amps or more 0 Building over three stories. [3 Demolition 0 Other: - where the available )omit current Q Marinas and Anatyanls. CATEGORY OF :CONSTRUCTION : cm:ceds 10,000 tunic at l50 volts or © Ilotning buildings. less to ' _ s t gro Commercial-tar n td. or exceeds 14.000 Commercial-tar -tar ngriCUttttrai ❑ I - and 2- family dwelling ❑ Commercial /Industrial © Accessory building; amps for all other i ta buildings. o Multi - family 0 Master builder 0 Other: El Fire pump. C) Installation ergs KVA el Q emergeney system, larger separately derived system. JOB SITS INFORMATION AND LOCATION ('� Addition erns motor load 01' ❑ e fi or more a rest Re Job no.: — 1 Job site address: 11909 SW 95TH AVE ©Six or raprc residcmuti units- ❑ Rccmatiuirnf vchklc lurk. City/State/ZIP: TIGARD, OR 97223 0 Health-cute r(reirties. ❑ Supply voltage for more than Ejl Haordous locations, 600 votes nominal. SuitclhIdg- /apt. no.: 1 -3 Project name: DOVE COURT APTS © Service or feeder 600 man or more. _ . .. :FEE SCHEDULE Cress Street /directions to job site: llrxrr I QiY- I r ot. I Tyrol I • New residential singl e - or nwlti- fllmily dwelling unit. Includes attached garage. _ - Subdivision: Lot no.: _1,000 sq. I . or less _ 145.15 4 —. Ea. ndd'l 500 sq. ft. or portion III. 33.40 1 Tax map/parcel no.; — Limited wedgy, residential DESCRIPTION OF WORK (with alive sot- ft.) _._ 75.00 INSTALL FIBER OPTICS FOR VERIZON Limited e iden et ial ( R •family 75.00 2 residential hvith; >Vdso. n.) Services or feeders instailation and /or relocation 200 amps or loss 80.30 2 El PROPERTY :OWNER , . w • U TENANT ` 201 amps to 400 amps 106.85 2 " 401 amps to 600 OInpa 160.60 2 Name: — — 601 amps to 1,000 amps 240,60 2 Add[esti: Over 1,000 amps or volts 454.65 2 City/State/ZIP: I einporary services or feeders installat alteration, and/or y relocation Phone: ( ) 1 Pax: ( ) 200 amps or less 66 85 I am . Owner iristt1311atiou: This installation is being made on property that 1 own which is not 201 �' s to 400 amp 100 - ., 2 intended for sale, lease. rent, or exchange, accotdiag to ORS 447, 440, 670, and 701. 401 amps to 399 amps 133.75 2 Thrunch circuits- new, alteration, or extension der panel Owner Signature :.. -. _ Dante: -- - A. Fee for branch circuits with Q APPLICANT . •L 17' CONTACT PERSON • above service or feeder fee. 6.65 2 each brunch Cireait Business name: NORTH SKY COMMUNICATIONS, INC. 13. Sec for branch circuits without service Or )getter loc. 46.85 2 Contact name: RYAN ROBERTS first branch 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 cud, manufactured or modular Ell 90.90 2 dwelling, service andfOr feeder Phone: (503) 519 -5264 Fax: : ( )1 -866- 905 -4907 R econnect only 66.85 2 E- trail: and _ • r • north on • • m Pump or irrigation circle 53.40 2 CONTRACTOR Sign or outline lighting I 53.40 ' — liuSirtCSS nasn8: NORTH SKY COMMUNICATIONS, INC. energy pile]. limited- cttergy poach alteration, or Address: 11818 SE MILL PLAIN BLVD. STE 410 extension. Describe: 1 Page 2 $75.00 2 City/State/ZIP: VANCOUVER, WA 98684 — Each additional inspection over allowable in any of the above Per inspection 6150 Phone: ( 360) 254 -6920 Fax: ( ) 1 -866- 530 -4325 Investigation per hour p h min) ....... 62.50 CC$ Lie.; 14117 Electrical Lie,17 -154CL Suplw. Lie.: 173LEB Indashyal plant per hour 73,75 ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: Subtotal; $75 W Phi review (25% of permit fee): _ Print name: JACK CAGLE Deis 6 -5 -08 State surcharge (12% of ponnit fee): $9,00 Authorized signature: - , / . - • TOTAL PCRM rCt:, $84.00, - �� his perennit Application espirvs if a permit is not obtnrncn within 150 Pri nt name: ETHON A. DQLPH Date: 6 -5.08 days after It has been accepted as complete. . r4snber ur inspections allowed per permit. ttutuildinell 'crnta.too.C- P,xmlr,rpp.nnc 05123f06 - 140- 4013117 1l1)3/COM/WIiit CITY OF TIGARD BUILDING DIVISION A .- PERMIT #: ELR2008 -00142 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 6/6. Phone: (503) 639 - 4171 Aort itA il Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: &113/2008 a TIME: 7:01AM PAGE: 40 SITE ADDRESS: 11909 SW 95TH AVE 1 CLASS OF WORK: SUBDIVISION: DOVE COURT APARTMENTS LOT #: 008 TYPE OF USE: PROJECT NAME: DOVE COURT APARTMENTS DESCRIPTION: Units: 1 -3. Installing fiber optics for Verizon. OWNER: HOUSING AUTHORITY OF, PHONE #: CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 360-254-6920 • Inspection Request Scheduled For: Date: 6113/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 071340-01 503- 572 -3532 N Corrections /Comments/ Instructions: de K PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS i FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: W / Phone #: (503) 718- ,G/� VIA