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Permit p CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT Permit #: ELR2009 00240 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/05/2009 Parcel: 2S110AA00200 Jurisdiction: Tigard Site address: 14130 SW 105TH AVE 27 Subdivision: CANTERBURY TERRACE APARTMENTS Lot: 0 Project: Canterbury Terrace Project Description: Install fiber optics for Verizon. Owner: FEES VOIEN, BETH TRUST Description Date Amount BY BETH VOIEN TR, 24 VILLA POINT DR Restricted Energy Permit 07/31/2009 $75.00 NEWPORT BEACH, CA 92660 12% State Surcharge - Electrical 07/31/2009 $9.00 PHONE: Contractor: PHONE: FAX: Type of Use: MF Class of Work: ALT Total Number of Systems: Audio & Stereo: N Boiler Controls: N CCTV: N Clock Systems: N Data & Telecommunications: Y Fire Alarm: N HVAC: N Instrumentation: N Total $84.00 Intercom /Paging: N Landscape /Irrigation: N Required Items and Reports (Conditions) Landscape Lighting: N Medical: N Nurse Calls: N Protective Signal: N Security Alarm: N Other: N Other Desc: This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 the 180 days. ATTENTION: Oregon law requires you to follow the 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 a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. 1 t Issued By: lbw •It t . • ,� ! ! LX Permittee Signature: Q 4, (Ace 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' 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. RECEIVED JUL 2 9 2009 Electric I Permit Anulicati OF TIG :_',,.'., ` *cOrEtEE USE OELV' :, :.. "..:: : • . City of Tigard DIVISIO • : *,' 40 i iial Blyd, Ti .gar OR 7221 � � t V V , 't ' t >lw ue 50 3.6 3.4(7( Pax: $03.59 0 0rkorYomdt: ins Icctioe Lac: 501.639.4175 'TIGARD i UartlRCady/ny: n; &J See I- ngc2tor Internet: www,rigard- or.gav NudnedtMakdd: -.� IC Supphmcnaet intermdo, TYP& bp WORK .•;':;•:•-• ':PLAN REVIEW C;:.::. 0 New construction CI Addition/alteration/replacement Plow Chock ,iillhat apply (submit lows MOM Wtimws ❑ Setvleo or feeler 4O1) amps ur m 0 floli ing ovarliwe sterbs. [Lpamolition ❑ Other: whore situ to/nibble laah taro+ 0 Mo,low wol Mrnry,rnle. • ' *.., % . :: •;.'.:";' . -.:.:: . .2.::;:: CATEGORY 0r= CONSI'1iUt:PION . • .. • exceeds t0,000 amps al150wdlsar ❑ Naming lwitdings. I -and 2•rarnil dwelling kg m loam), or exceeds 14,000 0 Commercial-ow aarkuhur, ID Y g ❑Co+amcrcial /industrinl 0 amps Wall other iriwtldimr. Wtildings, o Multi - family 0 Master builder ❑ Other: Line purrp. l3 fweidlorioo u(7$ KVA or ;: :.'. SITE- INFORMATION AND LOCATION '; 02nrergolio Ingot mbar:Haynorived'low, .,. . p Addition of new [mini lead or ❑ "A ",•Y; ",• "••1.1 Job no.: 1 Job she nddtess: SW 105TH AVE loom urr„rao ucrmpauey. Q Six Of mtlrc residentiut (wk. Cl Re4 abnsl vchiele parks, City/State/ZIP: TIGARD, OR 97224 0 Kesteven's facilities, CI Supply vrleagc for *now Om O Hazanlons locations. 000 Wilk nomri,■l. Suite /bldg. /apt. no. 27 - 28 I Project name: CANTERBURY TERRACE Cl Service or feedera00 mow or mole. ... E'SCI Wl:DUi.¢ •: • _Cross street/directions to job site: _ nnnruann 1 O+r. I Pee. I 'Nut New rusidontlal single- or murli fumlly dwelling tndi, Wholes Moulted garegc, Subdivision: Lot no,: 1,000 sq. 0. or tens 145.15 �� 4 B0. ddd'l 500 sq. Ii• or pomp( 3140 1 Tux Map/parcel neat Limited energy, rusidentinl DESCRIPTION OP WORK • Nils raomexn.rt.) 75.00 2 INSTALL Liuthetlmtagy,muhl•1hn)iiy 7500 2 , NSTALL FIBER OPTICS FOR VERIZON rcxidculial (wile alms at), n.) Services or feeders instarintlon ufteranion, at+dfar reloettlon _ 200 amps or less 80.30 2 ••'© PROPERTY:OWNER . °'I :,. , • .. ..0. TENANT •' 201 amps to400amps 106.85 2 Name: 401 amps to 600 slops 160.60 2 """-"" ^ 601 amps to 1,000 autps 240.60 2 Address: Over 1,000 »lops or volts 454.65 2 City /State /ZIP: Temporary services or feeders Inslullatiun,:titerldIon, audlor relocation _ _ , . Phone: ( ) j Fax: ( ) 200 amps or lest ] 66.8$ 1 I I Owner installation: This installation is being made on property that i own which is not 201°!--" to 400 einpe 1 ( 100.30 ( i 1 2 intended for sate, lease, rata. or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 13175 2 Owner signature: _Dale: Branch circuits - new, 011010% or ex tension, per panel A. Fee for broach circuils with • ... ! ..... . 0 APPI.CANT • . ' •' : '.:2.I • ' - m PERSON above service or feeder fee, 6.65 2 each brooch circuit Business ewe: NORTH SKY COMMUNICATIONS, INC. i1. Pee for brantobcircuits ' Contact natnet ERIK SCHENCK without sorvico Or fcedcrfey. 46,85 2 first branch circuit Address: 11818 SE MILL PLAIN BLVD STE. 410 Each add'Ibrtirlchcircuit 6,65 -- 2 lStatcl2 iP; Ivliscellancous (service or feeder not included) C1t Y VANCOUVER, WA 98684 Loch munufccurrcdormodular 1 9090 2 (866 4524853 dwet1410. service nndtor feeder Phone: (503) 969 - 7729 I Fax :: 866) Rcconncct only 6645 2 Bolted: mduor(p7northskycomm.COm Pomp oe irrigation circle 33,40 2 Ct)N'i'RACTOR Signoreedinglighting ' 53.40 — 2 Businole name: NORTH SKY COMMUNICATIONS, INC. Sigurd (heat energy paw, Signal n or limited- oration, or Address: 11818 SE MILL PLAIN BLVD. STE 410 extension. Describe: 1 Paget $75.00 2 City /State/ZIP: VANCOUVER, WA 98684 Bach additional Impeclion _allowobie the above Per inspection 62.50 Phone: (3603 254 -6920 I Fa ( ) 1-866-530-4325 tavesdgtuton par hour 0 town) 62.50 CCB Lie.: 14117 1 Electrical Lle.i 7 -154CL Suprv. Lie.: 173LEB htdramirtt plant per itour 73.75 • EIZCIRiCAE. PERMIT FEFS • . Suprv, Electrician signature, required: ` . 3abwlal: $75.00 Print name: JACK CAGLE Date: 7/29/09 Phut review (254b of permit fee): State surcharge (t2rb of permit fee): $9,00 Authorixc(Ixignalure: Q . 1) TOTAL PrIaM $84,00 Print name: ETHAN A. DOLPH J Date: 7 /29/09 • lbw per nib uppikoll oxplo r lf0 permit is not mowed wtthlu 180 days shat' a hew been avoided et' twoolde. • Number orbrpeerhms allowed per peram, Ido,,Iss e V'er.uk,Uil,c.p ,,mmtpp.dac waves ira.isiif tiswcosNV1i1)