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Permit v n CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT It . COMMUNITY DEVELOPMENT Permit #: ELR2009 -00236 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/05/2009 Parcel: 2S 110AA00200 Jurisdiction: Tigard Site address: 14130 SW 105TH AVE 1 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: NORTH SKY COMMUNICATIONS INC 11818 SE MILL PLAIN BLVD, SUITE 410 VANCOUVER, WA 98687 PHONE: 360 - 254 -6920 FAX: 1- 866- 530 -4325 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 95522 - - 0 -0100 You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By: Oi,f Q. Permittee Signature: APP 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 CITY OF TIGA ! Electrical Permit Application BUILDING DIVI' FOR 01111E USE ONLY' :.. "` •,,, • 1 Of Tigard — # � k 13122 5 SW [ {all Mod., Tibmrd, OR 97223 � Phone: 503.630.4 171 Fax: 503.598.1960 ENIIIII1111111. °114 66141: 'rIGARD inspection Line: 503.630.4175 ..BIEI 81 Ste t'ngc2for Internet: www.tigtlydwr,gov Supplemental Information ••- TYPE 4l' WORK "i..: : .. - •••• . 'rPL,AN RSV.igw.''ili . .'•`! . .2.• r - . Q New 4:0118.1lIKti0n In Addition/Aeration/replacement Mom chock ;41 that epply(whall 2 sett mutant wlileree oiucked leowl: F3CIn0lIt1011 ❑ Other; • Q Swalec or rceder40•'1 amps or more Q nunnUrg live limo storks, temps 1h0 Available !Ault corms! Q Muth. mad hnmyards. '.?'.•;::"":.%:'::',..:.:,:.:•",;:: :• CATEGORY •01 CONSTRUCTION , • .. .. - execole 10,r100amps ai ISO volts or a MatingWilding's. O l - and 2 - rttmlly dwelling oss a prowl. orexam& 14,0W p Commercial use agtkalntra1 g ❑ Commercial /industrial ❑ Accessory building amps fur MI other instoll Lieu, buildings. r4 Mutti•farnily 0 Master builder ❑ Other: Q Piro pume• 0 tnslaihnien er 75 KVA or :-- , ,•,• t-.. , . i 6, met g cm x y sla , a tar eepaaml real. . .: -••, '°'• J013 BJTF. [NF AND LOCATION '''' •. s .. .. ` ` � • , .- ❑ AAaitimra y t'0cwnnNnrinxa0r [] "R' " r I ; ", " I ?" "E•1•', Job no,: 1 Job xitenddt'cse: SW 105TH AVE 1110HPormm- aecttpana Q Six or more residcnlnd uailt, ❑ ReOnrarhl0a1 vchkto prim CitylState/zIP: TIGARD, OR 97224 Ei Heanh•carc rarebits. 0 sopply voltage for more th u ❑ Haraolen Icontienl. 600 veils 00104001. Suite/bldg./apt, no, 1 -8 , Project name: CANTERBURY TERRACE 0 Set vivo feeder 600umpxoromre. , , -,,, . -FEE SCHEDULE • • r .. • Cross street /directions to job site: thoorhohat 100% I Lon 1 'rniul 1 • ----- New resirlontlul single• or nadtI.(hndly 4wellhlg unit. Includes attached garage. _ Suldlivision: Lot no.: 1,000 se, ft. or less 145.15 4 La, add'I 500 sq. Ii. or portion 33.40 ��' t Tax ttulplparcc 1 no.: Limited energy, residentioi DESCRIrrtON OF WORE ' Nth abate sq. 0.) 75.00 2 INSTALL FIBER OPTICS FOR VERIZON LI" rocaeC ' , e i(;Y;t ' a ' shavesit 1 0,1 7500 ' • Services or feeders tnslmllation, and/or 1•elagttloo 200 ramps or less 80.30 2 •• •'© PROPRRTY•'OWNER . -. -'1 .. .. •.0•TENANT ':t' •.: 201 106.85 2 Name: 401 name 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, situation,. and/or reiocatiot Phone: ( ) I Fax: ( ) 200 amps or leis 66.85 I Owner Installation: This installation is being made on property that I own which is not 201 omits to 400 loops 100.30 1 2 intended for sate, Tease, rust, or exchange, according to ORS 447, 449, 670, and 701, 401 amps to 599 amps 133.75 2 Owner signature: Date: Branch circuits - new, alteration" or extension, per pane! A. Fee for branch ck emits with ' : ; . • ❑ APPLICANT ' ' :. -. •.. ' - :;'1 - ' © •CONT'ACf PERSON • above service or feeder No, 6,65 2 • Business =no: each brunch circuit NORTH SKY COMMUNICATIONS, INC, O. Poo ror brooch circuits Contact name: ERIK SCHENCK wir/out service of feeder fee, 4685 2 first branch circuit Address: 11818 SE MILL PLAIN BLVD STE. 410 Etachadd'tbnmchcircuit 6,65 _ — 2 iYtiacoilanoous (service or feeder out included) City /SIAIcJZIP; VANCOUVER, WA 98684 "Duetttlanmycturedormodular x ' 9 dwelling, service and /or (ceder ? Phones: (503 ) 989 -7729 Fax: : ( 866 ) 452 -4853 Reconnect only 66.85 2 E -mail: mduorenorthskycomm.com Pump orinigatiun circle 53.40 2 Ct)NY`RAOTOR Signs or outline lighting 53,40 2 Business name: NORTH SKY COMMUNICATIONS, INC, energy panel, al or limited- t usergy panel, aharalivn. or Address: 11818 SE MILL PLAIN BLVD. STE 410 extension, Describe: 1 Pagel $75.00 2 City/Slate/ZIP: VANCOUVER, WA 98684 Each additional inspection over allowable to any of the above Phone; ( 360) 254 -6920 I Fax: ( ) 1- 866 -530 -4325 Per inspection G2 1 rvc hsti per hair (I hr min) 6. 50 CC8 Lic.: 14117 Electrical Lic.17 -154CL C Supra, Lic.: 173LEB Indrrauinl pions ixr hour 73,75 . Suprv. Electrician signature, requited: �r�,� ....ELECTRICAL PERMIT FEES • - :•...'..• Subtotal: $751)0 print Hume: JACK CAGLE Date: 7/29/09 Plum review (25% of permit fee): State surcharge (12% of permit ice): $9.00 Authorized signature: er..p TOTALPt;RiviiT MEI $84.00 Prlot"mmc: ETHAN A. DOLPH Date: 7/29/09 'nix permit applicationoxpiroeifapermitIsnotobtalnalntrbh !180 days after It km been ism:pled as tom pleks • Number or hupceMns allowed par Mud!. 1:nk Oi l,C•IW'•a ne.tppdnr 0111: VCa 4o0•4415r01xmJCO Vw$n