Permit q CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
• COMMUNITY DEVELOPMENT PERMIT #: ELR2008 -00159
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/10/2008
PARCEL: 2S 115AA -01100
SITE ADDRESS: 16005 SW 108TH AVE 101 ZONING: R -25
SUBDIVISION: WILLOW BROOK FARM LOT: 027 JURISDICTION: TIG
PROJECT: OAK TREE APARTMENTS
Project Description: Units: 101 -106, 201 -206, 301 -306. 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:
MICHAEL ELTON NORTH SKY COMMUNICATIONS INC
BY MDE INSTITUTIONAL 11818 SE MILL PLAIN BLVD STE 4
6950 SW HAMPTON ST STE 320 VANCOUVER, WA 98687
PORTLAND, OR 97223
Phone: Contact #: PRI 360 - 254 -6920
FAX 1- 866 -530 -4325
FEES Reg #: ELE 17- 154CLE
LIC 14117
Description Date Amount
[ELPRMT] ELR Permit 6/10/2008 $75.00
[TAX] 12% State Surch 6/10/2008 $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: Vii_ -•ermittee Signature: �� cyi/
/ J
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 07 2008 3 : 47 AM FR TO 5 0 3 5 9 8 1 9 6 0 P . 1 3
.., 1
,T.
Electrical Permit Ay licati CEIVED • ..:".. ' • ''', • • ir''',4
e ' ' ' -'''.'..'''t. ' ,; "'' ''''':'.''. Ftan.
• ''''' i•••• •.' ' '-:,:; '-•. ...,,,,..• . , :. -. ' --- :•'.. '.'''''
Received
'‘ ,.,:•,':...t: City of Tigard
ln 8 tlitc/11 I ifft .. -
. ,.:,-. 4 13125 SW Hull Blvd., TigArd. OR 97221 \ 1. 0 6 ,_
1, p,„., Review
w
: •12 , ' . Phone; 503,0394171 Fax: 503.593.I9W " Datc/13 ; Ca Permit:
T i GA .) Inspection Lino; 501.630.4175 2 fr
OV CIGN
RD Date Ready/By:
OS Notified/Method: IMI 65 See Page o
Suplerner101 InfOrtO2fitto
Internet; www.tigard-ongov Ct1: ,../ r oDIN ISI
-' T '''.'':'':;.-,-'",•:-:::',.."..: • ' ..:' '..' - ..:' •, . • TYPE 1OttO110: '...:•.' :•..'.': .:..'•' ,.•• • ' •:, -.• `,.' :-.: • ; : ' -' PLAN REVIEW .,:-:,.: ::.. ' ;.•-.- , :-. •:,' . : .
Piet= Cl ; .41 tilt iliply1s4mit 2 sets or pines wines's,: elieehed below):
0 New construction Oil Addition/alteration/replacement
0 5ervtce or teedur 400 amps Or more I auitd ;rig over three tirvioi.
0 rxenoton 0 Other: where the available fetal current fl Marinas and boatyards.
- . .'.' .''',': ..' '. - ...' ' :: . ' • ' . ' CATEGORY 01;' CONSTRUCTION, ; '-: ;:' :.• ' : . •:,:. . .. ' '-:' .: eseeeth, (0,000 ;imps :u ISO votes or 01 last buildings;
Ices to gl'ound, or exceeds 14,000 0 Cornmercialmse agricutittral
171 1 - and 2-family dwelling 0 Commercial/industrial 0 Accessory building In altlings.
amps for ult other iustothitinne.
1:j Multi-famil y 0 Master builder 0 Other: 0 Fire puntp. 0 Installation of 75 KVA er
, , . D Emergency sysiem. larger sepapticly derived system.
• • ... ' ......:::.:: •••:::.: .: '' 'JOB SITE - INFORMATION A : .
AND. LOCATION :.::: • •- • • -....- ., ' • 0 Addition of new motor load or
10014P or mom. occupancy,
Job no.: Job site address: 16005 SW 108TH 0 Si% Or OlOre rttitIC Mitt' LAN. Otto:mailman vehicle parka.
City/Statc/ZIP: TIGARD, OR, 97224 0 Health-care fneililics, ['Supply voltage fey stare than
.. . 0 linittnxIous locatives, 600 soils nominal.
Suitc/bIdgiapt. no.: $ 101-106.) Project name: OAK TREE 1 & 2 APTS 0 Servitx or feeder 600 amps or more.
i011: FEE SCHEDULE • : •: • " ,
Cross strcet/dircctions to job 34;7 301-306 Ilexclpilen I Olv, I Fee. I Taint
' — New residential single- or multi-family dwelling unit.
Includes attached garage.
—
1,000 so, A, or less III 145.15
Subdivis Tot 11O.:
Ea, add1500 sq. ft, or portion 33.40 I
Tax map/pa:v.0 no.:
Limited citergY, lesidcalial
— ... 75.00 1
DESCRIPTION OF WORK (with shams ii5. t't.)
- * Limited energy, Multi
INSTALL FIBER OPTICS FOR VERIZON residential (with atxwe so, it) 75.00
services or reeders installation, alteration, and/Or relocatio
2
LL_-A.l 10/' tOte ) AC/ –Pap - '501— 50 co 200 atnps or less 30_30 2
El PROPERTY -. '.-: ' ' -,,. - • - . 1:1•TF,NANT • .' , • ' "'• 20i amps to 400 amps 2
. , . , ... ,,.... _
401 amps to 00 amps 160.0 2
Name: —.
— 601 amps to [Roo amps 24040 2
, .
Address: Over 1,000 amps or volts 454.65 2
.., . .-1
City/StalerZIP: — -7. reinporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.95 1
...
Owner installation: This installation is being made on property that I own which is n 201 alap3 to 400 amps 100.3(1 2
intended for sale, lease, rent, or exchange. according to ORS 447, 449, 070, and 701. 401 amps to 599 amps 133.75 2
Branch circuits - new, alteration. or extension, per panel
Owner signature: Date: . A. Fee for branch circuits with
: -• ' --. • ' :0 APPLICANT •.'.: . ''': • ::: I • .• ' M PERSON . above service or feeder ree,
6,65 2 •
each branch circuit
E nainc; NORTH SKY COMMUNICATIONS, — INC. B. Fee for branch circuits
without service or feeder fee,
COOtzlet name: RYAN ROBERTS first branch circuit 46,95 2
Address: 11818 SE MILL PLAIN BLVD STE. 410 Each add'1 branch circuit 6_65 2
Miscellaneous (service or tbeder not inclutRD
COY/Slate/ZIP: VANCOUVER, WA 98684 Each manufactured or modular
90,907 2 .
dwelling. service and/or feeder
Phone: (503 ) 519-5264 Fax; : ( ) 1-866-905-4907 Reconnect only 66,55 2
E" nii: mduore.porthaKyomnas.,Qni_ Pump or irrigation circle . . . 53.40 2
,.... ,.. „
, — - '' '.' ' ' . • • ' • • - • CONTRACTOR ' • ' • • ' ' ' - ' - ' Signor outline lighting 53.40 1 2
.. . . .
— -
Signal circuit(s) or
Business limited
name; NORTH SKY COMMUNICATIONS, INC. energy panel, alteration, or
Addr0SS: 11818 SE MILL PLAIN BLVD. STE 410 extension, Describe: 1 Page 2 $75.00 2
- L
City/State/ZIP: VANCOUVER, WA 98684 Each additional insection over allowable in any of the above
Per inspection 62.50
Phone: ( 360) 254-6920 Pax: ( ) 1-866-530-4325 Itnestigintin per hour (I lir min) 62.50
. . . —
CCB Lie.: 14117 Electrical Lie. 17-154CL surv. Lie. i 73LEB ,10(1,.trini Flom pe rtzt ,. Lail..
, r, 11{1C,Al. PERMXT EF,F,S • • -
Suprv. Electrician signature. required: Sobtotal: $75,00_
Platt review (25% Of penult fee):
Print mum: JACK CAGLE Datc: 6_6_08
State enroll:ego (12% of permit foe): $9.00
Authorized signature; ....,, , 4
--- 21e
, TorrAL p8ktvirr FEE1 $64.00
This permit application expires if a permit is not obtnined within ISO
Pritn nallw: ETHQN A. DOLPH I Oatc: 6-6-08 4111yx aficv il has been accented as complete.
-- —
' Number at irripectiods allowed per permit.
1:515oiktinglPerotinti5, -PennilAntIllner 0 $ 7 :::LMLC 4,10-4Giyiy11/05/COMAVER
.
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BUILDING DIVISION `'
~�~°"�~~°""~~� ~�"°"~,,~,"° PERMIT #: ELR2006-00169
| 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/10/2008
Phone: (503)639'4171 '
Inspection Requests Q4Hnaj: (503) 639-4175 .,
INSPECTION WORKSHEET FOR DATE: 5/11/2008 TIME: 7:008M PAGE: 29
SITE ADDRESS: 1GUO5Sm/1D8TM AVE 1O1 CLASS OF WORK:
SUBDIVISION: WILLOW BROOK FARM LOT #: 027 TYPE OF USE:
PROJECT NAME: OAK TREE APARTMENTS
DESCRIPTION: Units: 101'106.201'206 Installing fiber optics for Vsi
OWNER: ELTON, MICHAEL PHONE #:
CONTRACTOR: NORTH SKY COMMUNICATIONS INC PHONE #: 360-254-6920
Inspection Request Scheduled For: Date: 6/11/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 07121401 971'663+1082 Y
I eim\ c irsi & I~
Corrections/Comments/Instructions:
( \
.
��
�� || PARTIAL APPROVAL El CANCEL n NO ACCESS
I I FAIL I I CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: " ~���� ��� Date: (4 VL Phone #: (503) 7181.41-140
,... ... , _ , , . .