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Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT Permit #: ELR2009 -00222 TI CARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/31/2009 C Parcel: 2S115AA00100 Jurisdiction: Tigard Site address: 16160 SW 108TH AVE 139 Subdivision: DURHAM PARK APARTMENTS Lot: 36 Project: Brightwaters at Red Hawk Project Description: Install fiber optics for verizon. Owner: FEES DHP TERRACE LLC & Description Date Amount DHP ANNEX LLC, BY AKAWIE & LAPIETRA PC, Restricted Energy Permit 07/30/2009 $75.00 13 HERON DR 12% State Surcharge - Electrical 07/30/2009 $9.00 PHONE: Contractor: PHONE: FAX: Type of Use: MF Class of Work: ALT Total Number of Systems: 1 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. Issued By: II I . ! . L • Permittee Signature: C\ 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. :3 • RECEIVED J UL 2 9 2009 Electrical Permit Application . • - CITY OFTIG' FUI;OLrr10E USE ONL Y . ':: • 11 .. . City of Tigard a L Per u 1 nn„ ti _ R • oo / ' 1 1312 SW Hall Blvd., Tigard, OR 9722;tI3U DIVI pi Ua a Review 1 1 1 Phone: 503.639.4171 Par, 503.598 .1960 other Permit: SIGARD inspection tine: 501,639.4175 Dote Really /Try; 1 ^ tel Son Pmts 2for fntenmt: lwvw.tigou.k,cgov NotlncdfM0tii h l Supptemoatol Information .• . -TYPE; On WORT( '.. ;. ; ; PLAN REVIEW `;. El Now construction IjAddition /alteration /replacement Pleased, cck that npply( saiwir sets M'tn( i 0 Demoliiion El ma: El Se,vte0 or faxjor 40a amps or noon CI nulttting ovcrthroc ;tortes. where the available felt corona 0 Mnrtus amt Io uty:vds, ':'t ... ,S ,' :" ....." . •: : : CA'(3GORY•00;' (ONS"I'ttUC•r'ION cacacd to 1 r10(000 SOvoltcur a1 IInuhutldlogt. • - lams to 0.41 , or cxuccdm 14,000 0 Cvmmaoid•usu agdouhur:a ■ I - and 2- farnilydwelling ©Commercial/industrial ❑ Accessory building mops for 411 otherinctnrhulw+s. boilttiags. I] Multi - family Q Master builder Oiber: 0 rile tnnly,. 0 instatlntien of 75 KVA or JOB 'SITE INFORMATION AND LOCATION Cien,ctgeta;ysyawat. largeraciK,ructyaerlveasynma. C] Addition ofnelv !Wolof C "A" "1s" "14y' "1.3" Job no.: Job site address: 16160 SW 108TH AVE IOOH• urloom occupata:y. C 3six more resnloniiA oohs, O Rocreatb,nal vcllidop0tks, City/Stare/ZIP: TIGARD, OR 97223 C2 HeAllh , nrrofciti,icr. 0srpptymona0o for nwrotam C] Htoontous locution. MO oohs twmirul. Suite /bldg. /apt, no, 137 -144 Project nano: BRIGHTWATERS © REDFtAWK ❑ Rerviro or tecrier 600on,lo or nom. ..- FEE SCIIE »ULE . . Croke street/directions to job site: - Oeo I owl. I pre. I Troia ! • ___._.__.,_... -___. Now resite ntiulsingle •or multi-family dwelling unit, _ ideitutos attached garage. �� Subdivision: Lot no.: 1.000 sq. n, or less 145.15 4 b i. mar 1500 sq. U. or portion 33.40 1 TAX amp/parent Ito.; I.,tntilcrt 011015)'. residential 75.00 2 DESCRIPTION OF WOW( (with maim sq.a.) INSTALL FIBER OPTICS FOR VERIZON t. hnitett en m 6v it otrhl-ItnniIy 75.00 2 rcridurtial (witn ut.na s 0.) Services or feeders insitltntion,,olterntrnn, mtd/or relocation 200 maps or less 80.30 5 "'ID PROPERTY OWNER -7 17, . : . ' C]' TENANT 201 amps to 400 amps 106.85 2 Name: 401 amps 10600 amps ' 160.60 2 601 amps to 1,000 Justin 240.60 2 Addis ss: Over 1,000 amps or volts 454.65 2 City /Sinte/ZIP: 'Pompo services or feeders instullatlun, tdterntIon, and/or relocation Phone: ( ) Fax: ( ) 200 amps or less 66.85 1 Owner installation: This installation is being made on property that i own which is not 201 antis to 400 xmps 100.30 2 (tended for sale, Mow, rent, or exchange, according to ORS 447, 449, 670, and 701, 401 :ats to 599 mugs 133.75 _ 2 Owner signature: v _Due: Bruerlr circuits - new, liberation, or extension, per panel A. f'cc for brooch circuit): with _ :: i,' 0 APPLICAANT 7:•T -j ' r •C(NTAcr PERSON ubovcscrviceor feeder coo, 665 2 each branch circuit Rusincssnatnc: NORTH SKY COMMUNICATIONS, INC. B. Fee tor branch ciouits Contact tonne: e�irfaoad service or feeder fee, ERIK SCHENCK And blanch circuit 46'85 2 1 1818 SE MILL PLAIN BLVD STE. 410 cad ch W4'1 brooch circuit -•- 6.65 2 y • .. -- Miscellaneous (service or feeder not included) City /Stilts /ZIP: VANCOUVER, WA 98684 Each manufactured or modular 90,90 2 dwelling, service and/or (coder P1101101 (503 ) 969.7729 Fax:: ( 866 ) 452 -4853 • Recomtoot only . 66.66 2 Email: ill • _ • (+0 0 5 it I • .. • at ii • a Pump or irrigation circle 53.40 2 C(IN'PRACIOR Sign or out lino lighting 53.40 2 Business nnnne: NORTH SKY COMMUNICATIONS INC, Signal circuit(s) :Monition. yr energy pnnol, ullo yr Address: 11818 SE MiLL PLAIN BLVD. STE 410 ecIertsion, nescribe: 1 No 2 $75.00 2 City /Stato/ZIP: VANCOUVER, WA 98684 Each addl lional inspection over allowable In any of the above • Phone: ( 360) 254-6920 1 Fax; ( ) 1- 866 -530 -4325 Pot' inspection 62.50 Iavcstigntinn per Itolrr(1 Or mitt) 62.50 CCs Lit;,: 14117 Electrical Lic 17 -154CL : Strl,ty, Lie,: 173LEB tntLttsttial pl :nit ] tot• hota' 73.75 Suprv. electrician signature, required: •a te' � - ELECTRICAL PERMIT ubt al: $75 p0 S Subtotal: Print name: JACK CAGLE Date: 7/29/09 Phut rovieW (25%ofpermit fee): Siam surcharge (12% of permit foe): $9.00 Authorized xignniurc: . �� _ . / F . TOTAL rrrttrn'r nog:: $84.00 Print natm : Date: 7 /29/0 '1 tumult uppnrnnuu espies if a potent is not 0,tolncd wOI,1n 180 THAN A. DOLPH arty; after II box been mooted ro,complete. 0 Nu atoi of bispcclloor ('Unwed tar monk, InotMGrgv 'erm4Atit,C•t>or 09.1.905 0110 - 3540151 tnmcosHlwhn