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Permit
CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT $ • COMMUNITY DEVELOPMENT Permit #: ELR2009 -00219 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/31/2009 Parcel: 2S115AA00100 Jurisdiction: Tigard Site address: 16150 SW 108TH AVE 115 Subdivision: DURHAM PARK APARTMENTS Lot: 36 Project: Brightwaters at Red Hawk Project Description: Install fiber optics for verizon. FEES Owner: 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: n Q Q \ Permittee Signature: � ( ,`1 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. r e RECEIVED Electrical Permit Application 2 9 FOR; OFFICE USE ONLY .....; ; " • City of Tigard �� : � Nos h No.: ►♦ as • . `0 G lig � I I 33125 SW Hail Blvd., Tigard, OR 97223 CITY OF TIG Piw,rc: 503,639.4171 Pax: 503. ' BUILDING DI ;. - 5 8'19tl s- f)e Oil Petite: rl6A rospoctionLine: 503.639,4175 Bl See P geZfor fn tentot: wtvw.tigind- or.gav Supptententnl Intormmtoa . . .. TYPE Air WORK ` .. . •.'''..`:;' ' PLAN REV.IRw i .'i::;'•:::!' .... [] New construction I2 Addition /alteration/replacement picasecheek i that appty(suhmit aser.M' I Nn,,,,wi ntchor5 dbeluvyi Cl Demolition ❑ Other: O Service or littler 400 mot to more C3 Unsling over throe stoic , tome do ;wettable NM eartelrn 0 Minima$ mill hnmyaMS. :: : 1 ....::'...'.:Y . .....::,:.;:,:: - , (..ATEGORY•Or:CONS1'IOUCTION • • - ' exceeds te.WO umos At f50 wits or [I l4oannglw0diogs ground. toss to ground. or cxeeds 14,000 0 Ctmm,crclat -use n4<Icolmrat El I - and 2-family dwelling ❑Commercial /industrial (] Accessory building amps lisle otherIlnalwuo»s. 'building. o Multi - family 0 Master builder • Q Other: ❑ Re pang,. 0 Sssollc of 7S XVA w , •.. •JOB"SITE-INFORMATION AND LOCATION OCmgo,a;ysyatonr. 6,r4erseparatctydorioadsysdom. ':%:..''.. ' ..•,•. l3Aet chlitiannl'new,»,unrh,:nlnf ❑ "A" •'fi" "I•�" •'I.3" Job no,: I Job site address: 16150 SW 108TH AVE loom°tnxwv. oimin M.y. City/State/ZIP: TIGARD, OR C3 Sts li lent re c i lhi ci . We. 0 YClikk oll oret 97223 HeMrh•earo rncilili 0 Supply v ahayo for more the, 0 Hooanhms ieeotiuns. 400 volts nominal. Suite/bldg./Vt. no. 113 -120 I Project name: RRIGHTWATERS @ REDHAWK 0x:tvn;ear leader 400 muss ornem job site: "."' FCE •SCHEDUi.E Cross street /directions to J aaadploo QV. 1 I. l Thud i • New residential single• or m dwelling unit, includes attached gr unge. _ Subdivision: I Lot no.: 1,000 sq. g, or less 145.15 4 a, nckt'1500 sq. li. or p,ution _ 33.40 1 Tax m,rp /parcel nos ha, energy, residential 7500 3 Dl $CRWP I ION 01. WORK ' (with above tII , INSTALL FIBER OPTICS FOR VERIZON Limited snow, mahi- at »,ily 15.00 2 ' rcvid mile (with ntxmc �as . g.) Services or feeders insYallntlon ancUnr rebottles ' 200 amps or less 80.30 2 ••. PROPERTY OWNER .. :, .. '' . 201 mope lo400amps 10615 2 Name: 401 amps to600 amps 160.60 1 - 601 amps to 1,000 mops 240.60 2 Address: Over 1,0000m(tsorvolts 454.65 w. 2 City/Stale/ZIP: Temporary ser vices or feeders Installation, alteration, and/or relocation Phone: ( ) Pax: ( ) 200 amps or less 66.85 f Owner instuilnUonf This intonation is being made on property that 1 own which is not 201 mops to 400 turps 1 00.30 2 intended for sate, lease, rent, or exchange, according to ORS 447, 449, 670. and 701. 401 amps to 599 amps 133.75 2 _Date: Brunch circuits - new, Aeration, or extension, panel ' Owner signature: -,. -. A. free for brooch circuits with • • © APPLICANT • • '• 'rf ' ' `° CI "CONTACT PERSON • above service or leader fee. 645 2 t;uslness name: ach brunch cimitit NORTH SKY COMMUNICATIONS, INC, 1NC R. Fee for brooch circuits Co0lnc1 011100! ERIK SCHENCK wi//rotu scrviceorfccticrfee, 46.84 2 first branch circuit Address: 11818 SE MILL PLAIN BLVD STE. 410 Hatch WW1 branch circuit _ 6.65 -- 2 Miscellaneous (service or feeder not Included) City /Stale/ZiP: VANCOUVER, WA 98684 tacit 1, manufactured or modular 90.90 2 dwellin serv sc ut /o f Photo: (503 ) 969 -7729 I Fax :: ( 86 6) 4524853 Reconnect only 6685 2 man: mdtutfatlo ithskycomm.com Pump orinisntiun circle 53.40 2 Ct)N'eRACTOR " ' ' �' Sian or outline lighting 53.40 2 nar Susin0.5palm: Signed uitctrit(s) to limited• NORTH SKY COMMUNICATIONS, INC. energy panel, alteration, or Address: 11818 SE MiLL PLAIN BLVD. STE 410 extension. Describe: 1 Page 2 $75.00 2 City /State/ZiP: VANCOUVER. WA 98684 Bitch additional Inspection over altnwnhlo In any alike above • Per inspection 62.50 Phone: ( 360) 254 -6920 I Fax: ( ) 1- 866. 530.4325 Investigation per hour (I lirmbn 62.50 CCD Lie.: 14117 i Electrical Lic..17.154C Suprv, Lie.: 173LEB industrial plant per hour 73.75 • . • - • 'ELECTRICAL PERMIT PEES .- •- ••••• Suprv. Elcctricinn signature, required: Subtotal: $75.00 Print aloe: JACK CAGLE Date: 7/29/09 Phan review (25% of permit fee): State surcharge (1256 of permit fee): $9,00 Authorised signature: 4. f) " TOTAL PERMIT PRE: $84,00 Print nntnc: Date: 7/29/ '!'bb parnllt uppticntlun aspires If is parade Is not obinlneit Milk 150 - ETH N A .. DOL PH days liner It has bees. „ctvpfed ,Ir 0 u , "11. 1 . . Nmnbcr :six:cauns ollvtt•otllx7Permit. raps.nvtnru ernd,dlil.C•PoreaApp.anc 0512.106 440J615l' l VOVCOiIAVJ O