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Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT Permit #: ELR2009 -00229 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/31/2009 Parcel: 2S115AA00100 Jurisdiction: Tigard Site address: 16184 SW 108TH AVE 195 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 -0nL -a 0 001 - 0100. 0 X 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: ( ` I' t \ X�IJ(/ \l Permittee Signature: \� A34l .0 JK J OWNER INSTALLATION ONLY i 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. • 4 RECEIVED - ' 2 9 2009 Electrical Permit Application, CITY OF T I G A , F U l i cl {z ICS 11SE {.v • City of Tigard BUILDING DIVISI ' ` 1 Noon no.:c `� �� a9 i ' 1 13125 SW Half 13h1., Tigurd, OR 97221 t)ald c i 7 . - Non Rcviow Phomcr 503.6324171 hay: S03.S98J960 Ouu•rPCnnlc Untela� TIGARD fnNpoctiwt Lino: 503.639.4175 Data Ready /13y: 4 RI Soo Pop 2 for fntern(x: wtwv.tlgard- or.gav NwifiediMet6l,d: tt Se n ppleento l mat MI . TYPE Gtr WORK 'I PLAN REVIEW V."'"...''.'' . . © New sonstnIOtion 0 Adds dot /altef111101t(ref3fncenlcnt Plca`c chock ll that apply (submit 25eu ofplanz W1iletins checkers iclow): 0somiecorrccdcr :)iuepstomow 0flothoi: over naseOadeti. 10Dc1noIition ❑UIbCC' whom tin :tvnil:ark li,utt Porten ❑Marinas tedhn,nynrds, ... ■, ; ",,::. • . :, CATEGORY :Or • CONS1 ttW9ION . • moods 10,000 mops at 1501r its or O MOOS bonding:. i • and 2 - fttrnily dwellih fotr ut ground, ure.wcedr 14,000 0 Cetimlercl :d'twe ay)IC,thnm1 l g 0Conunet'eint /inctustritd El Accessory building owp>for nll other lestnlbniuns. heftiness. 0 Multi- fatnily 0 Master builder 0 Other: ClPitc ptwy 0 6,w;mmion of 73 KVA or , %JOB SITE INFORMATION AND LOCATION ': f7>:nurgawysy+�ro Mr "-or. .. .. . - ".' ... 1]AAditfnnnl'aotvnnt naOr Htulnr Cl'�A" " °' "i•2'• d"1.,1 l°, systc Job no., I lob the nWdmsn: 1 ^ 6 p 184 SW 108TH AVE try 81 o owpor Meru. try rxntpancy, .. 0 sl more re{I<klltinl unite, O Ro oehnnt City/State/ZIP: TIGAR ©, OR 97223 0 koatth•caro facitities. 0 &A vena;e for Min kin C] tlazudunv lu.aliOns. 600 volts nominal, Suite/bldg/opt. to 193 -200 1 Project BRIGHTWATERS @ REDHAWK Mario or feeder 600 mops o mom. , ' .:.•. .PCE•setrEDOCE • . • 1. Cross street/directions to job site: nr+erlpnun 1 014 1 Kr. 1 'Mu 1 I � � " New residential single- or mufttdtnity dwelling o th, lncludus p u nche d garage, Subdivision: Lot art.! 1.000 sq. O. or less 145.15 .__. 4 Tux map/parcel no,: 12a. ;WWI 500 sp. ti. or portion 33.40 1 Limited meaty. resi(tontfnl 73.00 2 Dli.ScRIP'rION Or WORK ' (wilt, at,,,e sit. 0 -) INSTALL FIBER OPTICS FOR VERIZON L ;h»rodcnogy,,adhf- family 7s.00 2. ,� rCidcmlla) (,vial u(wta a a.) Services or feeders ins4ctlntion, altoralikn, otcUor relocation 200 amps or less 8010 - 2 .. „' ' ''0 PROPi:R')'Y•'OWNER •' `'I :... . ..0' TENANT 201 amps to400amps 106.05 2 Name: 401 maps to 600 nn,iw i 160.60 2 ' '"""" 601 amps to 1,000 hum ' 240.60 2 Address: - �+ Over 1,000 amps or volts 454.65 2 City/Stoic/ZIP: rempncary services or feeders lnstuliallun, alteration, and/or retention Phone: ( ) Fox: ( ) 200 amps Or less 66.85 I Owner fltstuilatiOn: This installation is being made on property that I own which is not 201 )mops to 400 amps 100.30 2 intended for Rate, lease, rool, er exchange, according to ORS 447, 449, 670, end 701. 401 shops to 599 imps 1 33.75 a 2 linnet, etrculls - new. alteration, or extension, per {MCI sigaattire; _ __,- _.____Date: _ A. Iva for brooch °nuns with : ' 0 APPLICANT ' ' • : ' - : :'1 . Q CONTACT PERSON ' above. service or Teeter I''eu, G -6$ 2 I;n:iiA055 mile: each) branch circuit NORTH SKY COMMUNICATIONS, INC. n. Fee for branch oirct,;is Contact numC: wilhwN service or {'ceder fee, ERIK SCHENCK first hranchcircuit 4655 3 Address: 11818 SE MILL PLAIN BLVD STE. 410 Hach a d0'I branch circuit -- __ 6.65 - - -..� - -- Miscellaneous (service or feeder not included) W City /Statc/Z)P; VANCOUVER, WA 98684 'Ea ch snunutactnred or modular "- — dweliien, service moil /or feeder 80.90 2 Phone: (503 969 - 7729 I Fox:: (866 ) 452 - 4853 Reconnect only 66.85 2 C•ntail: mduat q�ftafl:flskyGOmm COm Pump or litigation circle 53,40 2 CON'I'RACtOR Sign or outline ughling 53,40 2 Busincssnamc: NORTH SKY COMMUNICATIONS, INC. OnC r6Y Ps t'tc an el ( a h otitti0n` C ( T Address: 11818 SE MILL PLAIN BLVD. STE 410 extension. Describe: 1 Paget $75.00 2 City /StatefZIP: VANCOUVER, WA 98684 Each additional Inspection over elfotrnbto In any of the above • Phone: ( 360) Per fnepeetion 62.50 Phon 254 -6920 l Fax: ( ) 1-866-530-4325 htvestiolon per hour° bruin) 6230 CCB Lie.: 14117 I Rteclncnl Lie.i 7_154CL Suprv. Lie.: 173LEB indloarial plant per hour 73.75 ■ •"ELECTRICAL PERMIT REPS ' " ` Suprv. Eleciricina signature, required: Subtotal-. $75,00 Print +loon: JACK CAGLE Date: 7/29/09 Platt review (25% of permit fee): Seeseare0arge(12% Ice): $9,00 Authorized signature: , . ;; _. J TOTAL PERM rr M olt{; - $84,00 Print name: ETHAN A DOLPH Date: 7/29/09 'd'hb permit! upp))catlun uxplNr Ir a purmIt Is not 01011124 whinta Igo toys Idler 1( has been lam:pion as complete. I Number w'I116po0lo.4 allowed per moth, 1A01101rOcemhaVtl,Cd+ttme Allp<tne 092.V00 4tlm +61 }'IC) I0I0ICOMAvSII