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Permit
i p CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT I COMMUNITY DEVELOPMENT Permit #: ELR2009 -00212 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/31!2009 Parcel: 2S115AA00100 Jurisdiction: Tigard Site address: 16128 SW 108TH AVE 57 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 t roug OAR 952-001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.699 or 1.800.332.234 J�(�) Issued By: �\ 't 2- t �Q � _L� Permittee Signature: % ..-Q-9 4 �� \ 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. 4..& F CEIVED Electrical Permit Appiicatioin . ) 200'' ., J' tt of 1 c i ' . .. . t l3I City Tigard � � iB' vet l; , IJ I.; ('t ,. 00 - U - i ' 131 SW Nall Blvd., Tigard, OR 97213 a )� II -rill it p Review s e Piano: 503.63' .4171 t "vtx; 503.59�1{�,p }�{�,p a By: Otht! Penal': Inspection Liner 5 03.630.4175 I}\J �iV tIGARD ateReadyAhY: ^ See Pogo 2 r Internet; wavw.tigard "oegov Nutlftommathtna ` il l 1 Suppt.." ....A". .' . . ., REVIEW. TI ..:. :' • ' ! �:' . i�•: p., •", .;' • :.•.. :; -TYPE OF WORK " ::.. ......:r.• ::• :•.:•:'�:•'•:.•,�� :PLAN REV. ..•.:r' .:•••' ' . -J New construction t O Addition /alteation /replaettmenl • "•. Moo cheek all 4ht spiny heltutit.2 sou Kilian? willow ducked Wow): [I Demolition (DOther: 0 Scrota* or limier 4Wl amps urnem: a Maing over Max sto.ics. z r; -•--- v � whom no avail:one huh ens, nl ❑ mottos and holy irds. .. <• CATREORY -01;: C0NS'"i'RISC'l'ION , •.. - exceeds MOO onyx al 150 volts or la rloattns headings. Ids to wound, erexceeds 14,0110 (] Cmlwromlal•un asrloulmmt ❑ 1- and 2- family dwelling ❑ Commercial /industrial Q Accessory building amps for all other Insinikaions. buildings. is Multi - family 0 Muster builder ❑Oilier: El Pilo pungt. ahvaatotion of 75 3CVA or '•-; : : §': F: . ..JOB SITEE•INF.ORMATION AND LOCATION " :1' c".• '. ❑Cmergamysystmn Larynrsepanncry rkstrved ' QA,klllinnnfnewm,nminutof [l " A " , • 'li » , "I•? " "I.1' Job no.; J ob sits address• 16128 SW 108TH AVE 1001.1P or mow. ory me^ey Cit /Stnte/ZIP: TIGARD, OR l Six or tam reddening unhx. p Rcenlwlonal vehicle parity, Y 97223 Heatih•eae facilities. 0 Supply voltage rev more than Hastarduur le anions. GOO vote, nominal. Suite/bldg. /apt. no, 57 -64 1 Project name: BRIGHTWATERS @ RED HAWK Cl limbo 0cfecdone° emu tmom. ..... . ; - '. fit 'SCHEDULE, : . • • Cross alrcetfdirectians10 job silo: m._ oast:autos 1 (Ity. I Fn. I 'Ott l ' ._ New rvsidcntlut single- or tnuhl•Mntliy dwelling unit. Includes attached garage, Subdivision; Lot no.: 1,000 xq, n, or Iola 145.15 4 Tux amp/parcel no.: Ea, odd'I 500 sq. ft, or portion 33.40 Limited energy, tesidcn6al 75,00 2 DESCRIPTION OP WORK ' (with alone sq. n.) INSTALL FIBER OPTICS FOR VERIZON LilnitOtlOitagy, mold- I`nntilY 75.00 2 relillentiai (wins uM>We( n.) Services or feeders Instal/Won, ol1erallon rolot ullo 200 minas or les 80.30 2 `© PROPERTY . J :... : • ,. •D. TENANT '' 201 amps Io400amps 106.85 2 Mantel 401 nips to 600 amps 1 160.60 2 " " 601 amps to 1.000 amps 1 240.60 2 Address: Over 1,000 amps or volts I 454.65 2 City/State/VP: Temporary services or feeders Instnlistlun, alteration, und/or relocation Phone: ( ) Fax: ( ) 200 amps or less 66.81 I Owner installation: This installation is being made on property that I own which is not 201 amps le 400 amps i l 100.30 12 intended for sale, lease, rent. or exehnnge, according to ORS 447, 449, 670, and 701. 401 amps to 590 mans 133.75 LL 2 Owner signature: Dated Branch circuits— new,aHcrnttoia or extension, per panel A. Poe for branch cii'ccuils with • ' 0 APPLICANT ' ' •••• '.' • `• :t:1 • ' - � I CONTACT PERSON above service Or feeder (Co, 6.65 2 each Brach ohnuit Business name: NORTH SKY COMMUNICATIONS, INC. B.FCC for branch chtutts Compel name: ERIK SCHENCK without service or feeder fee, 46.85 2 ."„ first branch circuit Address: 11818 SE MILL PLAIN BLVD STE. 410 Iiach WW1 breach circuit G65 2 Miseetls (service or fonder not it City/State/ZIP; VANCOUVER, WA 98684 Each inane monied or inodutur dwetlin1, cetvlcc earlier Wks 2 Phone: (503 > 969 - 7729 , Fax: i ( 8 66 ) 452 -4853 Reconnect only 66.85 2 Entail: t11duQC(4>1.fortbsiwcomm.com Pump or irrigation circle 53.40 2 CONTRACTOR '*". Sign aromling lighting 53.40 2 Bustnostt name: Signal circuit(s) or limited. NORTH SKY COMMUNICATIONS, INC. energy panel, allomlien,or Address: 11818 SE MILL PLAIN BLVD. STE 410 extension. Describe: 1 Paget $75.00 2 City /Statc/ZiP: VANCOUVER WA 98684 Each additional Inspection over allowable In any of the above • Phony ( 360) 254 -6920 Fax:( ) 1- 866.530 -4325 Per inspection 62.50 investigation per hour (I hrmitt) 6230 CCB L 14117 I Electrical Lic.:17 -154CL Supt', Lie.: 1731E8 industrial plant per hour 73,75 • • • • +•'ELECTRICAL. PERMIT PEES •'• . . Supra. Electrician signature, requited: 3ubrulal: $75,00 Print name: JACK CAGLE Date: 7/29109 Plun review (25%ot'permit fee): State surcharge (I2Se of ponnit fee); $9,00 Authorized signature: 40, / ±i� TOTAL PRIM fr PER: $84.00 Print mum: ETHAN A. DOL P H I Dote: 7/29/09 'AN mask uppltrnttun osplrosIf a purmtt Is not obtained adibtn ISO days mien R Inns been molded as eonrydete. ' Number of loam cAm4 allowed per wadi. I: td'auinevoahsIlI,C.Ovroo,app.doe 0023106 420 4 61srl tarOrcosinina t